‘Real-world’ priority setting for service improvement in English primary care: a decentred approach
基于Bevir的去中心化治理理论，通过定性研究分析英国初级保健中复杂多层治理背景下的人口层面优先级设定过程，揭示中层行动者如何利用治理网络的多元矛盾元素构建和推行服务改进优先级。
This article develops an analysis of population-level priority setting informed by Bevir's decentred theory of governance and drawing on a qualitative study of priority setting for service improvement conducted in the complex multi-layered governance context of English primary care. We show how powerful actors, operating at the meso-level, utilize pluralistic and contradictory elements of complex governance networks to discursively construct, legitimize and enact service improvement priorities. Our analysis highlights the role of situated agency in integrating top-down, bottom-up and horizontal influences on priority setting, which leads to variation in local priorities despite the continuous presence of strong hierarchical influences.