Are ethical predisposition and governance critical for success in National Health Service construction projects in England?

Critical success factors (CSF) for project success have been studied for nearly half a century, but there are few studies on governance and none on ethical predisposition as a CSF for project success. Although governance and ethical predisposition may appear to be unconnected, they are not. Governance is an organisation’s codified expression of moral behaviour, a set of rules that require compliance. Ethical predisposition is an individual’s preference for judging whether an act is moral based on following the rules or the outcome of one’s actions. As ethical predisposition affects decisions about the value of rules compliance, an understanding of ethical pre-disposition is helpful in the study of governance. Rationale: The NHS is a large user of construction services and the UK Government’s 2019 investment plan for investment healthcare infrastructure suggests that it will continue to be so. Successful project outcome is vital because of the negative impact that late, over budget and poor-quality NHS projects have on service provision and public finances. Aim: To investigate whether ethical predisposition and governance are CSFs for construction projects in the English NHS. Research Questions: Question 1 a) What is the ethical predisposition of project personnel in English NHS construction projects? b) What impact does ethical predisposition have on project success English NHS construction projects? Question 2: What impact do corporate and project governance have on English NHS construction projects? Objectives: to explore the ethical predisposition of client-side personnel in the delivery of construction projects; examine the relationship between ethical predisposition and project success; examine the relationship between project governance and project success; explain how success is measured and develop a project assurance model to guide project sponsors in the establishment of good governance in projects A mixed methods explanatory approach was employed using a survey and six follow-up face-to-face interviews. The survey revealed the predominance of rules-following, low effectiveness of corporate governance and evidence that time, cost and quality are not the main measures of project success. Statistical analysis showed weak correlation between ethical predisposition and governance and project success. Interviews suggested that culture, the trust board’s project oversight, and the lack of knowledge about project performance in the operational phase need to be addressed. It was concluded that ethical predisposition and governance are not levers for success, but rather should be adopted as measures of success because they are associated with openness, transparency and public confidence. Measurement of project success should be carried out at the end of the project management phase and during the operational phase. A Project Assurance Model (PAM) was developed to guide corporate boards in their stewardship of projects in the project management and operational phases.