Understanding inter-organizational trust among integrated care service provider networks: A perspective on organizational asymmetries.

OBJECTIVE

To explore the factors that influence trust among the integrated healthcare service provider network in the context of seeking combined health and care services in the UK.

DATA SOURCES/STUDY SETTING: Primary data were collected from three regional integrated care service provider networks from March 2016 to October 2017.

STUDY DESIGN

Explorative qualitative study and inductive methods from emerging findings.

DATA COLLECTION/EXTRACTION METHODS: We conducted qualitative semi-structured interviews in three care networks and collected organizational documents from local integration boards from 2016 to 2017. Thematic analysis was performed in three large care networks with hospital staff, local councils, integration boards, and community and voluntary organizations under the NHS England Better Care Fund.

PRINCIPAL FINDINGS

Our findings reveal that trust among integrated care service provider networks is influenced by the following factors on various asymmetries: 1) recognition and knowledge asymmetries among care service partners of each other's skills, expertise and capabilities; 2) capacity and financial imbalances within the network; and 3) organizational differences in management, culture and attitudes toward change.

CONCLUSION

There is a need to improve competence recognition and capacity imbalances and to foster open minds toward change within networks to build trust to overcome divisions and facilitate integrated services among health and care organizations.