A realist approach to understanding alliancing within Local Government public health and social care service provision

Redgate, S, Spencer, L, Adams, E A, Arnott, B, Brown, H, Christie, A, Hardy, C, Harrison, H, Kaner, E, Mawson, C, McGovern, William, Phillips, P, Rankin, J and McGovern, R (2022) A realist approach to understanding alliancing within Local Government public health and social care service provision. The European Journal of Public Health. ckac172. ISSN 1101-1262 (In Press)

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Official URL: https://doi.org/10.1093/eurpub/ckac172

Abstract

Background
Within the current context of continued austerity and post-pandemic recovery, it remains important that Local Government services address the increasing needs of residents as cost-effectively as possible. Alliancing, whereby services work collaboratively focusing on the ‘whole-system’, has gained popularity as a tool with the potential to support collaborative whole systems approaches. This synthesis aims to identify how alliancing can be successfully operationalised in the commissioning of public health, wider National Health Service (NHS) and social care-related services.

Methods
A realist literature synthesis was undertaken in order to identify underlying generative mechanisms associated with alliancing, the contextual conditions surrounding the implementation and operationalisation of the alliancing approach mechanisms, and the outcomes produced as a result. An iterative approach was taken, using a recent systematic review of the effectiveness of Alliancing, online database searches, and grey literature searches.

Results
Three mechanistic components were identified within the data as being core to the successful implementation of alliances in public health and social care-related services within Local Government: (i) Achieving a system-level approach; (ii) placing local populations at the heart of the system; and (iii) creating a cultural shift. Programme theories were postulated within these components.

Conclusions
The alliancing approach offers an opportunity to achieve system-level change with the potential to benefit local populations. The realist synthesis approach taken within this study has provided insights into the necessary contextual and mechanistic factors of the Alliancing approach, above and beyond effectiveness outcomes typically collected through more conventional evaluation methodologies.

Item Type: Article
Additional Information: Funding information: This project is funded by the National Institute for Health Research (NIHR) School for Public Health Research (SPHR) Public Health Practice Evaluation Scheme (PHPES), Grant Reference Number PD-SPH-2015. EAA is supported by the NIHR SPHR Pre-doctoral Fellowship (PD-SPH-2015). EK is supported by a NIHR Senior Investigator award and is Director of the NIHR Applied Research Collaboration North East and North Cumbria (NIHR200173). JR is funded by the NIHR Applied Research Collaboration North East and North Cumbria.
Subjects: B900 Others in Subjects allied to Medicine
L400 Social Policy
Department: Faculties > Health and Life Sciences > Social Work, Education and Community Wellbeing
Depositing User: John Coen
Date Deposited: 12 Dec 2022 12:24
Last Modified: 12 Dec 2022 12:30
URI: https://nrl.northumbria.ac.uk/id/eprint/50859

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