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

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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.

Bibliographical metadata

Original languageEnglish
Pages (from-to)1-25
JournalPublic Management Review
Early online date22 Jun 2021
DOIs
Publication statusPublished - 22 Jun 2021