Network and competition effects in the diffusion of innovation in the NHS Imperial College London

This project explored the factors that influence the take up of innovative cancer treatments in hospitals, focusing on laparoscopic surgery for colorectal cancer.

Semi-structured interviews and focus groups were conducted with consultants. A literature review was carried out on the determinants of adoption and diffusion of innovation in hospitals. Quantitative analysis was carried out, using Hospital Episode Statistics, data from the General Medical Council and workforce data.

The results highlighted that variation in innovation adoption and diffusion is associated with multiple factors, from patient characteristics, to physicians’ networks. It was found that uptake is driven by surgeons themselves, not hospitals.

Quantitative research that matched data on patient treatment and surgeon employment enabled the team to construct surgeons’ work networks and the behaviour of peers, and found that these are key predictors of adoption and diffusion of innovation.

In researching the impact of guidelines and training on the diffusion of innovation, the research found that physician networks speed up the response of senior physicians to policy interventions, and that both network size and the behaviour of peers are important factors.

Results highlight that using multiple channels to foster innovation uptake may be more effective that trying one; and that identifying and focusing on those that are poorly connected may have more impact than focusing on those who have good networks, or than targeting hospitals.

The findings are being published in various journals and have been presented at national and international conferences. The project team anticipates that the results will be used to inform policy on the design and implementation of best practice guidelines and quality standards.

Contact details

For more information, please contact Marisa Miraldo, Associate Professor in Health Economics at Imperial College London.