NHS IT strategy meso-level practice study

• Research type

  Research Study

• Full title

  National IT strategy in the turbulent English NHS: A structuration study of meso-level practice.

• IRAS ID

  263514

• Contact name

  William Green

• Contact email

  w.green@le.ac.uk

• Sponsor organisation

  University of Leicester

• Duration of Study in the UK

  0 years, 6 months, 00 days

• Research summary

  This project aims to explore the practice of various internal stakeholders in the implementation of national-level health IT strategy in the English NHS. Healthcare systems are complex and the NHS structure has been remarkably volatile throughout progressive and incremental national IT strategy initiatives over a twenty-five year period.
  The structural changes have affected policy / executive, intermediate regional and local management, and provider levels, and have involved primary care and hospital sectors. Within this dynamic landscape, local initiatives in health information management have attempted to integrate (or interface) with technical and data standards defined or imposed through the succession of national strategies. At the same time, the lower levels of the tiered hierarchy of the NHS have had to respond to changing degrees of centralised control of systems procurement.

  The intermediate NHS layer has a mediating function between the policy and provider levels (effectively between government and the end-users of clinical information systems). Strong structuration theory (SST) offers a three-level view of macro-, meso- and micro-levels and has previously been used to investigate governance in healthcare, information technology adoption, and NHS IT programmes. The research will use SST to explore how the dynamic structure of the NHS has affected meso-level practice in the delivery of its national IT strategy. Document analysis and semi-structured interviews will examine characteristics of progressive NHS IT strategies, the evolving NHS structures, alignment between executive policy and provider-level practice in IT implementation, and the impact of reorganisations on mediation by the intermediate NHS structural tier.

• REC name

  N/A

• REC reference

  N/A