Partnerships have never been out of vogue in UK public policy – and certainly not in recent times – but the need for them has arguably never been greater. This poses something of a paradox, with which our study has been concerned. The silo-based departmental culture and character of the UK, but especially English, system of government at both national and local levels has triggered a continuing interest in partnerships to overcome the worst effects of working in silos. However, few partnerships have succeeded altogether in overcoming the silo effect or departmentalism mindset. For the most part, partnerships represent another layer of governance, or ‘add-on’, and a patchy and uneven one at that in terms of their effectiveness, as the findings from our study of public health partnerships show. On the few occasions where partnerships appear to work well, there are many more instances where the costs may outweigh the benefits – at least those that can be ascribed to the partnership arrangements in place, which is not an easy calculation to make.

Given the enormity of the fiscal challenges facing all parts of the public sector over the coming years, the strengths and weaknesses of the new arrangements put in place from April 2013, following the passage of the Health and Social Care Act a year earlier in March 2012, will be tested to the limit. It is, of course, far too soon to offer a verdict on, or even to predict, the likely success of these new partnerships, which principally revolve around Health and Wellbeing Boards (HWBs), but it is a fair bet that unless they do operate in a quite different fashion from those that have preceded them, then in seeking to tackle the cross-cutting ‘wicked issues’ of the type to be found in public health, for the most part, they will be found wanting. But there does now exist a sizeable body of literature and learning upon which to draw that offers the new HWBs a real opportunity to avoid the path dependency option and to strike out in a new direction. Certainly, the overwhelming weight of oral and written evidence submitted to the House of Commons Communities and Local Government Committee's inquiry into the role of local authorities in health issues both acknowledged the opportunities facing HWBs and drew attention to the lessons from past attempts at partnership working.