Abstract
The network governance narrative of public management reform sponsored by post New Public Management (NPM) authors (Pollitt and Bouckaert in Public management reform: A comparative analysis, 3rd ed. Oxford University Press, Oxford, 2011; Christensen and Lsgreid in Transcending new public management: The transformation of public sector reforms. Ashgate, Aldershot, 2007) promoted more integrated and systemic approaches to the delivery of public services designed to address the fragmenting effects of earlier NPM reforms (Ferlie et al. in Health Services Management Research 30: 61–71, 2016). The different streams of governance have created what Jones (Jones in Decentring health policy, Routledge, Oxon, 2018) terms a complex sedimented governance architecture. While the NPM approach emphasises managerial authority and top-down implementation, network governance works through collaboration and partnerships. In this binary theoretical field, the decentred theory of governance offers a different perspective that focuses on how ‘people see the world’ (Bevir and Rhodes in A decentered theory of governance: Rational choice, institutionalism, and interpretation (UC Berkeley Working Papers), Berkeley, University of California, 2001). In this paper we use a bottom-up decentred lens to understand how local actors perceive reforms and use their agency to make sense of the changes in the delivery of stroke services.
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References
Baeza, J. I., Boaz, A., & Fraser, A. (2016). The roles of specialisation and evidence-based practice in interprofessional jurisdictions: A qualitative study of stroke services in England, Sweden and Poland. Social Science and Medicine, 155, 15–23.
Bevir, M., & Rhodes, R. (2001). A decentered theory of governance: Rational choice, institutionalism, and interpretation (UC Berkeley Working Papers). University of California, Berkeley.
Bevir, M., & Rhodes, R. (2007). Decentred theory change and network governance. In Theories of democratic network governance (pp. 77–91). Palgrave Macmillan UK.
Bevir, M., & Richards, D. (2009). Decentring policy networks: A theoretical agenda. Public Administration, 87(1), 3–14.
Boseley, S. (2014, August 5). Centralised stroke care saves more lives, says study. The Guardian. Available at: http://www.theguardian.com/society/2014/aug/05/centralised-stroke-care-study-hospitals.
Christensen, T., & lsgreid, P. (2007). Transcending new public management: The transformation of public sector reforms. Aldershot: Ashgate.
Daneski, K., Higgs, P., & Morgan, M. (2010). From gluttony to obesity: Moral discourses on apoplexy and stroke. Sociology of Health Illneess, 32, 730–744.
Department of Health. (2007). National stroke strategy. London: Department of Health.
Eisenhardt, K. (1989). Building theories from case study research. Academy of Management Review, 14, 532–550.
Eisenhardt, K., & Graebner, M. (2007). Theory building from cases: Opportunities and challenges. Academy of Management Journal, 50, 25–32.
Ferlie, E., Baeza, J., Addicott, R., & Mistry, R. (2016). The governance of pluralist health care systems: An initial review and typology. Health Services Management Research, 30, 61–71.
Flyvbjerg, B. (2006). Five misunderstandings about case-study research. Qualitative Inquiry, 12(2), 219–245.
Foster, P., & Wilding, P. (2000). Wither welfare professionalism? Social Policy and Administration, 34, 143–159.
Foucault, M. (1973). The birth of the clinic: An archaeology of the human sciences. New York: Vintage.
Fraser, A., Baeza, J. I., & Boaz, A. (2017). “Holding the line”: A qualitative study of the role of evidence in early phase decision-making in the reconfiguration of stroke services in London. Health Research Policy and Systems, 15(1), 45.
Fraser, A., Tan, S., & Mays, N. (2019). To SIB or not to SIB? A comparative analysis of the commissioning processes of two proposed health focused Social Impact Bond financed interventions in England. Journal of Economic Policy Reform, 1–16. https://doi.org/10.1080/17487870.2019.1572508.
Fraser, A., Baeza, J., Boaz, A., & Ferlie, E. (2019). Biopolitics, space and hospital reconfiguration. Social Science and Medicine. https://doi.org/10.1016/j.socscimed.2019.04.011.
Fulop, N. J., Ramsay, A. I., Perry, C., Boaden, R. J., McKevitt, C., Rudd, A. G., et al. (2015). Explaining outcomes in major system change: A qualitative study of implementing centralised acute stroke services in two large metropolitan regions in England. Implementation Science, 11, 80.
Geddes, M. (2014, April 14–16). Posing a Dilemma for Dilemmas: Where do they come from and why do they matter? Paper presented to the Political Studies Association Annual Conference, Manchester.
Hill, M., & Hupe, P. D. (2002). Implementing public policy: Governance in theory and in practice. London: Sage.
Iedema, R., & Rhodes, C. (2010). The undecided space of ethics in organizational surveillance. Organization Studies, 31(2), 199–217.
Johnston, S., Mendis, S., & Mathers, C. (2009). Global variation in stroke burden and mortality: Estimates from monitoring, surveillance, and modelling. The Lancet Nephrology, 8, 345–354.
Jones, L. (2018). Sedimented governance in the English National Health Service. In M. Bevir & J. Waring (Eds.), Decentring health policy. Oxon: Routledge.
Martin, G. P., Leslie, M., Minion, J., Willars, J., & Dixon-Woods, M. (2013). Between surveillance and subjectification: Professionals and the governance of quality and patient safety in English hospitals. Social Science and Medicine, 99, 80–88.
Nice. (2008). https://www.nice.org.uk/guidance/cg68/resources/guidance-stroke-pdf. Last accessed 30 August 2018.
NINDS—The National Institute of Neurological Disorders and Stroke rt-PA Study Group. (1995). Tissue Plasminogen activator for acute ischemic stroke. New England Journal of Medicine, 333, 1581–1587.
Nutley, S. M., Walter, I., & Davies, H. T. O. (2007). Using evidence: How research can inform public services. Bristol: The Policy Press.
Pollitt, C., & Bouckaert, G. (2011). Public management reform: A comparative analysis (3rd ed.). Oxford: Oxford University Press.
Pound, P., Bury, M., & Ebrahim, S. (1997). From apoplexy to stroke. Age and Ageing, 26, 331–337.
RCP. (2008). National clinical guidelines for stroke. London.
Spicer, A., Alvesson, M., & Kärreman, D. (2009). Critical performativity: The unfinished business of critical management studies. Human Relations, 62, 537–560.
Stroke Unit Triallists’ Collaboration. (2007). Organised inpatient (stroke unit) care for stroke. Cochrane Database Systematic Reviews (4), Cd000197.
Timmermans, S., & Berg, M. (2003). The gold standard: The challenge of evidence-based medicine and standardization in health care. Philadelphia: Temple University Press.
Turner, S., Ramsay, A., Perry, C., Boaden, R., McKevitt, C., Morris, S., et al. (2016). Lessons for major system change: Centralization of stroke services in two metropolitan areas of England. Journal of Health Services Research and Policy, 21, 156–165.
Yin, R. (2003). Case study research. Design and methods. Thousand Oaks, CA: Sage.
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Baeza, J.I., Fraser, A., Boaz, A. (2020). Analysing the Micro Implementation of Health Care Reforms: A Decentred Approach. In: Bevir, M., Waring, J. (eds) Decentring Health and Care Networks. Organizational Behaviour in Healthcare. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-40889-3_3
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