Waring, Justin;
Bishop, Simon;
Black, Georgia;
Clarke, Jenelle M;
Exworthy, Mark;
Fulop, Naomi J;
Hartley, Jean;
... Roe, Bridget; + view all
(2022)
Navigating the micro-politics of major system change: The implementation of Sustainability Transformation Partnerships in the English health and care system.
Journal of Health Services Research & Policy
10.1177/13558196221142237.
(In press).
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Abstract
Objective: To investigate how health and care leaders navigate the micro-politics of major system change (MSC) as manifest in the formulation and implementation of Sustainability and Transformation Partnerships (STPs) in the English National Health Service (NHS). / Methods: A comparative qualitative case study of three STPs carried out between 2018–2021. Data collection comprised 72 semi-structured interviews with STP leaders and stakeholders; 49h of observations of STP executive meetings, management teams and thematic committees, and documentary sources. Interpretative analysis involved developing individual and cross case reports to understand the ‘disagreements, ‘people and interests’ and the ‘skills, behaviours and practice’. / Findings: Three linked political fault-lines underpinned the micro-politics of formulating and implementing STPs: differences in meaning and value, perceptions of winners and losers, and structural differences in power and influence. In managing these issues, STP leaders engaged in a range of complementary strategies to understand and reconcile meanings, appraise and manage risks and benefits, and to redress longstanding power imbalances, as well as those related to their own ambiguous position. / Conclusion: Given the lack of formal authority and breadth of system change, navigating the micro-politics of MSC requires political skills in listening and engagement, strategic appraisal of the political landscape and effective negotiation and consensus-building.
| Type: | Article |
|---|---|
| Title: | Navigating the micro-politics of major system change: The implementation of Sustainability Transformation Partnerships in the English health and care system |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1177/13558196221142237 |
| Publisher version: | https://doi.org/10.1177/13558196221142237 |
| Language: | English |
| Additional information: | © The Author(s) 2022. Creative Commons License (CC BY 4.0) This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
| Keywords: | major system change, micro-politics, political skills |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Applied Health Research |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10168196 |
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