ORIGINAL ARTICLECross-sectoral frontline delivery of welfare-to-work services for young adults with complexproblems in NorwayFrøydis M. Bakken| Kjetil van der WelOslo Metropolitan University, Oslo, NorwayCorrespondenceFrøydis M. Bakken, Oslo MetropolitanUniversity Faculty of Social Sciences, SocialWork, Child Welfare and Social Policy,P.O. Box 4, St. Olavs plass, Oslo, Norway.Email:froydis-marie.bakken@oslomet.noFunding informationNorges Forskningsråd, Grant/AwardNumbers: 269298, 43942AbstractActivation policies have increasingly targeted new and‘hard-to-serve’clients with complex needs, often deprivedof the labour market experience, health, skills, and compe-tencies that employers look for. The role of the health sec-tor as a partner for welfare services has thus become moreimportant. Cross-sectoral frontline delivery of activation isseen as crucial in succeeding with activation and labourmarket integration in general and especially for youngadults with complex needs. The current study aims at con-tributing new insights on such cross-sectoral coordinationby investigating how various actors within the welfare andhealth services experience interagency collaboration in thecontext of activating young welfare clients in the Norwe-gian Work Assessment Allowance scheme (WAA). Our dataconsist of 33 interviews with frontline workers in the twosectors in six different municipalities. Our data suggest thatcross-sectoral work in Norway directed at young WAA-clients is hampered by a lack of coordination and communi-cation between frontline workers in the two sectors, leadingto tension and inefficiency in activating these young clients.We do, however, find that in-house medical advisers in thewelfare services have a potential to act as boundary span-ners, but that seem to be an underused asset in this regard.Received: 27 September 2021 Revised: 9 August 2022 Accepted: 31 August 2022DOI: 10.1111/spol.12860This is an open access article under the terms of theCreative Commons Attribution-NonCommercial-NoDerivsLicense, whichpermits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and nomodifications or adaptations are made.© 2022 The Authors. Social Policy & Administration published by John Wiley & Sons Ltd.Soc Policy Adm.2022;1–14.wileyonlinelibrary.com/journal/spol1
We conclude that frontline workers' opportunities forcross-sectoral coordination seem to be constrained by nar-row and insufficient spaces for integration and collabora-tion, possibly due to organisational and administrativebarriers.KEYWORDSactivation policy, cross-sectoral frontline work, disability,fragmentation problem, frontline workers, work assessmentallowance, young welfare clients1|INTRODUCTIONEuropean welfare states have increasingly turned towards active labour market policies to solve the financial andwelfare challenges associated with demographic change, new social risks and post-industrial labour markets (Esping-Andersen,1999; OECD,2017). A key ambition in the expansion of activation has been to better integrate disadvan-taged citizens in the labour market by means of economic incentives, conditionality, and sanctioning on one hand,and rehabilitation, up-skilling and education on the other.However, this shift from‘passive’to‘active’labour market policy soon led to calls for welfare service reform.As activation policies increasingly targeted new and‘hard-to-serve’clients, the‘fragmentation problem’in welfareservice delivery became steadily more salient (Champion & Bonoli,2011). The new client groups often had chal-lenges beyond not being able to find work, frequently lacking the labour market experience, health, skills, and com-petencies that employers demanded, so-called complex problems. The traditional public employment services,embedded in‘departmentalism’and New Public Management governance structures (Christensen & Lægreid,2007),were not set up to meet these challenges. In response to this, scholars and policy makers argued that different healthand welfare services needed to collaborate and coordinate their efforts to provide the necessary help and increaseservice efficacy (Heidenreich & Aurich-Beerheide,2014; Larsen & Caswell,2020; van Berkel et al.,2012).The fragmentation problem in social policy delivery has been widely acknowledged (EU.,2014; OECD,2015),and recent welfare and organisational reforms have been launched to aid successful labour market integration. Theseinclude major reforms such as the Hartz-reforms in Germany (2003–2005), the Dutch SUWI-reform (2002) and JobCentre Plus in Great Britain (2002) (Champion & Bonoli,2011). In Norway, the 2006 NAV-reform is yet anotherexpression of this reform-wave (Askim et al.,2011; Minas,2014).With the expansion of activation policies to beneficiaries with complex problems, the role of the health sectoras a partner for welfare services has become more important (Caswell, Larsen, et al.,2017). However, the two sec-tors have different institutional aims, professional values and understandings, as well as separate institutional logics,internal governance and technical infrastructure that may hamper coordination and cause inefficiencies(Andreassen & Fossestøl,2014; Loyens,2019; Saikku & Karjalainen,2012).While the preconditions and consequences of welfare reform and organisational change can be observed inaggregate studies, welfare reform arguably takes place locally and depend on frontline workers' practices and theresources and abilities available to them (van Berkel et al.,2017). To better understand the nature of integrated ser-vice delivery, including possibilities, hurdles and bottlenecks, a local cross-sectoral perspective is pertinent. Yet, arecent review established that there is a lack of knowledge on how frontline workers in different public-sector orga-nisations are related, interact and cooperate in their work with clients who have complex needs (van Berkel,2017).This article addresses this gap, using activation of young adults in Norway as a case. Young adults outside thelabour force often have complex needs, such as (combinations of) health problems, little education, lack of work2BAKKENANDvan der WEL