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Public Value and the English NHS

Public Value and the English NHS

Report Title

Public Value and the English NHS


Dr Iestyn Williams and Dr Heather Shearer, on behalf of the NHS Institute for Innovation and Improvement and Institute of Governance and Public Management (IGPM)

Year Published



 Public value has been described as ‘… a comprehensive approach to thinking about public management and about continuous improvement in public services’. At the heart of Moore’s concept of Public value is the strategic triangle, within which strategic managers operate and which both constrains and facilitates the pursuit of public value. 

Despite the increasing popularity of the concept of ‘public value’ within both academic and practice settings, there has to date been no formal review of the literature on its provenance, empirical basis, and application. This report seeks to fill this gap via a comprehensive, narrative review of the literature on public value in the public sector.

The most striking feature of the literature on public value is the absence of empirical investigation either of its normative propositions or its value as a framework for understanding public management practices.  The majority of literature on public value is normative and/or exhortatory in tone. However, recent contributions reflect a growing recognition of these challenges and limitations and the subsequent need to develop the theoretical and empirical foundations of public value. 
Based on the literature reviewed, the effect of viewing the NHS through a public value ‘lens’ are postulated.

None of the issues that the public value framework draws attention to in health care are entirely new.
What public value potentially offers however is an organising framework through which these sometimes disparate issues can be brought together.
Public value may also provide us with a set of basic principles through which we can evaluate NHS reforms.  However, we need to exercise some caution. It has yet to be demonstrated that the public value framework can be transferred to the context of the NHS.

We also need to locate Moore’s perspective within the broader tradition of theory and research into the public sector and to assess its specific usefulness for those engaged in the design, delivery and receipt of health care services.

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