What causes imbalance in complex service networks? Evidence from a public health service

Purpose Service networks are inherently complex as they comprise of many interrelated actors, often driven by divergent interests. This can result in imbalance, which refers to a situation where the interests of at least one actor in a network are not secured. Drawing on the “balanced centricity” perspective, the purpose of this paper is to explore the causes of imbalance in complex service networks. Design/methodology/approach Adopting a qualitative case-based approach, this paper examines a public health service network that experienced imbalance that was detrimental to the lives of its users: the Mid-Staffordshire National Health Service (NHS) Trust, UK. Drawing on service-dominant logic and stakeholder theory, case evidence provides insight into the origin and drivers of imbalance in complex public service networks. Findings The origin of imbalance stems from competing institutional logics of various actors (patients/public, employees, managers, regulatory bodies, etc.), but the degree to which these competing institutional logics lead to imbalance is moderated by accountability, communication, engagement, and responsiveness within the service network. Research limitations/implications By uncovering causes of imbalance in complex public service networks, this paper pinpoints important research avenues for developing the balanced centricity perspective. Practical implications The inherent existence of multiple parallel institutional arrangements makes networks imbalanced, but value creation can be achieved when the appropriate mechanisms are fostered to manage balance between divergent logics. Originality/value By examining imbalance as the underlying cause of network dysfunction, this research contributes to understanding of the dynamics in, and performance of, complex public service networks.