Policy might seem like something quite far removed from day to day activities. However, getting a better understanding of policy is important as the process has a major impact on how we see and understand healthcare.

A good place to start when thinking about the policy process is the work of Paul Cairney who provides a range of useful resources that introduce policy debates and what he calls the policy environment.

Policy environments are made up of:

  • A wide range of actors (which can be individuals and organisations with the ability to deliberate and act) making or influencing policy at many levels and types of government.
  • Institutions, defined as the rules followed by actors. Some are formal, written down, and easy to identify. Others are informal, reproduced via processes like socialisation, and difficult to spot and describe.
  • Networks, or the relationships between policymakers and influencers. Some are wide open, competitive, and contain many actors. Others are relatively closed, insulated from external attention, and contain few actors.
  • Ideas, or the beliefs held and shared by actors. There is often a tendency for certain beliefs or ‘paradigms’ to dominate discussion, constraining or facilitating the progress of new ‘ideas’ as policy solutions.
  • Context and events. Context describes the policy conditions – including economic, social, demographic, and technological factors – that provide the context for policy choice, and are often outside of the control of policymakers. Events can be routine and predictable, or unpredictable ‘focusing’ events that prompt policymaker attention to lurch at short notice.

A notable case study of policy is the NHS itself. This infographic by the Nuffield Trust provides a helpful summary of the various factors that have shaped the NHS since its creation.

The following video by Mark Exworthy provides an overview of some of the key themes and issues associated with NHS since its creation:

Last year the NHS celebrated its 70th anniversary and in doing so raised a number of debates about its future.

What do you think the NHS will look like in the future? Will it reach its 100th anniversary?