Team work in context : institutional mediation in the public-service professional bureaucracy

This paper examines how context shapes team work within the public-service professional bureaucracy. We examine the effects of an interaction between both macro-institutional and local-organizational context upon the micro-negotiation of team work. Specifically, we consider how features of local context mediate professional-institutional effects. Drawing upon neo-institutionalism (Lawrence and Suddaby 2006; Powell and DiMaggio 1991), we view team members as ‘institutional agents’ (Scott 2008), shaping team work in ways that either reproduce or transform professional structures within particular local conditions. Exemplary of international government transformative efforts for public-service enhancement (Newman 2001; Osborne and Gaebler 1992), we focus upon a UK government initiative to reconfigure professional relationships through introducing team work in National Health Service genetic care. Findings from two qualitative, comparative case studies reveal contrasting outcomes: reproduction or transformation of the professional institution, respectively. Specific local conditions — organizational, and human and social in particular — combine to produce these divergent mediating effects towards inertia or change. This highlights the importance of antecedents to team work and taking a historical perspective to understand the influence of context. While the challenges of reconfiguring professional structures through team work are shown, our analysis also suggests optimism regarding possibilities for change, albeit within certain local conditions. The challenge for management and policy-makers becomes the extent to which — and indeed, if at all — such facilitative local environments might be supported