What might Normalisation Process Theory bring to policy implementation studies? Learning lessons and uncovering questions through a case study of the profound implementation failure of a new policing policy

PurposeThe scaling up of promising, innovative integration projects presents challenges to social and health care systems. Evidence that a new service provides (cost) effective care in a (pilot) locality can often leave us some way from understanding how the innovation worked and what was crucial about the context to achieve the goals evidenced when applied to other localities. Even unpacking the “black box” of the innovation can still leave gaps in understanding with regard to scaling it up. Theory-led approaches are increasingly proposed as a means of helping to address this knowledge gap in understanding implementation. Our particular interest here is exploring the potential use of theory to help with understanding scaling up integration models across sites. The theory under consideration is Normalisation Process Theory (NPT).Design/methodology/approachThe article draws on a natural experiment providing a range of data from two sites working to scale up a well-thought-of, innovative integrated, primary care-based dementia service to other primary care sites. This provided an opportunity to use NPT as a means of framing understanding to explore what the theory adds to considering issues contributing to the success or failure of such a scaling up project.FindingsNPT offers a framework to potentially develop greater consistency in understanding the roll out of models of integrated care. The knowledge gained here and through further application of NPT could be applied to inform evaluation and planning of scaling-up programmes in the future.Research limitations/implicationsThe research was limited in the data collected from the case study; nevertheless, in the context of an exploration of the use of the theory, the observations provided a practical context in which to begin to examine the usefulness of NPT prior to embarking on its use in more expensive, larger-scale studies.Practical implicationsNPT provides a promising framework to better understand the detail of integrated service models from the point of view of what may contribute to their successful scaling up.Social implicationsNPT potentially provides a helpful framework to understand and manage efforts to have new integrated service models more widely adopted in practice and to help ensure that models which are effective in the small scale develop effectively when scaled up.Originality/valueThis paper examines the use of NPT as a theory to guide understanding of scaling up promising innovative integration service models.

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Evaluating a systematic voiding programme for patients with urinary incontinence after stroke in secondary care using soft systems analysis and Normalisation Process Theory: Findings from the ICONS case study phase

International Journal of Nursing Studies ◽

10.1016/j.ijnurstu.2014.02.009 ◽

2014 ◽

Vol 51 (10) ◽

pp. 1308-1320 ◽

Cited By ~ 18

Author(s):

L.H. Thomas ◽

B. French ◽

C.R. Burton ◽

C. Sutton ◽

D. Forshaw ◽

...

Keyword(s):

Urinary Incontinence ◽

Systems Analysis ◽

Secondary Care ◽

Process Theory ◽

Normalisation Process Theory ◽

Study Phase ◽

Soft Systems ◽

Systematic Voiding Programme

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The leader in me : a case study using normalization process theory to analyze school reform implementation

10.32469/10355/37828 ◽

2013 ◽

Author(s):

Jill E. Dunlap

Keyword(s):

School Reform ◽

Normalization Process Theory ◽

Process Theory ◽

Reform Implementation ◽

Leader In Me ◽

Normalization Process

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A case study evaluation of a community multidisciplinary team in South East England using a mixed-method approach

British Journal of General Practice ◽

10.3399/bjgp20x711569 ◽

2020 ◽

Vol 70 (suppl 1) ◽

pp. bjgp20X711569

Author(s):

Jessica Wyatt Muscat

Keyword(s):

Mental Health ◽

Mixed Method ◽

Social Care ◽

Free Form ◽

Normalisation Process Theory ◽

Multidisciplinary Teams ◽

Mixed Method Approach ◽

Health And Social Care ◽

Method Approach

BackgroundCommunity multidisciplinary teams (MDTs) represent a model of integrated care comprising health, social care, and the voluntary sector where members work collaboratively to coordinate care for those patients most at risk.AimThe evaluation will answer the question, ‘What are the enablers and what are the restrictors to the embedding of the case study MDT into the routine practice of the health and social care teams involved in the project?’MethodThe MDT was evaluated using a mixed-method approach with normalisation process theory as a methodological tool. Both quantitative and qualitative data were gathered through a questionnaire consisting of the NoMAD survey followed by free-form questions.ResultsThe concepts of the MDT were generally clear, and participants could see the potential benefits of the programme, though this was found to be lower in GPs. Certain professionals, particularly mental health and nursing professionals, found it difficult to integrate the MDT into normal working patterns because of a lack of resources. Participants also felt there was a lack of training for MDT working. A lack of awareness of evidence supporting the programme was shown particularly within management, GP, and nursing roles.ConclusionSpecific recommendations have been made in order to improve the MDT under evaluation. These include adjustments to IT systems and meeting documentation, continued education as to the purpose of the MDT, and the engagement of GPs to enable better buy-in. Recommendations were made to focus the agenda with specialist attendance when necessary, and to expand the MDT remit, particularly in mental health and geriatrics.

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Coordination in multi-actor policy implementation: case study of a livelihood enhancement programme in India

Development in Practice ◽

10.1080/09614524.2020.1861220 ◽

2021 ◽

pp. 1-10

Author(s):

Srilata Patnaik ◽

C. Shambu Prasad

Keyword(s):

Policy Implementation

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Moral economy, solidarity and labour process struggle in Irish public transport

Economic and Industrial Democracy ◽

10.1177/0143831x19891235 ◽

2019 ◽

pp. 0143831X1989123

Author(s):

Emma Hughes ◽

Tony Dobbins ◽

Doris Merkl-Davies

Keyword(s):

Conceptual Framework ◽

Trade Union ◽

Public Transport ◽

Qualitative Data ◽

Moral Economy ◽

Process Theory ◽

Transport Sector ◽

Competitive Tendering ◽

Labour Process

This article empirically applies Knut Laaser’s integrated conceptual framework, combining Sayer’s moral economy (ME) theory with labour process theory (LPT), to examine how two rival Irish unions engaged with an uneven moral economy and consciously sought to build collective worker solidarity during a dispute over competitive tendering and marketization. Using qualitative data from a case study of BusCo in Ireland’s public transport sector, the article enriches sociological understanding of trade union solidarity, and how it is engendered, contested and experienced.

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