Leadership of Health Innovation: Building an Innovative Health Organisation (A Mixed-Methods Study)

Abstract

This thesis explores leadership styles associated with innovation in the National Health Service in England, drawing on a review of leadership theories and concepts, and comparing what is found with an organisation in the United States recognised as a high performer in this area. Although leadership has been studied extensively, most research has focused on the political and military spheres. More recent work has also examined the role of leadership in sectors such as manufacturing and technology, both areas where it is essential to encourage and nurture innovation. Yet, in the health sector, where innovation is now high on the health policy agenda in many countries, there is a paucity of research on how leadership can foster a culture of innovation. It cannot be assumed that leadership theories and concepts developed in other sectors will automatically apply to the health sector, given its many complexities and specificities, including multiple and sometimes competing objectives, such as the need to match technological advances with cost containment. Moreover, these objectives may vary in different settings, reflecting the contextual embeddedness of health systems. This research asks what leadership styles have been adopted by those working at senior leadership and management levels in organisations created to support innovation within the NHS in England. To place these findings in a broader context, these findings will be compared with those obtained from a leading health sector organisation identified as a global leader in innovation that served as the US Pilot Study for this research. It will relate these findings to theory and previous empirical research on leadership for innovation while exploring the application of these findings to the health sector. The research uses a mixed method approach, commencing with a review of the literature to identify leadership styles and critical appraisal of evidence associating different styles with the extent and nature of innovation, which in turn has informed development of an instrument to be used in a survey (quantitative element) of those in leadership roles. The instrument draws extensively on that used by Handy (1996) to assess organisational culture. The survey questions are linked to leadership theories and concepts identified in the literature review and seek to identify the leadership styles adopted in the organisations studied. The findings inform the qualitative phase of the study, in which interviews with key informants are used to interpret and understand the quantitative results. The study findings have been used to generate a ‘Leadership Framework’ for assessing leadership styles in organisations seeking to foster innovation in the NHS. This is based upon the leadership styles described in the literature and leadership theories and concepts driving health innovation and to a minor extent to those adopted in a successful innovator in the United States health sector. The research concludes by offering contextually appropriate recommendations based on theory and empirical evidence.