This article illustrates how distributed change agency can implement complex organizational changes in the absence of formal management plans, roles, and structures. Distributed change agency typically involves small teams and senior groups. In this qualitative study of service improvements in...

This article focuses on the pattern and impact of change leadership in complex, pluralistic, public sector settings, and specifically in English healthcare. The argument draws on evidence from ten comparative cases, exploring links between leadership patterns and organizational outcomes. Our...

Background: This paper draws on data from five English primary care trust (PCT) case studies which formed part of a larger research project that explored the roles and relationships of clinical managers and their colleagues in periods of change within different healthcare organisations. Aims:...

The last two decades have seen a shift in public services organizations from hierarchies to networks. Network forms are seen as particularly suited to handling ‘wicked problems'. We make an assessment of the nature and impact of this shift. Using recent evidence from the United Kingdom (UK)...

We explore the argument that a new mode of health care organizing is emerging which moves beyond the established professional dominance versus New Public Management (NPM) debate. We review Foucault’s work on ‘governmentality’, as applied to health care organizations. We specify two...