Exploring Health Work: A Critical-Action Perspective

Purpose This article describes a hybrid approach to research developed during a multi-researcher, ethnographic study of NHS management in the UK.
Design/methodology/approach This methodological paper elaborates a hybrid approach to sociological analysis - Critical-Action Theory - and indicates how it can contribute to critical health management studies.
Findings After exploring the various theoretical, methodological and philosophical options available, the paper discusses the main research issues that influenced the development of this perspective and the process by which the Critical-Action perspective was applied to studies of managerial work in four health service sectors – Acute hospitals, ambulance services, community services and mental health care.
Research limitations/implications This methodological perspective enabled a critical analysis of health service organisation that considered macro, meso and micro effects, in particular and in this case, how new public management drained power from clinicians through managerialist discourses and practices.
Practical implications Health care organisations are often responding to decisions that lie outside of their control and may have to enact changes that make little sense locally. In order to make sense of these effects, micro-, meso- and macro-level analyses are necessary.
Originality/value The Critical-Action perspective is presented as an adjunct to traditional approaches that have been taken to the study of health service organisation and delivery.