Emerging Governances, Different Perspectives

Linking with the debate around new public management (NPM) and new public governance (NPG), the article studies different conceptual approaches for explaining dynamically changing systems that locally deliver integrated health and social care. To make our case, we analyse three health and social care ecosystems: London in England, Tampere in Finland, and West Lothian in Scotland. We argue (a) that network analysis is suited to NPM striving for efficiency, rather than NPGs seeking service effectiveness and innovation; (b) that classifying service systems as networks or ecosystem has important strategic and management implications; and (c) from examining three self-classified local public service ecosystems, that these distinctions are misunderstood in practice.