Community and public participation and involvement is an underpinning principle of primary health care, an essential component of a social justice-orientated approach to health care and a vehicle to improving health outcomes for patients, public and communities. However, influenced by history and context, there are intrinsic issues surrounding power imbalance and other barriers to partnerships between communities, public, policy makers and researchers. It is important to acknowledge these issues, and through doing so share experiences and learn from those working within very different settings.

In South Africa, community participation is seen as a route to decolonisation. It is also integral to the core functions of South African Higher Education Institutes, alongside teaching and research. In the UK, there has also been a history of participation and involvement as part of a social rights movement, but notably public involvement has become embedded in publicly funded health research as a policy imperative.

In this paper, we draw on our respective programmes of work in public and community participation and involvement. These include a South African community engagement project to reduce teenage pregnancy and HIV infection working through a partnership between teachers, students and university academics, and a national evaluation in England of public involvement in applied health research. We begin by highlighting the lack of clarity and terms used interchangeably to describe participation, engagement and involvement. Frameworks for partnership working with relevance to South Africa and the UK are then analysed, suggesting key themes of relationships, working together, and evaluation and monitoring. The South African project and examples of public involvement in English primary and community care research are examined through these themes. We conclude the paper by mapping out common enablers and barriers to partnership working within these very different contexts.

Primary care research networks were established in Scotland to encourage research in primary care and build capacity. The aim of this descriptive study was to evaluate the primary care research network in Dumfries and Galloway, a rural area of Scotland, by describing the methods used and the outcomes in terms of research training and completed projects. All primary care professionals working in the region were offered an initial grant to buy time for research training to develop their own research ideas. Those attending the two day research training course were encouraged to submit a protocol for funding and Local Research Ethics Committee approval. Of the 605 and 717 primary care professionals circulated in the first and second years, 23 (4%) and 11 (2%), respectively applied for a research training grant. Of these, eight completed a research project together with a further six who had previous research training. Eleven (79%) of the 14 completed projects were the subject of oral presentations and 11 were submitted for publication in peer-reviewed journals. Only a small minority of professionals working in primary care will want to develop their own research, and this requires support, protected time and long-term mentoring. Building research capacity in primary care involves a number of activities ranging from funding academic units, to giving opportunities for non-academics to undertake research. These distinctions are important for decisions about appropriate funding and support.

There is an emphasis on developing partnerships throughout the Department of Health and other Government departments. Health Action Zones (HAZs) highlight the need for flexible working across boundaries at a local level. How to evaluate these partnerships in a manner that is practicable, pragmatic, straightforward for researchers and non-researchers alike is an issue that needs to be addressed. This paper assesses the potential of a community based evaluation tool – the Theories of Change Model – as an approach to evaluating partnerships. The model was applied to a very focused partnership between the Nottingham HAZ Evaluation Manager and the Local Co-ordinator of Trent Focus (an organisation funded by the NHSE Trent, to promote research and development in primary care). The aim was to provide an opportunity to portray the usefulness and limitations of implementing a theory based approach to ‘valuing’ primary care partnership working at a local level. The evaluation process itself was an important element of the formulation and implementation of the partnership. It helped to decide the aims and objectives of the partnership and proposed a theory as to why the partnership was worth investing in. At a minimum, if applied at the inception of a new partnership, the model was seen as a very useful planning tool. The process was very time consuming and to be most effective, needed the commitment from all key stakeholders involved in the partnership. This paper is an attempt to provide researchers/evaluators, in the widest sense, with a possible framework that would allow organizations to acknowledge, justify and address complex partnership working for health gain. This paper is of importance to anyone interested in defining and measuring desired processes and outcomes from partnership working.