How digital orientation can help hospitals manage the performance implications of an ethnically diversifying workforce: Panel evidence from the English NHS

Abstract

Hospitals in the English National Health Service (NHS) face unprecedented patient care demands and persistent staff shortages, resulting in increased Ethnic Diversity in the workforce and intensifying pressure to adopt a Digital Orientation . Although these concurrent social and technological changes in hospitals are highly relevant in practice, organizational and healthcare research offers a limited understanding of how increasing ethnic diversity and digital orientation jointly affect Organizational Performance . We address this gap by examining the individual and interactive associations of both dimensions with hospital performance, conducting a longitudinal fixed-effects study using a panel dataset of 117 NHS hospitals over six years (April 2013 to March 2019). Our results reveal that increased ethnic diversity is associated with a decline in hospital performance. In contrast, enhancing digital orientation is associated with improved performance and attenuates the negative relationship between rising ethnic diversity and performance. Theoretically, we contribute by shifting the focus of ethnic diversity research to the intra-organizational level and by establishing digital orientation, beyond mere IT investments, as a strategic capability that both drives performance and buffers the performance consequences of social change. In practice, hospital managers should treat digital orientation as both a technology strategy and a lever for facilitating workforce integration and diversity management.

The authors' abstract, as published at the source. Technological Forecasting and Social Change, 2026 · DOI ↗