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Changing the Ties That Bind? The Emerging Roles and Identities of General Practitioners and Managers in the New Clinical Commissioning Groups in the English NHS

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  • Julia Segar
  • Kath Checkland
  • Anna Coleman
  • Imelda McDermott
  • Stephen Harrison
  • Stephen Peckham

Abstract

The English National Health Service (NHS) is undergoing significant reorganization following the 2012 Health and Social Care Act. Key to these changes is the shift of responsibility for commissioning services from Primary Care Trusts (PCTs) to general practitioners (GPs) working together in Clinical Commissioning Groups (CCGs). This article is based on an empirical study that examined the development of emerging CCGs in eight case studies across England between September 2011 and June 2012. The findings are based on interviews with GPs and managers, observations of meetings, and reading of related documents. Scott’s notion that institutions are constituted by three pillars—the regulative, normative, and cognitive–cultural—is explored here. This approach helps to understand the changing roles and identities of doctors and managers implicated by the present reforms. This article notes the far reaching changes in the regulative pillar and questions how these changes will affect the normative and cultural–cognitive pillars.

Suggested Citation

  • Julia Segar & Kath Checkland & Anna Coleman & Imelda McDermott & Stephen Harrison & Stephen Peckham, 2014. "Changing the Ties That Bind? The Emerging Roles and Identities of General Practitioners and Managers in the New Clinical Commissioning Groups in the English NHS," SAGE Open, , vol. 4(4), pages 21582440145, October.
    • Handle: RePEc:sae:sagope:v:4:y:2014:i:4:p:2158244014554203
    DOI: 10.1177/2158244014554203
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    References listed on IDEAS

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    1. Light, Donald W. & Connor, Martin, 2011. "Reflections on commissioning and the English coalition government NHS reforms," Social Science & Medicine, Elsevier, vol. 72(6), pages 821-822, March.
    2. Asthana, Sheena, 2011. "Liberating the NHS? A commentary on the Lansley White Paper, "Equity and Excellence"," Social Science & Medicine, Elsevier, vol. 72(6), pages 815-820, March.
    3. Bill Doolin, 2001. "DOCTORS AS MANAGERS - New Public Management in a New Zealand hospital," Public Management Review, Taylor & Francis Journals, vol. 3(2), pages 231-254, June.
    4. Alistair Hewison, 2002. "Managerial Values and Rationality in the UK National Health Service," Public Management Review, Taylor & Francis Journals, vol. 4(4), pages 549-579, January.
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