Working with Individual Plans: users' perspectives on the challenges and conflicts of users' needs in health and social services

In Norway, an Individual Plan (IP) is a statutory right and a tool for cooperation between the client in need of long-term, coordinated services and the public services. This study analyses the explicit needs of users, how the various actors in the IP process met these needs, as seen from the users’ perspective, and, finally, how disability influenced the outcomes. Participants expressed physical, psychological and social needs. These needs were similar for persons with physical or psychiatric health conditions, or for persons with an innate or acquired disability. However, time elapsed since a disability had been acquired did make a difference. The municipality or district of residence, the administrative and legislative boundaries, the interpretation of those and the coordinators’ position within the hierarchy of the system all affected how well users’ needs were met, indicating the existence of tension. This tension between the external conditions or framework of services and user participation may be an explanatory factor for the slow implementation of IP