The Dilemmas of Operationalizing Cluster Policy: The Medical Technology Cluster in the West Midlands

“Clusters” have become central to European regional economic development policy. However, concerns have emerged over the content and quality of delivery of cluster-based initiatives. Here we review the implementation of English cluster policy, with a focus on medical technologies in the West Midlands region of the UK. Using a policy streams framework, we seek rapprochement between counter arguments that implementation difficulties are the inevitable results of applying a “fuzzy” concept or are avoidable outcomes of organizational deficiencies. We illustrate how both can contribute to failure at different policy stages and suggest that before adopting a cluster approach more consideration should be given to the institutional capacity required for implementation.