Publication year: 2011
Source: Social Science & Medicine, In Press, Accepted Manuscript, Available online 9 March 2011
Andy, Lockett , Graeme, Currie , Justin, Waring , Rachael, Finn , Graham, Martin
We draw on institutional entrepreneurship theory to analyse the dynamics of institutional change in a healthcare context. The focus of our interest is in the relationship between an institutional entrepreneur’s ‘subject position’, defined in terms of their structural and normative legitimacy within the existing institutional landscape, and the nature of the change enacted. We develop this approach through an examination of the implementation of new pathways for cancer genetic services within the English National Health Service. Employing comparative case analysis we show that those who have limited structural legitimacy under prevailing conditions are most willing to engender change, but also…