Varieties of improvement expertise: Knowledge and contestation in health-care improvement

Alan Cribb* (Corresponding Author), Vikki Entwistle, Polly Mitchell

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)
3 Downloads (Pure)


The 'improvement' of health care is now established and growing as a field of research and practice. This article, based on qualitative data from interviews with 21 senior leaders in this field, analyses the growth of improvement expertise as not simply an expansion but also a multiplication of 'ways of knowing'. It illustrates how health-care improvement is an area where contests about relevant kinds of knowledge, approaches and purposes proliferate and intersect. One dimension of this story relates to the increasing relevance of sociological expertise-both as a disciplinary contributor to this arena of research and practice and as a spur to reflexive critique. The analysis highlights the threat of persistent hierarchies within improvement expertise reproducing and amplifying restricted conceptions of both improvement and 'better' health care.

Original languageEnglish
Pages (from-to)734-753
Number of pages20
JournalSociology of Health & Illness
Issue number4
Early online date27 Jan 2023
Publication statusPublished - May 2023

Bibliographical note

This research was funded in whole, or in part, by the Wellcome Trust (Grant number
209811/Z/17/Z). For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. In addition we would like to thank the two anonymous reviewers for their very helpful suggestions.

Data Availability Statement

The data that support the findings of this study are not publicly available due to privacy or ethical restrictions.


  • expertise
  • health service organisations
  • norms and values
  • quality of care
  • research and policy
  • sociology of scientific knowledge


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