How far has the integrated care come? Applying an asymmetric lens to inter-organisation trust amongst health and social care organisations

The extant literature on interpersonal and inter-organisational trust reveals there are many factors that can influence an organisations’ services to integrate and exchange. While these studies have enhanced our understanding of organisational collaboration, we propose an asymmetric perspective that concentrates on factors that eventually lead to the loss of inter-organisational trust in the context of the (National Health Services) NHS and local government by seeking to join-up health and care services. This paper explores trust and asymmetry factors that undermine collaborative spirits towards successful service integration among health and care players. Based on interviews with 42 subjects in the NHS England Better Care Fund (BCF) programme, we present a model that distinguishes between asymmetric factors and affected health and care service integration. Our findings contribute to a scholarly understanding of asymmetry in the public sector and the role of trust in overcoming divisions and facilitating joint-up services among health and care organisations.