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Partnership working across health and social care is considered key to manage rising service demand whilst ensuring flexible and high-quality services. Evidence suggests that partnership working is a local concern and that wider structural context is important to sustain and direct local collaboration. “Top down” needs to create space for “bottom up” management of local contingency. Scotland and Norway have recently introduced “top down” structural reforms for mandatory partnerships. The purpose of this paper is to describe and compare these policies to consider the extent to which top-down approaches can facilitate effective partnerships that deliver on key goals.

The authors compare Scottish (2015) and Norwegian (2012) reforms against the evidence of partnership working. The authors foreground the extent to which organisation, finance and performance management create room for partnerships to work collaboratively and in new ways.

The two reforms are held in place by different health and social care organisation and governance arrangements. Room for manoeuvre at local levels has been jeopardised in both countries, but in different ways, mirroring existing structural challenges to partnership working. Known impact of the reforms hitherto suggests that the potential of partnerships to facilitate user-centred care may be compromised by an agenda of reducing pressure on hospital resources.

Large-scale reforms risk losing sight of user outcomes. Making room for collaboration between user and services in delivering desired outcomes at individual and local levels is an incremental way to join bottom up to top down in partnership policy, retaining the necessary flexibility and involving key constituencies along the way.

Integration between health and local authority services has been informed more by policy than by evidence. The gap which often exists between the development of an evidence base and its implementation has in this way been circumvented, but new challenges have arisen as a result of the policy context and services' response to it. Research undertaken by a learning disability service to inform the local integration agenda failed to have any impact, possibly in part because the research itself was a product of the same organisational context that was shaping integration. Although several isolated integration initiatives were in existence, the lack of clear strategic direction identified by the project as a key feature of the local integration agenda also limited the extent to which the project itself could effect change. Both the project and those changes which were occurring in services became features of an overall stasis, which in itself can illuminate the challenge of effecting meaningful change through research on services in constant flux.

Rhetoric and reality lead separate lives when it comes to integrating health and social services in Scotland, and it is making planning and implementation difficult for practitioners of integration. This paper is a collaboration between a practitioner and two academics who teach, research and write about integration. It explores the views of other integration practitioners about the policy, language and nature of integration, and the issues practitioners are currently grappling with, especially how the policy language of ‘integration’ fails to connect with integration in practice. It appears that ‘integration’ has less to do with broad policy aspirations and principles of service (re)organisation, than with the specific aims, objectives and outcomes of individual projects delivered in very specific circumstances. Acknowledging the localisation of integration, and allowing the time for productive problem solving which can generate a new language, ought to be essential elements of integration.

The purpose of this paper is to consider how postgraduate education can contribute to the effective integration of health and social care through supporting public service managers to develop the skills required for collaborative working.

Review of documentation from ten years of delivery of a part-time postgraduate programme for health and social care managers, critical reflection on the findings in light of relevant literature.

The health and social care managers participating in this postgraduate programme report working across complex, shifting and hidden boundaries. Effective education for integration should: ground learning in experience; develop a shared language; be inter-professional and co-produced; and support skill development.

This paper addresses a gap in the literature relating to the educational and development needs of health and social care managers leading collaborative working.

The purpose of this article is to provide answers to two questions: what has been the impact of nGMS on practice organisation and teamwork; and how do general practice staff perceive the impact?

The article is based on comparative in‐depth case studies of four UK practices.

There was a discrepancy between changes observed and the way practice staff described the impact of the contract. Similar patterns of organisational change were apparent in all practices. Decision‐making became concentrated in fewer hands. Formally or informally constituted “elite” multidisciplinary groups monitored and controlled colleagues' behaviour for maximum performance and remuneration. This convergence of organisational form was not reflected in the dominant “story” each practice constructed about its unique ethos and style. The “stories” also failed to detect negative consequences to the practice flowing from its adaptation to the contract.

The paper highlights how collective “sensemaking” in practices may fail to detect and address key organisational consequences from the nGMS.