The third sector has been positioned as the key partner for successful integrated care at both system and national levels. Yet the NHS has always existed within a ‘mixed economy’ of healthcare; one with a ‘moving frontier’ between public, private and the third sectors. There has been continuity despite change and resilience within the local system against recurrent reform. This paper explores these continuities in Morecambe Bay from 1948 to 1979 covering voluntary, commercial, charitable, and private medicine across the historic tripartite division of the NHS. It demonstrates an enduring tension between bottom-up and top-down understanding of partnership between the NHS and other sectors mediated by place.