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Healthcare Leadership with Political Astuteness (HeLPA): a qualitative study of how service leaders understand and mediate the informal 'power and politics' of major health system change

Waring, Justin; Bishop, Simon; Clarke, Jenelle; Exworthy, Mark; Fulop, Naomi J.; Hartley, Jean; Ramsay, Angus I.G.

Authors

Justin Waring justin.waring@nottingham.ac.uk

Jenelle Clarke Jenelle.clarke@nottingham.ac.uk, m.exworthy@bham.ac.uk

Mark Exworthy

Naomi J. Fulop n.fulop@ucl.ac.uk

Jean Hartley

Angus I.G. Ramsay angus.ramsay@ucl.ac.uk



Abstract

Background: The implementation of strategic health system change is often complicated by a variety of contextual factors. Of these factors, there is widespread recognition that the informal politics and power of health systems can complicate change, such as competing interests and resistant groups. Evidence from other industries shows that strategic leaders need to be aware of and manage such ‘organisational politics’ when implementing change, which involves developing and using forms of political ‘skill’, ‘savvy’’ or ‘astuteness’. The purpose of this study is to investigate the acquisition, use and contribution of political ‘astuteness’ in the implementation of strategic health system change.
Methods: The qualitative study comprises four linked work packages. First, we will complete a systematic ‘review of reviews’ on the topic of political astuteness, and related social science concepts, which will be used to then review the existing health services research literature to identify exemplars of political astuteness in health care systems. Second, we will carry out semi-structured biographical interviews with regional and national service leaders, and recent recipients of leadership training, to understand their acquisition and use of political astuteness. Third, we will carry out in-depth ethnographic research looking at the utilisation and contribution of political astuteness in three contemporary examples of strategic health system change. Finally, we will explore and discuss the study findings through a series of co-production workshops to inform the development and testing of new learning resources and materials for future NHS leaders.
Discussion: The research will produce evidence about the relatively under-researched contribution that political skill and astuteness makes in the implementation of strategic health system change. It intends to offer new understanding of these skills and capabilities that takes greater account of the wider social, cultural organisational landscape, and offers tangible lessons and case examples for service leaders. The study will inform future learning materials and processes, and create spaces for future leaders to reflect upon their political astuteness in a constructive and development way.

Journal Article Type Article
Publication Date Dec 3, 2018
Publisher BMC
Peer Reviewed Peer Reviewed
APA6 Citation Waring, J., Bishop, S., Clarke, J., Exworthy, M., Fulop, N. J., Hartley, J., & Ramsay, A. I. (2018). Healthcare Leadership with Political Astuteness (HeLPA): a qualitative study of how service leaders understand and mediate the informal 'power and politics' of major health system change. BMC Health Services Research, doi:10.1186/s12913-018-3728-z
DOI https://doi.org/10.1186/s12913-018-3728-z
Keywords organisational politics; political skill; political astuteness; leadership; system change; qualitative; ethnography
Publisher URL https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-018-3728-z#Sec1
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