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首页> 外文期刊>BMC Health Services Research >Implementation of collaborative governance in cross-sector innovation and education networks: evidence from the National Health Service in England
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Implementation of collaborative governance in cross-sector innovation and education networks: evidence from the National Health Service in England

机译：在跨部门创新和教育网络中实施协作治理：英格兰国家卫生服务的证据

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Background Increasingly, health policy-makers and managers all over the world look for alternative forms of organisation and governance in order to add more value and quality to their health systems. In recent years, the central government in England mandated several cross-sector health initiatives based on collaborative governance arrangements. However, there is little empirical evidence that examines local implementation responses to such centrally-mandated collaborations. Methods Data from the national study of Health Innovation and Education Clusters (HIECs) are used to provide comprehensive empirical evidence about the implementation of collaborative governance arrangements in cross-sector health networks in England. The study employed a mixed-methods approach, integrating both quantitative and qualitative data from a national survey of the entire population of HIEC directors (N?=?17; response rate = 100%), a group discussion with 7 HIEC directors, and 15 in-depth interviews with HIEC directors and chairs. Results The study provides a description and analysis of local implementation responses to the central government mandate to establish HIECs. The latter represent cross-sector health networks characterised by a vague mandate with the provision of a small amount of new resources. Our findings indicate that in the case of HIECs such a mandate resulted in the creation of rather fluid and informal partnerships, which over the period of three years made partial-to-full progress on governance activities and, in most cases, did not become self-sustaining without government funding. Conclusion This study has produced valuable insights into the implementation responses in HIECs and possibly other cross-sector collaborations characterised by a vague mandate with the provision of a small amount of new resources. There is little evidence that local dominant coalitions appropriated the central HIEC mandate to their own ends. On the other hand, there is evidence of interpretation and implementation of the central mandate by HIEC leaders to serve their local needs. These findings augur well for Academic Health Science Networks, which pick up the mantle of large-scale, cross-sector collaborations for health and innovation. This study also highlights that a supportive policy environment and sufficient time would be crucial to the successful implementation of new cross-sector health collaborations.
机译：背景技术越来越多地，世界各地的健康政策制定者和管理人员寻找替代形式的组织和治理，以便为其卫生系统增加更多的价值和质量。近年来，英格兰中央政府根据协作治理安排强制了几项跨部门卫生倡议。但是，几乎没有实证证据，审查了对这些中央授权合作的本地实施答复。方法采用国家卫生创新和教育集群（HIECS）的国家研究资料，用于提供关于在英格兰跨部门卫生网络中实施协同治理安排的全面的经验证据。该研究采用了一种混合方法方法，整合了来自全国对董事人口的全国调查（N？=？17;响应率= 100％）的定量和定性数据，一个与7个Hiec董事的团体讨论，15与Hiec Directors和椅子进行了深入访谈。结果本研究规定了对中央政府授权建立床的局部实施响应的描述和分析。后者代表跨部门卫生网络，其特征在于提供少量新资源的模糊授权。我们的调查结果表明，在HIECS这样的授权中导致创造了相当流体和非正式伙伴关系，这在三年内完成了治理活动的部分全面进展，在大多数情况下，没有成为自我 - 没有政府资助的议员。结论本研究向HIECS的实施响应产生了有价值的见解，并可能具有少量新资源的模糊授权的其他跨领域合作。几乎没有证据表明当地的主导联盟将中央HIEC授权拨入他们自己的目的。另一方面，有证据表明HIEC领导人的解释和实施中央授权，以满足其当地需求。这些调查结果适用于学术健康科学网络，从而拿起大规模的跨部门合作的地幔进行健康和创新。本研究还强调了支持性政策环境和足够的时间对新的跨部门健康合作的成功实施至关重要。

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