Analysing the Micro Implementation of Health Care Reforms: A Decentred Approach

Juan I. Baeza*, Alec Fraser, Annette Boaz

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review


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.

Original languageEnglish
Title of host publicationOrganizational Behaviour in Healthcare
PublisherPalgrave Macmillan
Number of pages23
Publication statusPublished - 2020

Publication series

NameOrganizational Behaviour in Healthcare
ISSN (Print)2662-1053
ISSN (Electronic)2662-1045


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