Is it working together? A longitudinal case study to explore issues and pragmatic solutions involved in cross-sector working in public health

Purpose Policy, empirical research (and WCC) call for joined-up public services, to overcome silo-working and address cross-cutting social determinants of health and well being. Progress is slow. Relying on individual hard-work and goodwill is insufficient with major contextual factors impinging on success – opening this contextual black-box remains a research challenge. An in-depth case study explores the practical actions, barriers and opportunities encountered in cross–sector public health working. Methods Local authorityorganisedmutli-sector development workshops presented evidence syntheses to allow action groups to form and plan for local uptake. Four groups were followed to identify perceived progress against their own plans and aspirations at 6 months. Methods included: interviews (group members, colleagues, superiors, service recipients); documentary analysis; and other activity (eg. service changes). Results Findings highlight the role and impact of ongoing performance pressures, a changing context, political pressure and varying governance, research and practice cultures on unfolding events and perceived progress. Many factors diffuse efforts and stall progress. Pragmatic solutions to cross-sector working are detailed. Conclusions and Contribution Two contributions emerge: longitudinal evidence of the embedded complexity and challenges inherent in cross-sector working (getting research evidence, information and best practice flowing to inform services); facilitative practical steps for policy-makers and practitioners are suggested.