Exploring innovation landscapes: a national cross-sectional study of Swedish primary care from the viewpoint of primary care managers

BACKGROUND: Innovation is increasingly necessary in primary care policy, and healthcare managers play a pivotal role in translating policy ambitions into practice and shaping organisational conditions that foster innovation. The aim of this study was to explore innovation activities and their contextual conditions in Swedish primary care, as perceived by primary care managers. METHODS: A national cross-sectional mixed-methods survey was conducted across Swedish primary care centres. Quantitative data were analysed using descriptive statistics, while qualitative data were analysed using systematic text condensation. RESULTS: In total, 392 of the 1,028 invited primary care managers responded to the questionnaire. Approximately 80% of primary care managers reported product, process or organisational innovations, reflecting relatively high innovation activity at primary care centres. Innovation ideas predominantly emerged from within the primary care centre, and managers viewed themselves as playing a central role in generating these ideas. Most innovation activities involved internal collaboration between staff groups (86%) and units (62%), with limited external collaboration (6%-12%). Leadership was central in engaging staff with innovation and cultivating an innovation-supportive culture. Managers provided time, space and organisational support for continuous competence development. However, organisational and resource constraints limited staff involvement in innovation, as primary care remains tightly bound to economic and production-related demands. CONCLUSION: This study offers an overview of the innovation landscape in Swedish primary care from the perspective of primary care managers and contributes empirical knowledge on how innovation is understood and managed across different primary care contexts in Sweden. While Swedish primary care demonstrates strong engagement in innovation, the involvement of and collaboration with external stakeholders remain limited, underscoring the need for system-level strategies and processes to facilitate cross-sector innovation partnerships. Further research is needed on how system-level frameworks for collaboration and innovation can be established across the Swedish healthcare system, including primary care.