title: 'Animateurs' and animation: what makes a good commissioning manager?
abstract: OBJECTIVE
  To examine the managerial behaviours adopted by commissioning managers in English primary care trusts (PCTs), and to explore the impact of these behaviours.
  
  
  METHODS
  Qualitative case studies were undertaken in four PCTs, focusing on staff engaged in the commissioning of hospital services. Both formal and informal observation were undertaken (150 hours), and 41 in-depth interviews conducted with managers and general practitioners (GPs).
  
  
  RESULTS
  Managers adopted many managerial behaviours familiar from the literature, including sharing information, and networking inside and outside the organization. Multiple organizational layers and unclear decision-making processes hindered this activity. In addition, some managers with responsibility for facilitating practice-based commissioning (PbC) adopted a managerial mode that we have called being an 'animateur'. This approach involved the active management of disparate groups of people over whom the manager had no authority, and appeared to be a factor in determining success. It was facilitated by managerial autonomy and was more prevalent where managers were seen to have legitimacy. Some organizational practices appeared to inhibit its development.
  
  
  CONCLUSIONS
  From 2012/13 it is planned that GPs will be taking more responsibility for commissioning in the English NHS. This research suggests that managers of the new commissioning organizations will require a deep and contextualized understanding of the NHS and that it is important that organizational processes do not inhibit managerial behaviour. Legitimacy may be an issue in contexts were managers are automatically transferred from their existing appointments.
authors.affiliation: Health Policy, Politics and Organisation Group, School of Community-based Medicine, University of Manchester, Manchester, UK. catherine.checkland@manchester.ac.uk
authors.forename: Kath
authors.initials: K
authors.lastname: Checkland
authors.forename: Stephanie
authors.initials: S
authors.lastname: Snow
authors.forename: Imelda
authors.initials: I
authors.lastname: McDermott
authors.forename: Stephen
authors.initials: S
authors.lastname: Harrison
authors.forename: Anna
authors.initials: A
authors.lastname: Coleman
mesh_terms: D000288:Administrative Personnel / Q000592:standards*; D003284:Contract Services; D058005:General Practitioners; D006779:Hospitals, Public; D006801:Humans; D007407:Interviews as Topic; D011361:Professional Competence; D013222:State Medicine; D006113:United Kingdom