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Institutional Entrepreneurship in Hostile Settings: Health and Social Care Partnerships in Scotland, 2002–05

Using institutional entrepreneurship theory, I examine the emergence of a novel partnership model in Scotland between 2002 and 2005 to deliver health and social care services. Utilising a qualitative methodology based on interviews and secondary data, I investigate how health and social care managers in a large urban city area acted as institutional entrepreneurs. By engaging in institutional work at a microlevel, mesolevel, and macrolevel, these managers overcame institutional pressure to implement a centrally mandated partnership model advocated by the then Scottish Executive. The study suggests that institutional entrepreneurship is a specific form of change management that can provide unique insights into the political and negotiative processes involved in implementing divergent change in the face of local and national resistance and offers guidance to policy makers and practitioners in framing and implementing change initiatives.