Abstract

This paper analyzes the way in which the London Ambulance Service (LAS) recovered from the events of October 1992, when it implemented a computer aided despatch system (LASCAD) that remained in service for less than two weeks. It examines the enactment of a programme of long-term organizational change, focusing on the implementation of an alternative computer system in 1996. A contextualist approach, informed by the sociology of translation, is adopted for the analysis. The paper examines how alternative interests emerged and were stabilized over time through the use of discourse and power within and outside the organization. A key element in the process was the Golden Circle, a method of association used to engage key actors in a change intervention, while isolating them from external influences that might see things otherwise. The story traces four years in the history of the LAS from the aftermath of October 1992, through the birth of the Golden Circle to the achievement of National Health Service (NHS) trust status. LASCAD was the beginning of the story, this is the middle, an end lies in the future, when the remaining elements of the change programme are enacted beyond the Golden Circle.

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