Evolution of public-private partnership: the UK perspective through a case study approach

Abstract

Purpose Since the 1990s, the National Health Service (NHS)advisory officers have developed considerable expertise in managing the process of specifying, procuring, contracting and running public–private partnership (PPP) projects. However, there has been a relatively consistent trajectory in the findings of studies and evaluation of PPP from its initial introduction in the health sector in 1992 to the present time. Therefore, the purpose of this study is to critically evaluate the PPP experience in the UK context using a case study in the NHS. Design/methodology/approach The partnership literature is primarily focussed on process issues, and the impact of partnerships on improving outcomes cannot be assumed. By conducting a critical review on most updated research studies and innovative approaches in this area, the literature as to the place of PPPs in health in the context of the UK is critically explored and whether they have a role in system resilience is examined. A case study has be used as well to describing the processes of a PPP arrangement. Findings Health-care PPP is one of the options relating to health system resilience. However, their contribution in the NHS has been mixed, with success noted in short-term clinical and services contracts while in the long-term the value for money argument has not been proven. In theory, the role of PPPs in bringing together ingredients supporting system resilience such as finance, management and innovation in the UK has not always been successful, and NHS providers have taken the approach to exit such arrangements. Research limitations/implications More research work is needed to capture the 21st-century challenges and critical success factors during its implementation. Practical implications The creation of strong partnerships is moving service delivery away from a project-by-project approach to one that includes strategic and policy developments for long-term results. Originality/value This is a fresh discussion in the role of PPP in system resilience in the UK perspective through a case study describing an exit from a PPP arrangement.

Reaping the benefits of digital transformation through Public-Private Partnership: A service ecosystem view applied to healthcare

“…Nevertheless, PPPs enact unprecedented management and organizational challenges (Adamou et al, 2021 ). Inability to timely and effectively manage them expands the dark side of PPPs.…”

Exploring the Nature and Impact of Client-Related Delays on Contemporary Saudi Construction Projects

“…The study concluded that a lack of effective risk allocation as well as a short-term view of healthcare investments are among the challenges that, when overcome, can improve the PPP delivery process [45]. However, the resilience expected from PPP procurement has not always been successful, and the UK's National Health Service (NHS) has been moving away from such models [46].…”

International cooperation in developing countries health systems: in-depth analyses from Gaslini Children Hospital

“…Ferreira and Marques, (2021), on the other hand, identify critical factors, which include: great uncertainty, owing to the long duration of PPP projects; rigid and incomplete contracts; the large investments needed; and opportunistic behaviours among partners. Soon, on the one hand, the proliferation of PPP is justified by the advantages they can generate, but on the other hand, it is also necessary to assess what the problems of PPPs are, as well as the critical success factors (Adamou et al , 2021). Agency theory, information asymmetry, adverse selection, audit and monitoring costs are just some of the issues that need to be taken into account when building a successful partnership (Meissner, 2019).…”