This paper draws on a study of the implementation of business process reengineering (BPR) in a UK National Health Service (NHS) hospital to examine the challenge of effecting a transformatory shift to a new form of process organization in a large and complex public service organization. The paper’s theoretical and empirical interests go beyond BPR by bringing together literatures about organizational transformation, new organizational forms and the new public management (NPM) in a novel way. Data reveal important limits to intended organizational transformation and develop findings about sedimented rather than transformational change and the limitations of radical top-down change strategies in professionalized public service organizations. Within the domain of public service organizations, the paper also advances a new argument about why intended moves to post-NPM forms may remain contained in scope.
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