We examine the ‘identity work’ of manager–professional ‘hybrids’, specifically medical professionals in managerial roles British National Health Service, to maintain and hybridize their professional identity wider professionalism organizational policy contexts affected by managerialist ideas. Empirically, we differentiate between ‘incidental hybrids’, who represent protect traditional institutionalized while temporarily hybrid roles, ‘willing developed professional–managerial identities...

The last two decades have seen a shift in public services organizations from hierarchies to networks. Network forms are as particularly suited handling ‘wicked problems'. We make an assessment of the nature and impact this shift. Using recent evidence United Kingdom (UK) National Health Service (NHS), we explore functioning eight different policy also interested whether there has been radical transition – or not hierarchical network forms.

There has been increased interest in the UK network-based modes of organizing public services, as opposed to markets or hierarchies. One supposed advantage network form is a greater capacity for transfer evidence-based ‘best’ practices across and accelerated organizational learning. Such networks may have knowledge management role stimulate formation ‘communities practice’. This article tests these arguments using data from study managed NHS cancer London. The general pattern was concentrate...

We here examine the introduction of appraisal for senior medical professionals. Our recent qualitative field research found four main experiences (developmental, disappointed reflection, defensive assessment and cynical dismissal as a waste time), which we developed into typology. argue many professionals `play tick-box games' to give impression auditable practice while continuing practise in traditional way. develop existing theory on `audit society', social defences `mock bureaucracy'...

In this article, we discuss temporal work and politics situated between groups with different orientations, arguing that attention needs to be paid covert unarticulated silent during work. Drawing on a case study of management consultancy project redesign public health care, explain how interests orientations shape the construction problems, which, in turn, legitimate tasks time frames. We also show task frames are temporarily fixed imposed through boundary objects, way these may then...

Managed networks are increasingly common in the British National Health Service (NHS) as a means of streamlining and standardizing patient care across organizational professional boundaries. However, there has been limited research regarding whether this technique is most appropriate management style for delivery health services. This article draws upon authors' on managed clinical cancer UK–a model that set out to guide develop knowledge flows service providers. It examines how initial...

This ‘think piece’ paper contributes to the recent ‘business school business’ debate by examining whether an alternative form of business – specifically, public interest model can be created. Current criticisms conventional schools are reviewed and models explored. We take some examples from our own field health management research. define in more detail than previous accounts compare contrast it with other reformed school. identify certain conditions which this is likely succeed suggest a...

Background Crises, such as the COVID-19 pandemic, risk overwhelming health and social care systems. As part of their responses to a critical situation, healthcare professionals necessarily improvise. Some these local improvisations have potential contribute important innovations for systems with relevance beyond particular service area crisis in which they were developed. Findings This paper explores some key drivers improvised innovation that may arise response crisis. We highlight how...

The field of public administration and management exhibits a limited number favored themes theories, including influential New Public Management Network Governance accounts contemporary government. Can additional social science–based perspectives enrich its theoretical base, in particular, analyzing long-term shift to indirect governance evident the field? We suggest that variant Foucauldian analysis is helpful, namely “Anglo-governmentality.” Having reviewed literatures, we apply this...

Clinical leadership is recognized as a crucial element in health system strengthening and policy globally yet it has received relatively little attention low middle income countries (LMICs). Moreover, analyses of clinical tend to focus on senior-level individual leaders, overlooking wider constellation middle-level leaders delivering care practice way affected by their context. Using the theoretical lens 'distributed leadership', this article examines how practised context Kenyan county...

Abstract Background Regulation can improve professional practice and patient care, but is often weakly implemented enforced in health systems low- middle-income countries (LMICs). Taking a de-centred frontline perspective, we examine national regulatory actors’ professionals’ views experiences of regulation Kenya Uganda discuss how it might be improved LMICs more generally. Methods We conducted large-scale research on for doctors nurses (including midwives) during 2019–2021. interviewed 29...

We examine a multidisciplinary network established to translate genetics science into practice in the British NHS. Drawing on theory about epistemic communities and objects, we describe three stages their lifecycle (vision/formation, transformation reincarnation) clashes over knowledge objects. Medical academics captured jurisdiction at formation, through superior of nascent discipline, producing objects reflecting interests. A governmental community challenged medical for but, unable...

Purpose The purpose of this paper is to explore general practitioners' (GPs') and psychiatrists' views experiences transparent forms medical regulation in practice, as well those regulators representing patients professionals. Design/methodology/approach research included interviews with GPs, psychiatrists others involved regulation, A qualitative narrative analysis the was then conducted. Findings Narratives suggest rising levels complaints, legalisation blame within National Health Service...

Purpose The purpose of this paper is to describe a recent experiment in research coproduction an evaluation service planning at London Mental Health NHS Trust. aims consider whether members the team who have themselves been users mental health services are able contribute process as “experts by experience”, or if their experiential knowledge “colonized” within academic team. Design/methodology/approach A qualitative, comparative case study approach was adopted, using structured observations...

Have generic management texts and associated knowledges now extensively diffused into public services organizations? If so, why? Our empirical study of English healthcare organizations detects an extensive presence such texts. We argue that their ready diffusion relates to two macro‐level forces: (i) the influence underlying political economy reform (ii) a strongly developed business school/management consulting knowledge nexus. This macro perspective theoretically complements existing...

Purpose The purpose of this paper is to explore the way “hybrid” clinical managers in Kenyan public hospitals interpret and enact hybrid managerial roles complex healthcare settings affected by professional, practical norms. Design/methodology/approach authors conducted a case study two district hospitals, involving repeated interviews with eight mid-level complemented 51 frontline workers 6 senior managers, 480 h ethnographic field observations. analysed theorised data combining inductive...

We explain social and organisational processes influencing health professionals in a Kenyan clinical network to implement form of quality improvement (QI) into practice, using the concept 'pastoral practices'. Our qualitative empirical case study, conducted 2015-16, shows way practices constructing linking local evidence-based guidelines data collection provided foundation for QI. Participation these constructive gave leaders pastoral status then inscribe use evidence routine care, through...