Purpose: Fragmentation in health and social care services can result in poor access to services, lack of continuity and inadequate provision for needs. A focus on integration of services are thus suggested to prevent negative consequences of fragmentation for service recipients. There are, however, few studies that explore the competence needed for integration of services in municipal health and social care organizations. This study explores which types of competence stakeholders require and how collective competence can promote service integration. Methods: This is a single-case study, and the data consist of focus group interviews and individual interviews with service recipients, family caregivers, professionals and managers. The data were analysed both inductively and deductively. Results: The analysis resulted in four main themes: 1) Knowledge about individual life situations and organization and system, 2) investigation competence, 3) person-centred collaboration competence and 4) facilitating competence. The themes form the basis for a collective competence framework that can promote service integration. Conclusion: As service integration involves a high degree of interlinked activities between professionals and organizational units, a collective approach to the concept of competence is presumably applicable. When service integration competence is approached as a collective attribute of a network within and between organizational units, the organization can facilitate this competence by encouraging an active exchange of knowledge between professionals. We also argue that service integration competence increases connectivity and interdependency between professionals and organizational units, and includes service recipients and family caregivers as legitimate extra-professional parts of the collaborative network.

Purpose: New Public Management (NPM) has increased fragmentation in municipal health and social care organizations. In response, post-NPM reforms aim to enhance integration through service integration. Integration of municipal services is important for people with complex health and social challenges, such as concurrent substance abuse and mental health problems. This article explores the conditions for service integration in municipal health and social services by studying how public management values influence organizational and financial structures and professional practices.Design/methodology/approach: This is a case study with three Norwegian municipalities as case organizations. The study draws on observations of interprofessional and interagency meetings and in-depth interviews with professionals and managers. The empirical field is municipal services for people with concurrent substance abuse and mental health challenges. The data were analyzed both inductively and deductively.Findings: The study reveals that opportunities to assess, allocate and deliver integrated services were limited due to organizational and financial structures as the most important aim was to meet the financial goals. The authors also find that economic and frugal values in NPM doctrines impede service integration. Municipalities with integrative values in organizational and financial structures and in professional approaches have greater opportunities to succeed in integrating services.Originality/value: Applying a public management value perspective, this study finds that the values on which organizational and financial structures and professional practices are based are decisive in enabling and constraining service integration.

The home nursing care is responsible for providing health care to patients with chronic and complex disorders in the municipality. This requires interprofessional collaboration between the nurses and general practitioners (GP`s). This article explores how the Coordination Reform has affected the collaboration between GP`s and nurses in the home nursing care, and what organisational factors are important for the collaboration. The results are based on a case study with focus group interviews including 20 nurses and in depth interviews with four GP`s. Analysis revealed that the Coordination reform has led to an asymmetry in the need for collaboration where the nurses have an increase in the need for collaboration. In addition, nurses wanted more meetings in patients` homes to discuss patients' health care needs. However, the funding system attached to the GP`s and their role as self-employed was an organisational barrier meeting nurses' needs.

The theme of this chapter is how to encourage service recipients and family caregivers to participate in research within the substance abuse and mental health field. The aim is to highlight the challenges in recruitment and participation in a qualitative social science study and to reflect on how these challenges can be addressed. This is done through autoethnographic methods. The data consists of own notes after meetings, telephone conversations and focus group interviews, in addition to email correspondence with relevant persons. The empirical material culminates in three main findings: “Traditional recruitment strategy”, “Recruitment via service recipients” and “Performing focus groups: Need for and willingness to adapt”. The challenges within the main themes are discussed using a reflective perspective. The challenges in the recruitment process were in contrast to the interest, motivation and goodwill shown by the participants during the data collection, hence the discussion is also critically oriented towards resource allocation and conditions for maintaining quality in the recruitment process.

Tjenestene til personer med psykiske lidelser og ruslidelser har fått stadig større oppmerksomhet, både i den offentlige debatten, blant brukere og fagfolk og ikke minst fra politiske myndigheter. Det er stor politisk enighet om betydningen av å prioritere feltet, samtidig som det er uenighet om hvorvidt tjenestene faktisk blir bedre. I Statlig politikk og lokale utfordringer ser forfatterne på organisering av tjenestene til mennesker med samtidige ruslidelser og psykiske lidelser, fra de politiske føringene sentralt til kommunale tjenester lokalt. Spørsmålet som stilles er et av de mest utfordrende i den moderne velferdsstaten: Hvordan skal en organisere tiltak og tjenester slik at både brukere og tjenesteytere opplever dem som samordnet og integrerte? Forfatterne diskuterer dette gjennom å vise til sentrale trekk ved den nasjonale politikken, de endringsprosessene en kan observere i et utvalg kommuner og erfaringer med ulike tiltak og tjenester knyttet til arbeid, bolig og kriminalomsorg. Antologien har sitt utgangspunkt i et forskningsprosjekt som studerer samordning og integrering av tjenester til mennesker med sammensatte rus- og psykiske lidelser. Boka bygger på statsvitenskapelige og organisasjonsteoretiske perspektiver, og har som mål å gi innsikt i nytten av slike perspektiver i analysen av velferdsstatens utfordringer. Målgruppa for boka er forskere, studenter og ansatte i lokal forvaltning – samt tjenesteutøvere som jobber med brukere med sammensatte og komplekse behov.