Ambiguous workarounds in policy piloting in the NHS: Tensions, trade‐offs and legacies of organisational change projects

Mhorag Goff,Michael Bresnen,Simon Bailey,Rebecca Elvey,Katherine Checkland,Damian Hodgson

doi:10.1111/ntwe.12190

Abstract

AbstractPilot projects are increasingly used as a mechanism to enact organisational change, particularly government policy. Information technology's centrality to organisations often makes it key to the introduction of new processes. However, it can give rise to workarounds as employees circumvent impediments it presents by rejecting its prescribed use. Workarounds tend to be conceptualised dichotomously, as either ‘good’ problem solving, or ‘bad’ subversion of the technology. In pilot projects, workarounds are more ambiguous because those that support projects' successful completion in the short‐term may undermine day to day operations longer term. We draw on interview data from a policy pilot in general practice in the National Health Service in England aimed at extending access to care. We problematise the dichotomous conceptualisation of workarounds, finding they can be simultaneously supportive and undermining of policy pilots. Workarounds thereby become political, as employees are required to trade‐off consequences for themselves and the wider organisation.

Highlights

Many contemporary organisational change projects hinge on IT as an enabler of change, and it is within this context that the issue of workarounds arises
This article aims to address this by developing insights into the role of workarounds in pilot projects as an instance of organisational change, grounded in an empirical case study of a UK policy pilot in primary health care in the NHS (Bailey et al, 2017; Elvey et al, 2018)
By exploring how ambiguous workarounds intersect with pilot projects, we aim to contribute to theory on workarounds, and secondly to understand the implications of workarounds for organisations and for the workforce and during and after organisational change projects and pilots

Summary

Introduction

Many contemporary organisational change projects hinge on IT as an enabler of change, and it is within this context that the issue of workarounds arises. In certain literatures on organisational change, workarounds have long been problematised because they can undermine the intended benefits of change projects (Debono et al, 2010). A range of perspectives on workarounds conceptualises them variously as an inevitable aspect of organisations/work or as unethical or risky deviations from formal procedures (Alter, 2014). We argue that this portrayal has shaped a dichotomous understanding of workarounds as either ‘good’ or ‘bad’ that we frame as characterising the ‘ambiguity’ of workarounds. The article addresses the question: how do workarounds influence the role of pilot projects in bringing about organisational change?

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