Understanding the Relationship between the Adoption of Innovation and Institutions- An Exploratory Qualitative Case Study on NHS ProcurementDespite various efforts to introduce support measures and financial incentives to improve innovation in the public sector, it is widely perceived that the adoption of innovation is a slow and complex process (Albury, 2005; Coriat and Levinthal, 1990). Evidence of previous research indicates that the adoption of innovation varies considerably across public sector organisations, regardless of the perceived potential benefit of the new product (or service) (Cash and MOster, 2000; Edquist, 2005).The public procurement and innovation literature emphasises the potential of public sector organisations as important buyers and adopters of innovation, highlighting the role of public demand for the triggering and diffusion of innovation (Edler et al. 2011; Cunningham and Karakasidou, 2009; Edquist, 1997). However, innovation adoption in the public sector has been characterised as a slow and unpredictable process where the underlying institutional factors that play a role in the adoption process are not fully understood (Albury, 2005; Allman et al., 2011). The topic of poor adoption in the public sector is of great significance, not only for the innovation agenda, but also due to the increasing pressure on the public sector to achieve higher quality services with more efficient allocation of resources, particularly the NHS (Bonoma, 1985).The main objective of the research is to address the problem of slow and inconsistent adoption of innovation in the public sector, by providing a more holistic and institutional perspective to the study of innovation adoption, addressing the lack of context specific research on the topic. A major focus of this work is to understand the relationship between the adoption of innovation and institutions as a means to establish a more in-depth understanding of the institutional features that influence the adoption process. The research focuses on new technology procurement cases in the context of the English and Scottish NHS system, as two different institutional contexts, in order to identify the institutional features at the system's and organisational level hat make a difference in adoption of innovation.