International perspectives on health and social care. Partnership working in action
International Journal of Integrated Care, 5 October 2009 - ISSN 1568-4156
Book review
International perspectives on health and social care. Partnership working in action
Edited by Jon Glasby and Helen Dickinson
Oxford/Ames: Wiley-Blackwell Publishing Ltd, 2009, pp 184,
ISBN 978 1 4051 6743 7
Trudi Nederland, Researcher, Verwey-Jonker Institute, Kromme Nieuwegracht 6, 3512 HG Utrecht, The Netherlands

This volume contains thematic articles on cooperation within health and social care. The text explores key topics and approaches to partnership working.

Readers will find the following chapters: 1. Partnership working and organisational culture; 2. Interprofessional practice; 3. Partnership working: key concepts and approaches; 4. Key elements in effective partnership working; 5. Integrated service models: an exploration of North American models and lessons; 6. Working across the health and social care boundary; 7. Partnerships in the digital age; 8. The economics of integrated care; 9. Self-management with others: the role of partnerships in supporting self-management for people with long-term conditions; 10. Self-directed support as a framework for partnership working; 11. The outcomes of health and social care partnerships.

In their introduction, the editors of this volume state that they have brought together a large diversity of opinions and concepts regarding cooperation in health and social care. They claim that, notwithstanding the diversity in approaches of the authors, the underlying bottlenecks turn out to be the same almost everywhere. The many different ways to interpret the concept of cooperation provide an example of this diversity. I personally find the definition given by Glasby the most recognizable from a practical point of view. On two axes, he connects the various forms contributing to the intensity of a particular cooperative relation, such as sharing information, consulting each other, joint management, etc, with the scope of this cooperation. It could be limited, for instance, to the health care sector, or the scope could be widened to the social care sector, or to collaboration with municipal authorities, etc.

Thus, the book provides a rich source of knowledge for everyone actively involved in setting up and elaborating on partnerships in health and social care from an organizational perspective. A good example of this is the interesting article (Chapter 1) on the possibilities to manipulate an organization's culture in order to improve collaboration. Culture plays a vital role in setting up effective partnerships. A forced integration of the cultures of several organizations does not work; it will merely result in tensions and distrust. Is it possible to steer clear of such pitfalls? The authors favour the slogan ‘there needs to be difference’. A merger between two organizations with a more or less similar culture cannot lead to a positive result, while two culturally different organizations will be able to create an innovative entity.

The majority of the other articles deal with different aspects of the organizational dimension of cooperation in health and social care. Reading these articles left me with the impression that a great amount of knowledge has been gathered, but that the connecting thread is missing. The reader is confronted with the results of an impressive diversity of studies on collaborating, but risks losing sight of the purpose of all this knowledge along the way.

Also, throughout the compilation, little attention is paid to the impact of cooperation on the organizations' clients. Only chapter 10 has the client's perspective as its central subject, and this perspective is limited to impaired people only. The author argues the necessity of an approach in which clients get control over the provisions they need. The perspective of users on the quality of provisions and services is mentioned occasionally in several other articles. One author states, for instance, that the competence of staff members and the continuity of both the provided care and the presence of staff members are important to clients.

It is difficult to award this book an unequivocal rating. People who are at work dealing with organizational issues with regard to innovative constructions of cooperation, will find a wealth of concepts, ideas, and suggestions in this book about a more effective structuralization of their collaboration. For them, it offers a rich source of knowledge about the possibilities and bottlenecks of cooperation. Yet, for those people who regard innovation as striking a good match between the supply of services and provisions of health care and social care organizations on the one hand, and the need for care and support of the clients of these provisions and services on the other, this compilation can be disappointing. Thus, it all depends on the take the reader has on what innovation is about.

What I miss in this compilation, however, is the question of what space is cleared in cooperative relations for the input of the users. After all, working more effectively will only become possible when the experiential knowledge of users is incorporated in the design of a more integral approach. Only then can there be any improvement in health and social care.