Ambiguity and Conflict in Policy Implementation: The Case of the New Care Models (Vanguard) Programme in England
COLEMAN, ANNA;
BILLINGS, JENNY;
ALLEN, PAULINE;
MIKELYTE, RASA;
CROKE, SARAH;
MACINNES, JULIE;
CHECKLAND, KATH;
(2020)
Ambiguity and Conflict in Policy Implementation: The Case of the New Care Models (Vanguard) Programme in England.
Journal of Social Policy, 50 (2).
pp. 285-304.
ISSN 0047-2794
DOI: https://doi.org/10.1017/s0047279420000082
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Abstract
Policy driven change is challenging, with a significant gap between theory and practice. A key tension in enacting such change is achieving a balance between bottom-up development of local, context-specific approaches, and top-down, centrally determined policy solutions and their mutual sequencing. Ideal type models of the policy-making process envisage a rational ordered approach, driven by evidence and accompanied by ongoing evaluation of outcomes (Parsons, 1995, p77); however, the reality is far more complex. We examine the implementation and early operation of the New Care Models (NCM) Vanguard programme in England, using Matland’s (1995) ambiguity-conflict model, to explore the aims and expectations of the programme. We consider the relationship between top-down and bottom-up approaches to policy development and draw attention to the pressures coming from what was initially perceived as a permissive policy approach of encouraging experimentation, whilst also requiring rapid learning, scale and spread. We suggest that future programmes for large-scale policy implementation initiatives could be crafted differently to take account of the environment of implementation and render ambitions more realistic. Rather than aiming to create a set of definite products and templates, it may be that a set of principles for design and implementation should be developed and spread.