Researching Partnerships: Politics, Ethics and Pragmatism

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Researching PartnershipsPolitics, Ethics and
Pragmatism

• Sue Balloch Professor of Health and Social Care,
  University of Brighton

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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

3
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

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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

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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

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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, Childrens Fund
• Researchers sometimes struggle to present their
  analysis as they would wish

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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

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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 dont always tie
  up so research at the national level isnt
  validated at the local level and vice versa

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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

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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

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Does partnership working deliver improved
outcomes for service users?

• Rummery partnership working often strengthens
  the hand of the statelittle 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)

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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

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Whole Systems

• Distinguishes between four different types of
  working relationships
• Competition Co-operation
• Co-ordinationCo-evolution
• See model devised by Pratt, Gordon and Plamping
  in Working Whole Systems, Kings Fund, 1999
• Most types of partnership working fall between
  the first and second types.

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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)

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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
  Universitys Community University Partnership

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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)

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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

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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