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Open Access
Article
Publication date: 1 March 2019

Russell Mannion, Huw Davies, Martin Powell, John Blenkinsopp, Ross Millar, Jean McHale and Nick Snowden

The purpose of this paper is to explore whether official inquiries are an effective method for holding the medical profession to account for failings in the quality and…

4051

Abstract

Purpose

The purpose of this paper is to explore whether official inquiries are an effective method for holding the medical profession to account for failings in the quality and safety of care.

Design/methodology/approach

Through a review of the theoretical literature on professions and documentary analysis of key public inquiry documents and reports in the UK National Health Service (NHS) the authors examine how the misconduct of doctors can be understood using the metaphor of professional wrongdoing as a product of bad apples, bad barrels or bad cellars.

Findings

The wrongdoing literature tends to present an uncritical assumption of increasing sophistication in analysis, as the focus moves from bad apples (individuals) to bad barrels (organisations) and more latterly to bad cellars (the wider system). This evolution in thinking about wrongdoing is also visible in public inquiries, as analysis and recommendations increasingly tend to emphasise cultural and systematic issues. Yet, while organisational and systemic factors are undoubtedly important, there is a need to keep in sight the role of individuals, for two key reasons. First, there is growing evidence that a small number of doctors may be disproportionately responsible for large numbers of complaints and concerns. Second, there is a risk that the role of individual professionals in drawing attention to wrongdoing is being neglected.

Originality/value

To the best of the authors’ knowledge this is the first theoretical and empirical study specifically exploring the role of NHS inquiries in holding the medical profession to account for failings in professional practice.

Details

Journal of Health Organization and Management, vol. 33 no. 2
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 18 October 2019

John Blenkinsopp, Nick Snowden, Russell Mannion, Martin Powell, Huw Davies, Ross Millar and Jean McHale

The purpose of this paper is to review existing research on whistleblowing in healthcare in order to develop an evidence base for policy and research.

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Abstract

Purpose

The purpose of this paper is to review existing research on whistleblowing in healthcare in order to develop an evidence base for policy and research.

Design/methodology/approach

A narrative review, based on systematic literature protocols developed within the management field.

Findings

The authors identify valuable insights on the factors that influence healthcare whistleblowing, and how organizations respond, but also substantial gaps in the coverage of the literature, which is overly focused on nursing, has been largely carried out in the UK and Australia, and concentrates on the earlier stages of the whistleblowing process.

Research limitations/implications

The review identifies gaps in the literature on whistleblowing in healthcare, but also draws attention to an unhelpful lack of connection with the much larger mainstream literature on whistleblowing.

Practical implications

Despite the limitations to the existing literature important implications for practice can be identified, including enhancing employees’ sense of security and providing ethics training.

Originality/value

This paper provides a platform for future research on whistleblowing in healthcare, at a time when policymakers are increasingly aware of its role in ensuring patient safety and care quality.

Details

Journal of Health Organization and Management, vol. 33 no. 6
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 1 February 2000

Jonathan Allen and Huw Davies

Although it has been implicit in previous articles (see Becky's Story in issue 3.4), supported employment as a model for enabling people to get and keep jobs has not been…

Abstract

Although it has been implicit in previous articles (see Becky's Story in issue 3.4), supported employment as a model for enabling people to get and keep jobs has not been given as much coverage as other ways of creating job opportunities. The development of the supported employment model in the UK is mainly associated with people with developmental or learning disabilities. However, experience in the United States has shown that, with appropriate modifications, the supported employment model ‐ particularly the ‘place and train’ version ‐ can achieve outstanding results for mental health service users who want a proper job. We will return to the research evidence in a later issue, but first Huw Davies from the Bury EST (Employment, Support and Training) and Jonathan Allen from Enable in Shrewsbury have joined forces to describe the way they work and the difference it has made to their clients' lives.

Details

A Life in the Day, vol. 4 no. 1
Type: Research Article
ISSN: 1366-6282

Article
Publication date: 1 May 2002

Huw Davies, Bob Davies, Stephen Davies and Diana Moule

There is more to life and personal development than work — although it is sometimes hard to persuade funders of this fact. This article traces the development of a…

Abstract

There is more to life and personal development than work — although it is sometimes hard to persuade funders of this fact. This article traces the development of a supported education initiative and demonstrates how effective such programmes can be in improving peoples' lives.

Details

A Life in the Day, vol. 6 no. 2
Type: Research Article
ISSN: 1366-6282

Content available
1422

Abstract

Details

Journal of Health Organization and Management, vol. 22 no. 1
Type: Research Article
ISSN: 1477-7266

Article
Publication date: 21 March 2008

Guro Huby, Bruce Guthrie, Suzanne Grant, Francis Watkins, Kath Checkland, Ruth McDonald and Huw Davies

The purpose of this article is to provide answers to two questions: what has been the impact of nGMS on practice organisation and teamwork; and how do general practice…

Abstract

Purpose

The purpose of this article is to provide answers to two questions: what has been the impact of nGMS on practice organisation and teamwork; and how do general practice staff perceive the impact?

Design/methodology/approach

The article is based on comparative in‐depth case studies of four UK practices.

Findings

There was a discrepancy between changes observed and the way practice staff described the impact of the contract. Similar patterns of organisational change were apparent in all practices. Decision‐making became concentrated in fewer hands. Formally or informally constituted “elite” multidisciplinary groups monitored and controlled colleagues' behaviour for maximum performance and remuneration. This convergence of organisational form was not reflected in the dominant “story” each practice constructed about its unique ethos and style. The “stories” also failed to detect negative consequences to the practice flowing from its adaptation to the contract.

Originality/value

The paper highlights how collective “sensemaking” in practices may fail to detect and address key organisational consequences from the nGMS.

Details

Journal of Health Organization and Management, vol. 22 no. 1
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 1 February 1992

Roy Staughton, Nick Kinnie, Rebecca Smith and Huw Davies

Manufacturing strategy needs to be appropriate to the needs of theorganization acceptable to all employees, and capable of subsequentrenewal by management. To achieve…

Abstract

Manufacturing strategy needs to be appropriate to the needs of the organization acceptable to all employees, and capable of subsequent renewal by management. To achieve this, attention needs to be paid not only to the objectives and framework of the manufacturing strategy, but also to the processes through which the manufacturing strategy is formulated, implemented, and adapted. Argues that these processes are essentially iterative passing through a series of cycles in response to a changing set of conditions. Whilst education and training issues are central to these processes, little research has been carried out. Puts forward one possible approach to dealing with these issues where education and training are handled by analysts external to the organization. This temporary resource or “locum” team works with the organization to achieve the ultimate aim of managers being able to formulate, implement, and review their own manufacturing strategy. This is achieved by helping managers to formulate a manufacturing strategy, providing guidance to them to implement the strategy and setting up monitoring and review mechanisms.

Details

Integrated Manufacturing Systems, vol. 3 no. 2
Type: Research Article
ISSN: 0957-6061

Keywords

Book part
Publication date: 17 June 2019

Gareth Huw Davies, Sian Roderick, Michael D. Williams and Roderick Thomas

The Technium initiative started in 2001 with an initial Business and Innovation Centre established in the Swansea docklands area. Early success of this first Technium…

Abstract

The Technium initiative started in 2001 with an initial Business and Innovation Centre established in the Swansea docklands area. Early success of this first Technium building led to the concept being rapidly proliferated into a pan-Wales network of primarily sector-focussed centres. Although the Welsh Government withdrew its support for the Technium network initiative in 2010, the individual centres continued under a range of ownerships and the historic initiative of continued interest, particularly with respect to regional policy.

A vibrant policy and practice debate subsequently emerged together with strident media comment. Lack of coherence between Technium Centres and weaknesses in monitoring systems meant this debate has been poorly informed. This case study helps address the evidence deficit within this debate by revisiting the initial Technium Swansea initiative and its subsequent development.

The case study provides an insight into what can realistically be expected of such initiatives in the short, medium and long terms, with realistic time-horizons for ‘success’ and the role of learning for knowledge-based development in similar initiatives and regions.

Details

Creating Entrepreneurial Space: Talking Through Multi-Voices, Reflections on Emerging Debates
Type: Book
ISBN: 978-1-78769-577-1

Keywords

Article
Publication date: 8 August 2008

Frederick H. Konteh, Russell Mannion and Huw T.O. Davies

The purpose of this paper, based on a nation‐wide survey, is to explore how clinical governance managers in the English NHS are seeking to engage with the culture(s) of…

3124

Abstract

Purpose

The purpose of this paper, based on a nation‐wide survey, is to explore how clinical governance managers in the English NHS are seeking to engage with the culture(s) of their organisation to support quality improvement.

Design/methodology/approach

All English NHS primary and acute trusts, a total of 325, were contacted for R&D approval between March and September 2006. Clinical governance leads of organisations which gave their approval, 276 (or 85 per cent), were targeted in a nation‐wide postal survey between October 2006 and February 2007. A response rate of 77 per cent was obtained. The questionnaire contained mostly closed questions about the role and importance of culture in clinical governance and the use of tools for culture assessment. The questionnaire was piloted with eight respondents, seven in clinical governance from both primary care and acute trusts, and one from the National Patient Safety Agency. Useful feedback was received from five of the respondents, which was used to revise and refine the questionnaire. Confidence in the reliability and validity of the results is based on a high degree of consistency and similarity in the responses, both with respect to a few questions which were closely related and the two categories of respondents from primary care trusts and acute trusts.

Findings

There was found to be clear interest among clinical governance managers in culture renewal and management, in line with the growing national policy interest in promoting culture change as a lever for health system reform. Nearly, all clinical governance managers (98 per cent) saw the need to measure local culture in order to foster change for improved performance; 85 per cent, indicated that culture assessment should satisfy a formative purpose, whereas 64 per cent believed that it should serve summative ends. While nearly all clinical governance managers (99 per cent) acknowledge the importance of understanding and shaping local cultures, the majority are also conscious that there are many challenges to overcome in their efforts to implement and sustain beneficial culture change.

Originality/value

This research highlights the widespread practical interest in assessing and managing local health care cultures to support clinical governance and quality improvement activities. It also highlights the need for culture assessment tools that better reflect the needs and interests of clinical governance managers.

Details

Clinical Governance: An International Journal, vol. 13 no. 3
Type: Research Article
ISSN: 1477-7274

Keywords

Article
Publication date: 21 March 2008

Ruth McDonald, Stephen Harrison and Kath Checkland

The authors' aim was to investigate mechanisms and perceptions of control following the implementation of a new “pay‐for‐performance” contract (the new General Medical…

1394

Abstract

Purpose

The authors' aim was to investigate mechanisms and perceptions of control following the implementation of a new “pay‐for‐performance” contract (the new General Medical Services, or GMS, contract) in general practice.

Design/methodology/approach

This article was based on an in‐depth qualitative case study approach in two general practices in England.

Findings

A distinction is emerging amongst ostensibly equal partners between those general practitioners conducting and those subject to surveillance. Attitudes towards the contract were largely positive, although discontent was higher in the practice which employed a more intensive surveillance regime and greater amongst nurses than doctors.

Research limitations/implications

The sample was small and opportunistic. Further research is required to examine the longer‐term effects as new contractual arrangements evolve.

Practical implications

Increased surveillance and feedback mechanisms associated with new pay‐for‐performance schemes have the potential to constrain and shape clinical practice.

Originality/value

The paper highlights the emergence of new tensions within and between existing professional groupings.

Details

Journal of Health Organization and Management, vol. 22 no. 1
Type: Research Article
ISSN: 1477-7266

Keywords

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