A matter of (good) faith? Understanding the interplay of power and the moral agency of managers in healthcare service reconfiguration
Bibliographic Data
| ID | 4599280 |
|---|---|
| Authors | Chris Q Smith (0000-0001-6323-3491, University of Birmingham, corresponding author), Iestyn Williams (0000-0002-9462-9488, University of Birmingham), Will Leggett (0000-0001-7585-8253, University of Birmingham) |
| Year | 2024 |
| Volume | 342 |
| Pages | 116553 |
| Publication date | 2024-02-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Social Science & Medicine (JOURNAL) |
| Journal identifiers | ISSN: 0277-9536 • E-ISSN: 1873-5347 |
| Publisher | Elsevier BV (PUBLISHER) |
| DOI | 10.1016/j.socscimed.2023.116553 |
| PMID | 38199008 |
| OpenAlex | W4390168854 |
| Language | EN |
| Citations received | 1 |
| References cited | 31 |
Previous studies of service reconfiguration in healthcare have explored the influence of power on processes and outcomes. However, in these accounts the moral agency of managers is often underemphasised. This paper draws on the theoretical tools provided by the sociology of morality to help deepen understanding of the interaction between power and moral agency in service reconfiguration in healthcare. It presents results from a qualitative study of a pan-organisational service reconfiguration in the NHS in England, involving nineteen in-depth interviews with those leading the change and the analysis of twelve programme documents. We combine concepts of the moral background and epistemic governance to interpret participants' conviction that the service change was 'the right thing to do'. The paper shows how epistemic work carried out by service change regulations shaped the moral background within which participants worked. This, in turn, channelled their moral agency - specifically their commitment to patient care - in a way that also reflected central priorities. The paper adds to sociological understandings of service reconfiguration through considering the interaction of structure, agency and power, while also developing the concept of the moral background to show how power relations can influence moral beliefs
Agency (philosophy · Business · Control reconfiguration · Epistemology · Health care · Moral agency · Morality · Political science · Power (physics · Public relations · Service (business · Social cognitive theory of morality · Social science · Sociology · Computer Science · Health Services Management and Policy · Healthcare Quality and Management · Law · Management and Organizational Studies · Psychology · Social Psychology · Marketing
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The Reality of Social Construction
Why Things Matter to People
Epistemic governance
Evidence‐based Management
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Applying critical realism in qualitative research
A sociology of public responses to hospital change and closure
Modern Social Imaginaries
Outline of a sociology of decisionism
Biopolitics, space and hospital reconfiguration
Framing in policy processes
The Sociology of Critical Capacity
Thick Concepts and Sociological Research
The Love of Neuroscience
Making Things Possible
Explaining Society, Critical Realism in the Social Sciences
The New Sociology of Morality
Is the end in sight? A study of how and why services are decommissioned in the English National Health Service
Exploring the neglected and hidden dimensions of large-scale healthcare change
Two main problems in the sociology of morality
| Unique citing works | 1 |
|---|---|
| Citations per year | 1 |
| Citation span | 2026 - 2026 (1) |
| Citation velocity | current |
| Highly cited | No |