Ambiguity and Conflict in Policy Implementation

The Case of the New Care Models (Vanguard) Programme in England

Dados Bibliográficos

ID2116154
AutoresA Coleman (0000-0002-1866-7036, Manchester Academic Health Science Centre, autor correspondente), Jenny Billings (0000-0002-5660-9478, University of Kent), Pauline Allen (0000-0001-5598-1684, London School of Hygiene & Tropical Medicine), Rasa Mikelyte (0000-0002-2772-8240, University of Kent), Croke (0000-0001-6743-4573, Manchester Academic Health Science Centre), Sarah Croke (0000-0003-4120-4133), Julie Macinnes (0000-0002-9220-1007, University of Kent), Kath Checkland (0000-0002-9961-5317, Manchester Academic Health Science Centre)
Ano2021
Volume50
Fascículo2
Páginas285-304
Data de publicação2021-04-01
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoJournal of Social Policy (JOURNAL)
Identificadores do periódicoISSN: 0047-2794 • E-ISSN: 1469-7823
EditoraCambridge University Press (CUP) (PUBLISHER)
DOI10.1017/s0047279420000082
OpenAlexW3010632892
IdiomaEN
Citações recebidas13
Referências citadas24

Policy driven change is challenging, with a significant gap between theory and practice. A key tension in enacting such change is achieving a balance between bottom-up development of local, context-specific approaches, and top-down, centrally determined policy solutions and their mutual sequencing. Ideal type models of the policy-making process envisage a rational ordered approach, driven by evidence and accompanied by ongoing evaluation of outcomes (Parsons, 1995, p77); however, the reality is far more complex. We examine the implementation and early operation of the New Care Models (NCM) Vanguard programme in England, using Matland's (1995) ambiguity-conflict model, to explore the aims and expectations of the programme. We consider the relationship between top-down and bottom-up approaches to policy development and draw attention to the pressures coming from what was initially perceived as a permissive policy approach of encouraging experimentation, whilst also requiring rapid learning, scale and spread. We suggest that future programmes for large-scale policy implementation initiatives could be crafted differently to take account of the environment of implementation and render ambitions more realistic. Rather than aiming to create a set of definite products and templates, it may be that a set of principles for design and implementation should be developed and spread

Ambiguity · Business · Context (archaeology) · Economics · Management science · Political science · Process (computing) · Process management · Public relations · Scale (ratio) · Set (abstract data type) · Top-down and bottom-up design · Vanguard · Computer Science · Health Policy Implementation Science · Healthcare innovation and challenges · Social Policy and Reform Studies