ABSTRACT
Comparative case study analyses have demonstrated that districts addressing the same strategic change problem display both differences and similarities in their experience of the strategic change process. Therefore we need to confront the key generic question: why is it that the rate and pace of strategic change differs across districts? (See Appendix for research aims and methodology.)
The starting point was that the rate and pace of change could be explained by a subtle interplay between the content, context and the process of change. Context may therefore be a critical shaper of process (Pettigrew 1985). We conclude that the management of change is likely to be contextually very sensitive; that there is no one way of effecting change in such a pluralist organisation as the NHS, where the introduction of general management has not been at all general, and there seemed almost as many general managements as general managers.
