Helen E Dickinson

... Edward Peck, Helen Dickinson and Judith Smith ... crucial importance of attending to human resource management as the central activity during a process of organisational merger or transition (Devine & Hirsh, 1998; Swanson & Power, 2001; Aguilera & Dencker, 2004; Jeris et al ...

The success of organisational change is often thwarted by leaders' failure to consider staff feelings. Managers must communicate a clear vision for the future, even though they may be facing great professional uncertainty themselves. It is important to deal with post-merger issues such as helping staff to new roles and 'unlearning' old ways.

ABSTRACT At a time of fiscal restraint and reductions in the size of the public sector, governments in Australia are exploring new approaches to delivering public services. One model receiving attention is the prime provider approach. This is an approach where government contracts a lead or prime provider who in turn organizes and manages a group of sub-contractors. In prime provider approaches, non-government organizations take on a quasi-government role and this brings a new complexity into the relationships between the various actors involved in developing and delivering public services. This article provides an overview of prime provider approaches and, drawing on the limited research to date, poses questions that we view as being critical to the current debate. The aim is to provoke further discussion on the potential impact of prime provider approaches.

ABSTRACT A range of different countries have experimented with the concept of individualised funding and self-directed support, particularly for long term care. With the introduction of the National Disability Insurance Scheme, individual funding looks set to be an area of future development in Australia. Individual funding is concerned with making the financial aspects of care more explicit at the level of the individual. Supporters suggest that it has the potential to transform paternalistic and inflexible systems into ones that grant greater power to individuals. The introduction of individualised funding also poses a number of interesting questions about accountability. The paper considers these accountability dilemmas and provides evidence from different national settings to illustrate how these accountabilities may manifest in an Australian context. The paper concludes by setting out a framework of accountability bringing together these different dilemmas to think about provision of care as a whole.

ABSTRACT Despite government suggestions that joint commissioning between health and social care is (or at least should be) a key element of attempts to improve the health and well-being of local populations, the evidence to support this notion has lagged behind this aspiration. Although there is a wealth of different partnership arrangements in place around the country, there are a number of limitations to our existing knowledge relating to how these operate in practice and the types of impacts that these produce. Underpinning this study is a desire to explore a working hypothesis common in current policy and practice: that partnerships lead to better services and hence better outcomes for service users and their carers . Thus, this research seeks to investigate whether joint commissioning leads to improved services and subsequently improved outcomes for service users. To test this link in greater detail, this research seeks to provide a theoretically and empirically robust understanding of the dynamic relationship between joint commissioning, services and outcomes. Eight case study sites will be incorporated into this research, representing a range of the different types of commissioning activities which are in place around the country. This research project seeks to add to and complement existing and future SDO and Department of Health research projects to produce more clarity in relation to the types of activities and outcomes which joint commissioning is producing around England and make generalisable statements relating to what works for whom and within what circumstances' (Pawson and Tilley, 1997).

In recent years joint commissioning has assumed an important place in the policy and practice of English health and social care. Yet, despite much being claimed for this way of working there is a lack of evidence to demonstrate the outcomes of joint commissioning. This paper examines the types of impacts that have been claimed for joint commissioning within the literature. The paper reviews the extant literature concerning joint commissioning employing an interpretive schema to examine the different meanings afforded to this concept. The paper reviews over 100 documents that discuss joint commissioning, adopting an interpretive approach which sought to identify a series of discourses, each of which view the processes and outcomes of joint commissioning differently. This paper finds that although much has been written about joint commissioning there is little evidence to link it to changes in outcomes. Much of the evidence base focuses on the processes of joint commissioning and few studies have systematically studied the outcomes of this way of working. Further, there does not appear to be one single definition of joint commissioning and it is used in a variety of different ways across health and social care. The paper identifies three dominant discourses of joint commissioning - prevention, empowerment and efficiency. Each of these offers a different way of seeing joint commissioning and suggests that it should achieve different aims. There is a lack of clarity not only in terms of what joint commissioning has been demonstrated to achieve but even in terms of what it should achieve. Joint commissioning is far from a clear concept with a number of different potential meanings. Although this ambiguity can be helpful in some ways in the sense that it can bring together disparate groups, for example, if joint commissioning is to be delivered at a local level then more specificity may be required in terms of what they are being asked to deliver.

ABSTRACT Much of what has been written about collaboration treats it instrumentally as a means–ends tool of improvement. However, despite considerable collaborative activity there is little evidence that clearly links collaboration to improvements in service-user outcomes or reduced inequalities. In this article we draw on literature from critical public policy and governance studies to recast collaboration as an expression of cultural performance associated with a rather different set of values and measures. We argue that understanding collaboration in the round means that we need to pay attention to all dimensions of performance including cultural performance. We argue that this in turn helps to explain the persistent appeal of collaboration amongst policy makers and practitioners.