Purpose – Many developed countries have seen significant reforms of their health systems for the last few decades. Despite extensive investment in these changes, health systems still face a range of challenges which reform efforts do not seem to have overcome. The purpose of this paper is to...

Purpose – The purpose of the paper is to examine the metaphors used by senior managers and clinicians in the delivery of healthcare reform. Design/methodology/approach – A study of healthcare reform in England carried out a series of semi structured interviews with senior managers and...