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Delivering reform in English healthcare: an ideational perspective

Millar, Ross and Powell, Martin and Mulla, Abeda (2012) Delivering reform in English healthcare: an ideational perspective. Public Policy and Administration. ISSN 0952-0767

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URL of Published Version: http://ppa.sagepub.com/content/early/2012/07/12/0952076712452289.abstract?rss=1

Identification Number/DOI: 10.1177/0952076712452289

A variety of perspectives has been put forward to understand reform across healthcare systems. Recently, some have called for these perspectives to give greater recognition to the role of ideational processes. The purpose of this article is to present an ideational approach to understanding the delivery of healthcare reform. It draws on a case of English healthcare reform – the Next Stage Review led by Lord Darzi – to show how the delivery of its reform proposals was associated with four ideational frames. These frames built on the idea of “progress” in responding to existing problems; the idea of “prevailing policy” in forming part of a bricolage of ideas within institutional contexts; the idea of “prescription” as top-down structural change at odds with local contexts; and the idea of “professional disputes” in challenging the notion of clinical engagement across professional groups. The article discusses the implications of these ideas in furthering our understanding of policy change, conflict and continuity across healthcare settings.

Type of Work:Article
Date:12 July 2012 (Publication)
School/Faculty:Colleges (2008 onwards) > College of Social Sciences
Department:Health Services Management Centre
Keywords:healthcare reform, ideas, framing, Next Stage Review, NHS, Lord Darzi
Subjects:HN Social history and conditions. Social problems. Social reform
R Medicine (General)
RA Public aspects of medicine
Institution:University of Birmingham
Copyright Holders:Sage Publications
ID Code:1306
Refereed:YES
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