A new mode of organizing in health care? Governmentality and managed networks in cancer services in England

Ferlie, Ewan; McGivern, Gerry; Fitzgerald, Louise

doi:10.1016/j.socscimed.2011.03.021

Cited by 72 publications

(80 citation statements)

References 20 publications

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“…This finding highlights interdependencies between regimes of discipline and governmentality which are sometimes seen as opposed (e.g. Ferlie et al, 2012;Rose, 1993), providing empirical substance to an interdependency intimated by Foucault (1988) himself, and filling out connections that others have suggested (e.g. Waring, 2007).…”

Section: Beyond Discipline and Subjectification: The Depth Of The Socialmentioning

confidence: 62%

“…Waring (2007) and Levay and Waks (2009, p.512) similarly find quality of care to be achieved most effectively through a subjectification process, where "performance is increasingly assured through continuous self-reporting and self-evaluation, [and] actors and organizations participate in their own governance." More broadly, Sheaff et al (2004), Ferlie et al (2012) and Martin and Learmonth (2012) see the shift towards 'network governance' of healthcare as requiring increased investment in 'empowering' and 'responsibilising' professionals to govern themselves. In this way, healthcare governance can rely upon "an entrepreneurial, energetic, quality orientated and value led […] style, distinct from the neutral affect and routine based style typical of Weberian public bureaucrats" (Ferlie et al, 2012, p.346;cf.…”

Section: Governmentalitymentioning

confidence: 99%

“…With some exceptions (e.g. Ferlie et al, 2012;Iedema, Flabouris, Grant, & Jorm, 2006;Iedema & Rhodes, 2010;Martin & Waring, 2013;Waring, 2007), those drawing on governmentality in particular have been more concerned with the (assumed) power of macro-level governmental discourses and programmes than with their impact on microlevel practice and individual subjectivity (see, e.g., seminal papers on governmentality such as Rose, 1993; or, for a more recent healthcare-related example, Martin & Learmonth, 2012). Yet it is only in their micro-level impact that we can hope to understand the relative importance of disciplinary power and governmentality in influencing professional behaviour.…”

Section: Governmentalitymentioning

confidence: 99%

“…Governmentality has been used widely to analyse how power acts upon subjectivities in various contexts, including healthcare (e.g. Ferlie, McGivern, & Fitzgerald, 2012;Sheaff et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

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Between surveillance and subjectification: Professionals and the governance of quality and patient safety in English hospitals

Martin

Leslie

Minion

et al. 2013

Social Science & Medicine

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Two understandings of the dynamics of power developed by Foucault have been extensively used in analyses of contemporary healthcare: disciplinary power and governmentality. They are sometimes considered alternative or even contradictory conceptual frameworks. Here, we seek to deploy them as complementary ways of making sense of the complexities of healthcare organisation today. We focus on efforts to improve quality and safety in three UK hospitals. We find a prominent role for disciplinary power, including a panoptic gaze that is to some extent internalised by professionals. We suggest, however, that the role of disciplinary power relies for its impact on complementary strategies that are more akin to governmentality. These strategies foster organisational contexts that are receptive to disciplinary work. More fundamentally, we find that both disciplinary power and governmentality work on subjectivities in rather a different manner from that suggested by conventional accounts. We offer an alternative, less individualised and more socialised, understanding of the way in which power acts upon subjectivity and behaviour in professional contexts.

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Section: Beyond Discipline and Subjectification: The Depth Of The Socialmentioning

confidence: 62%

Section: Governmentalitymentioning

confidence: 99%

Section: Governmentalitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Between surveillance and subjectification: Professionals and the governance of quality and patient safety in English hospitals

Martin

Leslie

Minion

et al. 2013

Social Science & Medicine

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“…However, we begin by examining the concepts and themes based on Table 1, which underpin the theoretical component of this study into sustainable healthcare systems. Large-scale collaborative and networks are emerging as a prevalent structure for greater integrated care, quality and learning (Ferlie et al, 2011(Ferlie et al, , 2012Malby et al, 2013;Berry, 2015). Furthermore, the previous scoping literature review, which was undertaken for the LIQH (Mervyn and Amoo, 2014) allowed us to adapt the themes to create five critical themes, which have leadership and strategy as their focus.…”

Section: Theoretical Frameworkmentioning

confidence: 99%

Innovation and sustainability in a large-scale healthcare improvement collaborative - seven propositions for achieving system-wide innovation and sustainability

Amoo

Malby

Mervyn

2016

IJSSM

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Change and reform in the healthcare system, and policy determination to reduce costs has now necessitated a rethink and more innovation for this sector. Leadership needs to strengthen professionals who have the dual responsibility for ensuring the quality and effectiveness of healthcare and this requires new organisational forms beyond the traditional hierarchical structures. Drawing upon strategic management and leadership discourse to underpin the study into sustainable and high performing healthcare systems, we present seven key lessons (propositions) from a mixed-methods study of a city-wide collaboratives in Leeds, UK. Our study suggested that the sustainability of such collaboratives, requires a more effective structure that could be local city-wide collaborative in contrast to national/regional collaboratives. However, there are also several unknowns in such novel organisational structures. The study also finds that both an energetic strategic leader and promotion of professional learning cultures are vital for the sustainability of such collaboratives.

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Integrated care in action: opening the “black box” of implementation

Segato

Masella

2015

Int J Health Plann Mgmt

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The aim of this contribution is to explain how healthcare professionals implement policies for integrated care. More specifically, we aim to understand how these policies are received, interpreted and executed by primary care professionals. By opening the "black box" of policy implementation, we also explain how and why the process of implementation of the same policy diverges in practice. The research is framed according to both the neo-institutional and the change management perspectives. The empirical investigation is conducted through a documental analysis and a multiple-embedded case study. The results show that three forces affect and explain differences in the implementation processes: the unstable level of internal communication among the professionals involved, the limited use of power to resist to change and the poor learning process on the part of both the professionals and policy makers. The pressure of external institutions does not play a role in shaping the process. Through our study, we further knowledge about how healthcare professionals implement policies for integrated care, and we believe this is interesting, according to emerging evidence that variations in the effectiveness of policy outcomes may be explained by choices and potential distortions made during the initial stages of the policy implementation process. Copyright © 2015 John Wiley & Sons, Ltd. StartCopTextCopyright © 2015 John Wiley & Sons, Ltd.

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A new mode of organizing in health care? Governmentality and managed networks in cancer services in England

Cited by 72 publications

References 20 publications

Between surveillance and subjectification: Professionals and the governance of quality and patient safety in English hospitals

Between surveillance and subjectification: Professionals and the governance of quality and patient safety in English hospitals

Innovation and sustainability in a large-scale healthcare improvement collaborative - seven propositions for achieving system-wide innovation and sustainability

Integrated care in action: opening the “black box” of implementation

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