Continuities in Policies and Turnover Among Actors: Instrument Constituencies in French Primary Care Reforms

ABSTRACT Over the past decade, the concept of “instrument constituency” has been proposed as a way in which to bridge studies on policy networks and policy instruments. This concept focuses on policy networks composed of diverse actors who are brought together by the shared goal of promoting a specific instrument. In this study, we examine who is involved in policy instruments development, and the extent to which they drive change within the policy process. To do so, we focus on the case of two care coordination instruments, namely, the IPEP and PEPS, used in the French healthcare system. Drawing on qualitative methods, we identify the actors involved in the development of the two instruments. Our analysis reveals the formation of two instrument constituencies around the IPEP and PEPS. This finding suggests that the continuity of primary care policies is supported through these instruments, fostering shared approaches among the actors involved.