Search results

In this first of two articles, the authors assess the implications of policy developments in partnership and contestability, commissioning and procurement, and local jurisdiction for adult services joint ventures. They argue for creative responses to service delivery in which policy implementation is seen as an opportunity for local health and social care agencies to honour the history of, and future aspirations for, local partnerships. A second article will detail the very different responses to the policy agenda of four case study sites, exploring the local contours and aspirations underlying their decisions, with the intention of provoking discussion about the art of the possible in the broader community of interest.The papers draw on the authors' work funded by the Integrated Care Network (ICN) and Care Services Improvement (CSIP), which comprised a series of workshops to inform the further development of the plans of four local health and social care communities ‐ Portsmouth, Wolverhampton, Barnsley and Milton Keynes ‐ for commissioning and provision of adult care services, providing a community of interest in which aspirations, challenges and emerging solutions were exchanged and explored. Here we summarise transferable learning for the broader community of interest, drawn from the more detailed reports available from the ICN (Freeman & Peck, 2006, 2007).

In April 1999, Somerset Health Authority and Somerset County Council launched the first fully integrated adult mental health service in England, made up of a joint commissioning board and an integrated services provider. Between January 1999 and June 2001, the authors evaluated the implementation of the integration by investigating the impact of this initiative on service users, their carers, staff members at the new trust, and senior managers and members from health and social services. In this, the second part of the presentation of the results from the evaluation, the main themes relevant to the pursuance of integration in other localities will be drawn out and discussed in light of the literature currently available.

Discussion of ‘governance’ has become commonplace in health and social care in recent years, and ‘good governance’ seems to be seen in some quarters as offering potential answers to some of the complex challenges facing public services. Drawing on evidence from both the private and public sectors on governance, this short paper explores three key interrelated questions: What do we mean by governance (and how does it differ from management)? What is the evidence on governance? What can good governance do? It concludes with some reflections on the key messages for governance in health and social care. In so doing, it draws on material from the Integrated Care Network paper on governance and partnerships written by two of the authors (ICN, 2004) and an ESRC‐funded study of these issues by another (Skelcher & Mathur, 2004).

In April 1999, Somerset Health Authority and Somerset County Council launched the first fully integrated mental health service in England. The authors have evaluated this innovation and have already reported on progress on two occasions in this journal. This article gives data and conclusions for the final stage. In the next issue of MCC themes which will be important to the pursuance of integration in other localities will be drawn from the results presented and discussed in light of the available literature.

This Paper Looks at Health Action Zones, to be established from April 1998 with the intention of moving towards prevention of illness and promotion of health. It suggests how localities could begin to conceptualise a programme of work, and warns of some of the difficulties they may meet.

This paper is the first of two discussing the evaluation of the implementation of joint commissioning and integrated provision of mental health services in Somerset. The paper presents the methods of evaluation, and explores the potential limitations and environmental factors impacting on the effectiveness of data‐collection methods.

Within accounts of and frameworks for organisational leadership, especially in the public sector, there is continuing enthusiasm for the distinction between transformational and transactional models, where the latter is typically compared unfavourably with the former. This paper reports on a review of the literature on organisation transition (that is mergers and acquisitions), which found this distinction helpful in ordering the material considered. Unexpectedly, the review found that more of the advice contained within the papers examined focused on interventions that could be broadly categorised as transactional rather than transformational. This seems an important finding in a context where the distinction continues to have salience and when transformational characteristics are often seen as being essential to leadership and transactional attributes are perceived as merely being suggestive of management.