Intended for healthcare professionals

Education And Debate Modernising the NHS

Practical partnerships for health and local authorities

BMJ 2000; 320 doi: (Published 24 June 2000) Cite this as: BMJ 2000;320:1723
  1. Diane Plamping, research associate (,
  2. Pat Gordon, research associate,
  3. Julian Pratt, research associate
  1. Urban Partnerships Group, Department of Operational Research, London School of Economics, London WC2 2AE
  1. Correspondence to: D Plamping

    This is the last in a series of seven articles

    Partnership has become a legal, almost moral, imperative in the health and social care world in recent years. In policy document after policy document the analysis is consistent and welcome. We need to find new ways of working: “The strategic agenda is to work across boundaries … underpinned by a duty of partnership … past efforts to tackle these problems have shown that concentrating on single elements of the way services work together … without looking at the system as a whole does not work.” 1

    The result has been an explosion of partnership boards and partnership meetings throughout Britain—and now there is talk of partnership fatigue. This fatigue is mostly due to a proliferation of structures and plans. Yet frustration with talking about partnership should not be mistaken for rejection of the underlying principle. But now is the time to ask some hard questions. When is partnership effective? What sorts of partnerships are fit for what circumstances?

    Summary points

    A sense of fatigue and frustration with partnerships shouldn't obscure the fact that they are necessary and can be powerful ways of changing whole services for patients and clients

    Some partnerships depend on identifying a shared goal: focusing on the needs of patients helps to do this

    Organisations may achieve much with less demanding forms of cooperation—and also help to build the trust necessary for proper partnerships

    Different organisations need to find a shared “currency” for successful partnership: beds and money often aren't appropriate currencies

    Understand there are different sorts of partnerships

    The first need therefore is to understand that there are different sorts of partnerships. Studies of public sector partnerships have shown various sorts of partnerships, each effective in different conditions.2 3 This research describes a range of behaviours that organisations may usefully employ when working together …

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