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Within the ongoing digitalization of society and dimensions of integration, equality, citizen needs, sustainability and quality of life are of increasing importance as driving forces for cities to become smart. The purpose of this paper is to examine participatory management challenges in becoming a smart old town in the context of cultural heritage.

An explorative approach was applied on a qualitative single case study including in-depth interviews with 21 stakeholders representing local entrepreneurs, nonprofit organizations, the municipality, politicians, tourism organization and residents of an old town district in a Norwegian city. Additionally, participatory observations and document studies were performed. Findings were continuously validated with the respondents.

The present study contributes with stakeholder views on challenges arising from the development of a smart old town and suggests possible innovative solutions for participatory management. The transformation of a city with cultural heritage into a smart city require efforts that go beyond smart ICT implementations into issues of social sustainability.

The study brings forward the opportunities that lie in the dynamics of interaction between the spirit of cultural heritage and the body of participatory management. It con-tributes by responding to calls for further research to deepen the insights into stakeholder inclusion in cultural heritage-based city transformation. This explorative study has its limitations as it is based on one qualitative single case.

Participatory management insights and recommendations for smart city transformation are provided.

The study addresses socially sustainable outcomes to create democratic conditions that promote inclusion and community building by understanding what people need and expect from the place where they live and work.

This study is positioned as unique in terms of its complex nature of transforming an old town to become a smart old town based on cultural heritage and an open and coordinated inclusion of stakeholders. Smartness in context of city transformation is revealed in many dimensions ranging from technology-driven to more participant-driven.

To gain a deeper understanding of the development of a joint vision for Close Care, its obstacles and opportunities, in the region of Sörmland based on national health and social services reforms.

Seven semi-structured interviews were conducted with thirteen stakeholders. Documentation from the process was used to enhance the findings. A qualitative content analysis was performed.

Stakeholders described Close Care as entailing “person centeredness, cooperation, and resource sharing” but found it “too abstract”. Participation in developing the vision varied, with experiences of “external pressure” and low “readiness for organisational change”. Views on a regional vision’s “relevance and usability” differed. Participants highlighted several opportunities for the Close Care vision, such as: “a stepping-stone for implementation”, “harmonises with other health care visions” and “forming a cross municipal and regional network”. They also noted obstacles like “symbolic alienation”, “cognitive complexity”, “short-term economic reality” and “uncertainty around implementation”.

Opportunities and obstacles for the vision of Close Care can inform complex healthcare reforms that require stakeholder cooperation.

Understanding Close Care may enable health system stakeholders to more effectively cooperate around the citizens’ needs.

Research on common ground has mainly focused on national or international policy levels and individual hospitals, professionals or patients. This study offers insights on regional and municipal cooperation in health care driven by a common vision.