Building an initial realist theory of partnering across National Health Service providers
ISSN: 1476-9018
Article publication date: 19 September 2020
Issue publication date: 1 April 2021
Abstract
Purpose
The National Health Service (NHS) is facing unprecedented financial strain. These significant economic pressures have coincided with concerns regarding the quality and safety of the NHS provider sector. To make the necessary improvements to performance, policy interest has turned to encouraging greater collaboration and partnership working across providers.
Design/methodology/approach
Using a purposive search of academic and grey literature, this narrative review aimed (1) to establish a working typology of partnering arrangements for improvement across NHS providers and (2) inform the development of a plausible initial rough theory (IRF) of partnering to inform an ongoing realist synthesis.
Findings
Different types of partnership were characterised by degree of integration and/or organisational change. A review of existing theories of partnering also identified a suitable framework which incorporated key elements to partnerships, such as governance, workforce, leadership and culture. This informed the creation of an IRF of partnerships, which proposes that partnership “interventions” are proposed to primarily cause changes in governance, leadership, IT systems and care model design, which will then go on to affect culture, user engagement and workforce.
Research limitations/implications
Further realist evaluation, informed by this review, will aim to uncover configurations of mechanisms, contexts and outcomes in various partnering arrangements and limitations. As this is the starting point for building a programme theory, it draws on limited evidence.
Originality/value
This paper presents a novel theory of partnering and collaborating in healthcare with practical implications for policy makers and practitioners.
Keywords
Acknowledgements
The authors would like to thank the advisory group for this project for lending their time and expertise to help refine the theoretical framework presented herein. The research was funded by the National Institute for Health Research Health Services and Delivery Research (Project: NIHR127430 - Towards a framework for partnering as an intervention for improvement). The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HS&DR program.Funding: This research was supported by a grant from the National Institute of Health Research HS&DR fund under grant number NIHR127430.Conflict of interest: The authors declare that they have no conflicts of interest.
Citation
Aunger, J.A., Millar, R., Greenhalgh, J., Mannion, R., Rafferty, A.M. and McLeod, H. (2021), "Building an initial realist theory of partnering across National Health Service providers", Journal of Integrated Care, Vol. 29 No. 2, pp. 111-125. https://doi.org/10.1108/JICA-05-2020-0026
Publisher
:Emerald Publishing Limited
Copyright © 2020, Emerald Publishing Limited