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Current policy places great emphasis on the development of "partnerships", particularly between NHS and local authority services, with the aims of increasing service coordination and delivery and improving health. To this end, primary care groups (PCGs), at the forefront of NHS organizational developments, are required to include a social services representative on their governing boards; similarly, primary care trusts (PCTs) have a social services representative on their executive committees. Drawing on a representative longitudinal national survey of English PCGs, the paper evaluates the contribution of these new governance arrangements to the development of inter‐agency partnerships. Despite poor histories of collaboration and some major organizational barriers, there are some signs of progress, with social services representatives playing an active part in PCG affairs and having clear lines of communication about PCG matters with their employing authorities. Equally significantly, PCGs have also quickly established a wide range of contacts directly with other local authority services and departments. However, these early gains risk being limited by traditional professional inequalities between social work and medicine and, in particular, by the prospect of further organizational upheaval as PCGs merge with each other and/or acquire trust status.

AbstractThis research explored how newly forming clinical commissioning groups (CCGs) were beginning to think about their new 'duty' to tackle health inequalities (HIs), as outlined in UK health policy. The concept of 'sensemaking' (Weick 1995) was used to illustrate the influences on CCGs' interpretations of the policy. Three CCGs in the North of England were recruited, and qualitative methods, including interviews, observations and document analysis, were used to collect data, over a period from January 2012 to December 2012. The tangibility of central policy objectives is important in providing clear guidance and direction to organizations trying to tackle large scale policy agendas such as HIs. At a local level, both individual and collective organizational histories and wider relationships were influential on the way CCGs understood the problem of HIs and how they decided to try to tackle the issue locally. The research highlights what influences local level relationships and what factors need to be considered when trying to interpret and implement national policy at a local level.

Health and care policy is increasingly promoted within visions of the competitive city‐region. This paper examines the importance of policy boosterism within the political construction of city‐regions in the context of English devolution. Based on a two‐year case study of health and social care devolution in Greater Manchester, England, we trace the relational and territorial geographies of policy across and through new "devolved" city‐regional arrangements. Contributing to geographical debates on policy assemblages and city‐regionalism, we advance a conceptual framework linking crisis and opportunity, emulation and exceptionalism, and evidence and experimentation. The paper makes two key contributions. First, we argue health and care policy is increasingly drawn towards the logic of global competitiveness without being wholly defined by neoliberal political agendas. Fostering transnational policy networks helped embed global "best practice" policies while simultaneously hailing Greater Manchester as a place beyond compare. Second, we caution against positioning the city‐region solely at the receiving end of devolutionary austerity. Rather, we illustrate how the urgency of devolution was conditioned by crisis, yet concomitantly framed as a unique opportunity by the local state harnessing policy to negotiate a more fluid politics of scale. In doing so, the paper demonstrates how attempts to resolve the "local problem" of governing health and care under austerity were rearticulated as a "global opportunity" to forge new connections between place, health, and economy. Consequently, we foreground the multiple tensions and contradictions accumulating through turning to health and care to push Greater Manchester further, faster. The paper concludes by asking what the present crisis might mean for city‐regions in good health and turbulent times.

In this paper, we examine how space is integral to the practices and politics of restructuring health and care systems and services and specifically how ideas of assemblage can help understand the remaking of a region. We illustrate our arguments by focusing on health and social care devolution in Greater Manchester, England. Emphasising the open-ended political construction of the region, we consider the work of assembling different actors, organisations, policies and resources into a new territorial formation that provisionally holds together without becoming a fixed totality. We highlight how the governing of health and care is shaped through the interplay of local, regional and national actors and organisations coexisting, jostling and forging uneasy alliances. Our goal is to show that national agendas continued to be firmly embedded within the regional project, not least the politics of austerity. Yet through keeping the region together as if it was an integrated whole and by drawing upon new global policy networks, regional actors strategically reworked national agendas in attempts to leverage and compete for new resources and powers. We set out a research agenda that foregrounds how the political reorganisation of health and care is negotiated and contested across multiple spatial dimensions simultaneously.

In this paper, we examine how space is integral to the practices and politics of restructuring health and care systems and services and specifically how ideas of assemblage can help understand the remaking of a region. We illustrate our arguments by focusing on health and social care devolution in Greater Manchester, England. Emphasising the open‐ended political construction of the region, we consider the work of assembling different actors, organisations, policies and resources into a new territorial formation that provisionally holds together without becoming a fixed totality. We highlight how the governing of health and care is shaped through the interplay of local, regional and national actors and organisations coexisting, jostling and forging uneasy alliances. Our goal is to show that national agendas continued to be firmly embedded within the regional project, not least the politics of austerity. Yet through keeping the region together as if it was an integrated whole and by drawing upon new global policy networks, regional actors strategically reworked national agendas in attempts to leverage and compete for new resources and powers. We set out a research agenda that foregrounds how the political reorganisation of health and care is negotiated and contested across multiple spatial dimensions simultaneously.