A Balancing Act: Partnership Dynamics in Practice When Organising and Developing Integrated Care Initiatives.

Introduction: Integrated care for families provides tailored, coordinated support across various life domains. It relies on partnerships between families, professionals, organisations, and policymakers, navigating diverse perspectives, cultures, and structures. These differences make partnerships complex and not a given. While much is known about partnerships, the dynamics between stakeholders in practice remains underexplored. Therefore, this study examines the dynamics of partnerships in the organisation and development of integrated care initiatives, identifying important aspects, facilitators and barriers. Method: This qualitative study explored partnership by following five integrated care teams over two years, through interviews (n = 54), observations of clinical case discussions (n = 40) and four learning sessions, incorporating perspectives of families, professionals, managers and local policymakers on partnership. Results: Four aspects of partnership were identified: shared vision among stakeholders; roles and responsibilities; monitoring and evaluation; and funding. Facilitators included inclusive participation, transparent communication, and flexible approaches. Barriers were conflicting interests, undefined roles and leadership, and fragmented systems that may hinder collaboration. Conclusion/Discussion: Balancing relational and organisational aspects of integrated care is complex yet essential to provide person-centred care. Continuous stakeholder involvement, along with evaluation and reflection, is crucial for fostering shared learning and ensuring the development and sustainability of partnerships within these initiatives.