TY - JOUR T1 - Street-level bureaucracy: an underused theoretical model for general practice? JF - British Journal of General Practice JO - Br J Gen Pract SP - 376 LP - 377 DO - 10.3399/bjgp15X685921 VL - 65 IS - 636 AU - Maxwell JF Cooper AU - Sangeetha Sornalingam AU - Catherine O’Donnell Y1 - 2015/07/01 UR - http://bjgp.org/content/65/636/376.abstract N2 - Street-level bureaucracy (SLB) is a sociological theory that seeks to explain the working practices and beliefs of front-line workers in public services and the ways in which they enact public policy in their routine work. Developed by an American, Michael Lipsky,1,2 it examines the workplace in terms of systematic and practical dilemmas that must be overcome by employees, with a particular focus on public services such as welfare, policing, and education. The theory is based on the notion that public services represent ‘the coal mines of welfare where the “hard, dirty and dangerous work” of the state’ is done.’3 According to Lipsky,1,2 that is because: demand from clients will always outstrip supply due to finite resources (cost, time, or service access). Most clients are unable to obtain similar services elsewhere (such as private alternatives to state organisations). As a result, employees must resort to ‘mass processing’2 of excessive client caseloads.extensive personal discretion is a critical component of the work of many front-line public sector employees, particularly those who undertake private, face-to-face interaction with clients to assess the credibility of cases. Employees must use their personal discretion to become ‘inventive strategists’ by developing ways of working to resolve excessive workload, complex cases, and ambiguous performance targets.4employees compromise the quality of their work by ‘creaming off’2 cases that are likely to be straightforward or to have a positive outcome. Alternatively, workers may act as an ‘advocate’2 for … ER -