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Many town centres in England exhibit high retail property vacancies and require regeneration. Several alternatives for the replacement of town centre retail (TCR) have been suggested, one of which is healthcare. The healthcare sector in England is in distress, with the National Health Service (NHS) tackling extensive patient waiting lists, whilst operating from an ageing estate. This paper is an introductory study that uses seven carefully selected personalised surveys to raise academic awareness of the importance and potential of integrating healthcare into town centres and calls for large-scale research to establish the statistical validity of the reported observations.

This study is developed from an interpretative standpoint. Through semi-structured interviews with key stakeholders specific to retail-to-healthcare conversions, this study reports stakeholders' perspectives on opportunities and limitations for such conversions to give direction for large statistical research in the future.

All participants support the integration of healthcare into town centres and agreed that diagnostic services, mental health support and primary care services are appropriate for provision within town centres. The participants advocate large-scale change in town centres in England, with integrated healthcare co-located with complementary services to fit with wider regeneration plans. Participants prefer adaptation of existing buildings where technically feasible and emphasise the importance of obtaining the buy-in of other stakeholders whilst expressing concerns about the uncertainty of capital funding availability.

This is the first study to analyse the practice of retail-to-healthcare conversions in town centres. These are still rare in England and projects are complex. The market experience is limited, and thus, the literature is scarce. This study fills this void and provides a starting point for future quantitative research in this area and informs the new town-planning policies.

This study investigates the role of leadership and cultural transformation in facilitating Lean Six Sigma (LSS) practices in clinical pharmacy settings to reduce medicine waste within the UK National Health Services (NHS).

A systematic literature review on Lean Six Sigma in health care was conducted to develop an analytical framework. This was followed by a qualitative case study of an English NHS trust to test the framework, exploring pharmacists' adoption of LSS practices and their impact on staff behaviour, focussing on leadership decisions and organisational culture.

The research highlights the significance of leadership’s prioritisation in waste reduction efforts and its influence on staff engagement. It also examines the intricate relationship between leadership decisions, education and training, resource allocation, and the prevailing clinical culture, which shapes pharmacists' behaviours and attitudes towards LSS practices and waste reduction.

The study’s focus on a single NHS trust limits the generalisability of the findings, suggesting the need for further research across different healthcare settings.

The study recommends a cultural transformation, earlier training, and reformation in service strategy to enhance the adoption of LSS practices and contribute to a more sustainable future for the wider health services.

Effective medicine waste management prevents harm and helps address the current NHS medicine shortage. The NHS can allocate resources efficiently, ensure timely treatment, and prepare for future disruptions by implementing the proposed framework.

We developed a leadership model for the NHS to reduce medicine waste, offering a novel approach to addressing the challenge of medicine waste through leadership and cultural transformation.

This study aims to assess National Health Service (NHS) decision-making protocols during the pandemic, with two primary objectives: (1) to establish whether decision-making protocols changed during the pandemic and (2) to evaluate if these changes could inform future decision-making strategies beyond the pandemic. By focusing on the shift from traditional to emergency decision-making processes, this research seeks to derive actionable insights for enhancing policy and practice in crisis conditions.

We employ a mixed-methods approach, gathering data through an online survey targeted at senior NHS decision-makers involved in the pandemic response. Our survey collected quantitative and qualitative data to assess changes in decision-making protocols. The analysis included statistical techniques to quantify changes and thematic analysis to explore their implications, providing a detailed understanding of decision-making adaptations during the crisis and their potential future impact.

Our findings clarify the role of the NHS values and constitution, which prioritize patient welfare, dignity and equitable access to healthcare, guiding all decision-making. During the pandemic, the urgency to respond swiftly necessitated modifications to these guiding principles. Traditional processes were adapted, allowing for more rapid decision-making while still aligning with the core values, effectively balancing immediate response needs with long-term healthcare commitments.

Our research contributes to decision-making under crisis conditions within a healthcare context and brings together a theoretical background which has accommodated the development of models and approaches that can be utilized by both service and manufacturing organizations. In addition, we have sought to bring together the importance of decision-making protocols under crisis conditions using observations from respondents who experienced decision-making at a senior level prior, during and beyond the period of the COVID-19 pandemic, which has assisted in the models developed in this paper. In addition, our empirical research demonstrates the importance that the values of the organization have upon decision-making and how such values need to be adjusted in the light of crisis operations.

Our research provides insightful observations relating to the pressures upon decision-making protocols under crisis conditions and provides senior decision-makers with an approach to realigning values to cope with unusual and highly pressurized operating environments. Notably, there is a clear requirement for decision-makers to communicate clearly to staff the need to temporarily alter the modus operandi to reflect crisis operations.

To the best of the authors’ knowledge, this is the first study to explore decision-making in the NHS during a pandemic and to clearly demonstrate how such decision-making needs to be adapted to reflect the nature and scope of delivering a complex healthcare service under crisis conditions.

The outbreak of the COVID-19 pandemic has significantly impacted healthcare systems, presenting unforeseen challenges that necessitated the implementation of change management strategies to adapt to the new contextual conditions. This study aims to analyze organizational changes within the total hip replacement (THR) surgery pathway at multiple levels, including macro, meso and micro. It employs data triangulation from various sources to gauge the complexity of the change process and comprehend how multi-level decision-making influenced an unexpected shift.

A multicentric, single in-depth case study was conducted using a mixed-methods approach. Data sources included patient-reported outcome measures specific to the THR pathway and carefully structured in-depth interviews administered to managers and clinicians in two healthcare organizations serving the same population.

Decisions made at the macro level resulted in an overall reduction in surgical activities. Organizational changes at the meso level led to a complete cessation or partial reorganization of activities. Micro-level actions for change and adaptation revealed diverse and fragmented change management strategies.

Organizations with segmented structures may require a robust and structured department for coordinating change management responses to prevent the entire system from becoming stuck in the absorptive phase of change. However, it is important to recognize that absorptive solutions can serve as a starting point for genuine innovations in change management.

The utilization of data triangulation enables the authors to visualize how specific changes implemented in response to the pandemic have influenced the observed outcomes. From a managerial perspective, it provides insights into how future innovations could be introduced.

This paper aims to explore the antecedents and consequences of service chain flexibility (SCF) in healthcare service delivery.

A structural model was developed based on a literature review. A 29-indicator questionnaire was circulated among service providers in the healthcare system across India, and 253 valid responses were received, corresponding to a response rate of 46%. The research model was assessed using a cross-sectional research design, and the data were analyzed by structural equation modeling using analysis of moment structures (AMOS) software.

Service orientation (SO), technology integration (TI), knowledge sharing (KS) and supply chain integration (SCI) were identified as antecedents of SCF, the consequence of which is responsiveness in service delivery (RSD). Furthermore, patient-centered care moderates the relationship between SCF and RSD.

This paper highlights the impact of SCF on RSD in healthcare organizations. Consideration of the four constructs of SO, TI, KS and SCI as antecedents of SCF and, in turn, RSD may be one of the limitations. Future work may identify other theoretical constructs with potential impacts on SCF and RSD. Furthermore, eight months for data collection could have resulted in early-late response bias. This study was operationalized in India and may reflect political, economic, social, technological, environmental and legal factors unique to India.

The study provides suggestions to practitioners for building RSD by leveraging SO, TI, KS and SCI in flexibility-driven service chain processes. Recognizing the relationships among these constructs can aid in the timely formulation of corrective actions and patient-centric policies.

This paper highlights how focusing on a SCF can promote RSD. This understanding may aid the design of processes that develop patient-centricity and deliver health as a social good in an effective manner.

The empirical evidence from this study can help hospitals integrate and build flexibility in their functions, thus enabling them to deliver responsiveness in care.

A learning-focused culture promotes creativity, innovativeness and the acquisition of novel insights and competencies. The study aims to explore the relationship between human resource development (HRD) practice and employee competencies using organizational learning culture as a mediating variable.

Data were collected from 828 employees of 37 health care institutions comprising 24 (internationally-owned) and 13 (indigenously-owned). Construct reliability and validity was established through a confirmatory factor analysis. The proposed model and hypotheses were evaluated using structural equation modeling.

Data supported the hypothesized relationships. The results show that training and development and employee competencies were significantly related. Career development and employee competencies were significantly related. Organizational learning culture mediates the relationship between training and development and employee competencies. However, organizational learning culture did not mediate the relationship between career development and employee competencies.

The generalizability of the findings will be constrained due to the research’s health care focus and cross-sectional data.

The study’s findings will serve as valuable pointers to policy makers and stakeholders of health care institutions in developing system-level capacities that promote continuous learning and adaptive learning cultures to ensure sustainability and competitive advantage.

By evidencing empirically that organizational learning culture mediates the relationship between HRD practices and employee competencies the study extends the literature.

The digitalisation of healthcare services has proven to be difficult, with numerous negative effects. We argue that the reason for the problem is not poor project management, but a clash of different institutional logics. The aim of this article is to explore, define and theorise the concept of digitalism, as a term for a new institutional logic in contrast to other, more known logics in organisations, such as managerialism and professionalism, to better understand processes of digitalisation.

We illustrate our arguments with a case study of a process of organizational development before and after the implementation of centralised large-scale IT systems at a large Norwegian hospital. Data was extracted from documents and observations from January 2015 to January 2016 during an organizational audit. In addition, a follow-up study was conducted in 2019 and 2024 by interviewing eight key personnel who were involved in the implementation process.

The implementation of a new digital health record in a Norwegian hospital is a process of social restructuring that involves new actors, logics and control systems. The process of digitalisation shows us how digitalism create tensions, diverges and merges with other institutional logics.

Understanding digitalism as a sensitising concept offers insights into how large-scale technology and organizations are tied together and can help to reduce organizational dysfunctionalities and improve the implementation of IT systems.

This study contributes to a new understanding of digitalisation processes and links an ongoing theoretical debate on the digitalisation of organizations with empirical findings.

This paper synthesises international research on effective mentor training, education and development (MTED).

An adaptive theory methodology (Layder, 1998), combining deductive and inductive methods, was deployed in a qualitative meta-synthesis of thematic findings generated in three studies: a systematic review of literature published between January 2010 and July 2020, together with a secondary analysis of studies including evidence on MTED; a subsequent systematic review of literature published between August 2020 and May 2023 and a general inductive analysis (Thomas, 2006) of interviews of leaders of large-scale MTED programmes that had good evidence of impact.

Our meta-synthesis found that effective MTED is evidence-based, refined through ongoing research, tailored both to individual needs and context and includes sustained support. Effective pedagogical approaches in MTED are underpinned by adult learning principles and establish a learning climate that fosters open and trusting relationships. Effective MTED is shaped by the espoused mentoring model or approach, with particular emphasis on understanding, building and sustaining mentoring relationships and incorporating observing, practising, critically reflecting on and receiving feedback on mentoring.

The study will be helpful to practitioners designing, reviewing and evaluating MTED programmes, researchers seeking to enhance the sparse MTED evidence base and programme commissioners.

The original and significant contribution of this study is the identification of key principles relating to the overall design of – as well as specific content, pedagogical approaches and supporting resources within – MTED programmes that have evidenced positive effects on mentors, mentees, mentoring and/or organisations.

Organisations are confronted with the challenge of navigating various pressures arising from activities that shape environmental and social impacts, which stakeholders find significant. This research endeavours to ascertain a process facilitating the analysis and seamless integration of sustainability into corporate strategy. The goal is to establish an “integrated” ESG governance framework adept at effectively managing institutional pressures.

This research employs an action research approach, focusing on a leading company within the sugar industry. The investigation delves into the relationship dynamics associated with business issues through a process that engages, either directly or indirectly, board members, top managers, as well as industrial and commercial customers, along with final consumers.

The formulation of a sustainability strategy serves as a guiding framework for the Board of Directors in effectively navigating tensions arising from environmental, social and economic pressures.

The research contributes to bridging the realms of business governance and institutional theory (viewed under a paradoxical lens). On a managerial level, the study introduces a structured process aimed at seamlessly integrating sustainability objectives into governance, aligning with international ESG guidelines (OECD, 2023; WEF, 2020).

The originality of this research lies in crafting a sustainability strategy by the BoD that takes into account the impact of governance and responds to the demands of strategic stakeholders.