Innovation and the English National Health Service: A qualitative study of the independent sector treatment centre programme


Turner, S; Allen, P; Bartlett, W; Perotin, V; (2011) Innovation and the English National Health Service: A qualitative study of the independent sector treatment centre programme. Social science & medicine (1982), 73 (4). pp. 522-529. ISSN 0277-9536 DOI: https://doi.org/10.1016/j.socscimed.2011.06.014

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Abstract

Over the past two decades, an international trend of exposing public health services to different forms of economic organisation has emerged. In the English National Health Service (NHS), care is currently provided through a quasi-market including 'diverse' providers from the private and third sector. The predominant scheme through which private sector companies have been awarded NHS contracts is the Independent Sector Treatment Centre (ISTC) programme. ISTCs were designed to produce innovative models of service delivery for elective care and stimulate innovation among incumbent NHS providers. This paper investigates these claims using qualitative data on the impact of an ISTC upon a local health economy (LHE) composed of NHS organisations in England. Using the case of elective orthopaedic surgery, we conducted semi-structured interviews with senior managers from incumbent NHS providers and an ISTC in 2009. We show that ISTCs exhibit a different relationship with frontline clinicians because they counteract the power of professional communities associated with the NHS. This has positive and negative consequences for innovation. ISTCs have introduced new routines unencumbered by the extant norms of professional communities, but they appear to represent weaker learning environments and do not reproduce cooperation across organisational boundaries to the same extent as incumbent NHS providers. (C) 2011 Elsevier Ltd. All rights reserved.

Item Type: Article
Faculty and Department: Faculty of Public Health and Policy > Dept of Health Services Research and Policy
PubMed ID: 21782302
Web of Science ID: 295244100006
URI: http://researchonline.lshtm.ac.uk/id/eprint/18588

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