The challenges to distributed leadership and the boundary spanning of local entrepreneurs in emergent healthcare innovation: the telehealth experience of one Clinical Commissioning Group (CCG) in England

This research is based on the case study of one Clinical CommissioningGroup (CCG) in England and its plans to adopt telehealth for the development of one community-based service. Our focus is on the limitations to distributed leadership and boundary spanning during the conception of an innovation. We analyse the main challenges faced by local entrepreneurs as they seek to enroll various professional and organisational stakeholders in the innovation process. We adopt a narrative analysis method and compare the narratives of three major stakeholders: the project manager, the GPs and the community care provider. The differences in the vision of how telehealth should work, an evidence-basedapproach to innovation, and clinical collegiality were the three main causes that challenged the entrepreneurship of local innovators and collaboration across professional and organisational boundaries. As a result, a distributed leadership model did not emerge preventing a collective framing of the telehealth project.