DOI: 10.5176/2251-1970_BizStrategy16.18
Authors: Moira Fischbacher-Smith, Denis Fischbacher-Smith
Abstract: The use of partnership working is increasingly being considered as a central dynamic in strategies aimed at improving public health. The complexity of public health problems has proved to be a difficult issue for policy makers and partnership working has been muted as a solution to these wicked problems. Despite this optimism, there is little evidence that partnership working in public health is improving health outcomes. This paper seeks to examine how partnership effectiveness might be determined, and what the challenges are, both conceptually and practically, in arriving at such judgments. The paper draws primarily on empirical evidence from the UK but, it is argued, has applicability to a range of public health settings. The paper draws attention to the difficulties associated with attributing outcomes to interventions, the power of technical expertise, and the problems associated with measuring performance over time. It also examines the considerable difficulties associated with creating an evidence base for partnership working in public health due to the complexity of the public health setting, the limitations of our abilities to measure performance across organizations, and the demands of partnership evaluation. It concludes that whilst there may be compelling reasons for partnership performance to be measured, such evaluations are likely to be of limited policy use in real terms and are invariably costly. As a consequence, one might justifiably question the value of attempting to measure policy strategies that are virtually un-measurable within the current range of policy tools.
Keywords: partnership working; disruptive evironments; expertise; policy analysis; public health
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