The University of Southampton
University of Southampton Institutional Repository

Lost in translation: a multi-level case study of the metamorphosis of meanings and action in public sector organizational innovation

Pope, Catherine, Robert, Glenn, Bate, Paul, Le May, Andrée and Gabbay, John (2006) Lost in translation: a multi-level case study of the metamorphosis of meanings and action in public sector organizational innovation Public Administration, 84, (1), pp. 59-79. (doi:10.1111/j.0033-3298.2006.00493.x).

Record type: Article


This paper explores the early implementation of an organizational innovation in the UK National Health Service (NHS) – Treatment Centres (TCs) – designed to dramatically reduce waiting lists for elective care. The paper draws on case studies of 8 TCs (each at varying stages of their development) and aims to explore how meanings about TCs are created and evolve, and how these meanings impact upon the development of the organizational innovation. Research on organizational meanings needs to take greater account of the fact that modern organizations like the NHS are complex multi-level phenomena, comprising layers of interlacing networks. To understand the pace, direction and impact of organizational innovation and change we need to study the interconnections between meanings across different organizational levels. The data presented in this paper show how the apparently simple, relatively unformed, concept of a TC framed by central government is translated and transmuted by subsequent layers in the health service administration, and by players in local health economies, and, ultimately, in the TCs themselves, picking up new rationales, meanings and significance as it goes along. The developmental histories of TCs reveal a range of significant re-workings of macro policy with the result that there is considerable diversity and variation between local TC schemes. The picture is of important disconnections between meanings, that in many ways mirror Weick's (1976) 'loosely coupled systems'. The emergent meanings and the direction of micro-level development of TCs appear more strongly determined by interactions within the local TC environment, notably between what we identify as groups of 'idealists', 'pragmatists', 'opportunists' and 'sceptics' than by the framing (Goffman 1974) provided by macro and meso organizational levels. While this illustrates the limitations of top down and policy-driven attempts at change, and highlights the crucial importance of the front-line local 'micro-systems' (Donaldson and Mohr 2000) in the overall scheme of implementing organizational innovations, the space or headroom provided by frames at the macro and meso levels can enable local change, albeit at variable speed and with uncertain outcomes.

Full text not available from this repository.

More information

Published date: March 2006
Keywords: public sector organization, nhs, innovation, treatment centres, multi-level, organisational levels


Local EPrints ID: 38530
ISSN: 0033-3298
PURE UUID: ed5825b2-d073-4760-b682-3c4aa0b5e447
ORCID for Catherine Pope: ORCID iD

Catalogue record

Date deposited: 13 Jun 2006
Last modified: 17 Jul 2017 15:38

Export record



Author: Catherine Pope ORCID iD
Author: Glenn Robert
Author: Paul Bate
Author: Andrée Le May
Author: John Gabbay

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton:

ePrints Soton supports OAI 2.0 with a base URL of

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.