A Contingent Approach to the Organization and Management of Public–Private Partnerships: An Empirical Study of English Health Care


  • Justin Waring is professor of organizational sociology at Nottingham University Business School. His research deals with the organization and management of public service professionals, especially how organizational innovations interact with institutionalized professional practices, cultures, and identities. His research focuses on health care services and makes connections between organizational and medical sociology, sociology of the professions, and public management. His recent work has been published in Organization Studies, Public Administration, and Social Science and Medicine. E-mail: justin.waring@nottingham.ac.uk

  • Graeme Currie is professor of public management at Warwick Business School. His research focuses on the areas of leadership, knowledge mobilization, and workforce development, mainly in health care settings. His recent work has been published in Journal of Public Administration Research and Theory, Public Administration, Organization Studies, Human Relations, and Leadership Quarterly. In a previous life, prior to becoming an academic, he worked as an organization development advisor for a major car manufacturer and the National Health Service. E-mail: graeme.currie@wbs.ac.uk

  • Simon Bishop is lecturer in organizational behavior at Nottingham University Business School. His research focuses on shifting interorganizational relationships in the context of public service reform and how they impact processes within organizations, including employment, work design, and organizational culture. His recent empirical work has examined public– private partnerships, knowledge translation initiatives, and the changing relationship between health and social care. E-mail: simon.bishop@nottingham.ac.uk


Public–private partnerships (PPPs) have become a prominent feature of contemporary public policy. Although research shows variation in the contractual configuration of partnerships, there is little evidence of how these shape service and workforce organization. Through comparative ethnographic research on two PPP health care providers in the English National Health Service, this article develops the idea that PPPs exhibit “tight” and “loose” arrangements that relate to “downstream” service and workforce management. It induces four empirically grounded mediating factors to describe this relationship. The first relates to the “dependence” between partners in terms of financing, strategy, and resource sharing; the second to the “strategic orientation” of leaders; the third to the composition of the “professional workforce”; and the fourth to the “management approach” to service and workforce organization. The article contributes to the research literature by exploring the contingencies in how PPPs are operationalized on the ground.