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

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.