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To identify the papers, and publishing journals, describing psychiatry, surgery and paediatrics research funded by the National Health Service (NHS) in the UK. To make comparisons with non‐NHS research and examine the journal impact factors, and importance to clinicians, of journals publishing the most NHS research. To consider the implications, including those for research assessment.

Existing databases were examined: the research outputs database (ROD), which contains information on UK biomedical papers; NHS ROD, which contains details of papers on ROD funded by the NHS; lists of journal impact factors. These were combined with selective findings from surveys conducted to identify journals read and viewed as important for clinical practice by psychiatrists, surgeons and paediatricians.

In each specialty many papers publish NHS‐funded research and they out‐number the non‐NHS papers in the ROD. They appear in a wide range of journals but in each specialty one journal is clearly the most used. The impact factors of journals publishing the most NHS research vary considerably. In each specialty the journal containing most NHS publications is widely perceived to be important by clinicians.

Much NHS‐funded research is also funded by other bodies. Clinician survey response rates were between 38 per cent and 47 per cent. The analysis could be extended to other specialties.

Papers published in the few journals in each specialty that are viewed as important by clinicians could be given additional credit in assessments.

This paper describes outputs from NHS research and shows how assessment could be extended.

The purpose of this paper is to report on the dynamics of “identity leadership” with a quality improvement project undertaken by an International Medical Graduate (IMG) from Sri Lanka, on a two year Medical Training Initiative (MTI) placement in the National Health Service (NHS) [Academy of Medical Royal Colleges (AoMRC), 2017]. A combined MTI rotation with an integrated Fellowship in Quality Improvement (Subedi et al., 2019) provided the driver to implement the HEART score (HS) in an NHS Emergency Department (ED) in the UK. The project was undertaken across ED, Acute Medicine and Cardiology at the hospital, with stakeholders emphasizing different and conflicting priorities to improve the pathway for chest pain patients.

A social identity approach to leadership provided a framework to understand the insider/outsider approach to leadership which helped RH to negotiate and navigate the conflicting priorities from each departments’ perspective. A staff survey tool was undertaken to identify reasons for the lack of implementation of a clinical protocol for chest pain patients, specifically with reference to the use of the HS. A consensus was reached to develop and implement the pathway for multi-disciplinary use of the HS and a quality improvement methodology (with the use of plan do study act (PDSA) cycles) was used over a period of nine months.

The results demonstrated significant improvements in the reduction (60%) of waiting time by chronic chest pain patients in the ED. The use of the HS as a stratified risk assessment tool resulted in a more efficient and safe way to manage patients. There are specific leadership challenges faced by an MTI doctor when they arrive in the NHS, as the MTI doctor is considered an outsider to the NHS, with reduced influence. Drawing upon the Social Identity Theory of Leadership, NHS Trusts can introduce inclusion strategies to enable greater alignment in social identity with doctors from overseas.

More than one third of doctors (40%) in the English NHS are IMGs and identify as black and minority ethnic (GMC, 2019a) a trend that sees no sign of abating as the NHS continues its international medical workforce recruitment strategy for its survival (NHS England, 2019; Beech et al., 2019). IMGs can provide significant value to improving the NHS using skills developed from their own health-care system. This paper recommends a need for reciprocal learning from low to medium income countries by UK doctors to encourage the development of an inclusive global medical social identity.

This quality improvement research combined with identity leadership provides new insights into how overseas doctors can successfully lead sustainable improvement across different departments within one hospital in the NHS.

The purpose of this paper is to address the call for more public sector empirical studies on benefits realisation (BR), to contribute to the literature on BR as a dynamic capability (DC) within the context of IT-enabled innovation in a public sector context and to highlight the challenges facing organisations if they adopt a BR competence and capability framework.

The empirical research conducted within this paper is an exploratory survey. Exploratory surveys are particularly useful when investigating a little known phenomenon and can help to uncover or provide preliminary evidence of association among concepts. This survey was a census of all National Health Service acute hospital trusts in England.

The study indicates that most hospitals that participated in the survey have a basic approach to BR and have yet to develop a more mature approach that would provide the strong micro-foundations of a BR capability.

The BR framework that has been the basis of the survey is interesting in terms of its components but is limited with regards to the micro-foundations of a benefits realisation capability within an organisation. The research suggests that organisations in the public sector need to focus much more on staff development and recruitment in the area of BR to ensure that they have the appropriate skills sets for a rapidly changing environment.

The paper proposes a framework for BR capabilities and IT-enabled change, and suggests that although the concept of maturity is valuable when considering the micro-foundations of BR, DCs change and respond to stimuli within the external and internal environment and must be renewed and refreshed regularly.

This study investigates the current practice of referrers with regard to consent to treatment of adult patients who have learning disabilities. It addresses specifically referrers' awareness of any guidelines on consent, whether they obtain consent before referral and, if so, whether and how they keep written records on gaining consent. Professionals who had referred an adult patient to the Community Team Learning Disability (CTLD) in Newcastle in the last two years were sent a postal questionnaire. The results of the questionnaire are being used to gain better understanding of present practice among referrers and to provide local guidelines on gaining consent in line with recommendations from the Department of Health.

The health sector is increasingly dynamic and complex, in which (strategic) change has become a constant in the sector's adaptation to different challenges. This study aims to meet the need to understand which trends in the literature on strategic change in the health sector and which elements comprise it.

To advance research in this area, the authors systematically review 285 articles collected from the Scopus database. The authors conducted a bibliometric analysis using the VOSviewer software by applying the bibliographic matching method to understand how these articles were grouped and thus characterise the literature trends.

Through a systematic literature review (SLR), this study analyses the various lenses of literature on strategic change in the context of the health sector, classifying and conceptually mapping existing research into four thematic groups: key factors in strategic change, theories and models underlying strategic change, decentralisation in strategic change and the challenges to strategic change in this millennium.

The trends in the literature on strategic change in the health sector explore strategic change from different perspectives. Key features in strategic change suffered reciprocal influence from the theories/models of strategic change and decentralisation of health care so that the health sector could define strategies to respond to the challenges it faced.

The health sector has been in great prominence worldwide, specifically due to the recent events that have occurred on a planetary scale. Therefore, a systematic review is essential to help understand the strategic changes that have occurred in the health sector and their impact. The authors did not find any SLR that focuses on global strategic changes in the health sector, so this study will fill this gap, systematising the main topics on strategic change in the health sector. The authors also suggest an integrative research framework and a future research agenda.

Purpose – The aim of this paper is to examine the diffusion of a new surgical procedure with lower per-case cost and how its diffusion path is affected by the simultaneous introduction of a new drug class that may be an effective treatment to prevent surgery. In particular, we examine whether a process of technology substitution exists that influences the diffusion process of the surgical technology. Given their different cost implications, the interaction of these two different technologies, surgery and drug intervention, is relevant from the perspective of health expenditure. This is of particular interest in health care as technology adoption and diffusion has been cited as a major driver of expenditure growth. Such expenditure growth has been increasingly targeted through the use of market-orientated policy tools aimed at increasing efficiency. Our research is thus addressing the question of how economic incentives influence the diffusion process and we discuss the impact of a set of incentives on hospital behavior.

Design/methodology – Hospital admission data for the financial years 1998/1999 to 2007/2008 in England are used to empirically test the contribution of prescription uptake and market-oriented reforms. Dynamic panel data models are used to capture any changes in technology preference during the period of study.

Findings – Our results suggest that the hospital sector exhibits a strong new technology preference, tempered by the interaction of competition for patients and the ability of the primary care sector to substitute treatments.

Value/originality – Given the current fast technological change, we examine the technological race occurring in the health care sector. We account simultaneously for the diffusion of different technologies not only within the same typology but also with technologies of a different class.

The study aims to analyze the previous literature on government initiatives to implement health information systems (HISs).

Proknow-C (Knowledge Development Process-Constructivist) was used in the selection of the literature and in the bibliometric and systematic analysis.

The research identified a portfolio composed of 33 articles aligned with the research theme and with scientific recognition, as well as periodicals, authors, papers and keywords that stood out the most. Amongst the government initiatives in the 24 identified countries, England has been the most studied nation, and there is a certain prominence of research arising from developed countries. Electronic health records (EHRs) have been the most explored technology. Efficiency and safety of health care delivery, integration of information and among health organizations, cost reduction and economicity are the most expected benefits from government programs. The difficulties found are related to the broader context in which the system is inserted, to the management of the program, to technology itself and to individuals. The most emphasized difficulties identified in most countries were previous context marked by a lack of standardization/interoperability, acceptance of providers and users and project financing. The findings of the present article provide a theoretical framework for future studies, in addition to yielding a replicable process for future use.

This research may be considered original as it analyzes – through a constructivism-structured process (Proknow-C) – the phenomenon under investigation by gathering bibliometric and systematic review data concomitantly. The countries and technologies reported emerge from the process itself.

The purpose of this paper is to determine whether some aspects of the distinctive Mayo Clinic care model could be translated into English National Health Service (NHS) hospital settings, to overcome the fragmented and episodic nature of non-emergency patient care.

The authors used a rapid review to assess the literature on integrated clinical care in hospital settings and critical analysis of links between Mayo Clinic’s care model and the organisation’s performance and associated patient outcomes.

The literature directly concerned with Mayo Clinic’s distinctive ethos and approach to patient care is limited in scope and largely confined to “grey” sources or to authors and institutions with links to Mayo Clinic. The authors found only two peer-reviewed articles which offer critical analysis of the contribution of the Mayo model to the performance of the organisation.

Mayo Clinic is not the only organisation to practice integrated, in-hospital clinical care; however, it is widely regarded as an exemplar.

There are barriers to implementing a Mayo-style model in English NHS hospitals, but they are not insurmountable and could lead to much better coordination of care for some patients.

The study shows that there is an appetite among NHS patients and staff for better coordinated, multi-specialty care within NHS hospitals.

In the English NHS integrated care generally aims to improve coordination between primary, community and secondary care, but problems remain of fragmented care for non-emergency hospital patients. Use of a Mayo-type care model, within hospital settings, could offer significant benefits to this patient group, particularly for multi-morbid patients.

The purpose of this paper is, for English acute NHS hospitals, to investigate how they operate their governance systems in the area of secondary care contracting and identify the key determinants of relationship building within the contacting/commissioning of secondary care focusing upon non‐price competitive behaviour.

A survey instrument was designed and mailed to a sample of all acute NHS hospitals in England of whom 35 per cent responded. This survey was then analysed using logit techniques.

The analysis suggests that: those NHS Trusts offering volume discounts, non‐price competitive incentives or having a strong belief in performance being by “payment by results” criteria are significantly more likely to offer augmented services to secondary care purchasers over and above contractual minima; those NHS Trusts strongly believing in the importance of non‐price factors (such as contract augmentation or quality) in the contracting process are more likely to offer customisation of generic services; and those NHS Trusts using cost‐sharing agreements to realign contracts when negotiating contracts or who strongly believe in the importance of service augmentation in strengthening relationships, or that increased hospital efficiency is the most important aspect of recent NHS reform are more likely to utilise default measures to help realign contracts.

This paper fills a gap in the area of non‐price competition in English NHS acute secondary care contracting.

Purpose: In this chapter, we examine the National Health Service (NHS) and Adult Social Care (ASC) in England, focussing on policies that have been introduced since 2000 and considering the challenges that providers face in their quest to provide a high standard and affordable health service in the near future.

Methodology/Approach: We discuss recent policy developments and published analysis covering innovations within major aspects of health care (primary, secondary and tertiary) and ASC, before considering future challenges faced by providers in England, highlighted by a 2017 UK Parliament Select Committee.

Findings: The NHS and ASC system have experienced tightening budgets and serious financial pressure, with historically low real-terms growth in health funding from central government and local authorities. Policymakers have tried to overcome these challenges with several policy innovations, but many still remain. With large-scale investment and reform, there is potential for the health and social care system to evolve into a modern service capable of dealing with the needs of an ageing population. However, if these challenges are not met, then it is set to continue struggling with a lack of appropriate facilities, an overstretched staff and a system not entirely appropriate for its patients.