Transcript Slide 1

Researching Partnerships:
Politics, Ethics and
Pragmatism
Sue Balloch: Professor of Health and Social Care,
University of Brighton
A New Governance of
Welfare
• Partnerships seen as central to new
forms of governance
• A political agenda for citizenship and
empowerment
• A ‘paradigm shift’ in thinking which has
remained very popular over the last
decade
The Logic of Partnerships
• Better than the unfettered workings of
the market
• Value for money
• Seamless service delivery
• Breaking down barriers
• Sharing information
• Putting the service users/consumers at
the heart of policy and practice
What is the evidence base?
• Government commitment to evidence based
practice would suggest a strong evidence
base for partnerships
• In fact research is quite limited and is mostly
confined to the public/voluntary sectors –
what there is on public/private partnerships
suggest the latter do well from the
arrangement
• Health and social care and neighbourhood
renewal – among the main research areas
Types of research into
partnerships
• Research and evaluation reports
• Analysis of cross cutting issues e.g.
inter professional training and working
• Toolkits and guides
• Theoretical overviews and syntheses
(See Percy-Smith 2005)
• We will now take a look at the first and
the last of these
Research and Evaluation
• Major national initiatives politically driven with
a need for positive evaluation because of
substantial financial investment
• Example: 39 New Deal for Communities
projects each awarded around £50m over ten
years
• Most of this research is policy driven and
developed from an audit rather than a
research culture: e.g. Sure Start, Children’s
Fund
• Researchers sometimes struggle to present
their analysis as they would wish
Concern over validity of
evaluations
• Concern voiced in forthcoming issue of Public
Administration Review over validity of
program evaluation in USA
• ‘When politically sensitive programs ..aligned
with the political party in power are to be
evaluated, administrators have an interest in
minimizing the uncertainty of evaluation
results and will likely favor in-house
evaluation or third-party evaluation by a
research firm thought to be supportive of the
program’
Structure, Process and Outcome
in Partnership Evaluation
• Three types of indicators can be used. Most
evaluations are a lot better on structure and
process than on outcomes.
• National and local divisions: often national
indicators leave out issues that local people
are very concerned about (Ambrose in Taylor
and Balloch, 2005, gives examples)
• National and local evaluations don’t always
tie up so research at the national level isn’t
validated at the local level and vice versa
Systematic Review of Joint
Working
• Identified three major research categories
(Cameron, Lart, Harrison, Macdonald and
Smith, 2000, based on 32 studies)
• Organisational issues: aims, roles,
support,communications, co-location,
resources, past history etc.
• Cultural and professional issues: stereotypes,
trust and respect, joint training, differing
ideologies.
• Contextual issues: political climate, constant
reorganisation, coterminosity, financial
uncertainty
Outcomes
• Difficulties in researching outcomes
include:
• complex nature of outcomes
• need for lengthy period for assessing
outcomes
• ascertaining the extent to which the
outcome is the result of the partnership
• different definitions of desired outcomes
Does partnership working deliver
improved outcomes for service users?
• Rummery: partnership working often
strengthens the hand of the state…little
evidence that (it) delivers improved services
to users and could sometimes even have a
negative effect (2003 p243)
• Hudson: confirms ‘difficulties that partnership
working has in putting user and carer
engagement at the forefront of activity (see
Social Policy and Society, April, 2006 p227237)
Theoretical Frameworks for
Researching Partnerships
• Research into partnerships criticised for
being theoretically underdeveloped
(McDonald, Journal of Social Policy,
2005 pp 579-601)
• Three possible frameworks:
• Governance of welfare approach
• Whole systems approach
• Complexity theory approach
Whole Systems
• Distinguishes between four different types
of working relationships:
• Competition; Co-operation
• Co-ordination;Co-evolution
• See model devised by Pratt, Gordon and
Plamping in ‘Working Whole Systems’,
King’s Fund, 1999
• Most types of ‘partnership working’
fall between the first and second
types.
Complexity Theory
• Tiny changes can create major changes over
time
• Systems are unpredictable
• What we think of as a ‘system’ is probably not
one at all – we need maps of our own
organisation to locate ourselves
• Leadership becomes very important
• Trust between individuals is fundamental
• (See Haynes 2003)
Networks and Communities
of Practice
• Complexity theory encourages us to think
about partnerships in different ways e.g
• As networks (see Hudson p 3-13 in Journal of
Integrated Care, February 2007)
• As ‘Communities of Practice’ in which the
interests and aims are shared and there is a
commitment to mutual benefit for all partners
– see www.cupp.org.uk, the website of
Brighton University’s Community University
Partnership
Pity the Researcher!
• Major difficulties where researchers are
working with people with very different
perceptions of how partnerships do and
should work
• Unequal power and status divisions make
this more complicated still – lots of unspoken
agendas and hidden conflicts
• Goal posts get moved while research is
taking place
• (See Balloch et al 2005)
Ethics
• Importance of observing good ethics practice
and ensuring well being and empowerment of
those involved
• Difficult to develop a participatory approach
to research when the partnership is ‘top
down’
• Major restrictions placed on partnership
research by health ethics demands and
domination of the medical model
• Predicted disappearance of small scale local
research projects
Pragmatism in research
•
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Recognise the politics
Be clear about research responsibilities
Clarify the ethics issues
Focus on both measurable and
perceived outcomes as well as process
• Aim for the longer term by enabling
those involved to carry out their own
research and use the findings