Suggestions for Developing Public Service Logic through a Study of Interactive Value Formation

ABSTRACT

This article aims to initiate an expansion of the concept of public service logic (PSL) towards acknowledging how value co-creation and value co-destruction can affect value outcome for family carers. It is also a starting point for including the third person in PSL. As PSL is developed mainly through conceptual research, this article contributes by suggesting further developments based on empirical findings. The findings confirm that there is no fixed connection between interactive value formation (IVF) and value-in-use. The article suggests an emphasis on the connection between operand and operant resources in PSL to facilitate increased value-in-use. Furthermore, family carers as co-recoverers of initial value co-destruction are illuminated, suggesting a potential result of simultaneously increased and decreased value-in-use. The article argues for including IVF in PSL based on empirical findings of co-destruction and value decrease and to further emphasize the third party’s role in the theory of public service logic.

KEYWORDS:

• Public service logic
• value co-creation
• value co-destruction
• family carers
• value-in-use

Introduction

Western welfare states increasingly promote the involvement of users, citizens and family carers in the development of public care services, often referred to as value co-creation (VCC). Previous studies find that family caregivers are disposed to health and stress deterioration due to their care work burden and to dissatisfying collaboration with the care services (Acton, 2002; Cummins, 2001; Todd & Jones, 2003). The aim of involving users through co-creation is to increase sustainability, to develop better outcomes for users and, simultaneously, to build trust in the welfare policy. Supporting these goals, Osborne and colleagues (Osborne, 2018; Osborne et al.,2013, 2015, 2016) conceptualize a public service logic (PSL). This conceptualization is based on services’ unavoidable collaborations with users, a service logic that matured, originally, within service marketing literature (see e.g., Grönroos, 2008; Grönroos & Voima, 2013; Vargo & Lusch 2004, 2008). PSL is developed primarily through conceptual research and lacks empirical confirmation at a micro level (for an exception, see Engen et al. (2020)). In line with service logic, PSL emphasizes mainly the positive notion of VCC (Osborne, 2018). Osborne et al. (2016) and Osborne et al. (2015) also acknowledged co-destruction as part of a public sector logic, although co-destructive processes regarding users’ value experiences have scarcely been examined in PSL previously. The only empirical work found for studying value co-destruction in PSL is by Engen et al. (2020).¹ Thus, PSL appears to be normatively biased, giving predominantly positive connotations to interactions between users and services and taking user influence for granted:

It is no longer the case, for example, of exploring the top-down relationship between public policy, PSOs and the recipients of public services. Emerging new technology has offered service users potential routes to wrest (some) bottom-up control over public services from the policy, administrative and managerial structures. (Osborne et al., 2016, p. 641)

This statement assessing users to be increasingly influential and connected to an emphasis on value co-creation obscures a well-documented power imbalance experienced by the user side in care service provision and can be seen as a rationale for a lack of focus on users’ negative experiences that may result from interaction with service, presumably affecting care services’ actions. Furthermore, PSL concentrates on the user–employee relationship, missing an elaboration on the interaction between employees and third persons, which is called for by Hardyman et al. (2015). Thus, this article aims to illuminate the complexity of service provision from a third-person perspective.

Within marketing literature, service logic has been criticized by some service scholars for harmonizing VCC not recognizing potential negative outcomes for users who interact with services (Echeverri & Skålén, 2011; Plé & Chumpitaz Cáceres, 2010; Smith, 2013), which may lead to their exploitation (Zwick et al., 2008). To support the outline of a more neutral frame for public service logic that acknowledges the possibility of value co-destruction (VCD) when services and the user side interact, this article follows Echeverri and Skålén (2011) and adopts the term ‘interactive value formation (IVF)’ in regard to service provision. Thus, the article reveals how experiences of increased and decreased value outcomes may be experienced by family carers. The notion of value in this article is based on the definition by Vargo et al. (2008, p. 149): “An improvement in system well-being”, “system” identified as, e.g., the user system or the service system. “Well-being” can be measured “in terms of a system’s adaptiveness or ability to fit in its environment” (Vargo et al., 2008, p. 149). Grönroos (2008, p. 303) concretizes this in the following:

Value for customers means that after they have been assisted by a self-service process (cooking a meal or withdrawing cash from an ATM) or a full-service process (eating out at a restaurant or withdrawing cash over the counter in a bank) they are or feel better off than before.

Value, then, is seen as well-being and means that people perceive themselves to be or to feel “better off than before”. According to Grönroos (2008), value is created when using a service after delivery, called value-in-use. Taking the family carer perspective,² this article considers value-in-use as individual well-being (being better off after than before interacting with the employees). Acknowledging that well-being is not a fixed experience, the article considers it as increased or decreased value-in-use. In other words, increased value-in-use in the context of the present work is considered as more-positive subjective evaluations of life, e.g., improvement of health or reduction of stress.

This article supports acknowledging VCD as important for identifying and illustrating processes that may lead to negative value outcomes (Echeverri & Skålén, 2011; Engen et al., 2020; Plé & Chumpitaz Cáceres, 2010; Smith, 2013), in turn enabling a shift towards value-creating processes that engage and retain users as contributors (Alford, 2016). The starting point for this article is the importance of understanding family carers’ experiences of co-destruction as well as co-creation when pursuing increased participation. Against this background, the present article’s aim is twofold: (i) it aims to illustrate why IVF is a fruitful concept within PSL by identifying processes of value co-destruction (VCD) and value co-creation (VCC) that influence value-in-use; and (ii) it aims to introduce theoretical and practical implications of considering third persons as collaborators in PSL.

Family carers are important interactive partners for care services when end users cannot or will not contribute or when services need extra support to care for, represent, and/or assist users. Likewise, family carers are significant contributors to a sustainable care sector; currently, they perform almost as much care work as paid employees in Norway (Hjemås et al., 2019). Maintaining and increasing family carers’ contributions are emphasized political aims in Western welfare states (Hughes, 2010; Jenhaug, 2018), thus making in-depth understanding of their IVF experiences of notable interest.

This article informs and broadens the PSL framework through an empirical study of daily collaboration between family carers and employees in care services in Norway. The data were collected from an interview study with seven family carers, here defined as family members involved in the care of a relative in need of these services; one was also a leader of a family carer organization in Norway. The family carers represent several user groups, and the aim for the article is to illuminate general mechanisms concerning their interactions with public care service employees. The research, therefore, operates at an individual micro level, and the outcome regarding general public value is not examined in this article.

First, the article outlines the literature on PSL and IVF. Then, the methodology section frames the empirical study, methods and analytical tools used. The findings section highlights connections between interaction and value-in-use, which are further discussed in light of the theory of IVF and PSL in the discussion part. The discussion also suggests paying more attention to third persons’ experiences of value co-destruction and decreased value-in-use in practice and to the further development of a public sector logic, arguing for IVF as part of the terminology of PSL.

PSL and value co-creation

Public service logic (PSL) aims to adapt public service research to a more complex public sector responsible for solving an increasing number of severe problems. Thus, PSL moves away from both the public administration perspective and the “new public management” paradigm towards a “governance” paradigm, seeing users as important partners in public service organizations (Hardyman et al., 2015; Osborne, 2010, 2018; Osborne et al., 2015). Recognizing similarities between public and private sector service provision, PSL is based on service logic developed within service management theory, e.g., Vargo and Lusch (2008), Vargo and Lusch (2012), Vargo and Lusch (2016), Grönroos (2008), Grönroos (2011), Grönroos et al. (2015), Grönroos and Gummerus (2014), and Grönroos and Voima (2013). This logic for service production is based on the assumption that user value, in contrast to goods logic,³ is intangible and unavoidably proposed or facilitated in cooperation with the customers or users when delivered. In other words, users’ value experiences are connected to the quality of the interaction and can be created when the service is delivered as well as when planning the service together. Thus, the quality of interaction experienced can be empirically evaluated by interviewing participants of these interactions.

The latest developments in PSL by Osborne (2018, 2020) build on Grönroos and colleagues’ theory of value creation and co-creation (Grönroos, 2011; Grönroos & Gummerus, 2014; Grönroos et al., 2015; Grönroos & Voima, 2013). Here, value is determined by the user, who also controls value creation. Value co-creation facilitates the user’s creation of value-in-use. Grönroos and Gummerus (2014, p. 217) consider value co-creation as direct interaction, which is defined as “two (or more) actors act together in one process, in which their doings and sayings influence each other’s actions and perceptions. The two actors’ processes thus merge into one collaborative, dialogical joint process”. Direct interaction can be person-to-person or through “an intelligent non-human-resource” (Grönroos and Gummerus 2014, p. 217), meaning technological communication systems. In other words, value can be facilitated as co-creation through interaction and experienced in use by the user (value-in-use) (Grönroos & Voima, 2013; Osborne, 2018). For the aims of this article, value-in-use is equivalent to the value outcome for family carers.

A PSL argument for a service logic adapted to the public sector is that public sector sustainability depends on the value experienced by service users and, thus, needs to integrate user knowledge in developing services (Alford, 2016; Osborne et al., 2015). Alford (2016) expanded PSL to include strategies to encourage users’ co-production, thereby offering a social-exchange view of value as an alternative to the economic-exchange view of the for-profit sector. To ensure that users or citizens co-produce, services must recognize what individuals value and provide that in return. Thus, the social-exchange view focuses on contributing to the production of services, which aligns with an interactive view of value creation described by Echeverri and Skålén (2011) as an alternative to the economic-exchange view. This article aims to contribute to the user-value focus by examining the link between interaction and value-in-use.

A significant concept addressed by the VCC literature is participants’ resource integration (Grönroos & Gummerus, 2014; Vargo et al., 2008). Resources are referred to as “operant” and “operand”; operant resources are considered primary resources, e.g., skills and knowledge that contribute to the potential value of the experience (Echeverri & Skålén, 2011; Smith, 2013; Vargo & Lusch, 2008, 2004). Conversely, operand resources refer to more-concrete, tangible resources, e.g., natural resources associated with the production of goods and an economic-exchange view of service. Operant resources act on operand resources (making things happen) and are “likely to be dynamic and infinite and not statistic and finite, as is usually the case with operand resources” (Vargo & Lusch, 2004, p. 3).

In service logic theory, in general, there is a growing interest in examining and understanding how value may also be co-destructed in the interaction between customers or users and services (Echeverri & Skålén, 2011; Järvi et al., 2018; Plé & Chumpitaz Cáceres, 2010; Smith, 2013). Value co-destruction (VCD) is defined as the opposite of value co-creation as “the collaborative destruction, or diminishment, of value by providers and customers” (Echeverri & Skålén, 2011, p. 8).

Recently, also PSL is taking VCD into consideration, describing VCD as derived in the providers’ sphere, the joint sphere or the users’ sphere (Osborne, 2020) and caused by the misuse of resources by one or several actors (Engen et al., 2020). This article elaborates on VCD in PSL by examining interactions between family carers and care services from the family carers’ perspectives, including how co-creation and co-destruction by resource integration can predict the value experience for family carers. This article argues for including “interactive value formation” (IVF) as a significant concept in PSL.

IVF

IVF embraces both value co-destruction (VCC) and value co-creation (VCD), in line with its more-neutral connotation. Echeverri and Skålén (2011) outlined the notion of IVF, acknowledging and understanding value co-creation and value co-destruction as interconnected and as a result of interaction between users and service providers. The outcome is dependent on the resources integrated in the interaction, and co-creation or co-destruction of value depends on congruence or incongruence between involved actors’ expectations and the resources integrated. Additionally, co-destruction is found to relate to the misuse of the other’s resources, e.g., “organizations may be motivated to conserve their own resources by drawing more on those of customers”, leading to users’ resource losses (Smith, 2013, p. 31). In other words, care services leaning on family carers as care workers could, according to these findings, lead to utilization and loss or decrease in well-being for those family carers. This idea aligns with that of Plé and Chumpitaz Cáceres (2010), who found that a decline in well-being related to an opportunity for adaptiveness to society is due to a system’s misuse of resources, which may be accidental or intentional (Echeverri & Skålén, 2011; Plé & Chumpitaz Cáceres, 2010; Vafeas et al., 2016).

In their work, Echeverri and Skålén (2011) determined that IVF comprises four types of interactions leading to VCC or VCD: (i) reinforcing value co-creation, (ii) recovery value co-formation, (iii) reductive value co-formation, and (iv) reinforcing value co-destruction. These interactions are connected to equivalent subject positions: (i) value co-creator, (ii) value co-recoverer, (iii) value co-reducer, and (iv) value co-destroyer in relation to the resources integrated. The recoverer and reducer positions describe reactions that turn the initial experience of potential VCC or VCD in the reverse direction. For example, decreased well-being for one party, based on an initial experience, can be recovered by integrating skills or knowledge, and the end result can be a co-creation of value. The co-destroyer contributes to VCD, for example, through resource integration that is incongruent with the other party’s expectations or needs; and the co-creator contributes to VCC, for instance, through resource integration that is congruent to the other party’s expectations or needs. These types of interactions provide knowledge about how value is co-created or co-destructed in regard to participants’ actions. The present article aims to provide information about these mechanisms in regard to family carers’ experiences.

Järvi et al. (2018) identified eight possible reasons for VCD in the public sector from the employees’ perspective: (i) absence of information, (ii) insufficient level of trust, (iii) mistakes, (iv) inability to serve, (v) inability to change, (vi) absence of clear expectations, (vii) customer misbehaviour, and (viii) blaming. Accordingly, knowledge about family carers’ experiences is needed to understand how to enhance collaboration. The present study elaborates on family carers’ experiences of interaction with services and implementation of care service.

As PSL integrates the notions of VCC from service logic, this article argues that PSL should, additionally, take into consideration the growing body of literature that focuses on the processes of VCD in order to minimize them. Smith (2013), not separating sectors, considered VCD from the customer perspective; Echeverri and Skålén (2011) and Järvi et al. (2018) outlined VCD with users in public sector practice from the employees’ perspective and without explicitly distinguishing between the private or public sector.

This section has outlined how value in management-oriented literature is conceptualized as created in the user’s sphere and facilitated in the provider’s sphere or in co-creative efforts. Value could additionally be co-destructed, and also co-recovered, depending on the resources integrated.

Micro-level mechanisms for co-creation and co-destruction in public care services regarding user-side collaborators, generally, and family carers, in particular, remain scarce; yet they are important for understanding how to include the actors on the user side in a productive way.

Methodology

To uncover and elucidate on value co-destruction and value co-creation in relation to value-in-use specific to a public service logic, the present study qualitatively examines interactions between employees in care services and family carers in two municipalities in Norway from the perspective of family carers. The aim of the interviews was to gain in-depth knowledge about family carers’ experiences of collaboration with service employees regarding value outcome for the family carers.

Empirical sources

This article’s empirical design comprises individual face-to-face interviews with seven family carers who were collaborating with care services that included a psychiatric day care program, housing services for mentally disabled people, a nursing home, and a service distribution office. One of the seven was also a leader at a family carer centre (the PIO Centre in Oslo, Norway). She has personal experience collaborating with services as well as in-depth knowledge of family carers’ experiences in general. She thus reports on others’ experiences, which are called “shadowed data” and are seen as important contributions for analysis and theory sampling (Morse, 2000). Therefore, this leader is a key informant for the present study. In addition to being interviewed, she was asked to elaborate on her experiences by e-mail, thereby reinforcing the database. Her comments refer to general experiences encountered in her role at the PIO Centre.

Here, the letters A through F refer to the family carers interviewed, except for the leader of the centre, who requested that she be called by her title. Four were family carers for their children (one minor child and three adults); two cared for one sibling each; and one cared for a parent. All of the family members required care due to some type of brain-related disability. The family carers who reported their interests in participating in the study were all women, which is reflective of the fact that women continue to perform most of the informal care work in spite of increasing equality in the Norwegian welfare state (Herlofson & Ugreninov, 2014; Hernes, 2014; Jakobsson et al., 2016). A criterion for participation was experience with interactions between family carers and employees, and all participants except for the leader of the PIO Centre were recruited through the collaborating service distribution office, the housing service and the psychiatric day care program, reporting their interest after an initial request from the health and care leaders initiated by the author. The distribution office recruited five family carers in one municipality including the collaborator with the nursing home, and the housing service and the psychiatric day care program from the other municipality recruited a family caregiver each. This field study was initially part of a bigger study examining service collaboration and innovation with family carers that was soon divided in two different studies. The leader of the PIO Centre was recruited as a result from a preliminary reconniotring of family caregiving.

In order to gain rich, in-depth knowledge, the interviews were semi-structured, meaning that they were based on several questions prepared in advance, as well as allowing the family carers to elaborate. The interviews also encouraged an informative and reflexive dialogue between the researcher and the family carer, for example, by asking follow-up questions based on the researcher’s knowledge or lack of knowledge, as advocated by Carter and Little (2007) and Alvesson and Kärreman (2007). The objective of the interviews was to scrutinize personal experiences in order to problematize the hitherto predominantly positive connotations of PSL theory by illuminating the relevance for including value co-destruction to a greater extent as important in PSL and to begin an elaboration towards an understanding of collaboration with third person in PSL. This aligns with the theory-evolving approach promoted by Crouch and McKenzie (2006) and Alvesson and Kärreman (2007). The interviews were intended to couple individual experiences with a social context and previous knowledge to further develop the theory of public service logic, which, in line with Crouch and McKenzie (2006), requires a continuous focus on both theory and empirical findings. Thus, it “clearly requires small sample sizes so that all the emerging material can be kept in the researcher’s mind as a totality under investigation at all stages of the research” (Crouch & McKenzie, 2006, p. 495). The coupling with previous knowledge on family carers’ experiences seeks to secure the representativeness of this study (Acton, 2002; Cummins, 2001; Todd & Jones, 2003). In addition, Brinkmann (2013) recommends a small number of interviews in relation to qualitative inquiries, thus making it possible to process and analyze them in greater depth. Here, more than seven hours of verbatim transcriptions were analyzed. Malterud et al. (2016) introduces the concept of “information power”, an alternative to “saturation”, arguing that “the more information the sample holds, relevant for the actual study, the lower amount of participants is needed” (Malterud et al., 2016, p. 1753). Here, information power is relative to when the information from the interviews in combination with previous knowledge about family carers’ experiences can adequately challenge the substantive theory of PSL. The material is evaluated to have a high level of information power, meaning that the family carers opened up, were engaged and gave detailed, in-depth descriptions of their experiences, and all interviewees are referred to in the article. Thus, the seven interviewees are recognized as suitable, enabling a focus on theory and empirical findings simultaneously, giving opportunity for in-depth analysis as each interview held a great amount of information. The interview questions were related to how the family carers experienced their relationships with the services/employees regarding being listened to, asked about the family member, and being informed of changes or other matters that affected them, and whether and how the service employees met the family carers’ wishes if these were, indeed, addressed. The family carers were also asked to what extent they trusted the services’ decisions and whether they felt that the services trusted and acted upon their advice. Most interviews were conducted at the family carers’ workplaces, and one took place at the carer’s home; all interviews were conducted between June 2017 and April 2018. The further elaborations from the leader of the PIO Centre were acquired in April 2020. All interviews lasted approximately one hour and were recorded and then transcribed.

Analysis

The analysis process began immediately following the first interviews in order to regulate the questions for the next interviews, in accordance with Carter and Little (2007). The data were coded and analyzed using NVivo 12.

The first overview of the empirical material revealed a complicated picture. Moving between the theory and the empirical material, and according to an abductive approach (Alvesson & Kärreman, 2007; Samuels, 2000), a pattern was identified that described experiences of interactions and experiences of value that did not necessarily correspond. This paved the way for categorization according to co-creation and co-destruction of value and value experiences, as Table 1 illustrates.

Table 1. Categorization of quotes from the empirical material

Interactive Value Formation	Value co-creation Being listened to, being asked, agreements		Value co-destruction Experiences of unpleasant employees, disagreements, having to complain, long processing time
Value-in-use	Increased value-in-use - Implementations of family carers’ suggestions - Further positive collaborations of implementations	Decreased value-in-use - Suggestions not being implemented	Increased value-in-use - Further interaction leading to implementation because of the family carers’ resources - Complaints leading to implementation - Family carers as co-recoverers	Decreased value-in-use - Family carers’ wishes are not implemented - Positive results regarding the end user is too demanding, leading to health issues for the family carer (co-recovering is too demanding)
Quotes	Leader of the Family Carer Centre: -You cannot only listen to me so that I can empty myself; rather discuss with me, […] and have an equal dialogue about the users’ best. FC A: -[…] then I talked to the allocation officer, and she said, “I’ll call on him”. When she said, “[end user’s name], you’ll do it, you’ll have three days”, [the user] said, “So you think so … .”. [The allocation officer said] “Yes, I think you should”. And then it was okay, yes, because he listened more to her. Because, if he is not activated, he just sits drowsy or sleeping. FC C: -It’s a very good dialogue. We are well received, and you really experience that they have seen the whole picture, understood the needs. At one point, we received even more than we expected and thought was possible. -I am a sort of promotor. [I] Make sure things happen, and we are in a dialogue and discussion FC D: -[…] They [the allocation office] know who I am; they know what I work with; and they sort of know that I know something about what you can claim. […] You need to have resources to have children with disabilities, I think … because if you don’t have that many resources, so … yes. Then things might drift a bit more […]. Then it’s a pity that no one embraces them. Because we are hunkering down somehow, but the ones that don’t have enough strength, that might have a bigger need for help, someone should knock at the door and say, “Hey you, we can offer this and that. What do you think? Do you need something?” (Family Carer D)	FC B: -What is … my complaint is that nothing happens”. FC A: -[I said] anyway, call me and tell me, because we don’t want him to come there and be alone. I thought, don’t call and nag them because they promised yesterday to call if he was moved.” - Then he called at three o’clock in the afternoon and said he was moved. And that was what we wanted to avoid. […] I will tell them at the ward that I don’t think it was good enough. Yes, I think so, it wasn’t good enough for me.	FC F: -[…] I wrote many letters, like, three letters, three rejections [came back] where it said that … the rejection, it was terrible … that it is not economically justifiable. Yes, it was so painful to read, as if you had applied for a loan and were rejected. I thought, this is how they measure people. It is A and B human beings we are talking about, that’s the feeling. […] I keep thinking that I couldn’t die now. That really hurts. (Family Carer F) -He got it [therapy] at last; he started in February, and it is every fortnight at a really nice psychologist’s. It’s very limited, but she has said, both her and the regular doctor, that they will not let him go before he receives an offer that will last because that is what I have tried to inform them that he needs. […] I am glad every time this support system is functioning; it is a great pleasure because I know that he can manage without me. - The support system that he has now, it has not come to count on a mountain. No one has said, “Yes, look, this is what you’re entitled to”. Sometimes I’ve got health problems. I’ve got high blood pressure … problems with sleep and … a lot of these things. FC E: -The problem in the housing service is that they can’t make the instructions to reach everybody [employees]. That is to say, they might reach everybody, but not everybody reads them and follows them”. -I have to make them [employees] do it [lead the resident]; that’s what I do much of the time. If not, no activities. -I bought a shorter couch for [the end user]. Some of them [the employees] thought that was cruel. It was because a few [employees] just sit down, and [the end user] just lies there. I am very much against it.	Leader of the Family Carer Centre: -We do hear about employees being incredibly supportive and listening to family carers, [and] seeing the benefits of collaborating, but they are, unfortunately, the exceptions. […] Once we sent out a request to the members on Facebook for examples of positive experiences with the support system, but we got none. FC B: - For at least two years, I have asked if I have to send a complaint to the county governor for them to listen and act. And I had to actually do it. […] But they had told the county governor that they would work for it, but they needed time, so that is what the governor answered, that “from the municipal letter it seems as [though] they will fulfil your demands”

The study seeks transferability to similar cases limited by context, recognized as typical by the reader and based on the researcher’s theoretical understanding of family carers’ collaboration with care services, in accordance with Brinkmann (2013) and Patton (2002). To secure the opportunity for recognition and transferability, the interviewees’ situations are described above while maintaining the anonymity of the family carers and end users. However, the limited number of interviewees, as well as the specific work-related tasks in the service areas of collaboration examined for this research, might have influenced the findings presented below, thereby also limiting the transferability of the results to practice. Nevertheless, the findings are considered appropriate for advancing PSL as they point to important experiences affecting third-person collaboration in service provision, demonstrating family carers’ experiences of value co-destruction and value co-creation related to value-in-use. The four categories elaborated upon in the findings section reflect the interviews’ information power by their capacity to reflect a variety of experiences, as aimed for in this study.

Ethical implications

Investigating a sensitive theme requires that ethical considerations be especially considered and adhered to in the course of a study. Here, the family carers were asked to obtain permission from their relatives to participate, and all information related to the end users was anonymized.

The leader of the PIO Centre did not want to be further anonymized. This lack of anonymity demanded that any examples connected to her family member be excluded.

All participants received written information and gave their consent of participation, and the Norwegian Centre for Research Data (NSD) gave the study ethical approval.

Findings

The analysis of the data reveals experienced connections between interactive value formation (IVF) and value-in-use that are not obvious: Value co-creating and value co-destructing activities between family carers and employees could both be followed by either a decrease or an increase of value-in-use for family carers. This section pays particular attention to the mechanisms of interaction leading to the value outcome for these family carers, whose narratives reflected various experiences of value outcome. Table 1 above illustrates how the categories outlined below emerged; Value co-creation and value co-destruction practices can be followed by either increased or decreased value-in-use as outcome according to family carers, as further explained below. The section is structured as follows: (i) value co-creation and increased value-in-use (ii) value co-creation and decreased value-in-use, (iii) value co-destruction and increased value-in-use, and (iv) value co-destruction and decreased value-in-use.

Value co-creation and increased value-in-use

The positive interactions involved in co-creation can lead to increased value-in-use for family carers. The leader of the PIO Centre saw such interactions as a criterion for achieving increased value-in-use: “You cannot only listen to me so that I can empty myself; rather discuss with me, […] and have an equal dialogue about the users’ best”. In addition, she mentioned the importance of “evaluating the agreements along the way”. This signals the importance of being taken seriously in regard to decision-making as a value co-creative interaction, as well as further continuing the interaction of value co-creation.

Some family carers described an effortless value co-creative interaction concerning planning and implementing services, leading to increased value-in-use for the family carer when the employee responded positively and signalled a willingness to help. The result was for family carer A that the employee interacted with the end user resulting into improving the user’s quality of life. That was also crucial for the family carer, being the reason for initiating the interaction. Thus, the family carer experienced increased value-in-use as the end user could enhance his quality of life, according to the family carer’s beliefs, and she did not have to worry about him sitting “drowsy or sleeping”.

Family Carer C even “received more than we expected and thought was possible”. Family Carer E described increased well-being when she planned a trip to the dentist for the end user together with the employee, and they went there together. She saw herself as being taken seriously in regard to her knowing and interpreting what would be best for the end user, resulting in action. In other words, the interactive integration of operant resources consisting of knowledge about what was needed resulted in the implementation of operand resources of help that was critical for increasing value-in-use for the family carers, as the experience of being well received and listened to, in itself, would not result in the family receiving more help. These statements describe a congruence of expectations between service providers and family carers’ resource integration in both the interaction and the implementation of service.

Nevertheless, family carers explain their typical experiences of good and fruitful interactions with the allocation office and the results of implementation as highly related to the family carer’s skills and knowledge, such as being able to write effective applications, having legal and system-related knowledge, and having effective personal skills such as good communication. “I am a sort of promotor. [I] Make sure things happen, and we are in a dialogue and discussion”. (Family Carer C)

In this vein, Family Carer D said:

[…] You need to have resources to have children with disabilities, I think … because if you don’t have that many resources, so … yes. Then things might drift a bit more […].

The importance of the resources integrated is highlighted as crucial for receiving services and, thereby, for increased value-in-use.

Value co-creation and decreased value-in-use

Value co-creation might not always lead to increased value-in-use for family carers, e.g., meetings are friendly; information is appreciated; answers from the service are timely, but still the results concerning the end user are not what a family carer had hoped for. The leader of the PIO Centre reported that some family carers have “[…] been called on by a health carer only to hear how they are, and then they have started to cry, owing [to] the fact that they had never experienced that before”. The statement talks about co-creation initiated by the service employee, potentially increasing value-in-use. However, the family carers also have to trust that agreements will be followed up. “Many family carers come to us and tell us that they cannot […] trust agreements they have committed with the services” (Leader of the PIO Centre). This leads to stress and decreased value-in-use for family carers.

Family Carer B described being included in decision-making initially but a lack of results: “I have always been welcomed, and they have listened to me. What is … my complaint is that nothing happens”.

Family Carer A describes a positive, co-creating planning phase with a nursing home where they agreed on further communication regarding being told when her relative was moved from one nursing home ward to another. However, she was disappointed:

Then he called at three o’clock in the afternoon and said he was moved. And that was what we wanted to avoid. […] I will tell them at the ward that I don’t think it was good enough […]. (Family Carer A)

The statement shows that a lack of interaction following initial value co-creation has potentially led to a value decrease as an outcome for the family carer, hindering her wish to take care of the end user.

These are examples of situations where resource integration from family carers’ perspectives still results in a value decrease for the carer because of a lack of congruence and follow-through regarding resource integration in the next phase after planning. According to the family carers, building good relations, being listened to, and making plans does not help them to increase value-in-use if the planning fails to correspond to the resources expected to be implemented in the next phase.

Value co-destruction and increased value-in-use

The findings, accordingly, reveal incidents of initial co-destruction that end in increased value-in-use. These findings confirm and elaborate on the role of value co-recoverers (Echeverri & Skålén, 2011), as further elucidated in the discussion section.

Family Carer F described struggles concerning the help she and the user need. Many complaints were sent before their requests were considered in regard to secure psychological therapy for the user.

Being rejected after sending numerous requests for assistance clearly indicates VCD in regard to the interaction between the distribution officers and the family carer. After acting as co-recoverer for some time and fighting to get what she considered necessary for the end user, she experienced some sense of increased well-being owing to the fact that

the demands made by the family carer were finally realized andshe reports on increased value-in-use expressed as an absence of fear of dying related to the consideration of the end user’s opportunity for well-being. Family Carer F had to fight hard to convert initial VCD into service implementation and, thereby, increased the value-in-use. Thus, her increased value-in-use is an example of family carers as co-recoverers.

Family Carer E said that she is a “custodian” regarding the housing service. “The problem in the housing service is that they can’t make the instructions to reach everybody [employees]. That is to say, they might reach everybody, but not everybody reads them and follows them”. Regarding activities for the resident, the family carer said, “I have to make them [employees] do it [lead the resident]; that’s what I do much of the time. If not, no activities”. To translate the skills and knowledge from the planning stage to the implementation stage of activities, tangible resources such as physical contact and objects need to be integrated, and it is the family carer who has to think about these things and what they entail, according to her. “I bought a shorter couch for [the end user]. Some of them [the employees] thought that was cruel. It was because a few [employees] just sit down, and [the end user] just lies there. I am very much against it”. The new couch is too short for lying down, and the family carer’s efforts as co-recoverer led to increased value-in-use for her, thereby relieving her concerns about the user’s low level of activity.

However, despite consideration of satisfactory service realization as a result, sometimes the value outcome is experienced as decreased and increased simultaneously. This may be the case if the resources integrated become too heavy a burden for the family carer. Family Carer F blames her health issues on the workload and resources invested into the interaction with employees to receive the services the user needs:

The support system that he has now, it has not come to count on a mountain. No one has said, “Yes, look, this is what you’re entitled to”. Sometimes I’ve got health problems. I’ve got high blood pressure … problems with sleep and … a lot of these things. (Family Carer F)

Family Carer F’s statements constitute an example of initial VCD leading to co-recovery efforts that result, concurrently, in increased value-in-use (regarding the end user’s needs being met) and value decrease (regarding the family carer’s health problems).

Value co-destruction and decreased value-in-use

Value co-destruction can lead directly to decreased value-in-use. The leader of the PIO Centre wrote that, according to PIO’s experiences, “Many family carers come to us and tell [us] that they are not being listened to, that they are not informed when the end user is discharged from an institution, that they cannot trust that the deals with the care services are kept.”

Despite the previously mentioned family carers’ experiences of increased value-in-use from IVF with service employees, the leader of the PIO Centre has experienced mostly decreased value-in-use for family carers.

According to the PIO Centre leader, a decrease in value-in-use occurs when the interaction consists of trying to be heard and still not being recognized as a partner and when services are not being conducted as the family carer believes they should be. Her experience is that increased value-in-use from collaborating with service employees is rare.

Family Carer B reported a long-standing argument in which she and the allocation office do not agree when planning help for the user. She wishes to limit the amount of time the family member spends at a respite care institution as she considers the care there to be insufficient and wants the user to stay at home more with his own support:

For at least two years, I have asked if I have to send a complaint to the county governor for them to listen and act. And I had to actually do it. […] But they had told the county governor that they would work for it, but they needed time, so that is what the governor answered, that “from the municipal letter it seems as [though] they will fulfil your demands”. (Family Carer B)

This fight for better planning had yet to bear fruit, and the family carer was hindered in creating increased value-in-use. As a consequence of not providing adequate safety for the end user, the respite care institution demanded more help from the family carer in this regard. IVF as co-destruction, therefore, leads to a heavier workload for the family carer who is attempting to meet all the needs of the end user. The expectation of resource integration is, thus, experienced as incongruent. The family carer takes on the subject position as value co-recoverer without being able to restore VCD for facilitating increased value-in-use.

Discussion

The findings illustrate processes of value co-destruction and value co-creation and how they connect with value-in-use for the family carers. This section discusses these findings related to potential areas for the further development of PSL by focusing on IVF and demonstrating why it is a fruitful concept within developing PSL. Connections between IVF and value-in-use in regard to family carers as third parties to PSL will be discussed in relation to the co-destruction and co-recovery of value.

Building on the work of Grönroos and colleagues, PSL finds value-in-use to be realized due to the organization’s facilitation through value co-creation if it is invited by the service user (Osborne, 2018; Osborne et al., 2016). The findings of the present article, however, reveal exceptions to this link and suggest that, despite VCC’s facilitation for increased value-in-use, there is no consistent link between the two regarding the third person. VCC can facilitate not only increased value-in-use but also, alternatively, decreased value-in-use for the family carer, depending on the follow-up of the operant resource integration. Thus, value co-creation is seen as an important starting point for the family carers of this study but not as the only facilitation for increased value-in-use. Similarly, VCD does not necessarily lead to decreased value-in-use; the family carer as co-recoverer can still, according to the findings, facilitate increased value-in-use, or the result can be simultaneously increased and decreased value-in-use for the family carer.

While the IVF theory suggests an interaction view emphasizing operant resources as skills and knowledge, this article identifies the importance of operant resources to lead to operand resources as implementations of practice to facilitate increased value-in-use for family carers. Thus, consistent with Smith (2013), the findings point to the importance of follow-up in practice. In other words, IVF needs to clarify the expectations of operand resource integration coming after the IVF, in addition to the integration of operant resources needed to plan the service. Following these implications, PSL should include an emphasis on operant resources’ facilitation for implementing operand resources as a crucial part of VCC. According to the findings, this facilitation could consist of stating appreciation for the operant resources of family carers as significant and formulating agreements about the distribution of tasks as part of the IVF process. In agreement of Grönroos’ (1984, 2019) conseptualization of service quality as separated in technical and functional quality of services, this paper finds, for the third person, that operant resources do not necessarily act upon operand resources in the output of service, although operand resources are important for facilitating increased value-in-use for them. In other words, the findings suggest that the social exchange view of service logic should also relate to the economic exchange view for third person. This could be developed by further examining the importance of operand resources like tangible goods, concrete activities and physical work force, for the family carers’ wellbeing.

While Järvi et al. (2018) found that co-destruction occurred, potentially, at the three phases before, during, and after the interaction, according to employees, this article finds value co-destruction solely as the experience of interaction in the “during” phase, which facilitates – but is not necessarily consistent with – the “after” phase for the third person. The “after” phase is additionally seen here as including concrete implementation.

This article also examines knowledge about co-destruction by elaborating on the family carer’s position as co-recoverer. Echeverri and Skålén (2011) found individuals to be potential co-recoverers of co-destructive initiatives, framing co-recovering as micro interventions and part of the initial interaction and leading to VCC. The findings discussed in this article confirm users as potential co-recoverers facilitating a positive value outcome. However, co-recovering here is additionally revealed as several interferences over time, demanding a great number of resources from family carers. Additionally, the findings suggest that VCD recovered to facilitate increased value-in-use can simultaneously lead to decreased value-in-use if the burden is too heavy to bear, leading to physical and psychological health problems. The increased value-in-use for the end user affects the family carer positively, while the family carer’s own health concerns affect them negatively. In other words, adding on previous knowledge on family carers, these findings uncover a connection between the action of value co-recovery and decreased value-in-use.

These findings must be seen in the context of family carers as third parties, distinguishing them from end users in two ways. First, family carers are not bound to interaction when employees deliver and implement services in the way that end users are, according to service logic. Second and according to the findings, their well-being in addition to their interaction with the services depends on their considerations of the user’s well-being. This leads to the need for further attention to what the users as well as the family carers value in future conceptualizations of PSL regarding the inclusion of third persons in care services.

Limitations and conclusions pointing to further research

Public care services today face increasing sustainability challenges due to a growing elderly population in need of help from family carers, here considered as resource integration. Much care work today is conducted by family carers with no interaction with the helping services system; this leads to burdensome workloads that often result in carers’ own health problems and concerns.

This article confirms that family carers’ well-being is connected to their loved ones’ well-being. However, it also finds and confirms decreased well-being as a possible outcome of the interaction between services and family carers, leading to a potentially severe reduction in the quality of life of family carers. The findings regarding value co-destruction and decreased value-in-use demonstrate the need to emphasize IVF as a more neutral concept suitable for further research on PSL, embracing co-destruction and value decrease, as well as co-creation and value increase.

IVF’s potential for decreased as well as increased value-in-use for family carers points to the importance of further research on connections between IVF and value-in-use for family carers as part of a public service logic. This study suggests that, in order to include family carers more effectively in care services, such services need to acknowledge and act on information regarding family carers’ increased or decreased value-in-use and its potential association with their own health and stress factors as well as the value outcomes for end users. To achieve increased value-in-use, inclusion in interactive value formation and the experience of congruence between operant and operand resource integration is crucial for the family carers included in this study. The most critical factor is follow-up by care services, potentially preventing decreased value-in-use resulting from co-recovering initial co-destruction for family carers, whether this calls for implementing operand resources or further interaction with the family carer. The emphasis on prior expectations as essential for the perception of service outcome (Echeverri & Skålén, 2011; Grönroos, 2019) opens for further research related to resource integration in value co-creation between family carers and care service employees. To study the potential efforts of expectation regulation connected to resource integration and value-in-use for family carers would be useful when examining solutions to today’s sustainability issues in the welfare services.

Aiming at problematizing certain theoretical understandings, the empirical base for this study has limitations regarding the study’s transferability to practice and should be considered a first step and a call for more research on the public service logic related to third persons that would need further empirical research for confirmation. For example, for generalizing how family carers experience collaboration with care services, quantitative research would be appropriate; as such, this study may indicate relevant topics. Moreover, to find variations between different care services regarding interactions with family carers would demand a larger number of participants. Moreover, empirical studies that focus on other parties, such as employees and end users, would expand PSL theory related to IVF and co-destruction more and would be interesting and useful for providing more in-depth knowledge about service logic as it pertains to the public sector. In addition, family carers do not represent third-person collaborators in general, and further research would be interesting, for example, regarding voluntary workers.

Notes

1. For negative outcomes of co-production regarding public value, see Williams et al.

2. Family carers here represent “the user side”, and some findings point specifically to what is important to family carers’ value experiences.

3. Goods (dominant) logic refers to value embedded in a tangible product delivered from a firm and consumed by a customer (Vargo & Lusch, 2004).