Implementing health and social care policy – England and Scotland compared

This article explores the implementation of health and social care policy designed to improve partnership working between the health and social care sectors in the UK. Devolution has allowed Scotland to develop its own policies in several key areas. Given the potential for policy divergence, health and social care policy in England and Scotland is compared and contrasted. Using four partnership case studies, similar issues were apparent in both countries. Policy was dominated by the National Health Service at the expense of local authority partners and each partnership found the implementation of policy challenging, often due to inadequate policy guidance and difficult working relationships between the health and social care sectors. A key finding was that devolution had allowed Scotland more freedom to experiment with policy and the policy process became more readily influenced and challenged by local practitioners. Implications for policy implementation in similar devolved and decentralised contexts are considered.