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While it has long been established that social factors, such as housing, transportation, and income, influence health and health care outcomes, over the last decade, attention to this topic has grown dramatically. Reforms that promote high-quality care as well as responsibility for total cost of care have shifted focus among health care providers toward upstream determinants of health care outcomes. As a result, there has been a proliferation of activity focused on integrating and aligning social and medical care, many of which depend critically on cross-sector alliances. Despite considerable activity in this area, cross-sector alliances in health care remain largely undertheorized. Both literatures stand to gain from more attention to carefully knitting together the theoretical and management literature on alliances with the empirical, health policy and health services literature on cross-sector alliances in health care. In this chapter, we lay out what exists in the current scientific literature as well as a framework for considering much needed work in this area. We organize the literature and our commentary around the lifecycle of alliances: alliance formation, including factors prompting alliance formation, partner selection, and alliance goals; alliance maturity, including the work of these cross-sector alliances, governance, finance and contracts, staffing structure, and rewards; and critical crossroads, including alliance timelines, definitions of success, and dissolution. We also lay out critical areas for future inquiry, including better theorizing on cross-sector alliances, developing typologies of these cross-sector health care alliances, and the role of policy in cross-sector alliances.

The Public Bodies (Joint Working) (Scotland) Act 2014 set the framework for the integration of adult health and social care services. Teams, organisations and sectors are now required to work in partnership and interdependently to deliver shared outcomes for the people they serve. The purpose of this paper is to explore any features, practices and behaviours that could influence effective partnership working across sectors.

A questionnaire was designed and distributed to a range of stakeholders working in health, social care and the third sector. With reference to the changing health and social care reform agenda, the aims of the survey were to gather views, experiences and perceptions of working across sectors, and any workforce development needs.

The majority of respondents were from the NHS (80.3 per cent, 118/147), and experiences were largely drawn from those working with the third sector. The utility of working with the third sector was positively highlighted; however, there were limited opportunities to fully engage. Whilst formal education and training was welcomed, workforce development needs were mostly related to fostering relationships and building mutual trust.

This paper highlights views, perceptions, enablers and barriers to integrated care in Scotland. Whilst the Scottish integration landscape is currently not fully fledged, insights into prevailing attitudes towards integrated care, by a cohort of the Scottish health and care workforce, are offered. In particular, reflections by the NHS workforce to working with third sector services are discussed.

This study analyses the different factors contributing to the retention and turnover of local- and overseas-born workers in the elderly care sector as an integral part of ensuring a stable workforce and quality care for the growing elderly population.

Using a respondent-driven sampling method, a sample of individuals who worked or are working in residential aged care facilities in Dunedin, New Zealand were surveyed.

The factors associated with intention to stay or leave are not necessarily the same factors influencing workers to leave.

Policies need to consider how to make workers want to stay and address the issues that make workers leave the aged care sector.

Results of this study can be used to develop more relevant labour and migration policies that reflect a more grounded insight into the experiences of those who are directly and personally affected by these policies.

There are limited international or national empirical studies on the economics of care worker migration and the labour market. This study can provide practical policy advice to help improve recruitment and retention strategies for care workers in countries dependent on global labour markets for health workers. In New Zealand, changes in policies concerning remuneration and immigration highlight the importance of ensuring that care worker needs are met both financially and in terms of institutional support.

This paper is the sequel to the authors' earlier paper in this journal and aims to present the “future research” outlined in that paper.

The approaches being employed by Welsh local authorities in commissioning home care from the independent sector are surveyed to see how a mixed economy of care is being implemented. The observed differences are analysed to see what can be learnt for the benefit of public sector managers concerned with the development of commissioning practices. Semi‐structured interviews have been performed with home care managers and commissioning officers in 13 (60 per cent) of the local, unitary authorities in Wales. Managers at independent home care providers have been interviewed also. The study has been ongoing since September 2004. For comparison, Barnet in England has been included because, unlike any Welsh authority, it has implemented 100 per cent outsourcing of home care. Croydon has been included as it has a good practice brokerage that has helped it to expand its provision from the independent sector.

Great diversity is seen in the approaches adopted by the Welsh local authorities when commissioning home care from the independent sector. They differ in the proportion of home care that is commissioned from the independent sector, what is commissioned, the number of independent providers and the contractual arrangements. These features are used to develop a taxonomy of home care strategies that reveals high levels of diversity. It is seen that in Wales there has been less political drive and compulsion to outsource home care than in England, but the natural desire to reduce costs in the face of a growing need for home care is now driving outsourcing in Wales.

This paper provides guidance to public sector managers in local authorities seeking best practice in the commissioning of home care from the independent sector.

The existing literature contains little research into good practice in the commissioning of home care by local authorities from the independent sector. This paper is a timely contribution to addressing this shortfall.

The challenge of developing leadership in a mass public service where previous notions of leadership have been narrow and limited only to senior positions is being taken up by the National Skills Academy for Social Care. This article describes the leadership development challenge in the English adult care sector, which is undergoing major policy and organisational change as a result of greater control of resources passing directly to people who need care support. The author sets out the initial guiding principles of the Skills Academy for Social Care and their approach to leadership development rooted in the values of the care sector and the reality of care and support work ‐ dispersed, low status, highly skilled and with a strong commitment to rights, entitlements and empowerment. In particular the Academy is adopting an emphasis on behaviours and personal attributes in its leadership approach that are informed by people who use care services who demand more responsive and personalised support. The article sets out a number of key principles on which the Academy will seek partnerships and collaboration to deliver greater engagement with leadership development across all who work in the sector.

Economists and sociologists have proposed arguments for why there can exist wage penalties for work involving helping and caring for others, penalties borne disproportionately by women. Evidence on wage penalties is neither abundant nor compelling. We examine wage differentials associated with caring jobs using multiple years of Current Population Survey (CPS) earnings files matched to O*NET job descriptors that provide continuous measures of “assisting & caring” and “concern” for others across all occupations. This approach differs from prior studies that assume occupations either do or do not require a high level of caring. Cross-section and longitudinal analyses are used to examine wage differences associated with the level of caring, conditioned on worker, location, and job attributes. Wage level estimates suggest substantive caring penalties, particularly among men. Longitudinal estimates based on wage changes among job switchers indicate smaller wage penalties, our preferred estimate being a 2% wage penalty resulting from a one standard deviation increase in our caring index. We find little difference in caring wage gaps across the earnings distribution. Measuring mean levels of caring across the U.S. labor market over nearly thirty years, we find a steady upward trend, but overall changes are small and there is no evidence of convergence between women and men.

An increase in life expectancy brings about an aging society, necessitating increasing demand for elderly care services. The purpose of this paper is to present an examination of: how an aging society affects the demand for elderly care services and the labor market for elderly care services; how the labor share and wage inequality between the final goods sector and elderly care sector are determined; and whether the subsidy for elderly care service increases demand for elderly care services or not.

This paper sets the dynamics general equilibrium model with two sectors model: one for final goods sector and the other for elderly care services. This paper derives how the labor supply for elderly care services is determined in the theoretical model. In addition to analytical research works, this paper examines how the subsidy for elderly care service affects the labor share allocated for elderly care sector and wage inequality between the final goods sector and the elderly care sector with the numerical examples.

Related reports of the literature describe that an aging society raises the share of labor dedicated to elderly care services. However, considering a closed economy in which saving affects the capital stock, an aging society does not always raise the share of labor used for elderly care services because the wage rate of the final goods sector increases with an aging society. This effect prevents the increase of the labor supplied to elderly care services. On the other hand, the subsidy for the elderly care service raises the labor share of elderly care sector.

The related literatures derive that an aging society raises the labor share allocated for elderly care sector. However, the paper shows that the subsidy for elderly care plays an important role in the increase in the labor share of elderly care sector.

This paper examines how the aging society affects the labor share of elderly care sector, wage inequality between final goods sector and elderly care sector and others with numerical examples. Thanks to the numerical examples, this paper derives the quantitative result and shows how the subsidy for elderly care service should be provided.

The author thinks that this paper has rich implications and originality. There exists no literature that examines how the labor share of elderly care sector and the relative wage rate of elderly care sector are determined by the aging and the subsidy for elderly care service. The author thinks that it is a very important analysis because many economically developed countries face the aging society problem.

There has been much research focusing on contracting and its effect on individual voluntary sector organisation, and some mapping of the extent of voluntary sector participation in joint community care planning. Each of these is a new and formal relationship with the statutory sector, and in many cases the tasks are fulfilled by the same voluntary sector worker (usually the senior paid officer of the agency). But the impact that these two new relationships have on the voluntary organisation’s perception of its dependence and inter‐dependence has received less attention. The paper will draw on structured interviews in three local authorities, with voluntary sector participants in contracts for social care, and with participants in joint community care planning groups, as well as on documentary research. It will explore the impact of the evolving roles for those seeking to operate effectively in the pluralist provision of public services. It will analyse experiences within joint community care planning structures, and will analyse experiences of contractual relationships. The paper will seek to identify the elements present in each research site which influence the culture of joint working within the two statutory/ voluntary relationships.

The purpose of this paper is to study the appropriateness of applying “manufacturing sector” quality management strategies to residential care homes sector and to analyze its influence on the quality of care.

Observation and in‐depth interviews were conducted with 41 Spanish care home top and middle managers, consultants and employees.

The quality management paradigm based on ISO 9001 has certain shortcomings in the elderly residential care home sector. There is a need to fit general quality management models to the sector's specific characteristics and to integrate generic quality management with specialized models.

Research findings should be noted by different agents involved in the process of improving services.

Useful, up‐to‐date conceptual overview for different agents interested in the sector (managers, consultants, academics, etc.) as well as interesting evidence for reflection.

At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public health) and other industry sectors, began to recognize the limitations of the current fragmented healthcare system paradigm. Primary stakeholders, including employers, insurance companies, and healthcare professional organizations, also voiced dissatisfaction with unacceptable health outcomes and rising costs. Grand challenges and wicked problems threatened the viability of the health sector. American health systems responded with innovations and advances in healthcare delivery frameworks that encouraged shifts from intra- and inter-sector arrangements to multi-sector, lasting relationships that emphasized patient centrality along with long-term commitments to sustainability and accountability. This pathway, leading to a population health approach, also generated the need for transformative business models. The coproduction of health framework, with its emphasis on cross-sector alignments, nontraditional partner relationships, sustainable missions, and accountability capable of yielding return on investments, has emerged as a unique strategy for facing disruptive threats and challenges from nonhealth sector corporations. This chapter presents a coproduction of health framework, goals and criteria, examples of boundary spanning network alliance models, and operational (integrator, convener, aggregator) strategies. A comparison of important organizational science theories, including institutional theory, network/network analysis theory, and resource dependency theory, provides suggestions for future research directions necessary to validate the utility of the coproduction of health framework as a precursor for paradigm change.