How do professionals in home-based health care services react to a new trust-based way of working? – A story dialogue study

Abstract

This study explored professionals’ reflections regarding a new, trust-based way of working in municipal homebased services, in relation to the concept of trust. The new way of working represents an alternative to the purchaser–provider split model. Instead of decisions being made on behalf of the service user by an intermediate purchaser, small, interdisciplinary teams are to cooperate to make decisions. The study is qualitative and exploratory, and data were collected via workshops with home-based service professionals. Eight professionals with different backgrounds participated. Data were both collected and analyzed using the story dialogue method. Adopting a wider view on trust, this study contributes by discussing the results according to three interrelated platforms of trust: relational/interactional, pre-contractual, and structural/institutional. The results indicate that to build trust after transferring autonomy to horizontally organized teams, work needs to be done to develop relational and pre-contractual trust before the new practice has been formalized in new routines, new structural trust bases have been formed, and trust has become institutionally embedded.