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This article analyses how governance and organisational dynamics produce different forms of health and social care integration. The ethnographic study, carried out in two different Italian organisations, highlighted two forms of integration, which the authors term mechanical and cultural. The first is characterised by the prevalence of codified and hierarchical forms of coordination and the substantial isolation of professional groups, with limited contact opportunities. Under these conditions, integration is mainly achieved in the final product through the independent and uncoordinated delivery of specific social and health services. In the second, codified tools occur alongside informal coordination activities, based on face-to-face interactions and the sharing of knowledge, values and goals. Integration takes place in daily formal and informal interactions and in the development of professional intimacy. The results of the study suggest that public policies need to be clear about the form of integration at which they aim. The mechanical form is appropriate for product integration, while cultural integration is the preferred form for process and professional integration. In the latter case, ICTs are undoubtedly useful but not sufficient. To stimulate informal coordination, mutual trust and professional reciprocity, analogic communicative patterns are needed to allow the symbolic dimension to be expressed.

This article arises from the urgent need to reflect on the current situation resulting from the dramatic consequences of a crisis which appears to be epochal and which, as sociologists, questions us at first hand. This is to understand the socio-cultural, economic and technological processes that triggered it and to attempt to imagine future scenarios. At the dawn of the third millennium, it seems as if the juggernaut of modernity, with its dream of unlimited progress and cargo of unconditional trust in instrumental rationality, has abruptly slowed down. The pandemic challenges contemporary society to develop a different weltanschauung, alternative to the performative and conformist idea of social planification supported by the neoliberal paradigm. It compels us to finally acquire the consciousness that the complexity of knowledge and global interdependency require collective awareness, political participation, and shared responsibility.

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