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The role of institutional entrepreneurs in reforming healthcare

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Lockett, Andy, Currie, Graeme, Waring, Justin, Finn, Rachael and Martin, Graham P. (2012) The role of institutional entrepreneurs in reforming healthcare. Social Science & Medicine, Vol.74 (No.3). pp. 356-363. doi:10.1016/j.socscimed.2011.02.031

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Official URL: http://dx.doi.org/10.1016/j.socscimed.2011.02.031

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Abstract

We draw on institutional entrepreneurship theory to analyse the dynamics of institutional change in a healthcare context. The focus of our interest is in the relationship between an institutional entrepreneur’s ‘subject position’, defined in terms of their structural and normative legitimacy within the existing institutional landscape, and the nature of the change enacted. We develop this approach through an examination of the implementation of new pathways for cancer genetic services within the English National Health Service. Employing comparative case analysis we show that those who have limited structural legitimacy under prevailing conditions are most willing to engender change, but also least able; whereas those who have strong structural legitimacy are most able, but often least willing. However, those who are able rhetorically to combine a balance of structural and normative legitimacy are most able to produce change. In doing so, we demonstrate the importance of the concept of institutional entrepreneurship to understand healthcare reform.

Item Type: Journal Article
Subjects: H Social Sciences > H Social Sciences (General)
Divisions: Faculty of Social Sciences > Warwick Business School > Centre for Small & Medium-Sized Enterprises
Faculty of Social Sciences > Warwick Business School > Entrepreneurship, Innovation & Management
Faculty of Science > Centre for Scientific Computing
Faculty of Social Sciences > Warwick Business School
Journal or Publication Title: Social Science & Medicine
Publisher: Elsevier
ISSN: 0277-9536
Official Date: February 2012
Dates:
DateEvent
February 2012Published
Volume: Vol.74
Number: No.3
Number of Pages: 8
Page Range: pp. 356-363
DOI: 10.1016/j.socscimed.2011.02.031
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access

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