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Tracing healthcare organisation integration in the UK using actor–network theory

Abdelhakim Altabaibeh (Middlesex University, London, UK)
Kay Ann Caldwell (Middlesex University School of Health and Education, London, UK)
Margaret A Volante (Middlesex University School of Health and Education, London, UK)

Journal of Health Organization and Management

ISSN: 1477-7266

Article publication date: 14 February 2020

Issue publication date: 2 April 2020



The study presents the findings from a study over a four-year period of the emergence of an integrated healthcare organisation in response to policy changes within the United Kingdom (UK). The aim of the research was to understand the process of healthcare organisation integration through the lens of actor–network theory (ANT).


An instrumental case study approach to data collection was selected. Three methods of data collection were used to trace the healthcare organisation integration process: in depth semistructured interviews using a virtual patient journey across services with 36 purposefully selected informants, document analysis and field observations and notes.


The findings of this study suggest that neither the context nor the actors were the sole determinants of the outcome of the integration. Rather it was the dynamic interplay between the actors, their context, the shared agency and the resources available to them as the change emerged shaped the end result.

Research implications

The findings denote that organisations need to attend to frontline workers as key contributors to change and development that is meaningful for service users. Methodologically, combining the ANT and constructive case study to understand the integration process provided us with new perspective to understand the trajectory of change process.


This original case study fills a gap in information about the role of healthcare professionals in healthcare policy process and the interactive relationship between all stakeholders of policy process including nonhuman actors.



Altabaibeh, A., Caldwell, K.A. and Volante, M.A. (2020), "Tracing healthcare organisation integration in the UK using actor–network theory", Journal of Health Organization and Management, Vol. 34 No. 2, pp. 192-206.



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