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Peer influence as a driver of technological innovation in the UK National Health Service: a qualitative study of clinicians’ experiences and attitudes
  1. Claire Greszczuk1,
  2. Faraz Mughal2,
  3. Rammya Mathew3,
  4. Ahmed Rashid4
  1. 1 South London Health Protection Team, Public Health England, London, UK
  2. 2 Warwick Primary Care, University of Warwick, Coventry, West Midlands, UK
  3. 3 Care Quality Improvement Department, Royal College of Physicians, London, UK
  4. 4 University College London Medical School, Royal Free Hospital, London, UK
  1. Correspondence to Dr Claire Greszczuk, South London Health Protection Team, Public Health England, London SE1 6LH, UK; clairegreszczuk{at}


Background Accelerating innovation to improve quality is a key policy target for healthcare systems around the world. Effectively influencing individuals’ behaviour is crucial to the success of innovation initiatives. This study explores UK clinicians’ lived experiences of, and attitudes towards, clinical peers endorsing healthcare innovations.

Methods Qualitative interviews with UK-based clinicians in one of two groups: (1) clinicians working in ‘front-line’ service provision and (2) clinicians in strategic leadership roles within health institutions. Participants were identified through purposive sampling, and participated in semistructured telephone interviews. Thematic analysis was used to identify and analyse themes in the data.

Results 17 participants were recruited: eight clinicians from front-line UK healthcare settings and nine clinicians in leadership roles. Two major themes were identified from the interviews: power and trust. Participants recognised and valued peers’ powerful influence, exerted in person via social networks and routine work-related activities. Peers were implicitly trusted, although often on condition of their credibility and deservingness of respect, supporting evidence and absence of conflict of interest. While the groups shared similar views, they diverged on the subject of institutions, felt to be powerful by strategic leaders yet scarcely mentioned by front-line clinicians.

Conclusions UK clinicians view peers as a powerful and trustworthy source to promote innovative technologies. Policies that aim to support this process should seek to control the wider conditions that nurture peer-to-peer influence. Further research into interpersonal influence in health settings may improve implementation of change initiatives.

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  • Contributors CG and AR were responsible for study concept and design, sampling and participant recruitment. RM and FM were responsible for data acquisition. CG led the data analysis, with contribution from all authors. CG led the drafting of the manuscript, with contribution from all authors. All authors contributed to critical revision of the manuscript.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Ethics approval The study was approved by The University of Sheffield School of Health and Related Research (ScHARR) Research Ethics Committee (ref: NICE008).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The study team have access to the interview transcripts (which will be permanently deleted in December 2017 as pre-agreed at the beginning of the study). No additional unpublished data are otherwise available.