Institutional logics interplay: the case of hospital care commissioning in the National Health Service in England

The objective of this research is to explore the nature of the interplay among various institutional influences within public sector institutional fields in circumstances where radical institutional change originating from financial and non-financial concerns is present. The paper uses insights from the institutional logics theory in the context of hospital commissioning in the English National Health Service (NHS). It argues that multiple institutional logics coexist, conflict, and compete with one another in the newly-reformed healthcare field in England. These logics are: the medical/professional logic, the neo-liberal business logic, and the governance logic, among others. New legislative structures, inspired by the political logic, have exacerbated the tensions among logics, while bringing opportunities for competing and conflicting logics to complement one another in harmony in the persona of the new GP-commissioner hero