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Article
Publication date: 21 August 2019

Stephanie D. Short, Nikhil Hawal, Nasser Sai Albusaidi and Farah Purwaningrum

The purpose of this paper is to identify the elements of effective policies and processes to inform future health professional regulation reforms and practice in the Emirates.

Abstract

Purpose

The purpose of this paper is to identify the elements of effective policies and processes to inform future health professional regulation reforms and practice in the Emirates.

Design/methodology/approach

This study is based on qualitative exploratory methodology. Methods of data collection and analysis included document analysis of the relevant literature, newspapers (as featured on their online websites), policy documents and official statistics. In-depth semi-structured interviews were conducted with key stakeholders, including employers in the health and higher education sectors in Ras Al Khaimah, human resources managers, regulators and public health professionals and scholars.

Findings

This paper brings to light the issues of maldistribution of the medical workforce, Emiritisation and examines implications for more effective medical workforce governance in the United Arab Emirates (UAE).

Originality/value

First, the study provides policy recommendations for medical workforce governance in the context of UAE. Next, empirical studies on health workforce governance in the Middle East’s Gulf Cooperation Council are lacking and primarily focus on the international mobility of expatriates. The study addresses the lack of empirical studies on this topic in the UAE. Third, the UAE is a fertile ground for research on medical workforce governance and, more broadly, the mobility of health professionals due to its economic diversification strategy and thriving medical tourism industry.

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Book part
Publication date: 12 November 2018

Fiona Pacey

This study is a considered interpretation of the National Registration and Accreditation Scheme for the health professions, which commenced operations in Australia in…

Abstract

This study is a considered interpretation of the National Registration and Accreditation Scheme for the health professions, which commenced operations in Australia in 2010. The development of the Scheme and its operational elements (namely the Australian Health Practitioner Regulation Agency and 14 profession-specific national Boards) are positioned within the context of regulatory capitalism. Regulatory capitalism merges the experience of neoliberalism with an attentiveness to risk, particularly by the State. Nationally consistent legislation put in place a new set of arrangements that enabled the continuity of governments’ role in health workforce governance. The new arrangements resulted in an entity which is neither exclusively subservient to nor independent of the State, but rather “quasi-independent.” In exploring this arrangement, specific consideration is given to how the regulatory response matched the existing reality of a global (and national) health workforce market. This study considers this activity by the State as one of consolidation, as opposed to fracturing, against a backdrop of purposeful regulatory reform.

Details

Applied Ethics in the Fractured State
Type: Book
ISBN: 978-1-78769-600-6

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Article
Publication date: 6 March 2017

Fiona Pacey, Jennifer Smith-Merry, James Gillespie and Stephanie D. Short

In 2010, Australia introduced the National Registration and Accreditation Scheme for the health professions (the Australian scheme) creating a legislative framework for a…

Abstract

Purpose

In 2010, Australia introduced the National Registration and Accreditation Scheme for the health professions (the Australian scheme) creating a legislative framework for a national system of health workforce regulation, delivering a model of collective (and multi-level) government involvement in regulatory activities. The purpose of this paper is to examine how its governance arrangement compares to different national systems and other health regulatory bodies in Australia.

Design/methodology/approach

This qualitative case study is informed by documentary analysis in conjunction with policy mapping. This is part of a larger project investigating the policy pathway which led to establishment of the Scheme. The authors compare the Scheme with other Australian health standard setting and regulatory bodies.

Findings

The Australian scheme’s governance model supported existing constitutional arrangements, and enabled local variations. This facilitated the enduring interest of ministers (and governments) on matters of health workforce and articulated the activities of the new regulatory player. It maintains involvement of the six states and two territories, with the Commonwealth Government, and profession-specific boards and accreditation agencies. This resulted in a unique governance framework delivering a new model of collective ministerial responsibility. The governance design is complex, but forges a new way to embed existing constitutional arrangements within a tripartite arrangement that also delivers National Boards specific to individual health professions and an organisation to administer regulatory activities.

Originality/value

This study demonstrates that effective design of governance arrangements for regulatory bodies needs to address regulatory tasks to be undertaken as well as the existing roles, and ongoing interests of governments in participating in those regulatory activities. It highlights that a unique arrangement, while appearing problematic in theory may in practice deliver intended regulatory outcomes.

Details

International Journal of Health Governance, vol. 22 no. 1
Type: Research Article
ISSN: 2059-4631

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Article
Publication date: 7 October 2020

Gareth H. Rees, Peter Crampton, Robin Gauld and Stephen MacDonell

Integrated care presents health workforce planners with significant uncertainty. This results from: (1) these workforces are likely in the future to be different from the…

Abstract

Purpose

Integrated care presents health workforce planners with significant uncertainty. This results from: (1) these workforces are likely in the future to be different from the present, (2) integrated care's variable definitions and (3) workforce policy and planning is not familiar with addressing such challenges. One means to deal with uncertainty is scenario analysis. In this study we reveal some integration-supportive workforce governance and planning policies that were derived from the application of scenario analysis.

Design/methodology/approach

Through a mixed methods design that applies content analysis, scenario construction and the policy Delphi method, we analysed a set of New Zealand's older persons health sector workforce scenarios. Developed from data gathered from workforce documents and studies, the scenarios were evaluated by a suitably qualified panel, and derived policy statements were assessed for desirability and feasibility.

Findings

One scenario was found to be most favourable, based on its broad focus, inclusion of prevention and references to patient dignity, although funding changes were indicated as necessary for its realisation. The integration-supportive policies are based on promoting network-based care models, patient-centric funding that promotes collaboration and the enhancement of interprofessional education and educator involvement.

Originality/value

Scenario analysis for policy production is rare in health workforce planning. We show how it is possible to identify policies to address an integrated care workforce's development using this method. The article provides value for planners and decision-makers by identifying the pros and cons of future situations and offers guidance on how to reduce uncertainty through policy rehearsal and reflection.

Details

Journal of Integrated Care, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1476-9018

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Article
Publication date: 7 August 2017

Charlie Labarda, Meredith Del Pilar Labarda and Exaltacion Ellevera Lamberte

Resilient health facilities, particularly hospitals, are critical for a responsive local health system in post-disaster settings. The purpose of this paper is to look at…

Abstract

Purpose

Resilient health facilities, particularly hospitals, are critical for a responsive local health system in post-disaster settings. The purpose of this paper is to look at the experiences of two hospitals (public and private) in Tacloban City, Philippines in the aftermath of a super typhoon and their respective delivery of health services in such setting.

Design/methodology/approach

It described the impact of Typhoon Haiyan on health services delivery capacity and the factors instrumental in the resilience of the case hospitals. Lessons learned from the hospitals’ experiences, both at the level of the hospital staff and the institution, were also drawn. Disaster preparedness of case hospitals were assessed along several domains of resilience. Key informant interviews among stakeholders were conducted with key themes on disaster resilience extracted.

Findings

Disaster preparedness scores for case hospitals were different from each other and were reflected in their experiences of health services delivery in the aftermath of the disaster.

Research limitations/implications

This study on hospital resilience of two case hospitals, in the aftermath of Typhoon Haiyan, is exploratory in nature. The retrospective design of the study made it prone to recall bias. Further, the use of self-report measures for hospital resilience needs to be validated by more objective measures. The lack of baseline pre-disaster resilience indicators and the unpredictability of disasters could perhaps be addressed by a longitudinal study on hospital resilience in disasters in the future.

Originality/value

This study revealed several key findings. Some of the themes that emerged were: public health in disaster is the responsibility of both public and private hospitals; need for flexibility in disaster preparedness and planning, disaster resilience is an emergent process not a static construct, chaos results from zeal without coordination, and the need for integration of disaster preparedness in daily processes and structures of hospital facilities.

Details

Disaster Prevention and Management: An International Journal, vol. 26 no. 4
Type: Research Article
ISSN: 0965-3562

Keywords

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Book part
Publication date: 24 October 2019

Hugh Breakey, William Ransome and Charles Sampford

This chapter explores the ethics of a critical vulnerability suffered by migrant health professionals (MHPs): the problem of ‘pathways to nowhere’. This problem arises…

Abstract

This chapter explores the ethics of a critical vulnerability suffered by migrant health professionals (MHPs): the problem of ‘pathways to nowhere’. This problem arises from dynamic change in the processes, practices and policies governing how migrant professionals achieve accreditation, training and employment in destination countries, whereby established pathways to professional practice are unexpectedly altered or removed. The authors detail the significance of this phenomenon in Australian and Canadian contexts. Drawing on the literature on legitimate expectations and the rule of law, the authors outline the ethical stakes and responsibilities that attach to states creating and then disappointing people’s legitimate expectations, and discuss how these considerations apply to destination countries’ treatment of MHPs.

Details

Ethics in a Crowded World: Globalisation, Human Movement and Professional Ethics
Type: Book
ISBN: 978-1-83867-008-5

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Article
Publication date: 8 July 2014

Fleur Beaupert, Terry Carney, Mary Chiarella, Claudette Satchell, Merrilyn Walton, Belinda Bennett and Patrick Kelly

– The purpose of this paper is to explore approaches to the regulation of healthcare complaints and disciplinary processes.

Abstract

Purpose

The purpose of this paper is to explore approaches to the regulation of healthcare complaints and disciplinary processes.

Design/methodology/approach

A literature review was conducted across Medline, Sociological Abstracts, Web of Science, Google Scholar and the health, law and social sciences collections of Informit, using terms tapping both the complaints process and regulation generally.

Findings

A total of 118 papers dealing with regulation of health complaints or disciplinary proceedings were located. The review reveals a shift away from self-regulation towards greater external oversight, including innovative regulatory approaches including “networked governance” and flexible or “responsive” regulation. It reports growing interest in adoption of strategic and responsive approaches to health complaints governance, by rejecting traditional legal forms in favor of more strategic and responsive forms, taking account of the complexity of adverse health events by tailoring responses to individual circumstances of complainants and their local environments.

Originality/value

The challenge of how to collect and harness complaints data to improve the quality of healthcare at a systemic level warrants further research. Scope also exists for researching health complaints commissions and other “meta-regulatory” bodies to explore how to make these processes fairer and better able to meet the complex needs of complainants, health professionals, health services and society.

Details

International Journal of Health Care Quality Assurance, vol. 27 no. 6
Type: Research Article
ISSN: 0952-6862

Keywords

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Abstract

Details

Applied Ethics in the Fractured State
Type: Book
ISBN: 978-1-78769-600-6

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Article
Publication date: 5 January 2021

Mahima Jain, Apoorva Goel, Shuchi Sinha and Sanjay Dhir

Intervention of artificial intelligence (AI) has brought up the issue of future job prospects in terms of the employability of the professionals and their readiness to…

Abstract

Purpose

Intervention of artificial intelligence (AI) has brought up the issue of future job prospects in terms of the employability of the professionals and their readiness to harness the benefits of the AI. The purpose of this study is to recognize the implications of AI on employability by analyzing the issues in the health-care sector that if not addressed, can dampen the possibilities offered by AI intervention and its pervasiveness (Cornell University, INSEAD, and WIPO, 2019).

Design/methodology/approach

To get an insight on these concerns, an approach of total interpretive structural modelling, cross impact matrix multiplication applied to classification and path analysis have been used to understand the role of the critical factors influencing employability in the health-care sector.

Findings

This study primarily explores the driving-dependence power of the critical factors of the employability and displays hierarchical relationships. It also discusses measures which, if adopted, can enhance employability in the health-care sector with the intervention of AI.

Research limitations/implications

Employability also has an impact on the productivity of the health-care service delivery which may provide a holistic opportunity to the management in health-care organizations to forecast the allocation and training of human resources and technological resources.

Originality/value

The paper attempts to analyze AI intervention and other driving factors (operational changes, customized training intervention, openness to learning, attitude toward technology, job-related skills and AI knowledge) to analyze their impact on employability with the changing needs. It establishes the hierarchical relationship among the critical factors influencing employability in the health-care sector because of the intervention of AI.

Details

foresight, vol. 23 no. 1
Type: Research Article
ISSN: 1463-6689

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Article
Publication date: 9 March 2020

Philippa Miskelly, Ngaire Kerse and Janine Wiles

Managing patients in advanced age is complex, especially when it comes to multi-morbidities and polypharmacy. The purpose of this qualitative study is to investigate…

Abstract

Purpose

Managing patients in advanced age is complex, especially when it comes to multi-morbidities and polypharmacy. The purpose of this qualitative study is to investigate challenges, opportunities and potential solutions from a primary healthcare provider perspective.

Design/methodology/approach

Fifty-seven participants joined in group discussions on challenges and opportunities of working with advanced age. Participants included general practitioners (GPs), practice nurses, students and administration staff working in ten general practices. A thematic analysis was developed, supported by NVivo software.

Findings

Poor lines of communication and fragmentation of services between differing levels of health care services available for older people were highlighted. This has implications for quality of care and equity of services. Participants also reported challenges in treatment and funding regimes.

Research limitations/implications

The small sample size and regional nature of the study, along with the semi-structured nature of the group discussions and rigorous thematic analysis, indicate that this qualitative data is transferable, dependable, confirmable and credible. Comparing the views of tertiary and community services would be useful.

Practical implications

A range of potential strategies and solutions to the current fragmented services was offered by GPs. For example, adequately funded and staffed community-based health hubs; IT platforms enabling timely flow of patient information between primary and tertiary health providers and creation of medical, nursing and allied health roles aimed at improving synergy between GP and tertiary services.

Originality/value

Obtaining the perspectives of general practice highlights the challenges and complexities of caring for those in advanced age brings. These insights have not been previously been explored in-depth within this setting in New Zealand.

Details

Quality in Ageing and Older Adults, vol. 21 no. 1
Type: Research Article
ISSN: 1471-7794

Keywords

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