Healthcare managers, professionals and service users operate in an increasingly complex environment in terms of policy, regulation and governance arrangements. The policy process is becoming pluralised as competing narratives are drawn upon to influence practice. A wide range of contradictory and inconsistent policies are on offer to healthcare stakeholders, which ultimately results in a broad spectrum of responses, adaptations and improvisations throughout the process of policy implementation. The impact on managerial and professional practice is significant: Whilst some voices are suppressed or ignored, the complex nature of contemporary policy contexts can also help local actors exercise their agency and advance their agenda.

This edited volume investigates how contemporary policy trends are influencing healthcare systems, organisations and professions and explores the various ways in which policy implementation could be enacted, resisted and reinvented by healthcare managers and professionals on the ground. It sheds light on the complex web of connections that exist between policy development (Part I), its translation into practice (Part II), and the activities of organisational leaders who are trying their best to make sense of – and succeed in – challenging policy contexts (Part III).