User-led Innovation in the UK National Health Service

Savory, Clive (2009). User-led Innovation in the UK National Health Service. PhD thesis The Open University.



Healthcare services are delivered to patients using complex technology systems. Many innovative healthcare technologies are produced by industrial suppliers; however, healthcare staff are also active innovators of the technologies that they use in their own work. By assuming the role of user-innovators, they can create new technologies, procedures, processes and service-designs that improve and support healthcare provision. The focus of the research reported in this thesis is the phenomenon of user-led innovation of healthcare technology in the UK National Health Service (NHS).

Exploratory research was carried out to develop a detailed understanding of user-led innovation within the NHS based on the perspectives of user-innovators. This thesis presents the results of the research in the form of four interpretive case studies, that contribute to an understanding of the enabling and inhibiting factors affecting user-led innovation. Each case presents an overview of the process of user-led innovation which was followed and the context in which it occurred. Several distinctive characteristics of user-led innovation are identified and a generic activity model of the user-led innovation process is described. Evaluation in user-led innovation processes is highlighted to have multiple purposes,beyond objective technology assessment. It is shown to support the on-going social-construction of user-developed technologies but also highlights the role of evaluation as a resource for exercising political influence within the innovation process.

User led innovation is established as a theoretically useful and coherently defined mode of innovation, distinct from the lead user or open innovation paradigms. The major contribution of the thesis is an integrated model of healthcare technology systems that emphasises the role of protoinstitutions as critical products of user-led innovation. The thesis concludes that in order to maximise the benefit of user-led innovation in the NHS, innovation policy and practice should be
broadened to recognise the role of proto-institutions as a valuable product of user-led innovation.

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