A new workforce in the making?

Fraser Macfarlane (School of Management, University of Surrey, Guildford, UK)
Trish Greenhalgh (University College London, London, UK)
Charlotte Humphrey (King's College London, London, UK)
Jane Hughes (King's College London, London, UK)
Ceri Butler (University College London, London, UK)
Ray Pawson (University of Leeds, Leeds, UK)

Journal of Health Organization and Management

ISSN: 1477-7266

Publication date: 22 March 2011



This paper seeks to describe the exploration of human resource issues in one large‐scale program of innovation in healthcare. It is informed by established theories of management in the workplace and a multi‐level model of diffusion of innovations.


A realist approach was used based on interviews, ethnographic observation and documentary analysis.


Five main approaches (“theories of change”) were adopted to develop and support the workforce: recruiting staff with skills in service transformation; redesigning roles and creating new roles; enhancing workforce planning; linking staff development to service needs; creating opportunities for shared learning and knowledge exchange. Each had differing levels of success.

Practical implications

The paper includes HR implications for the modernisation of a complex service organisation.


This is the first time a realist evaluation of a complex health modernisation initiative has been undertaken.



Macfarlane, F., Greenhalgh, T., Humphrey, C., Hughes, J., Butler, C. and Pawson, R. (2011), "A new workforce in the making?", Journal of Health Organization and Management, Vol. 25 No. 1, pp. 55-72. https://doi.org/10.1108/14777261111116824

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Copyright © 2011, Emerald Group Publishing Limited

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