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Evaluating partnership working: lessons for palliative care.

C Walshe1, A Caress, C Chew-Graham

  • 1Department of Health Research Training Fellow, School of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, UK. catherine.walshe@manchester.ac.uk

European Journal of Cancer Care
|January 18, 2007
PubMed
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Partnership working in palliative care faces significant barriers, including structural, financial, and legitimacy issues. Critical evaluation of palliative care partnerships is essential to ensure patient benefit and avoid service fragmentation.

Area of Science:

  • Health Services Research
  • Palliative Care
  • Organizational Studies

Background:

  • Partnership working is promoted to improve fragmented palliative care services.
  • UK National Institute for Clinical Excellence (NICE) guidance emphasizes supportive and palliative care partnerships.
  • Partnerships incur costs and may not always be the most effective service improvement method.

Purpose of the Study:

  • To explore barriers to partnership working in palliative care.
  • To critically evaluate the effectiveness and patient impact of palliative care partnerships.
  • To inform appropriate use of partnerships in palliative care.

Main Methods:

  • Exploration of structural, procedural, financial, professional, and legitimacy barriers.
  • Analysis of existing palliative care partnership models and guidance.

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  • Conceptual review of partnership costs, processes, and outcomes.

    • Main Results:

    • Five key barriers (structural, procedural, financial, professional, legitimacy) can impede or destroy emerging palliative care partnerships.
    • These barriers are not acknowledged in current NICE guidance on supportive and palliative care.
    • Partnerships may not be a universal solution for service fragmentation.

    Conclusions:

    • Palliative care partnerships require critical evaluation against process and outcome criteria.
    • Learning from partnership implementation is crucial for anticipating patient benefit.
    • Partnerships should be used judiciously, not as the sole solution for service improvement.