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This paper seeks to understand relationships between prison healthcare and integrated care systems (ICS), including how these affect the delivery of new healthcare interventions. It also aims to understand how closer integration between prison and ICS could improve cross system working between community and prison healthcare teams, and highlights challenges that exist to integration between prison healthcare and ICS.

The study uses evidence from research on the implementation of a pilot study to establish telemedicine secondary care appointments between prisons and an acute trust in one English region (a cross-system intervention). Qualitative interview data were collected from prison (n = 12) and community (n = 8) healthcare staff related to the experience of implementing a cross-system telemedicine initiative. Thematic analysis was undertaken on interview data, guided by an implementation theory and framework.

The research found four main themes related to the closer integration between prison healthcare and ICS: (1) Recognition of prison health as a priority; (2) Finding a way to reconcile networks and finances between community and prison commissioning; (3) Awareness of prison service influence on NHS healthcare planning and delivery; and (4) Shared investment in prison health can lead to benefits.

This is the first article to provide research evidence to support or challenge the integration of specialist health and justice (H&J) commissioning into local population health.

The purpose of this article is to delve into the precise leadership and governance roles required of general practitioners (GPs) in England as they are propelled into clinical commissioning groups (CCGs).

A conceptual framework which captures the complementary essences of both leadership and governance is developed and then used to assess the extent to which GPs will be undertaking leadership and/or governance roles under the reformed National Health Service (NHS) plan.

It is found that there are some key particular aspects of both leadership and governance which are likely to be required of GPs as they form clinical commissioning groups. These elements are identified and discussed.

Using this analysis, general practitioners, health service managers and policy makers will be able to make a more informed assessment of the roles that they will have to adopt in the future and those roles which they may find it difficult to play. GPs in future will need to expand their roles in line with new responsibilities. The ways in which, and the success with which, they discharge their new roles will depend crucially on how they, and significant others (NHS managers), understand the nature of leadership and governance.

Most analyses of the new GP commissioning consortia have focused on issues concerning size and structure of commissioning consortia, the risks involved, the population size required, and risk. This article is original in its clear focus on the teasing‐out of the distinct leadership and governance elements required under the GP commissioning arrangements.

The paper attempts to examine the development of Primary Care Groups in the NHS, utilising a conceptual framework taken from relationship marketing. In particular, it looks at a framework representing the complex relationships between the Primary Care Group and a diverse range of internal and external stakeholders and the implications of these relationships. It reports the preliminary findings of an ongoing, in‐depth case study of two Primary Care Groups; with data collected from in‐depth interviews with a small number of key stakeholders. The results, so far, suggest the importance of developing and maintaining longer‐term relationships with a range of partners, both internal and external. It recommends that Primary Care Groups should develop strategies to work closely with these stakeholders, as an essential underpinning to developing continuous improvement in performance, quality and “user” retention.

The purpose of this paper is to outline relevant policies on the integration of health and social care (HSC) in the four home nations: Scotland, Wales, Northern Ireland and England and offer a comparison of emphasis and approaches and draw out general insights on the implementation of integrated care policy.

The paper is written as a piece of critical reflection by drawing on the authors’ knowledge and expertise and wider evidence where available.

Since 2010, HSC integration has started to diverge significantly in the four constituent countries of the UK. Although England and Wales have undergone considerable re-organisation of the NHS, Scotland and Northern Ireland have largely been marked by organisational continuity. However, beyond organisational differences, policy approaches, policy emphases and implementation strategies have also started to show considerable dissimilarity across the UK. An important contributory factor may be different ideological perspectives on the role of competition and pilots, partnership, patient choice and organisational incentives to bring about change in the field.

The paper identifies a serious lack of comparative research in integration policy, despite the considerable opportunities for quasi-experimental studies. This lack of empirical research impedes shared learning across the home nations.

The paper presents a descriptive comparison of current integration policy between HSC providers in the four home nations. It reveals considerable opportunities for further research and comparative modelling of integration approaches.

Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) are a new UK initiative to promote collaboration between universities and healthcare organisations in carrying out and applying the findings of applied health research. But they face significant, institutionalised barriers to their success. This paper seeks to analyse these challenges and discuss prospects for overcoming them.

The paper draws on in‐depth qualitative interview data from the first round of an ongoing evaluation of one CLAHRC to understand the views of different stakeholders on its progress so far, challenges faced, and emergent solutions.

The breadth of CLAHRCs' missions seems crucial to mobilise the diverse stakeholders needed to succeed, but also produces disagreement about what the prime goal of the Collaborations should be. A process of consensus building is necessary to instil a common vision among CLAHRC members, but deep‐seated institutional divisions continue to orient them in divergent directions, which may need to be overcome through other means.

This analysis suggests some of the key means by which those involved in joint enterprises such as CLAHRCs can achieve consensus and action towards a current goal, and offers recommendations for those involved in their design, commissioning and performance management.

This paper aims to contribute to the discourse on the role and efficacy of the newly emerging health and well being boards which are established within the Health and Social Care Act 2012. It also aims to propose the importance of high functioning relationships underpinning clear but flexible local design.

The paper is based on the reflections of the chair of the shadow Health and Well Being Board in Bath and North East Somerset and the chief executive of one of the local provider organisations. They share a commitment to effective joint working and see the workings of health and well being boards epitomising the functionality of local interagency working. This is explored through a case study of the development of the Health and Well Being Board in Bath and North East Somerset.

The paper proposes the importance of high functioning relationships that can transcend structures and suggests that health and well being boards be considered as system orchestrators creating space for the challenge and creativity that creates “good enough” solutions to complex issues.

The paper contributes to the active discourse on how best to establish and develop effective health and well being boards and aims to create value through shared learning and experience.

Purpose – The chapter aims to understand what kind of policy approach has been more successful in facilitating the involvement of patients and the public in the design and provision of health-care services at the local level and the explanatory factors justifying the implementation outcome.Methodology – By applying Richard Matland's ambiguity/conflict policy implementation model, the chapter analyses the impact of a number of policies introduced after 1997 in the English National Health Service that targeted final users and the local population in decision-making processes.Findings – The evidence shows that policies emphasising the importance of context-specific contingencies can be more effectively implemented when room for interpretation and discretion in selecting the appropriate means for involvement is given. In this way, the overall aims/purposes of health policies can be locally reshaped by allowing the adoption of flexible strategies within the implementation process.Practical implications – A strong leadership at the top of public sector organisations and, in particular, from the board of directors is needed to steer and facilitate a consensus oriented outcome in organisational decision-making processes that aim to incorporate the views and opinions of patients and the public.Social implications – Local initiatives in increasing participation, for specific purposes, are bound to be more successful than a general initiative, expecting comparatively uniform implementation.

This article aims to consider the transfer of public health responsibilities to Local Authorities, and implications for promotion of health and wellbeing through partnership. The article describes findings of interviews with stakeholders in one London borough.

Elements of the Partnership Assessment Tool (PAT) provided a framework for semi‐structured interviews.

A limited history of successful partnership between health and social care was attributed to a focus on partnership structures over behaviours. Transfer of public health responsibilities to the Local Authority was seen as an opportunity to address the wider determinants of health, but a shared vision for health and wellbeing had not been articulated. There appeared to be an expectation that the public health team would operate in a network partnership model.

While the PAT is presented as a complete tool, this project isolated elements of the tool to support development of the interview structure. The project did not include interviews with clinical members of the developing Clinical Commissioning Group, who may have different requirements of the public health function; this is an area for future research.

Recommendations are made to support effective integration of public health responsibilities into Local Authority functions.

This project provides a snapshot of preparations for the transfer of public health responsibilities to the Local Authority in one area. Relevant literature suggests that experiences in this area are not unique and findings and recommendations are likely to be applicable elsewhere.

To demonstrate transparency and accountability, the three boards in this study are required to meet in public in front of an audience, although the boards reserve confidential issues for discussion in private sessions. This study examines boardroom public accountability, contrasting it with accountability in board meetings held in private. The study adopts Erving Goffman's impression management theory to interpret divergences between boardroom behaviour in public and private, or “frontstage” and “backstage” in Goffman's terminology.

The research observes and video-records three board meetings for each of the three boards (nine board meetings), in public and private. The research operationalises accountability in terms of director-manager question-and-answer interactions.

In the presence of an audience of local stakeholders, the boards employ impression management techniques to demonstrate accountability, by creating the impression that non-executive directors are performing challenge and managers are providing satisfactory answers. Thus, they “save the show” in Goffman terms. These techniques enable board members and managers to navigate the interface between demonstrating the required good governance and the competence of the organisations and their managers, while not revealing issues that could tarnish their image and concern the stakeholders. The boards need to demonstrate to the audience that “matters are what they appear to be”, even if they are not. The research identifies behaviour consistent with impression management to manage this complexity. The authors conclude that regulatory objectives have not met their transparency aspirations.

For the first time, the research studies the effect of transparency regulations (“sunshine” laws) on the behaviour of boards of directors meeting in public. The study contributes to the embryonic literature based on video-taped board meetings to access the “black box” of the boardroom, which permits a study of impression management at board meetings not previously possible. This study extends prior impression management theory by identifying eleven impression management techniques that non-executive directors and managers use and which are unique to a boardroom context.

As it is now some time since the publication of the Health White Paper, and there is currently a pause in the progress of the Health and Social Care Bill through Parliament, it seems timely to look at how the proposed changes to patient and public involvement (PPI) may develop. This paper seeks to address these issues.

The paper examines the proposals for PPI set out in the legislation and uses the findings of the authors' recent research to examine them.

The paper argues that the legislation, as currently written, contains nothing that will guarantee a more effective engagement with either patients or the public.

This is a fast moving field at present, and the eventual outcome of this major reorganisation is unclear. This paper uses evidence from previous studies to provide an overview of the issues relating to patient and public involvement in the National Health Service and highlights the potential problems in the proposals as they stand at present.