Skip to main content

Ambiguity and Conflict in Policy Implementation: The Case of the New Care Models (Vanguard) Programme in England

Coleman, Anna, Billings, Jenny, Allen, Pauline, Mikelyte, Rasa, Croke, Sarah, MacInnes, Julie, Checkland, Kath (2020) Ambiguity and Conflict in Policy Implementation: The Case of the New Care Models (Vanguard) Programme in England. Journal of Social Policy, . ISSN 0047-2794. E-ISSN 1469-7823. (doi:10.1017/S0047279420000082) (KAR id:80716)

PDF Author's Accepted Manuscript
Language: English

Creative Commons Licence
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Download (395kB) Preview
PDF (Box 1: Elaboration of Matland’s model of conflict, ambiguity and implementation) Supplemental Material
Language: English
Download (166kB) Preview
PDF (Table 2: Types of Vanguard) Supplemental Material
Language: English
Download (79kB) Preview
Microsoft Word Author's Accepted Manuscript
Language: English

Restricted to Repository staff only
Contact us about this Publication
Official URL


Policy driven change is challenging, with a significant gap between theory and practice. A key tension in enacting such change is achieving a balance between bottom-up development of local, context-specific approaches, and top-down, centrally determined policy solutions and their mutual sequencing. Ideal type models of the policy-making process envisage a rational ordered approach, driven by evidence and accompanied by ongoing evaluation of outcomes (Parsons, 1995, p77); however, the reality is far more complex. We examine the implementation and early operation of the New Care Models (NCM) Vanguard programme in England, using Matland’s (1995) ambiguity-conflict model, to explore the aims and expectations of the programme. We consider the relationship between top-down and bottom-up approaches to policy development and draw attention to the pressures coming from what was initially perceived as a permissive policy approach of encouraging experimentation, whilst also requiring rapid learning, scale and spread. We suggest that future programmes for large-scale policy implementation initiatives could be crafted differently to take account of the environment of implementation and render ambitions more realistic. Rather than aiming to create a set of definite products and templates, it may be that a set of principles for design and implementation should be developed and spread.

Item Type: Article
DOI/Identification number: 10.1017/S0047279420000082
Uncontrolled keywords: Policy implementation; New Care models; ambiguity; conflict
Subjects: H Social Sciences > H Social Sciences (General)
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Depositing User: Rasa Mikelyte
Date Deposited: 03 Apr 2020 12:55 UTC
Last Modified: 29 Sep 2020 10:51 UTC
Resource URI: (The current URI for this page, for reference purposes)
Billings, Jenny:
Mikelyte, Rasa:
MacInnes, Julie:
  • Depositors only (login required):