Shaping innovation in health care: A content analysis of innovation policies in the English NHS, 1948-2015

- Nature of innovation policies and institutional support rely on policymakers' understanding of the innovation concept.
- First inductive thematic analysis of key policy documents related to innovation in the English NHS from 1948 to 2015.
- Study reveals a phased evolution of the concept, underscoring three distinctive phases associated with an expanded concept.
- Policy discourse contains traces of other discourses (political, media, academic), suggesting a process of intertextuality.

Governments around the world seek to design policies that enhance the innovative capacity of public service. Hence, identifying the underlying meanings attributed to innovation concepts in public policies is critical, as these very understandings inform not only the policy discourses, but also the overall institutional landscape regulating innovation activities. This paper examines such fundamental definitional aspects in the specific context of the National Health Service in England. For this purpose, it traces the evolution of the innovation concept in policy discourse based on the analysis of 21 key policy documents published or commissioned by the English Department of Health between 1948 and 2015. Systematic analysis of these texts reveals that policymakers' conception of healthcare innovation broadened considerably over time. English health innovation policy initially focused on basic biomedical research. Subsequently, it entered a transitional period, zeroing in on science- and technology-based innovation. Finally, this focus gradually shifted to a broader conception of innovation translating into health, economic, and service design benefits.