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Healthcare tribalism refers to the phenomenon through which different groups in a healthcare setting strictly adhere to their profession-based silo, within which they exhibit stereotypical behaviours. In turn, this can lead to deleterious downstream effects upon productivity and care delivered to patients. This study highlights a clinician-led governance model, implemented at a National Health Service (NHS) trust, to investigate whether it successfully overcame tribalism and helped drive innovation.

This was a convergent mixed-methods study including qualitative and quantitative data collected in parallel. Qualitative data included 27 semi-structured interviews with representatives from four professional groups. Quantitative data were collected through a verbally administered survey and scored on a 10-point scale.

The trust arranged its services under five autonomous business units, with a clinician and a manager sharing the leadership role at each unit. According to interviewees replies, this equivalent authority was cascaded down and enabled breaking down professional siloes, which in turn aided in the adoption of an innovative clinical model restructure.

This study contributes to the literature by characterizing a real-world example in which healthcare tribalism was mitigated while reflecting on the advantages yielded as a result.

Previous studies from all over the world identified major differences in the perspectives of different healthcare professional groups. In the United Kingdom, clinicians largely felt cut off from decision-making and dissatisfied with their managerial role. The study findings explain a governance model that allowed harmony and inclusion of different professions. Given the long-standing strains on healthcare systems worldwide, stakeholders can leverage the study findings for guidance in developing and implementing innovative managerial approaches.

This study aims to investigate which factors are associated with the willingness of employers to hire people with disability from the perspective of disability employment service providers. We also identify social marketing approaches that disability employment service providers consider to be most effective in increasing employer willingness to hire people with disability.

Using the framework of the theory of planned behavior, this study examines the association of attitude, subjective norms and perceived behavioral control with employer willingness to hire people with disability. The authors do this from the perspective of disability employment service providers, who are responsible for matching people with disability with suitable employment opportunities. The authors used a qualitative approach to data collection and conducted 30 in-depth interviews. Data analysis included deductive and inductive coding to develop the themes and subthemes.

Attitude, subjective norms and perceived behavioral control were all perceived to influence employers’ willingness to hire people with disability. However, the importance of each construct was perceived to differ by location and organization type. Three key social marketing approaches were perceived to be most effective in increasing employer willingness to hire people with disability: educational, relational and interactive. The educational intervention attempts to increase employers’ knowledge about disability, the relational approach aims to develop relationships within the community to strengthen relationships with employers and the interactive approach involves direct contact between employers and people with disability.

Theoretically, this study reveals perceived heterogeneity in terms of the theoretical constructs that are employer hiring decisions. Practically, results help disability employment service providers design social marketing strategies that are effective in reducing barriers and increasing employment for people with disability. Methodologically, this study adds a new perspective on employer willingness to hire people with disability – that of disability employment service providers – which avoids the social desirability bias found in many self-reported studies of employer attitudes and behavior.

The purpose of this paper is to report on how early years practitioners worked with the ORIM Framework to support work with parents to promote early literacy experiences.

Co-produced Knowledge Exchange (KE) was used to develop and evaluate work with parents to facilitate their young children’s literacy. Information was gathered in discussion groups, interviews with parents and practitioners and feedback from all the parties involved.

Practitioners and families engaged with each other in the further development of an established literacy programme, and families demonstrated “ownership” of the co-produced knowledge after the end of the project.

Project design in co-produced research and KE is necessarily flexible. The focus is on practitioners’ knowledge and ownership of the process, sharing knowledge with parents and enhancing children’s experiences.

Practices that can enhance parental engagement in their children’s early literacy are varied and multiple and ORIM can be used flexibly to plan, develop and evaluate innovative and community – (and family –) specific practices.

Where parents have more knowledge of children’s early literacy development they are in a better position to support them; for learning communities there are implications in terms of future development of work with families to support early literacy development.

This paper contributes an original approach to the co-production of research with early years practitioners. It also identifies specific issues around the ethics of ownership in co-produced research.

Response to suggestion that EU-wide cash payment limits would assist in the control of terrorism finance and money laundering.

Desk review and interviews

The inception impact assessment (IIA) is ill-conceived, not grounded on firm empirical evidence and harmful to both crime control and the legitimate interests and rights of the EU citizens. The action under discussion is presented as a measure against terrorism finance, serious crime and tax evasion. The problem is that these criminal acts correspond to very different methods, volumes, perpetrators, causes and control challenges. Cash payment limitations (CPLs) are nowhere near a panacea that can address all of them and cannot make any of them go away magically. Even when each of these crime challenges are considered on their own, the empirical linkage of CPLs to effective controls is not there. The evidence from EU countries with CPLs in place shows higher levels of informal economy, corruption, tax evasion and terrorism risks than those without. There is substantial evidence of non-cash, very serious and organized crime, while the amounts needed and used by terrorists in Europe are usually very small in cash transactions, way below the thresholds under consideration. In fact, determined offenders will shift to other methods and become more sophisticated, posing new problems to controllers. Displacement and incentives for better-organized crime may well be the main products of such measures.

It counters the argument that the cash payment limits can help reduce serious crime, while pointing to several adverse consequences on legitimate interests and human rights.