Management knowledge and learning in the UK healthcare context: change and continuity

Major recent changes witnessed within UK healthcare have had dramatic consequences for management, while the increased expectation that healthcare managers demonstrate leadership has put the spotlight firmly on their managerial knowledge. As yet, however, we know comparatively little about how healthcare managers acquire and apply management knowledge, and how this is influenced by their professional development. Drawing upon situated learning theory and Blackler's framework of knowledge types, we examine managers' orientations to knowledge in the context of recent policy changes. Recognizing that healthcare management is complex, comparative case study evidence is presented from three types of hospital trust (acute, care and specialist) and across three generic managerial groups (clinical, general and functional). Our research highlights the obstacles faced by managers in developing their knowledge and learning, and how contemporary changes are reinforcing long-established preferences for embodied ('tried and tested') knowledge as well as locally encultured ('home-grown') management solutions.