Space and Place in Network Governance: Putting Integrated Care into Place

Abstract

The improved integration of health and social care organisations has become a prominent public policy and management narrative, premised on the ideal of networks governance. In promoting a vision of seamless coordination across professional and organisational boundaries, what is not often considered is how projects of integrated care are formed in relation to contested understandings of space and place. This chapter presents qualitative data gathered during an evaluation of an integrated care project that took place between 2012 and 2015 in a metropolitan borough in the North of England. Regional reform plans were shaped around policy and managerial imperatives for more joined-up, integrated and resource-efficient forms of care delivery. Findings focus on how the integrated care project involved reconceptualising place and space to create new localities, places of work and hierarchies of service provision. This rationalised reformation of space interacted with both embedded meanings and understandings of localities and neighbourhoods, as well as the everyday spatial practices of health and social care work. It is suggested that rather than able to construct new cross-boundary social relations based on to a rationalised model of service provision, projects of integration are tightly entwined with both existing attachments to place and the way place is enacted in health and social care practice.