Normalisation Process Theory (NPT), used nationally and internationally to explore implementation within health services research, is used for the first time within policing to understand profound policy implementation failure and to generate broader discussion of policy implementation theory. The policy in question (Police to Primary Care [P2PC]) was an intervention designed to notify GPs when women are assessed by police as at high risk of future domestic abuse. Designed to improve interagency communication, it took place amidst radical organisational change. Using qualitative interviews with domestic abuse specialist and frontline officers, this paper addresses how NPT helps to explain the (non)implementation of P2PC, how such an analysis differs from other policy implementation approaches, and what this means for our understandings of policy implementation more broadly. NPT proved useful in understanding mechanisms leading to (non)implementation of the intervention: fuzzy alignment with existing practice, faulty communication of purpose, and inattention to discretionary implementation spaces. It helped us understand why the intervention came to be invisible. Dwarfed by its organisational context, made institutionally hard to read by a lack of formal protocols, and given restricted view to police officers, it was compromised by a failure to instigate systems of organisational learning. More broadly, NPT helped reveal practices intersecting top-down and bottom-up implementation theory. The paper concludes by asking how NPT and theories of street-level bureaucracy might be better used in tandem and, particularly, how this might help explorations of policy implementation where human actors are joined by technological actors in interpreting and making policy in vivo.
- Bristol Population Health Science Institute
- domestic abuse
- normalisation process theory
- oganisational change
- policy implementation