Partnership Working in the British Nhs

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A review by Dr. Ignatius Gwanmesia on how inter-professional partnership working impacts on service delivery (NHS) (2007)

Introduction
In a utopian scenario, inter-professionalism should reciprocate efficiency in service delivery for service users. However in practice, inherent constraints left unresolved can construe to hinder rather enhance the safeguarding of clients welfare. Service users are experts on their own needs, Smale et al (1993), and they expect and judge the quality of health and social care services they receive in terms of whether they “help them achieve the outcome they aspire to, and whether these services are delivered in ways which empower rather than disempower them.” Davies et al (2005, 195). Realising these expectations is a factor not only of the user-staff ideologies and value bases but of the model (medical or social) and theories developed by service users Oliver, (1996, p. 31-33). While service users expect staff in joined up working to assist them to address both their medical and social needs, due to multifaceted constraints, partnership working is not readily able to deliver since it can be “tense and conflictual; a place of strife where members compete for territory and vie for recognition. Davies et al (2005, p. 158). Experience show that holistically the result can be compromised service delivery. To critically evaluate how inter-professional partnership impacts on service delivery, this discourse will start with an attempt to resolve the polarisation in its conceptualisation. The background will trace the evolution of the ideology from a theoretical, policy and practice perspective. The body of the discourse will first analyse those factors that impact on effective partnership; power relationship, empowerment, communication, power relationship and value differentials. Next, will be a critical examination on how the social, legal and political structures in Britain have been instrumental in realising the vision of the ‘Third way’. Next, different codes of practices will be examined to ascertain their effectiveness as instruments for ensuring practice standards. Then using ‘process’ and ‘outcome’ as evaluation criteria, Dowling, (2004, p. 309), the advantages and disadvantages of partnership will be compared. The conclusion will be an objective synthesis of those relevant dialogues developed within the discourse. Finally, the bibliography will alphabetically credit all the references employed within the essay. Definition

Inter-professional partnership as developed in New Labour’s quasi-market partnership ideology is devoid of singularity in its conceptualisation. The concept is so highly polarised, Hutchison and Campbell, (1998); Ling, (2000) that different writers use or interchange different terminologies to infer similar ideology; multi-organisational partnership, (Lownders and Skelcher, (1998); collaborative governance, Huxham, (2000); inter-agency collaboration, Hudson et al, (1999); networks, (Kirkpatrick) and inter-organisational relationship and networks, Hage and Alter, (1997). With such visible variance, it is not surprising that Glendinning et al, (2002, p. 3) describes partnership in government circulars and policy pronouncements as, “largely a rhetorical invocation of a vague ideal.” In consonance, Balloch and Taylor, (2001. p. 6) state that partnership” lays claim to no single definition or model.” Despite this lack of singularity or consensus in its conceptualisation, Tennyson (1998) provides what I consider the most stipulative and appropriate definition for this discourse;

“a cross-sector alliance in which individuals, groups or organisations agree to work together to fulfil an obligation or undertake a specific task; share the risk as well as the benefits; and review the relationship regularly, revising their agreement as necessary”...
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