ABSTRACT
This chapter aims to develop an account of contemporary healthcare governance that combines insights from the governance and governmentality literatures. It explores the interaction of markets, networks and hierarchies. The chapter describes how, in this contemporary context of ‘sedimented’ governance, governing is accomplished through inscription practices that align local action with government ambitions. Integrated care policies illustrate a form of governance based on local networks of interconnected organisations cooperating together on the basis of trust and reciprocity to realise greater coordination. A key critique of market-based policies in the National Health Service is that they prevent the collaboration between individuals and organisations that is necessary in health and social care. The evaluation of the Integrated Care and Support Pioneers included plans to conduct a cost-effectiveness analysis. A sedimented governance framework is attuned to the interaction of governance mechanisms in local contexts.
