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Professor Justin Waring

Area of study
Systems and culture
Fellowship level
Year awarded
Host university
Health Services Management Centre
University of Birmingham
Justin’s research deals with the changing organisation of healthcare systems, especially how the design, implementation and embedding of improvement interventions is shaped by institutionalised professional practices, cultures and identities. Justin is interested in the application of social theory to different social, cultural and organisational contexts, as a means of analysing improvement initiatives and extending theoretical rigour.
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Understanding the interlocking activities of spread, adaption and adoption: spreading and embedding the POPS model in NHS Organisations


Older people often experience complications after operations because they tend to have co-morbidities or other health problems that add risk to the surgical procedure and recovery. The Perioperative care for Older People undergoing Surgery (POPS) model has been developed to pre-assess patients prior to surgery to identify interventions that can reduce the risk of complications. The POPS Network offers a dedicated programme of learning materials, coaching, and organisational development to support NHS organisations to learn about and implement the POPS model.

There is a need to understand how the POPS Network ‘spreads’ the POPS model and how, through working with the POPS Network, NHS organisations adapt and adopt the POPS model across different service contexts. As more NHS organisations implement the POPS model, there are opportunities for these organisations to act as additional sites of learning, and so the study will also examine the feasibility of this extended spread network.


The study will utilise qualitative methods to understand how the NHS Frailty POPS Network has supported the spread, adapted and adopted of the POPS model across NHS organisations.

This will involve four linked activities:

  • The first will focus on the development of the POPS model to understand its social history of the innovation, its theory of change and evidence base.
  • The second will focus on the development of activities to support the spread and adoption of the POPS model, especially the programme of support provided by the POPS team at Guy’s and St. Thomas and the POPS Network.
  • The third will look at how and why NHS organisations engage with the POPS Network, including their experiences of learning about the POPS model, and how they then adapt and adopt the POPS model into different organisational contexts.
  • The fourth will investigate how these NHS organisations can provide support to other organisations to learning and implement about the POPS model.

Watch Justin’s HSR UK 2023 conference presentation, ‘Watching the detectives: questions of legitimacy and public value with the introduction of a novel accident investigation agency in the English healthcare sector’


Research articles

Waring, J., et al. (2023) Implementing a Perioperative care of Older People undergoing Surgery (POPS) service: findings from a multi-site qualitative implementation study. Age and Ageing. 

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