Developing organizational learning in the NHS

Learning has been identified as a central concern for a modernized NHS. Con tinuing professional development has an important role to play in improving learning but there is also a need to pay more attention to collective (org anizational) learning. Such learning is concerned with the way organization s build and organize knowledge. Recent emphasis within the NHS has been on the codification of individual and collective knowledge - for example, guid elines and National Service Frameworks. This needs to be balanced by more p ersonalized knowledge management strategies, especially when dealing with i nnovative services that rely on tacit knowledge to solve problems. Having r obust systems for storing and communicating knowledge is only one part of t he challenge. It is also important to consider how such knowledge gets used , and how routines become established within organizations that structure t he way in which knowledge is deployed. In many organizations these routines favour the adaptive use of knowledge, which helps organizations to achieve incremental improvements to existing practices. However, the development o f organizational learning in the NHS needs to move beyond adaptive (single loop) learning, to foster skills in generative (double loop) learning and m eta-learning. Such learning leads to a redefinition of the organization's g oals, norms, policies, procedures or even structures. This paper argues tha t moving the NHS in this direction will require attention to the cultural v alues and structural mechanisms that facilitate organizational learning.