Title:
|
Strategy as practice from macro to micro : a critical realist morphogenetic-morphostatic analysis of evidenced based health and social care policy and strategy development in NHS Wales
|
The aim of this longitudinal, in-depth, explanatory case study is to develop an integrated
view of strategy as a social practice from `macro to micro' in the organisational arena
circumscribed by the Welsh Assembly Government, NHS Wales, and its partner
agencies. It is therefore centred upon the development of the Lifelong Learning Strategy
for NHS Wales. In doing so, Archer's (1995) Morphogenetic-Morphostatic Cycle is used
as a framework through which to loop together macro extra-organisational societal forces
with micro intra-organisational strategic managerial activities in order to determine their
linked interplay in strategising, thereby rising to Whittington's challenge to `complete the
practice turn', and thus address a fundamental gap in the extant literature (2006a: 613,
617; 2006b: 1903). Firstly, the macro level paradigmatic and subordinate institutional
logics underpinning the reform of the United Kingdom's health care state during the Blair
decade (1997-2007) are identified, thereby highlighting the emergence of discordant
logics in post-devolution Wales. Secondly, the emergence of the Project Board, tasked by
the Welsh Assembly Government with the oversight of the Lifelong Learning Strategy
for NHS Wales, is considered. Here, attention is primarily focused upon the positional,
professional, role and organisational composition of the Project Board, drawing into
consideration the discordant institutional logics, and the power disparity between its elite
members. Thirdly, the structural, cultural, and agential emergent properties which
manifested during the development of the Lifelong Learning Strategy for NHS Wales are
identified. Finally, the macro to micro cascade of generative mechanisms which
modulated the development of the Lifelong Learning Strategy for NHS Wales is
retroduced, and the situational logic that fostered morphogenesis or morphostasis within
the strategic arena is exposed.
V
|