the role of the policy process on health service reconfigurations: evidence, path dependency and framing; comment on “‘attending to history’ in major system change in healthcare in england: specialist cancer surgery service reconfiguration”

Historically healthcare services have largely developed on an incremental basis, with various piecemeal changes and some notable policy leaps that illustrate a punctuated equilibrium health policy process. more recently policy-makers have attempted, successfully and unsuccessfully, to reconfigure healthcare services to address perceived problems in the delivery of important services such as stroke, cancer, and trauma. perry et al provide a welcome addition to research in this area by focusing on the importance of history in a reconfiguration of cancer services in greater manchester (gm). perry et al analyse how and why this configuration was successful after several failed attempts in the past and in this commentary, i want to reflect on the explanatory role health policy analysis can contribute to studying the reconfiguration of healthcare services.