CROSS-SECTOR COMMUNICATION
Identified channels for knowledge- sharing among NHS EFM staff
Publications
e.g. Health Estate Journal (HEJ) Health Service Journal (HSJ)
Codification
Policies & strategies l Government, e.g. Five Year Forward View (2014)
l NHS, e.g. Delivering a ‘Net Zero’ National Health Service (2020)
Undocumented knowledge
Social Network Personalisation
Communities of Practice l Professional bodies. e.g. IHEEM, HEFMA l Knowledge networks, e.g. SALUS
Documented knowledge
Official guidance l Health Building Notes (HBNs) l Health Technical Memoranda (HTMs)
Independent reports e.g. Lord Carter of Coles (2016) Naylor (2017)
Estates Team Collaboration Hub l Sharing of documents and case studies l Discussion forums
Regional/local networks l Formal networks, e.g. CCGs, ICSs l Informal networks, e.g. Shelford Group, Centre for Sustainable Healthcare
Knowledge brokers l Authorising Engineers (AEs) l Consulting & contracting firms
Figure 4: Available channels to share both documented and undocumented knowledge among NHS EFM staff.
without the need to contact the source of the knowledge. For example, government, NHS, and other independent bodies, regularly publish new plans and reports regarding the status quo and the future strategic direction of the NHS built estate.
Of limited value?
Additionally, NHSE/I disseminates guidance documents such as HBNs and Health Technical Memoranda (HTMs) as an essential set of information for EFM staff. However, these are only reviewed and updated after long approval processes over the course of many years, and only have limited value when faced with complex sustainability challenges. The online ‘NHS Estates Team Collaboration Hub’, to which only NHS EFM staff have access, was created as a central location for key EFM documents. The discussion forums for different technical disciplines allow users to ask questions – mostly regarding day-to-day matters – and receive answers from colleagues in other Trusts. In the interviews, practitioners mentioned the importance of the Hub, but also outlined that the structure and content require more detailed reflection to be an even more valuable knowledge-sharing resource. Publications such as Health Estate Journal provide another means of sharing best practice and know-how across the NHS EFM landscape. The analysis of the available channels reveals that there are various mechanisms by which to share knowledge with colleagues across the NHS EFM landscape and beyond. However, many interviewees stated that if they do not find help in their social network, they struggle to determine an appropriate
channel for their question, since many ‘don’t have the time to scroll through stuff and look for people’. Hence, an overarching strategy and consistent structure for knowledge-sharing among NHS Trusts are much needed. However, to be able to create this effective knowledge-sharing strategy, the underlying factors influencing the actors involved need to be studied in detail.
A range of inhibitory factors Our research suggests that various organisational, social, and political barriers inhibit effective knowledge-sharing. To break down the underlying complexity of human behaviour involved in knowledge- sharing across organisational boundaries, the amended cultural-historical activity
theory (CHAT) model8 (Fig 5) summarises
the key elements: (i) knowledge transferred, (ii) boundary (source and recipient), (iii) flow mechanisms (channel), and (iv) organisational context. In ideal knowledge-sharing communities, the knowledge flow is multi-directional, so that a recipient of one piece of information can be the source of another. Hence, both individual and social factors impacting source and recipient can be summarised as boundary-related factors. Many NHS EFM practitioners mentioned a sense of reluctance of EFM staff to communicate across organisational boundaries in some regions. Some explained this as stemming from a lack of time and priority dedicated to knowledge-sharing, while others
Factors influencing the knowledge-sharing process
Organisational context
Source
Knowledge
Recipient
Flow mechanisms
Figure 5: The Cultural Historical Activity Theory (CHAT) model visualises the involved elements in the knowledge-sharing process, and allows for a structured investigation of underlying barriers.
November 2021 Health Estate Journal 59
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