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The medium-term sustainability of organisational innovations in the National Health Service

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Martin, Graham P., Currie, Graeme, Finn, Rachael and McDonald, Ruth. (2011) The medium-term sustainability of organisational innovations in the National Health Service. Implementation Science, Vol.6 (No.19). ISSN 1748-5908

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Official URL: http://dx.doi.org/10.1186/1748-5908-6-19

Abstract

Background: There is a growing recognition of the importance of introducing new ways of working into the UK’s
National Health Service (NHS) and other health systems, in order to ensure that patient care is provided as
effectively and efficiently as possible. Researchers have examined the challenges of introducing new ways of
working–’organisational innovations’–into complex organisations such as the NHS, and this has given rise to a
much better understanding of how this takes place–and why seemingly good ideas do not always result in
changes in practice. However, there has been less research on the medium- and longer-term outcomes for
organisational innovations and on the question of how new ways of working, introduced by frontline clinicians
and managers, are sustained and become established in day-to-day practice. Clearly, this question of sustainability
is crucial if the gains in patient care that derive from organisational innovations are to be maintained, rather than
lost to what the NHS Institute has called the ‘improvement-evaporation effect’.
Methods: The study will involve research in four case-study sites around England, each of which was successful in
sustaining its new model of service provision beyond an initial period of pilot funding for new genetics services
provided by the Department of Health. Building on findings relating to the introduction and sustainability of these
services already gained from an earlier study, the research will use qualitative methods–in-depth interviews,
observation of key meetings, and analysis of relevant documents–to understand the longer-term challenges
involved in each case and how these were surmounted. The research will provide lessons for those seeking to
sustain their own organisational innovations in wide-ranging clinical areas and for those designing the systems and
organisations that make up the NHS, to make them more receptive contexts for the sustainment of innovation.
Discussion: Through comparison and contrast across four sites, each involving different organisational innovations,
different forms of leadership, and different organisational contexts to contend with, the findings of the study will
have wide relevance. The research will produce outputs that are useful for managers and clinicians responsible for
organisational innovation, policy makers and senior managers, and academics.

Item Type:	Journal Article
Subjects:	H Social Sciences > HD Industries. Land use. Labor R Medicine > RA Public aspects of medicine
Divisions:	Faculty of Social Sciences > Warwick Business School > International Centre for Governance & Public Management Faculty of Social Sciences > Warwick Business School
Library of Congress Subject Headings (LCSH):	Organizational change, Great Britain. National Health Service -- Case studies, Medical care -- Great Britain -- Case studies
Journal or Publication Title:	Implementation Science
Publisher:	BioMed Central Ltd.
ISSN:	1748-5908
Official Date:	14 March 2011
Volume:	Vol.6
Number:	No.19
Identification Number:	10.1186/1748-5908-6-19
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access
Funder:	National Institute for Health Research (Great Britain) (NIHR)
Grant number:	09/1001/40 (NIHR)
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URI:	http://wrap.warwick.ac.uk/id/eprint/34586