Crowded out? The capacity of HR to change healthcare work practices

Abstract

This article analyses the role of HR in changing healthcare work practices. It uses a large, mainly qualitative, empirical study of a national HR initiative in England, document review and secondary sources to indicate how HR struggles to carve out a role for itself within the crowded space of workforce modernisation. The concept of regulatory space is used to indicate how government policy placing HR at the forefront of workforce change is challenged, first, by its complexity, and second, by the reality of regulating workforce practice at local levels. The highly technical nature of work organisation in healthcare, and constraints on the capacity and capability of the HR function, meant that such changes tended to be controlled and designed by clinicians, in contrast to the broad, strategic approach to HR envisaged by policymakers.