Healthcare planning: roles, relationships, and action

Marwaha, Samta 2026. Healthcare planning: roles, relationships, and action. PhD Thesis, Cardiff University. Item availability restricted.

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Abstract

In 2014, NHS Wales introduced the healthcare planner role- a pioneering development that recognised the growing complexity of modern healthcare systems and the need for dedicated planning expertise. Since then, factors including the Covid-19 pandemic, evolving population health needs, workforce shortages, and ongoing financial constraints have made understanding this role increasingly relevant internationally. Yet significant gaps remain in our knowledge of what healthcare planners actually do and how they navigate their responsibilities. This research addresses these gaps through interviews with policy practitioners and frontline healthcare planners, exploring who these professionals are, what their work involves, and how they accomplish their objectives. The study provides a detailed analysis of healthcare planners' role content, competencies, processes, outcomes, and actions. At its core, the role centres on triangulation that strategically integrates three critical planning areas: workforce, finance, and operations. Healthcare planners frequently act as translators amongst diverse internal and external stakeholders to achieve these integrated planning goals. The empirical evidence reveals a significant gap between how the role is conceived in policy documents and how it unfolds in practice. Conceptually, the study introduces "complex hybridity" to describe healthcare planners' roles and address their lack of professional recognition. Complex hybridity is a bi-dimensional construct comprising of specialist and relational dimensions that identifies multiple layers of hybridity built into the role reflective of their complex professional backgrounds, work actions, and interactions. In turn, the research contributes to Biddle’s (1979; 1986) role theory, highlighting how shared expectations can determine the degree of role conformity and consensus. It shows that complex hybrid roles inevitably create gaps between expectations and reality, leading to role conflict, ambiguity, and desires for greater role autonomy and significance. Furthermore, by integrating role theory with Nicolini and Korica's (2012; 2017) practice lens, the study reveals that role theory alone cannot fully capture the experience of complex hybrid roles. A broader understanding of context and systems of practice is essential for comprehending how such roles operate in reality. Unlike traditional clinical-managerial hybrids, complex hybridity places the content, processes, and layers of interactions at the centre of the role. Hence, signifying the need to study complex management roles beyond healthcare planning, like occupations in sectors of education, social work, and government, where roles are becoming more complex and intermediary. Thereby, highlighting the challenge of implementing policy-defined roles on the frontline.

Item Type:	Thesis (PhD)
Date Type:	Completion
Status:	Unpublished
Schools:	Schools > Business (Including Economics)
Subjects:	H Social Sciences > H Social Sciences (General)
Uncontrolled Keywords:	1. Healthcare 2. Planning 3. Management 4. Hybridity 5. Actions 6. Roles
Date of First Compliant Deposit:	9 September 2026
Last Modified:	09 Sep 2026 08:16
URI:	https://orca.cardiff.ac.uk/id/eprint/189412

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