Partnership is the word of the moment, and it is central to a range of recent shifts in policy aimed at modernising institutions across the whole field of civil and public life.
Partnership is one of the NHS's 10 core principles established by the NHS Plan. New partnership arrangements are a central feature of the health and social care policy landscape.
This preoccupation with the development of effective partnership arrangements can be seen in the areas of crime, education, legal services, housing, regeneration and community development, skills and workforce development.
Partnership is no longer an add-on, but the fundamental characteristic of the public sector's modernisation endeavour.
This promises significant changes to the experience of those who use or work within public services.
So why partnership? There seem to be two main influences on the health partnership programme.
First, there has been widespread concern about the performance of the NHS, local government and other agencies, particularly the responsiveness of these systems to the needs of patients and their families.
Second, the government has recognised there are links between policies on health and those on areas such as housing, physical environment, employment. This means tackling long-standing, interconnected problems affecting the public's health more successfully.
There are practical benefits of partnership, and aiming for effective partnerships is a logical strategy to adopt in attempting to realise the vision in the NHS Plan:
-The creation of a patient-focused, whole-system responses designed for service users not providers
-Partnership expands the capacity to deploy a wide range of methods to improve health and well-being
-Partnership allows longer term planning to minimise turbulence and draw on partners' strengths
-The strongest forms of partnership can help to reduce perverse incentives and undesirable behaviours such as cost shifting
-It allows more opportunities for innovation
-Partnership improves efficiency if the agencies
work closely together to minimise bureaucracy and duplication
-It maximises integration for service users, staff, technical and capital resources.
But as the new structures and systems struggle to impose themselves on the legacy of the old arrangements, there is bound to be confusion at a local level.
Partnership itself should be an answer to this problem, with regular dialogue and debate enabling each party to better understand the language and culture of the other.
Finally health authorities, primary care and NHS trusts need strengthened management capacity to drive this and other necessary change and modernisation, and to engage the enthusiasm and skills of hard-pressed staff in the partnership drive.
However, the ambitions for partnership are rapidly outstripping management capacity.
-Janice Miles, policy manager, NHS Confederation.