Managing Cultural Diversity in Healthcare Partnerships: The Case of LIFT

Purpose: The National Health Service (NHS) Local Improvement Finance Trust (LIFT) programme was launched in 2001 as an innovative public-private partnership to address the historical under-investment in local primary care facilities in England. The organisations from the public and private sector that comprise a local LIFT partnership each have their own distinctive norms of behaviour and acceptable working practices - ultimately different organisational cultures. The purpose of this article is to assess the role of organisational culture in facilitating (or impeding) LIFT partnerships and to contribute to an understanding of how cultural diversity in public-private partnerships is managed at the local level. Design/methodology/approach: The approach taken was qualitative case studies, with data gathering comprising interviews and a review of background documentation in three LIFT companies purposefully sampled to represent a range of background factors. Elite interviews were also conducted with senior policy makers responsible for implementing LIFT policy at the national level. Findings: Interpreting the data against a conceptual framework designed to assess approaches to managing strategic alliances, the authors identified a number of key differences in the values, working practices and cultures in public and private organisations that influenced the quality of joint working. On the whole, however, partners in the three LIFT companies appeared to be working well together, with neither side dominating the development of strategy. Differences in culture were being managed and accommodated as partnerships matured. Research limitations/implications: As LIFT develops and becomes the primary source of investment for managing, developing and channelling funding into regenerating the primary care infrastructure, further longitudinal work might examine how ongoing partnerships are working, and how changes in the cultures of public and private partners impact upon wider relationships within local health economies and shape the delivery of patient care. Originality/value: To the authors' knowledge this is the first study of the role of culture in mediating LIFT partnerships and the findings add to the evidence on public-private partnerships in the NHS

Living in Exospace: ISS and Discovery 1

The concept of exospace, as an alternative liveable structure, is discussed in this article to improve our comprehension of architectural space. Exospace is a man-made space designed for living beyond Earth’s atmosphere. Humankind has developed outerspace technologies to build the International Space Station as a significant experiment in exospace design. The ISS is a new building type for scientific experiments and for testing human existence in outerspace.

A fictional example of exospace, on the other hand, is Discovery 1 spaceship in Stanley Kubrick’s legendary science fiction film 2001: A Space Odyssey (1968). It is a ship travelling to Jupiter with a crew of five astronauts and HAL9000, the artificial intelligence controlling the ship. I will first discuss the ISS, and the space stations built before, from a spatial point of view. A spatial study of Discovery 1 will follow. Finally, through an understanding of exospace, I will return to architectural space with a critical appraisal. The comparison of architectural space with exospace will add to the discussion of space theories from a technological approach.

Exospace creates an alternative reality to architectural space. Architects cannot consider exospaces without comparing them with the spaces they design on Earth. The different context of outerspace shows that a work of terrestrial architecture is very much dependent on its context. A building is not an ‘object’ that can be located anywhere; it is designed for its site. Architectural space is a real, material, continuous, static and extroverted habitable space designed for and used in the specific physical context of Earth. The existence of exospace in science opens a new discussion in architectural theory, both terrestrial and extraterrestrial.