title: Managing cultural diversity in healthcare partnerships: the case of LIFT.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Health Systems, University of Birmingham, Birmingham, UK. rm15@york.ac.uk
authors.forename: Russell
authors.initials: R
authors.lastname: Mannion
authors.forename: Sally
authors.initials: S
authors.lastname: Brown
authors.forename: Matthias
authors.initials: M
authors.lastname: Beck
authors.forename: Neil
authors.initials: N
authors.lastname: Lunt
mesh_terms: D018864:Cultural Diversity; D004739:England; D006801:Humans; D019982:Organizational Case Studies; D015279:Organizational Culture; D011320:Primary Health Care / Q000191:economics / Q000458:organization & administration*; D055818:Public-Private Sector Partnerships / Q000191:economics / Q000458:organization & administration*; D013222:State Medicine / Q000191:economics