The micro-politics of operational adjustment: veto players and the consolidation of demand in the NHS

Glyn Watson, Daniel Chicksand, Chris Lonsdale

Research output: Contribution to journalArticlepeer-review

Abstract

Recent reports about procurement within the NHS have been highly critical. One problem identified in the reports is the fragmentation of NHS demand across an unnecessarily large number of suppliers. This fragmentation is said to increase transaction costs, reduce opportunities for scale economies and reduce NHS leverage over suppliers. It has been suggested, therefore, that an important way of improving procurement in the NHS is the better consolidation of demand with a lower number of preferred suppliers. However, such a policy, because it will create ‘winners’ and ‘losers’ within NHS organisations, has political as well as technical and practical ramifications. In this article, the authors present a model, the Veto Players Model, in order to assist managers to address these political ramifications. In the article, the authors not only demonstrate the utility of this model with regard to demand consolidation policies, but also argue that the model provides useful lessons for change management initiatives more generally.
Original languageEnglish
Pages (from-to)948-961
Number of pages14
JournalProduction Planning and Control
Volume24
Issue number10-11
DOIs
Publication statusE-pub ahead of print - 29 May 2012

Keywords

  • NHS purchasing
  • demand consolidation
  • organisational power
  • social choice theory

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