The Limitations of Closed-System Reasoning in NHS Improvement Initiatives

Marios Adamou

No j4ney, OSF Preprints from Center for Open Science

Abstract: This paper examines the pervasive role of closed-system reasoning in the governance and reform strategies of the National Health Service (NHS) in England. By drawing on interdisciplinary critiques, particularly from Bhaskar, Polanyi, Scott, and Capra, and enriched with insights from Pierson’s policy feedback and Kornai’s The Socialist System, it highlights the systemic rigidity created by centralised governance, metric-driven performance evaluations, and limited adaptability. These dynamics are explored in the context of NHS policies, including the Long Term Plan, to demonstrate how such reasoning constrains meaningful reform. The paper concludes with recommendations to incorporate open-system thinking, decentralisation, and iterative governance to address the challenges facing the NHS.

Date: 2025-01-03
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://osf.io/download/6775a470d5895ccb0de6d835/

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:osf:osfxxx:j4ney

DOI: 10.31219/osf.io/j4ney

Access Statistics for this paper

More papers in OSF Preprints from Center for Open Science
Bibliographic data for series maintained by OSF ().