This chapter reports on a systematic literature review of public health partnerships in England between 1997 and 2010 under the auspices of three Labour governments. The review was undertaken as the first stage of the National Institute for Health Research Service Delivery and Organisation (NIHR SDO) (now Health Services & Delivery Research) programme study.
As we explained in the last chapter, partnership working was a central feature of New Labour's approach to the delivery of health and social policy after 1997. A number of partnership-based initiatives centred on reducing health inequalities and improving health. Based on the literature review, which has been updated to include additional and more recent references covering the same period, this chapter considers whether these partnerships have delivered better health outcomes for local/target populations.
Public health partnerships under New Labour
Interest in partnerships intensified under New Labour and was broadened to embrace public health issues, requiring the NHS to work with other agencies in order to achieve the government's wider policy objectives (Secretary of State for Health, 1999; Wanless, 2004). Reflecting this increased interest, Glasby and Dickinson (2008) note that the word ‘partnership’ was recorded no less than 11,319 times in official parliamentary records in 2006, compared with just 38 times in 1989 (this is after removing references to civil partnerships, which were being debated in 2006). Indeed, more recently, Bacon and Samuel (2012) note that partnership arrangements now cover almost one third of public sector employees in Britain. As Dowling et al (2004, p 309) state: ‘The message is clear…. Partnership is no longer simply an option; it is a requirement’. This is evident in the plethora of public health partnerships established during the New Labour era, including: Health Action Zones (HAZs); Healthy Living Centres (HLCs); Neighbourhood Renewal Partnerships; Health Improvement Programmes (HImPs); and Local Strategic Partnerships (LSPs).
Yet, partnerships are not cost-free. Indeed, they incur significant costs (Matka et al, 2002), and their contribution to improving health outcomes is far from clear (Dowling et al, 2004; Lowndes and Sullivan, 2004). In part, this is because the research literature on partnerships focuses predominantly on process-related issues rather than on outcomes (Dowling et al, 2004).