Art of developing a vision for integrated healthcare and social services: an interview study with stakeholders in Sweden

Purpose To gain a deeper understanding of the development of a joint vision for Close Care, its obstacles and opportunities, in the region of Sörmland based on national health and social services reforms. Design/methodology/approach Seven semi-structured interviews were conducted with thirteen stakeholders. Documentation from the process was used to enhance the findings. A qualitative content analysis was performed. Findings Stakeholders described Close Care as entailing “person centeredness, cooperation, and resource sharing” but found it “too abstract”. Participation in developing the vision varied, with experiences of “external pressure” and low “readiness for organisational change”. Views on a regional vision’s “relevance and usability” differed. Participants highlighted several opportunities for the Close Care vision, such as: “a stepping-stone for implementation”, “harmonises with other health care visions” and “forming a cross municipal and regional network”. They also noted obstacles like “symbolic alienation”, “cognitive complexity”, “short-term economic reality” and “uncertainty around implementation”. Practical implications Opportunities and obstacles for the vision of Close Care can inform complex healthcare reforms that require stakeholder cooperation. Social implications Understanding Close Care may enable health system stakeholders to more effectively cooperate around the citizens’ needs. Originality/value Research on common ground has mainly focused on national or international policy levels and individual hospitals, professionals or patients. This study offers insights on regional and municipal cooperation in health care driven by a common vision.