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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

Identiferoai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:542771
Date January 2010
CreatorsHerepath, A.
PublisherCardiff University
Source SetsEthos UK
Detected LanguageEnglish
TypeElectronic Thesis or Dissertation

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