Talking about practice: agency and its structural context in regional healthcare practice change

Abstract

Ageing societies and rising instances of non-communicable diseases require changes in public healthcare service provision. Despite a plethora of propositions, most innovations never become practically applied. In understanding innovation as a place- and path-dependent change process which depends on actors’ agency to reconfigure routinised practices and their structural context, we show how actors create, perceive and act upon opportunities for change while tracing the development trajectories of two networks in the regions of Murcia (Spain) and Örebro (Sweden), respectively. The cases illustrate the role intermediary actors play in creating opportunities and shaping organisational and institutional context.