What is NPT?

NPT is a sociological toolkit that we can use to understand the dynamics of implementing, embedding, and integrating some new technology or complex intervention. 

Everyone is interested in innovation in healthcare. Innovation promises better ways of organizing and delivering treatment, improvements in the clinical and cost-effectiveness of services, and reductions in the burdens of illness - especially chronic illness.

Most research on healthcare innovation focuses on the outcomes of innovations - measuring their impact and exploring their effects - but this doesn't always tell us the things that we need to know.  Researchers try to help healthcare providers by quantifying outcomes and comparing the effects of these innovations.  But it is also understood that outcomes evaluations are not enough, and that we need to perform process evaluations that help us to understand how these effects come about. Identifying and adopting an innovative health technology, or a new way of organizing professional work, is the beginning of the story, not the end.  Down the line, policy-makers, managers, professionals, and patients all face two important problems as they try to get innovations into practice.

  • Process problems: about the implementation of new ways of thinking, acting and organizing in health care
  • Structural problems: about the integration of new systems of practice into existing organizational and professional settings.

These are important problems for researchers and evaluators too. To understand implementation and integration, we need focus on the dynamic processes that lead to innovations becoming embedded in everyday work.  Normalization Process Theory is an explanatory model that helps managers, clinicians, and researchers understand these  processes.

There's nothing so practical as a good theory, and this website will guide you through the uses of NPT, and some of the theory's basic concepts.  Not only that, but we also provide a simple toolkit to enable you to think through implementation and integration problems using NPT.

NPT helps us disassemble the human processes that are at work when we encounter a new set of practices - whether they're bundled around a large randomized controlled trial across many sites, or in a falls prevention program on a single hospital ward. NPT has a robust theoretical basis - but we don't discuss that in detail on this website (although we do discuss what a theory is and does, and the formal propositions that are the basis of NPT). That's because this website is intended to translate the formal theory into something you can use, in practice, right now.

Like all theories NPT is build up around a set of constructs - organizing ideas that represent human processes that really happen in the world. But it also presents these in an idealized and abstract form. That's so they can be transported from one problem to another in a stable way. Let's look at the core constructs of NPT, and their specific components. Details about the underlying theory and its development have been published in open access papers.