“All the worlds a stage, and all the men and women merely players ” (Shakespeare, As You Like It, Act 2. Scene 7). Acting or Collaborating? Managing the Conflict in Health and Social Care Integration

As another crisis in funding and in care hits the English NHS, attention has once again turned to the need for improved collaboration and integration between health and social services. While most attention tends to be directed at the processes, outputs and effectiveness of individuals on the ground, arguably the most influential groups are the top management teams charged with determining integration strategy and the parameters for practice (Kozlowski and Bell, 2013; Baumeister et al, 2016).

Extant literature on group performance, intergroup relations and inter-organizational collaborative suggest team outputs and effectiveness are contingent upon personality antecedents such as the knowledge, skills and abilities of individual team members, and; process antecedents such as interactions, team dynamics, decision making participation, information exchange and social support (West and Anderson, 1996, Barrick et al, 2007).

Drawing on interviews with 21 top level managers, and observations of an English Health and Well-being Boards (Health and Social Care Act, 2012) charged with integrating the provision of health and social care in a single locality, this study employs grounded theory and constant comparative analysis (Charmas, 2006) to conceptualize conflict in the context of mandated collaborative relations. Specifically, this study builds upon previous research by exploring collaborative interactions between top management teams to construct a new map of the social processes that attend attempts to improve integration between health and social services.

Focusing on the social process for managing conflict in the context of collaboration it explains the various practices, strategies, actions and attitudes individuals adopt when interacting with each other, both front and back stage (Goffman,1959). These are mapped in terms of competing tensions between that which I term: Social Justice and Social Order Orientations; Identities of High and Low Power; Acting Out verse Being Directed, and; Etic and Emic Interacting Strategies. The implication for understanding and repairing collaborative failures is then considered.