Readiness for innovation in public healthcare service delivery organisations in the UK.

Abstract

Purpose – Despite the fact that research in readiness is growing, there are gaps in the context of enacting readiness within healthcare. Adopting the complex adaptive systems theory, this thesis aimed to extend the theoretical understanding of the concept of organisational readiness for innovation in the context of healthcare. It examined the meanings and the processes involved in achieving and maintaining a state of readiness for innovation in the UK public healthcare services sector from the perspective of its senior leaders. Methodological approach – The thesis included three studies. First, a narrative systematic review was conducted across different bibliographic databases to explore the associated meanings and factors influencing organisational readiness for innovation. The search revealed that there were different meanings and processes associated with the development, implementation and sustainability of the construct. These included the stage vs. the process-based debate, the various disagreements amongst theorists on the multifaceted nature of the construct and its impact (i.e. behavioral, psychological and structural), and its relation to organisational change. This led to the adoption of a qualitative research method to further investigate the topic in the context of UK public healthcare services. Twenty semi-structured individual interviews in total were conducted. The data were collected in two phases. The first phase consisted of a total of ten senior managers working in NHS organisations. This first phase investigated from an internal point of view how organisational readiness for innovation was successfully managed within the National Health Service (NHS) – it explored meanings, discrepancies between organisational change management and innovation, and identified contextual (pre) conditions and processes of how leadership may influence readiness for innovation, its enactment and sustainability. In the second phase, a total of ten semi-structured personal interviews were conducted with senior management representatives from the Academic Health Science Networks groups. This second phase provided information on the perspective and role of an external facilitator’s organisation in supporting and sustaining an innovation ‘ready’ culture in the NHS. Conducting the study in two phases allowed the researcher to see the level and reasons for alignment in the senior management’s views from different organisational perspectives – internal and external. Summary of results – A significant distinction was found in the senior managers’ opinion regarding the definition of innovation and organisational change. Successful innovation management was described as a much more complex and intricate process than organisational change management. Readiness was perceived as an iterative process of interaction between different stakeholders, their new ideas and the environment to enable innovation development and service improvement. Participants acknowledged that readiness for innovation was driven by collective engagement and intrinsic motivation from members of the NHS organisation. The findings presented, among others, some unique key contextual factors enabling organisational readiness for innovation which include: free spaces, communities of practice, and five types of leadership style: systems leadership, collective leadership, distributed leadership, lateral leadership, and transformational leadership. Conclusions – The study generated new understanding about the theoretical distinction of innovation from organisational change. It provided new rationale about the meaning of organisational readiness for innovation based on views from those managing the process internally and externally in the NHS. The study recommended a conceptual framework enabling scholars, practitioners, senior managers, and policy makers to understand the actions required in order to prepare the NHS for the long-term success, adaptability, and the sustainability of organisational innovations in healthcare services.