Dynamic and relational aspects of collaborative innovation in health and social care

Policymakers acknowledge the need to innovate within public health and social care services in the context of complex, 'wicked' problems. Public administration scholars have proposed the concept of ‘collaborative innovation’ as a vehicle through which to arrive at and analyse solutions. The collaborative innovation literature was reviewed and found to be useful in framing analyses of the facilitators and challenges in supporting innovation in complex public services. However, the literature pays relatively little attention to how collaborative innovation might combat the influence of institutionalised power inequalities both within organisational hierarchies and between organisations. A conceptual framework was devised based on a thorough synthesis of the literature and provided a practical guide to the complex processes of collaborative innovation. This framework was then operationalised in undertaking two in-depth case studies of health and social care innovation, through which a heft of rich data was generated and analysed. The conceptual framework generally proved effective in exploring the dimensions of collaborative innovation present within the two case studies; and the four key processes of collaborative innovation – empowered participation, joint ownership, mutual & transformative learning and joint selection – were indeed found to be critical to the development and delivery of innovation in both cases. However, power and the role of metagovernance in mediating this power shaped the processes and outcomes in both cases. The findings of the first case study highlight the implementation consequences of frontline worker exclusion in collaborative innovation, and the challenges of maintaining multilevel governance over long-term innovation projects. The second case study focused on how metagovernors can transform the collaborative arena through material recognition of power-deficient actors’ value. As per the literature, processes of collaborative innovation were associated with transformative change that was jointly owned and a discontinuous step-change from the status quo in services and ways of working. This research contributes to the growing theoretical literature that frames collaborative innovation as a means to address complex policy problems and provides a critical lens to understand the role of metagovernance in mitigating power asymmetries between stakeholders.Policymakers acknowledge the need to innovate within public health and social care services in the context of complex, 'wicked' problems. Public administration scholars have proposed the concept of ‘collaborative innovation’ as a vehicle through which to arrive at and analyse solutions. The collaborative innovation literature was reviewed and found to be useful in framing analyses of the facilitators and challenges in supporting innovation in complex public services. However, the literature pays relatively little attention to how collaborative innovation might combat the influence of institutionalised power inequalities both within organisational hierarchies and between organisations. A conceptual framework was devised based on a thorough synthesis of the literature and provided a practical guide to the complex processes of collaborative innovation. This framework was then operationalised in undertaking two in-depth case studies of health and social care innovation, through which a heft of rich data was generated and analysed. The conceptual framework generally proved effective in exploring the dimensions of collaborative innovation present within the two case studies; and the four key processes of collaborative innovation – empowered participation, joint ownership, mutual & transformative learning and joint selection – were indeed found to be critical to the development and delivery of innovation in both cases. However, power and the role of metagovernance in mediating this power shaped the processes and outcomes in both cases. The findings of the first case study highlight the implementation consequences of frontline worker exclusion in collaborative innovation, and the challenges of maintaining multilevel governance over long-term innovation projects. The second case study focused on how metagovernors can transform the collaborative arena through material recognition of power-deficient actors’ value. As per the literature, processes of collaborative innovation were associated with transformative change that was jointly owned and a discontinuous step-change from the status quo in services and ways of working. This research contributes to the growing theoretical literature that frames collaborative innovation as a means to address complex policy problems and provides a critical lens to understand the role of metagovernance in mitigating power asymmetries between stakeholders