Facilitating participation : a health action zone experience

Partnership working, engagement and participation of service recipients and providers are issues at the core of UK and international health and social care policies. Although always considered desirable, recent legislation makes this practice a legal imperative in England. However, the operationalization of the concepts pose a number of challenges. This paper draws on evaluative data to examine how these concepts were addressed within one of the largest health action zones (HAZ) in England. The research took a generative perspective and was intended to promote learning, deepen understanding, model actions and consequences, and to provide a guide to decision making. Three approaches of theories of change, pluralistic evaluation and soft systems methodology were combined in the research design. Data was collected through 39 individual tape-recorded interviews with people involved with HAZ at both strategic and operational levels. The findings allowed partnership and engagement activity to be categorized into two domains, those that led to entrenchment in old practices and those that facilitated engaging with a partnership and community involvement ethos. By making the facilitating and inhibiting variables more explicit, the potential for working to a partnership philosophy is enhanced.