Conflicting institutional logics: a national programme for IT in the organisational field of healthcare

Abstract

This paper reports the findings from a 4- year study on the UK National Health Service on the introduction of a national programme for information technology. 1 This is the largest civil IT programme worldwide at an estimated technical cost of 6.2 pound billion over a 10- year period. An institutional analysis of our historical and empirical data from six NHS organisations identifies growing fragmentation in the organisational field of healthcare, as past and present institutional logics both fuel and inhibit changes in the governance systems and working practices of healthcare practitioners. This is further complicated by new institutional logics that place the citizen at centre stage of the NPfIT, in a move to promote patient choice and public value