Network and Competition Effects in the NHS

Principal Investigator: Dr Marisa Miraldo

Researchers: Professor Carol Propper

Funder: Health Foundation

Duration: April 2015 – June 2018


This project will use a multidisciplinary research approach to explore the factors that influence the take-up of innovative cancer treatments in hospitals, by investigating how the adoption and spread of innovation is shaped by factors such as attitudes to best practice guidelines, formal and informal networks, collaboration and competition between hospitals.

The project will focus on two innovations that represent best practice in cancer treatment: laparoscopic surgery for colorectal cancer and sentinel lymph node dissection for breast cancer. Over three years, the team will:

  • examine published research to identify what is currently known about the medical decision making process and the adoption of innovation in hospitals
  • use surveys to collect quantitative data on consultants’ characteristics, behaviour, attitudes and beliefs, and their formal and informal networks
  • conduct semi-structured interviews with consultants, including individuals identified as fast adopters of innovation and those identified as non-adopters
  • analyse primary and secondary data to understand how competition and networks influence the adoption and spread of innovation

The study will contribute to improving the quality and safety of hospital care by:

  • making sure that treatments reflect up-to-date medical knowledge
  • increasing efficiency of hospital care by avoiding unnecessary treatments
  • promoting equity of access to hospital care by ensuring that patients with the same condition receive the same standard of care.

The findings will be used to inform policy on the design and implementation of best practice guidelines and quality standards.

Outputs & Impact