People, Place and Innovation: How Organizational Culture and Physical Environment Shaped the Implementation of the NHS TC Programme

Abstract

This chapter describes the experience of NHS organisational change relating to the development of NHS Treatment Centres (TCs), an innovative form of health care, designed to streamline patient care, reduce excessive waiting times for routine elective surgery, and transform traditional professional roles. They required major changes in working practices and culture, and many involved major renovation or construction of new facilities. A longitudinal analysis of eight TCs was conducted, examining the early implementation of this change. It combined mathematical modelling and ethnographic investigation of the social and organisational factors associated with their development. The way each was adapted and shaped by particular local configurations of people and place is described, along with how the physical environment was altered to adapt to the TCs 'vision'. It concludes that when considering organisational innovation, it is important to creatively recognise the importance of 'harnessing the interactions of people and place'. Cites 14 references.