Partnership working has become a central feature of British social welfare policy since 1997. Although this development is applicable to all areas of public welfare, nowhere is it more evident than in the planning and provision of care that overlaps health and social services. The literature survey described in the present paper focused on research examining the impact of partnership working in these areas to assess the evidence concerning its effects and to investigate how partnership 'success' is conceptualised. The literature conceptualised the success of partnerships in two main ways: (1) process issues, such as how well the partners work together in addressing joint aims and the long-term sustainability of the partnership; and (2) outcome issues, including changes in service delivery, and subsequent effects on the health or well-being of service users. The authors found that research into partnerships has centred heavily on process issues, while much less emphasis has been given to outcome success. If social welfare policy is to be more concerned with improving service delivery and user outcomes than with the internal mechanics of administrative structures and decision-making, this is a knowledge gap that urgently needs to be filled.

Abstract. We present a different approach to appraising welfare regimes, stressing different dimensions, variables and techniques to those used by Esping‐Andersen in his path‐breaking work entitled The Three Worlds of Welfare Capitalism. First, instead of focusing on social rights, we construct an alternative path to identifying welfare regimes starting from the welfare mix. Second, we incorporate active labour market policies (ALMP) as a key variable of the welfare mix. Third, we use hierarchical and k‐means cluster analysis to identify welfare regimes in the data. Fourth, we compare regimes over time. Nevertheless, despite these different approaches, we conclude, like Esping‐Andersen, that there are three clusters or worlds of welfare capitalism. We also find that the clustering of welfare regimes was sharper in the mid‐1990s as compared to the mid‐1980s, but that comparing welfare regimes in the 1980s with the 1990s indicates strong path‐dependence. Faced with high and persistent levels of unemployment in the 1990s, OECD countries have adopted policies, including ALMP, which reinforce their welfare mix.

This paper argues for the need to re-assess models of policy implementation in the 'congested state'. This re-appraisal focuses on two main directions. The first involves locating implementation in the context of wider models of the policy process. We fuse three models, those of Kingdon, Wolman, and Challis et al., to form a new 'policy streams' approach. The second examines implementation in multi-level governance. In the UK and elsewhere, much of the focus of traditional implementation studies has been on the link between one central government department and a local agency. However, this vertical (central-local) dimension fails to give sufficient stress to the other horizontal dimensions of 'central-central' and 'local-local'. Paraphrasing Kingdon's terms, implementation models also need to incorporate the 'little windows' at local level as well as the 'big' windows at national level. Using evidence relating to the implementation of UK policy towards health inequalities, this paper argues successful implementation is more likely when the three policy streams are linked across the three dimensions. The model is thought to be applicable to other areas of the public sectors and complex issues facing all governments. Mark

The 'welfare modelling business' has become central to comparative social policy in recent years. However, we argue that one important element in this literature, the usefulness of identifying 'ideal types' of welfare production that support theoretical development, has been neglected. While much effort has been devoted to the results of the number and composition of the worlds, insufficient attention has been paid to the analytical basis of welfare regimes. This article attempts an audit of the 'welfare modelling business', with a review and consideration of the main concepts used in the literature. Our main conclusion is that definitions, concepts and methods need to be given urgent priority for the investment in the business to produce future returns.

English Tackling health inequalities is a policy priority for the Labour government in the UK. We use Kingdon’s model of ‘policy streams’ to explain how the issue of health inequalities gets onto the policy agenda nationally and locally, and how it is being implemented. Using empirical evidence from local agencies, we suggest that the issue of health inequalities is on the agenda nationally and locally but implementation is hampered by deficiencies in performance management, insufficient integration between policy sectors, and contradictions between health inequalities and other policy imperatives. Thus, the government’s expectations are not only dashed locally, but also local expectations are being dashed at the centre.

New Labour and the third way in the British welfare state: a new and distinctive approach? AbstractThe Labour government elected in May 1997 has seen the reform of the welfare state to be one of its major tasks. Its big idea to achieve this is the third way, which is said to be a new and distinctive approach that differs from both the old left and the new right. It is argued that the third way is best summarized by a new acronym-PAP-pragmatism and populism. It appears to be neither distinctive nor new, leaning to the right rather than the centre or centre-left, and having some roots in the New Poor Law and the mixed economy of welfare of Beveridge.

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Background There is compelling evidence to suggest that some (or even many) NHS staff feel unable to speak up, and that even when they do, their organisation may respond inappropriately. Objectives The specific project objectives were (1) to explore the academic and grey literature on whistleblowing and related concepts, identifying the key theoretical frameworks that can inform an understanding of whistleblowing; (2) to synthesise the empirical evidence about the processes that facilitate or impede employees raising concerns; (3) to examine the legal framework(s) underpinning whistleblowing; (4) to distil the lessons for whistleblowing policies from the findings of Inquiries into failings of NHS care; (5) to ascertain the views of stakeholders about the development of whistleblowing policies; and (6) to develop practical guidance for future policy-making in this area. Methods The study comprised four distinct but interlocking strands: (1) a series of narrative literature reviews, (2) an analysis of the legal issues related to whistleblowing, (3) a review of formal Inquiries related to previous failings of NHS care and (4) interviews with key informants. Results Policy prescriptions often conceive the issue of raising concerns as a simple choice between deciding to ‘blow the whistle’ and remaining silent. Yet research suggests that health-care professionals may raise concerns internally within the organisation in more informal ways before utilising whistleblowing processes. Potential areas for development here include the oversight of whistleblowing from an independent agency; early-stage protection for whistleblowers; an examination of the role of incentives in encouraging whistleblowing; and improvements to criminal law to protect whistleblowers. Perhaps surprisingly, there is little discussion of, or recommendations concerning, whistleblowing across the previous NHS Inquiry reports. Limitations Although every effort was made to capture all relevant papers and documents in the various reviews using comprehensive search strategies, some may have been missed as indexing in this area is challenging. We interviewed only a small number of people in the key informant interviews, and our findings may have been different if we had included a larger sample or informants with different roles and responsibilities. Conclusions Current policy prescriptions that seek to develop better whistleblowing policies and nurture open reporting cultures are in need of more evidence. Although we set out a wide range of issues, it is beyond our remit to convert these concerns into specific recommendations: that is a process that needs to be led from elsewhere, and in partnership with the service. There is also still much to learn regarding this important area of health policy, and we have highlighted a number of important gaps in knowledge that are in need of more sustained research. Future work A key area for future research is to explore whistleblowing as an unfolding, situated and interactional process and not just a one-off act by an identifiable whistleblower. In particular, we need more evidence and insights into the tendency for senior managers not to hear, accept or act on concerns about care raised by employees. Funding The National Institute for Health Research Health Services and Delivery Research programme.