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 p227-237)

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

• 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