Using complexity theory to analyse the organisational response to resurgent tuberculosis across London

Soc Sci Med. 2013 Sep:93:229-37. doi: 10.1016/j.socscimed.2012.08.001. Epub 2012 Aug 10.

Abstract

We employ complexity theory to analyse the English National Health Service (NHS)'s organisational response to resurgent tuberculosis across London. Tennison (2002) suggests that complexity theory could fruitfully explore a healthcare system's response to this complex and emergent phenomenon: we explore this claim here. We also bring in established New Public Management principles to enhance our empirical analysis, which is based on data collected between late 2009 and mid-2011. We find that the operation of complexity theory based features, especially self-organisation, are significantly impacted by the macro context of a New Public Management-based regime which values control, measurement and risk management more than innovation, flexibility and lateral system building. We finally explore limitations and suggest perspectives for further research.

Keywords: Complexity theory; Healthcare organisations; NHS; New Public Management; Tuberculosis; UK.

MeSH terms

  • Delivery of Health Care / organization & administration*
  • Humans
  • London
  • Models, Organizational
  • National Health Programs
  • Secondary Prevention
  • Tuberculosis / prevention & control*