Background The 2010 NHS White Paper Equity and Excellence: Liberating the NHS proposed major changes to how public health services are delivered from 2013. The imminent transition of public health into local authorities will have implications for how services are planned, commissioned and implemented, particularly for wellbeing initiatives. Anticipating this transition, a city-wide initiative brought together Local Authority and NHS Public Health partners to plan, manage and implement a health and mental wellbeing improvement programme over three years (2009-2012). This qualitative study examines the attitudes and views of stakeholders on their involvement in this programme and their experiences of ‘practising partnership’.
Methods Qualitative thematic analysis (as part of a mix-methods study). Purposive sampling was used to identify potential participants from three groups (programme stakeholders): directorate, programme managers and intervention managers. One-to-one semi-structured interviews were conducted. We used Schutz’s theory of social phenomenology to support the analytical method and the One Sheet of Paper technique was used to identify emerging themes. Creswell’s (2009) strategies for qualitative validity were used to enhance the accuracy of our findings.
Results Fifteen one-on-one interviews were completed, out of seventeen requests for interview, with five participants from each stakeholder group. Interview times ranged from 45 minutes to 2 hours and were conducted after participants gave informed consent. Three main themes emerged. The first theme, ‘defining, designing and adapting’ represents stakeholders’ challenges using language with culturally different organisational meaning, introducing new concepts (such as mental wellbeing) and designing a programme with implementation and evaluation structures that were both rigid and flexible. The ‘practice of partnership’ theme reflected how partnership was more of a ‘façade’ at the programmes’ commencement and how, by working through stages of conflict and confusion, stakeholders developed an understanding of what the practice of partnership meant and achieved clarity on how it could be done. The third theme ‘knowledge, learning and understanding’ describes how knowledge was created, diffused and utilised. For example ‘evidence’ was used for different strategic ends depending on the stakeholder perspective -- to promote new ideas or interventions or to bolster an existing intervention to prove its merit.
Conclusion This study demonstrates the challenges and opportunities for partnership working that are likely to be encountered in the transition of Public Health into local authorities. It offers insight into understanding and practising partnership and has implications for planning, managing and implementing public health and wellbeing improvement interventions post-transition.
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