Purpose – The purpose of the paper is to examine the metaphors used by senior managers and clinicians in the delivery of healthcare reform. Design/methodology/approach – A study of healthcare reform in England carried out a series of semi structured interviews with senior managers and...

Purpose – The purpose of this paper is to examine the motivations behind public sector spin outs, focusing on the Right to Request policy, which enabled NHS staff to set up their own social enterprises to deliver healthcare services. Design/methodology/approach – The paper draws on empirical...