1. Barriers to partnership working in public health: a qualitative study
- Author
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Lois Orton, David Taylor-Robinson, M Moonan, Simon Capewell, Ffion Lloyd-Williams, and Martin O'Flaherty
- Subjects
Non-Clinical Medicine ,Culture ,lcsh:Medicine ,Validation Studies as Topic ,Cardiovascular ,Social and Behavioral Sciences ,0302 clinical medicine ,White paper ,Science Policy and Economics ,Medicine ,Interdisciplinary communication ,030212 general & internal medicine ,Cooperative Behavior ,lcsh:Science ,health care economics and organizations ,Multidisciplinary ,030503 health policy & services ,Communication Barriers ,Public relations ,3. Good health ,Interinstitutional Relations ,England ,Public Health ,0305 other medical science ,Research Article ,medicine.medical_specialty ,Clinical Research Design ,Science Policy ,Political Science ,Public policy ,Partnership working ,Public-Private Sector Partnerships ,Interviews as Topic ,03 medical and health sciences ,Environmental health ,Humans ,Health Care Policy ,business.industry ,Public health ,lcsh:R ,Health promotion ,Interdisciplinary Communication ,Perception ,lcsh:Q ,sense organs ,Cooperative behavior ,business ,Public Health Administration ,Qualitative research - Abstract
Background Public health provision in England is undergoing dramatic changes. Currently established partnerships are thus likely to be significantly disrupted by the radical reforms outlined in the Public Health White Paper. We therefore explored the process of partnership working in public health, in order to better understand the potential opportunities and threats associated with the proposed changes. Methodology/Principal Findings 70 participants took part in an in-depth qualitative study involving 40 semi-structured interviews and three focus group discussions. Participants were senior and middle grade public health decision makers working in Primary Care Trusts, Local Authorities, Department of Health, academia, General Practice and Hospital Trusts and the third sector in England. Despite mature arrangements for partnership working in many areas, and much support for joint working in principle, many important barriers exist. These include cultural issues such as a lack of shared values and language, the inherent complexity of intersectoral collaboration for public health, and macro issues including political and resource constraints. There is particular uncertainty and anxiety about the future of joint working relating to the availability and distribution of scarce and diminishing financial resources. There is also the concern that existing effective collaborative networks may be completely disrupted as the proposed changes unfold. The extent to which the proposed reforms might mitigate or potentiate these issues remains unclear. However the threats currently remain more salient than opportunities. Conclusions The current re-organisation of public health offers real opportunity to address some of the barriers to partnership working identified in this study. However, significant threats exist. These include the breakup of established networks, and the risk of cost cutting on effective public health interventions.
- Published
- 2012