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Research innovations and breakthroughs are increasingly realised through collaborative networks amongst state and non-state actors. This article investigates the utilisation of such networks in the field of applied health services research, where policy narratives repeatedly emphasise the importance of collaboration between university researchers, clinical and health service leaders, patient representatives and industry. The translation of policy into practice suggests that these networks are not always designed and managed in line with policy aspirations. Taking a decentred approach, the study reported in this article examines how local policy actors translate national policies for collaborative health research networks in the context of their own histories of applied research, including local narratives and priorities for health research. The study shows that local actors face key dilemmas and opportunities for situated agency, as they experience three competing policy narratives, first, for carrying out world-class research; second, for ensuring research meets local needs and third, for developing new understanding about the implementation of research into practice. Although these expectations might appear coherent to policy-makers, at the regional level, they provide the basis for disagreement and negotiation amongst local policy actors through which the local narrative of collaborative research is framed to regional stakeholders. The study shows how the tensions between elite and local narratives can be reconciled through re-framing activities, especially the articulation of 'parallel frames' within a 'cascade framing' process.

Research innovations and breakthroughs are increasingly realised through collaborative networks amongst state and non-state actors. This article investigates the utilisation of such networks in the field of applied health services research, where policy narratives repeatedly emphasise the importance of collaboration between university researchers, clinical and health service leaders, patient representatives and industry. The translation of policy into practice suggests that these networks are not always designed and managed in line with policy aspirations. Taking a decentred approach, the study reported in this article examines how local policy actors translate national policies for collaborative health research networks in the context of their own histories of applied research, including local narratives and priorities for health research. The study shows that local actors face key dilemmas and opportunities for situated agency, as they experience three competing policy narratives, first, for carrying out world-class research; second, for ensuring research meets local needs and third, for developing new understanding about the implementation of research into practice. Although these expectations might appear coherent to policy-makers, at the regional level, they provide the basis for disagreement and negotiation amongst local policy actors through which the local narrative of collaborative research is framed to regional stakeholders. The study shows how the tensions between elite and local narratives can be reconciled through re-framing activities, especially the articulation of 'parallel frames' within a 'cascade framing' process.

© 2017 Informa UK Limited, trading as Taylor & Francis Group. Collaborative governance has given rise to decision-making methodologies promoting democracy, inclusivity and transparency. This is exemplified by deliberative priority-setting (DPS) that blends cost-effectiveness analysis with stakeholder deliberation. Little is known however, about the facilitation challenges when 'technical' and 'social' elements are combined in a methodology. This paper investigates the facilitation challenges of implementing a DPS project within the English National Health Service (NHS). Our study examines the relationship between facilitation and the effectiveness of DPS processes, highlighting the importance of knowledge management as facilitators seek to translate technical information, to enhance the deliberative experience and promote legitimate decisions.

BACKGROUND: The implementation of strategic health system change is often complicated by informal 'politics' in healthcare organisations. Leadership development programmes increasingly call for the development and use of 'political skill' as a means for understanding and managing the politics of healthcare organisations. The primary purpose of this review is to determine how political skill contributes to the implementation of health services change, within and across organisations. The secondary purpose is to demonstrate the conceptual variations within the literature. METHODS: The article is based upon a narrative synthesis that included quantitative, qualitative and mixed methods research papers, review articles and professional commentaries that deployed the concept of political skill (or associated terms) to describe and analyse the implementation of change in healthcare services. RESULTS: Sixty-two papers were included for review drawn from over four decades of empirically and conceptually diverse research. The literature is comprised of four distinct literatures with a lack of conceptual coherence. Within and across these domains, political skill is described as influencing health services change through five dimensions of leadership: personal performance; contextual awareness; inter-personal influence; stakeholder engagement, networks and alliances; and influence on policy processes. CONCLUSION: There is a growing body of evidence showing how political skill can contribute to the implementation of health services change, but the evidence on explanatory processes is weak. Moreover, the conceptualisation of political skill is variable making comparative analysis difficult, with research often favouring individual-level psychological and behavioural properties over more social or group processes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-021-06272-z.

Background The implementation of change in health and care services is often complicated by the micro-politics of healthcare organisations. There are calls for those leading change to develop and utilise political skills and behaviours to understand and mediate such politics, but to date there has been little research within the healthcare sector that offers a developed and empirical conceptualisation of the political skills and behaviours for leading change. MethodsA qualitative interview study was undertaken with 66 healthcare leaders and change agents from the English National Health Service (NHS). Participants were sampled to reflect anticipated differences career stage, leadership level and role, care sector, and professional backgrounds. Interpretative data analysis led to the development of five themes. Results Participants accounts highlighted five overarching sets of interlinked skills and behaviours: personal and inter-personal qualities relating to self-belief, resilience and the ability to adapt to different audiences; strategic thinking relating to the ability to understand the wider and local political landscape from which to develop plans that are aligned with national, regional and local agendas; communication skills for engaging and influencing stakeholders, especially for understanding the competing interests and framing rationale for change; networks and networking in terms of access to resources, and building connections between stakeholders; and relational tactics for dealing with difficult individuals through more direct forms of negotiation and persuasion.Conclusions The study offers new empirical insight into the reported political skills and behaviours of implementing health services change that extend existing conceptualisations derived from outside of the healthcare sector. The findings offer further understanding into the political challenges faced by services leaders and practical insights for future leadership development.