The Professional Experience of Governance and Incentives: Meeting the Needs of Individuals with Complex Conditions in Primary Care Conditions in Primary Care

Background: Rapidly changing systems of organisational governance in health and social care create uncertainty and ambiguity for professionals, teams and the delivery of care. Recent literature and empirical studies, that have explored the links between governance, incentives and outcomes, highlight the lack of evidence on the relationship between different blends of governance with
professional behaviour and performance. Aims and objectives: The purpose of this study was to explore the professional experience of evolving organisational and governance structures in the context of primary health and social care and in relation to the management of long term conditions. The objectives were to describe the governance and incentive arrangements in the three health and social care sites at the level of the organisation, team and the individual; to explore the views and emotional experiences and reactions of staff to the organisational priorities and funding arrangements for care; and to develop hypotheses and empirically grounded models for organisational development in the management of long term conditions. Methods: The study was conducted by a multidisciplinary research team with service user representation, working with the local health and social care sectors in three case study sites in London, Surrey and the South West. The work was undertaken in three phases over two years.