NHS top managers, knowledge exchange and leadership: the early development of Academic Health Science Networks – a mixed-methods study

• Main Authors: Ewan Ferlie, Davide Nicolini, Jean Ledger, Daniela D’Andreta, Dmitrijs Kravcenko, John de Pury
• Format: Article
• Language: English
• Published: NIHR Journals Library 2017-05-01
• Series: Health Services and Delivery Research
• Online Access: https://doi.org/10.3310/hsdr05170

Background: Academic Health Science Networks (AHSNs) were recently created in the NHS to accelerate the spread of innovations that could promote population-level health gain and also pursue novel goals of wealth creation. They are 15 regionally based networks. They reflect a continuing stream of national health policy on stimulating NHS knowledge mobilisation, which has now created a novel institutional architecture. Objectives: The overall research aims were (1) to explore AHSNs’ strategies and practices of knowledge mobilisation in their formative phase, when they were building up health- and wealth-related networks; and (2) to investigate how knowledge leadership took place in these settings and the characteristics of people perceived as knowledge leaders (KLs). Specific research objectives operationalised these broad aims. Design: It was a mixed-methods study with a large qualitative component but also social network analysis (SNA). It contained a sequence of work packages: (1) an initial literature review to inform interviews; (2) an analysis of the national policy stream in this field; (3) a SNA of the AHSNs’ health and wealth networks; (4) five case studies of different AHSNs with 10 innovation tracers; and (5) interviews with individuals nominated as KLs. Setting: We studied a sample of five of the 15 English AHSNs, along with the development of the national policy stream. Participants: We interviewed and surveyed AHSNs and other relevant staff, including national policy-level respondents. Data sources: (1) A review of national- and AHSN-level documents, grey literature and relevant academic material; (2) semi-structured interviews with AHSN very senior managers, along with other staff, policy respondents and nominated ‘KLs’; and (3) a SNA (with two time points) using snowball survey methods. Review methods: The literature review took a structured and narrative-based approach in what was a diffuse and multidisciplinary academic field. Results: (1) We found that different networks were emerging around AHSNs’ health and wealth goals and, perhaps not surprisingly, the wealth networks were at an exploratory stage; (2) we found that these networks took different forms in different AHSNs; (3) we developed a general typology of the approaches AHSNs took towards spreading new ideas and innovations; and (4) we uncovered some characteristics of ‘KLs’. Limitations: The study proceeded with the AHSNs still in a formative phase (early 2014 to early 2016). The SNA had two data points that were close together. We could not undertake a longer-term impact assessment. Future work should take a more longitudinal approach. Conclusions: The study’s results have implications for (1) AHSN knowledge mobilisation strategies and networks, (2) the shape of AHSN regional knowledge networks and (3) the construction of knowledge leadership in these settings. Future research: Our top priority recommendations were (1) a longer-term AHSN impact assessment and (2) greater exploration of the AHSNs’ novel wealth creating role. Funding: The National Institute for Health Research Health Services and Delivery Research programme.