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Partnership working often fails because no account is taken of people's emotions, a Department of Health official told a London conference on alternatives to care trusts last week.

Andrea Campbell, director of the North-West regional secure commissioning team, said it was essential to take account of the feelings of those being asked to work in partnership, particularly given the rival orthodoxies of the health and social models of care.

"What we find is that, if we can understand how it feels for people, then we can work round it. We need to move ourselves beyond the personal feeling that somehow something is going to be taken away from us," she said.

Linda Tully, Older People Task Force project manager for the Trent regional DoH office, said the sector needed to broaden its horizons when considering alternatives to care trusts.

"We automatically think about social care and health. But we need to think further than that. We need to include the police and education."

Tully said she was concerned that the calls for "seamless care" could result in the loss of specialisms, and instead backed the notion of "strong seams" to prevent organisations splitting from each other and patients falling through gaps.

"Partnerships are about forgetting what organisation you work for," Tully said. "It is about thinking what we can do for the patient. It is not about dumping on one organisation. It is about giving and taking. And it is about learning the difficulties that different organisations have to cope with."

Carole Rouse, head of primary care at Huntingdon Primary Care Trust, said it was important for partnerships to be able to evolve and not be restrictive in their membership.

She said Huntingdon's partnership arrangements on intermediate care had involved transferring social services home care staff under Transfer of Undertaking (Protection of Employment) arrangements to a multi-disciplinary intermediate care team and transferring skills between team members. For example nurses could now carry out neurological assessments. All of this had been achieved without becoming a care trust, she added.