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‘Real-world’ priority setting for service improvement in English primary care: a decentred approach

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  • Roman Kislov
  • Kath Checkland
  • Paul M. Wilson
  • Susan J. Howard

Abstract

This article develops an analysis of population-level priority setting informed by Bevir’s decentred theory of governance and drawing on a qualitative study of priority setting for service improvement conducted in the complex multi-layered governance context of English primary care. We show how powerful actors, operating at the meso-level, utilize pluralistic and contradictory elements of complex governance networks to discursively construct, legitimize and enact service improvement priorities. Our analysis highlights the role of situated agency in integrating top-down, bottom-up and horizontal influences on priority setting, which leads to variation in local priorities despite the continuous presence of strong hierarchical influences.

Suggested Citation

  • Roman Kislov & Kath Checkland & Paul M. Wilson & Susan J. Howard, 2023. "‘Real-world’ priority setting for service improvement in English primary care: a decentred approach," Public Management Review, Taylor & Francis Journals, vol. 25(1), pages 150-174, January.
    • Handle: RePEc:taf:rpxmxx:v:25:y:2023:i:1:p:150-174
    DOI: 10.1080/14719037.2021.1942534
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