"Knowledge capital" comes in many forms based on the context of its creation, some in
terms of pure knowledge, some of which is public good and some rival. Furthermore, some
of its forms are less easy to describe since it includes custom, practice and understanding
of how best to organise things. Practitioners and academics, across disciplines of
organisational management, economics, and accounting define the concept of "knowledge
capital" (KC) or "intellectual capital" (IC) as human skills enhanced by organisational
structures, resources and relationships to form a composite knowledge based resource,
which creates competencies, capability and capacity that generate revenue for the
organisation.
Health service provision is based on the transfer of tacit, explicit, established and emerging
knowledge. The capture of learning gained during service delivery is therefore critical for
the safety, effectiveness and quality of service provision co-creating knowledge based
resources including enhanced understanding, skills, processes and routines. The need
arises, therefore, to understand if the way resources are managed should change to take
account of the generation of more or less of something that is of value to health
organisations and systems.
The joint production and "public goods" features of inexhaustibility and non-exclusivity, in
certain circumstances, make the measurement of "knowledge capital" in health
challenging. The management and maintenance of this key resource in health service requires it to be recognised and measured, although there are problems in defining
"knowledge capital". There are challenges in measuring it and even bigger ones in valuing
it. There is a need, therefore, to start with a clearer understanding on what it is and then
attempt to measure it.
This research through an empirical case study highlights the co-creation of, explores its
nature and attempts to measures the scale of "knowledge capital" in health service, as a
resource. The models "knowledge creation cycle in health" and "dimensions of knowledge
capital in health" developed from the literature review are investigated in the study of the
specialised pulmonary hypertension (PH) services at Papworth hospital, a NHS specialist
centre. The additional dimensions of "public goods in health" and "capacity in health" are
surfaced in this study.
Management accountancy method of costing, informed by the economic concept of
opportunity cost of capital, provides a helpful mechanism for the measurement of this
difficult to measure resource in this study. This method is based on the estimates of the
inputs of joint production of "knowledge capital" using the "bottom up" approach being
recommended by NHS guidance. This case study at Papworth hospital reveals that the
scale of the value of stock of "knowledge capital" can be more than twice the value of its
tangible assets. This highlights the necessity for management strategies of health
organisations and health systems to recognise fully its co-creation and measure the scale of
“knowledge capital” in health service. A systematic stock take of "knowledge capital"
assets in health organisations and systems is therefore recommended to enable informed
decision making for effective and efficient management of health services
