The importance of context in the health sector has been recognised by social scientists for some time, starting with the Andrew Pettigrew’s studies of District Health Authorities in the 1980s. But learning from the academic literature seems to have had little impact on practice. The influence of context on effectiveness is one that would benefit from closer cooperation between the academic and service sectors.

Download Perspectives on context.

The Health Foundation has been eager to explore the role of context in improving the quality of patient care. In 2011, we invited leading academics in the field to discuss the following questions:

  • How do you define and frame context?
  • What do you see as the key conceptual and empirical literature in the field?
  • How would you identify the main unanswered questions about context and improvement?

The essays they produced in response are presented in this report and provide a fascinating range of insights into the importance – and challenges – of context.

Building on these essays, we have commissioned Professors Glenn Robert and Naomi Fulop to undertake an evidence review on the subject of 'Context for successful improvement'.

As well as the full report, the essays are available to download individually (see Publication options box).

We are very grateful to all of the authors for their work and insights. The relationship between improvements and context is arguably the most knotty problem in improvement science. We hope these essays will continue to stimulate ideas about how context impacts on the effectiveness of interventions to improve care for patients.

Further reading

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