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The purpose of this paper is to use theories of institutional logics and institutional entrepreneurship to examine how and why macro-, meso-, and micro-level influences inter-relate in the implementation of integrated transitional care out of hospital in the English National Health Service.

The authors conducted an ethnographic case study of a hospital and surrounding services within a large urban centre in England. Specific methods included qualitative interviews with patients/caregivers, health/social care providers, and organizational leaders; observations of hospital transition planning meetings, community “hub” meetings, and other instances of transition planning; reviews of patient records; and analysis of key policy documents. Analysis was iterative and informed by theory on institutional logics and institutional entrepreneurship.

Organizational leaders at the meso-level of health and social care promoted a partnership logic of integrated care in response to conflicting institutional ideas found within a key macro-level policy enacted in 2003 (The Community Care (Delayed Discharges) Act). Through institutional entrepreneurship at the micro-level, the partnership logic became manifest in the form of relationship work among health and social care providers; they sought to build strong interpersonal relationships to enact more integrated transitional care.

This study has three key implications. First, efforts to promote integrated care should strategically include institutional entrepreneurs at the organizational and clinical levels. Second, integrated care initiatives should emphasize relationship-building among health and social care providers. Finally, theoretical development on institutional logics should further examine the role of interpersonal relationships in facilitating the “spread” of logics between macro-, meso-, and micro-level influences on inter-organizational change.

This paper assesses the recommendations and proposals contained in Transforming Your Care, the recent review of health and social care in Northern Ireland, in the context of the existing integrated structures. It is designed to promote a better understanding of the implications of the proposed reconfiguration of health and social care.

This paper reviews a number of published documents encompassing an independent review and subsequent plans and strategies. It also draws upon a case study of a Rapid Access Clinic undertaken by the authors as part of a wider research project.

The paper concludes that the planned changes question the ability of an integrated structure operating across primary, secondary and social care. It notes that there are real concerns about the capacity of the social care workforce to deliver services. It is suggested that the proposal for Integrated Care Partnerships can be seen as a reflection of the need for a more localised approach to delivery.

The findings are derived from a small‐scale study and as such may make generalisation difficult. There is a clear need for a more robust evidence‐based approach to the evaluation of structural integration in health and social care and a process for monitoring of this change process.

The article is a reminder of the unique example of structural integration within the UK. As such it could have important lessons for England, Scotland and Wales which are moving in a similar direction.

The research analyzes good practices in health care “management experimentation models,” which fall within the broader range of the integrative public–private partnerships (PPPs). Introduced by the Italian National Healthcare System in 1991, the “management experimentation models” are based on a public governance system mixed with a private management approach, a patient-centric orientation, a shared financial risk, and payment mechanisms correlated with clinical outcomes, quality, and cost-savings. This model makes public hospitals more competitive and efficient without affecting the principles of universal coverage, solidarity, and equity of access, but requires higher financial responsibility for managers and more flexibility in operations.

In Italy the experience of such experimental models is limited but successful. The study adopts the case study methodology and refers to the international collaboration started in 1997 between two Italian hospitals and the University of Pittsburgh Medical Center (UPMC – Pennsylvania, USA) in the field of organ transplants and biomedical advanced therapies.

The research allows identifying what constitutes good management practices and factors associated with higher clinical performance. Thus, it allows to understand whether and how the management experimentation model can be implemented on a broader basis, both nationwide and internationally. However, the implementation of integrative PPPs requires strategic, cultural, and managerial changes in the way in which a hospital operates; these transformations are not always sustainable.

The recognition of ISMETT’s good management practices is useful for competitive benchmarking among hospitals specialized in organ transplants and for its insights on the strategies concerning the governance reorganization in the hospital setting. Findings can be used in the future for analyzing the cross-country differences in productivity among well-managed public hospitals.

This paper reports on experience in making use of Health Act flexibilities and care trusts. Three areas were chosen for study because they were known to have attached priority to health and social care integration and were at the leading edge of development. Drawing on discussions at a series of seminars at which the experience of each area was presented and reviewed, the paper identifies a number of emerging lessons for the future of integration in a context in which the Government has established a Minister‐led review to explore what more needs to be done to encourage integration.

Comment on the contribution that housing can make to delivering better health and wellbeing outcomes. More specifically, the purpose of this paper is threefold: summarise recent evidence that makes the case for housing in helping to address health and social care issues; comment on the challenges and opportunities of partnership working; and describe examples of interesting and innovative local joint provision.

Draws on the author’s briefing papers on housing, health and social care for housing quality network, which is a national housing consultancy organisation as well as the author’s role as Chairperson of East Midlands Housing Care and Support, which is a regional housing association.

Collaboration between housing, health and social care is making slow progress at the national level in England. This is despite an ever-increasing evidence base highlighting that good housing can help to address issues, such as delayed discharges. Nevertheless, there are an increasing number of interesting examples of successful local initiatives on housing, health and adult social care. The way forward is to facilitate joint working at a local level.

Focusses on the success of examples of local joint working between housing, health and social care to achieve better outcomes for vulnerable people.

This review aims to focus on the role of evidence in informing policy and practice in health and social care integration.

Following discussion of the importance of defining the terms that are being used, the review addresses UK policy and practice developments in respect of integrated health and social care over the last two decades. It explores the extent to which these accord with the available evidence on effective strategies.

The review demonstrates that the focus in delivering integrated care should be on the local systems and cultures that can deliver positive outcomes for individuals. Structural change will not guarantee integrated care and diverts from the detail of local implementation that needs to be achieved. Current developments in both Scotland and England have some promise of delivering enduring progress.

The review provides a synthesis of key bodies of evidence and allows comparison between different polities within the UK.

The purpose of this paper is to probe experiences of entrepreneurs in the social and health care service provision.

Information was collected regarding entrepreneurs’ views on the factors affecting the collaboration between public and private sectors. A sample of social and health care entrepreneurs was interviewed using open-ended questions. The interviews were transcribed and analysed using inductive content analysis.

Three main categories of factors affecting the success of partnership were identified: the nature of partnership, business aspects and tension builders.

The research was undertaken in rural Finland and the sample consisted 13 entrepreneurs. The results must be considered as observations with more generalised conclusions.

The results of this study support municipalities in their social and health care service strategy work and especially in consideration of how to also facilitate a fruitful public-private partnership (PPP)-framework, which will largely depend on mutual understanding and consensus.

The reform of the social and health care system has raised intensive public debate throughout Europe. Key issues include the reorganising of social and health care processes as well as PPPs in provision of services. This study observes the views and experiences of private entrepreneurs and points out where some potential problems and solutions of social and health care PPPs are.

A partnership is founded on equality and mutual respect. In health care there is no balance of power between the patient and the health‐care professional. To be able to create healthy partnerships we can aim for a balance by focusing on the interpersonal relationship between partners. To understand the system and be able to change it we have to see it from the patient’s point of view. This implies a change of attitude in health care. Each of us have to select, plan and execute our own behavioural changes. We also have to create a system based on the premises of the consumers. Establishing a patient/relative panel is an example of creating an arena for building partnerships with patients. By combining professional knowledge with systematic input from experienced consumers the hospital organization can get access to valuable knowledge and insight to improve the care for the patients.

This article will examine the legal basis for joint working between health and social services and will look at some of the problem areas in the implementation of partnership arrangements.

In this second and concluding paper on adult care joint ventures, the authors detail the very different approaches to adult care services taken by four case study sites, exploring the local contours and aspirations underlying their decisions. These are not intended as ‘off the shelf’ solutions for wide dissemination, rather to encourage others to engage with the legacy of previous partnership working and specific local contingencies.