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Purpose

The purpose of this paper is to investigate the impact of recent outsourcing and public‐private partnership (PPPs) arrangements on the consistency of professional employment in health care.

Design/methodology/approach

A case study methodology is applied.

Findings

The paper finds that multiple arrangements for employment within the ISTC creates numerous sources for inconsistency in employment: across the workplace, within professional groups and with national frameworks for health care employment. These are identified as having implications for organisational outcomes, threatening the stability of current partnerships, and partially stymieing intended behavioural change.

Research limitations/implications

The study is a single case study of an independent sector treatment centre. Future research is required to investigate wider trends of employment in heterogeneous outsourcing and PPP arrangements.

Practical implications

The paper informs both managers and clinical professionals of the unanticipated complexities and practical challenges that can arise in partnerships and outsourcing arrangements.

Originality/value

The paper presents a unique in‐depth investigation of employment within recently established ISTCs, and highlights important employment changes for the core health care workforce and high‐status professionals in the evolving health care organisational landscape.

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