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Article
Publication date: 18 October 2021

Jiju Antony, James Lancastle, Olivia McDermott, Shreeranga Bhat, Ratri Parida and Elizabeth A. Cudney

The purpose of this paper is to conduct an empirical study derived from the previous literature from the perspective of benefits, tools and techniques, continuous…

Abstract

Purpose

The purpose of this paper is to conduct an empirical study derived from the previous literature from the perspective of benefits, tools and techniques, continuous improvement (CI) and quality improvement (QI) methodologies and critical failure factors (CFFs) of Lean and Six Sigma (SS) in the national health service (NHS).

Design/methodology/approach

A literature review was carried out to identify previous findings, empirical data and critical variables concerning Lean and SS in healthcare for over ten years. Second, primary research in quantitative surveys and qualitative interviews was carried out with 110 participants who have experience using Lean and SS in the NHS.

Findings

Lean and SS have evolved into common practices within the NHS and now have an established list of tools and techniques frequently employed by staff. Lean and SS are considered robust CI methodologies capable of effectively delivering extensive benefits across many different categories. The NHS must overcome a sizable amount of highly important CFFs and divided organizational culture.

Originality/value

This paper has developed the most extensive empirical study ever produced on Lean and SS in the NHS and has expanded on previous works to create new and updated research. The findings produced in this paper will assist NHS medical directors and practitioners in obtaining up-to-date insight into Lean and SS status in the NHS. The paper will also guide the NHS to critically evaluate their current CI strategy to ensure long-term sustainability and deliver improved levels of service to patients.

Details

International Journal of Quality & Reliability Management, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0265-671X

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Article
Publication date: 18 October 2021

Michael Clark, Andy Bradley, Laura Simms, Benna Waites, Alister Scott, Charlie Jones, Paul Dodd, Tom Howell and Giles Tinsley

This paper aims to discuss the importance of compassion in health care and experiences of Compassion Circles (CCs) in supporting it, placing this into the national policy…

Abstract

Purpose

This paper aims to discuss the importance of compassion in health care and experiences of Compassion Circles (CCs) in supporting it, placing this into the national policy context of the National Health Service (NHS), whilst focusing on lessons from using the practice in mental health care.

Design/methodology/approach

This conceptual paper is a discussion of the context of compassion in health care and a description of model and related concepts of CCs. This paper also discusses lessons from implementation of CCs in mental health care.

Findings

CCs were developed from an initial broad concern with the place of compassion and well-being in communities and organisations, particularly in health and social care after a number of scandals about failures of care. Through experience CCs have been refined into a flexible model of supporting staff in mental health care settings. Experience to date suggests they are a valuable method of increasing compassion for self and others, improving relationships between team members and raising issues of organisational support to enable compassionate practice.

Research limitations/implications

This paper is a discussion of CCs and their conceptual underpinnings and of insights and lessons from their adoption to date, and more robust evaluation is required.

Practical implications

As an emergent area of practice CCs have been seen to present a powerful and practical approach to supporting individual members of staff and teams. Organisations and individuals might wish to join the community of practice that exists around CCs to consider the potential of this intervention in their workplaces and add to the growing body of learning about it. It is worth further investigation to examine the impact of CCs on current concerns with maintaining staff well-being and engagement, and, hence, on stress, absence and the sustainability of work environments over time.

Social implications

CCs present a promising means of developing a culture and practice of more compassion in mental health care and other care contexts.

Originality/value

CCs have become supported in national NHS guidance and more support to adopt, evaluate and learn from this model is warranted. This paper is a contribution to developing a better understanding of the CCs model, implementation lessons and early insights into impact.

Details

The Journal of Mental Health Training, Education and Practice, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1755-6228

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Article
Publication date: 1 January 1992

A composite of the views of nine eminent doctors, managers andacademics on just what the business of the NHS is. Issues discussedinclude: resource limitations: “care and…

Abstract

A composite of the views of nine eminent doctors, managers and academics on just what the business of the NHS is. Issues discussed include: resource limitations: “care and repair” versus prevention and health promotion; balance between sectors, services and population groups; quality and efficiency.

Details

Journal of Management in Medicine, vol. 6 no. 1
Type: Research Article
ISSN: 0268-9235

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Book part
Publication date: 22 March 2021

Stuart Redding, Richard Hobbs, Catia Nicodemo, Luigi Siciliani and Raphael Wittenberg

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…

Abstract

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.

Details

The Sustainability of Health Care Systems in Europe
Type: Book
ISBN: 978-1-83909-499-6

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Book part
Publication date: 16 August 2014

Claire Marsh

This chapter presents an organizational learning approach to understanding the objectives and challenges of an National Health Service (NHS) Sustainable Development…

Abstract

Purpose

This chapter presents an organizational learning approach to understanding the objectives and challenges of an National Health Service (NHS) Sustainable Development agenda, which involves the integration of social, ecological and economic concerns into organizational functioning, for example the construction and management of buildings, design and delivery of services, and employment of staff.

Methodology

The approach is used to frame an empirical analysis of 11 Projects conducted by NHS organizations aiming to advance this agenda during a particularly active phase in the mid to late 2000s. The approach helps identify the assumptions of organizational purpose, strategy and practice inherent in proposals for Sustainable Development and expose the challenges these are likely to pose. This framing helps articulate a vision and identify the actor groups, and their guiding assumptions, which need to be engaged if progress is to be made.

Findings

The vision of Sustainable Development being promoted was predominantly one of an NHS contributing to the economic and social determinants of health through its procurement, service development and employment activities. Contributions to environmental determinants only took place where financial gains to the NHS organizations themselves made activities, such as investment in renewable energy, viable in the short-term. Within most Projects strategic tools able to predict and measure benefits had to be developed on-the-job and most received help from external agencies to do this work.

Social implications

Rather than expecting individual NHS organizations to progress this agenda alone, others involved in the shaping of collective assumptions of the NHS' purpose and strategies for growth must be engaged in what can be viewed as a social process of learning.

Details

Ecological Health: Society, Ecology and Health
Type: Book
ISBN: 978-1-78190-323-0

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Book part
Publication date: 28 November 2019

Debbie Porteous

The long-term plan for the National Health Service (NHS, 2019) identifies a blueprint to make the NHS fit for the future with a greater focus on prevention, improving…

Abstract

The long-term plan for the National Health Service (NHS, 2019) identifies a blueprint to make the NHS fit for the future with a greater focus on prevention, improving services for patients and the importance of integrating services to make them more effective and efficient. The challenge is in the delivery and who is responsible to implement changes. The key is to enable staff at local levels to have responsibility for ensuring that the health and social needs of their local population are met.

Established to oversee the implementation is the NHS Assembly with 50 individuals from across the health and care sector to advise NHS England and NHS Improvement on the implementation. This requires shared commitment and motivation to change; ensuring patient centred care is at the forefront of any changes to delivering care. At regional level, Sustainability and Transformation Partnerships and Integrated Care Systems are groups of local NHS organisations, local councils and other partners, who are working together in the region to develop and implement the NHS plan. There are many challenges ahead to ensure the plan delivers better regional health and social care, including the impending UK’s decision to leave the European Union. Brexit may present some opportunities but if freedom of movement and membership of the single market and customs union end as planned, NHS and social care face several significant threats in the region.

Details

The North East After Brexit: Impact and Policy
Type: Book
ISBN: 978-1-83909-009-7

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Book part
Publication date: 27 September 2021

Isabella Bertolini

A Memorandum of Understanding (MoU) was uncovered in January 2017 detailing the sharing of patient data from NHS Digital to the Home Office. It signified a deepening of…

Abstract

A Memorandum of Understanding (MoU) was uncovered in January 2017 detailing the sharing of patient data from NHS Digital to the Home Office. It signified a deepening of the hostile environment’s presence in the NHS, and was comprehensively rejected by medical professionals. In November 2018, following extensive action calling for its removal, the MoU was withdrawn. This chapter explores how three factors: the lack of legal basis, wide reaching effects, and ethical conflicts of the MoU led to the success of this action, and aims to apply these lessons to other areas of hostile environment policy. It will be established that ethics proved the most influential factor in inciting the opposition, however, all factors may have been integral to the overall success. It shall be demonstrated that, although the success of this action promises much with regards to charging policy, it may be of limited applicability to other areas of the hostile environment.

Details

Privatisation of Migration Control: Power without Accountability?
Type: Book
ISBN: 978-1-80117-663-7

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Book part
Publication date: 7 August 2019

Liisa Kurunmäki, Andrea Mennicken and Peter Miller

Much has been made of economizing. Yet, social scientists have paid little attention to the moment of economic failure, the moments that precede it, and the calculative…

Abstract

Much has been made of economizing. Yet, social scientists have paid little attention to the moment of economic failure, the moments that precede it, and the calculative infrastructures and related processes through which both failing and failure are made operable. This chapter examines the shift from the economizing of the market economy, which took place across much of the nineteenth century, to the economizing and marketizing of the social sphere, which is still ongoing. The authors consider a specific case of the economizing of failure, namely the repeated attempts over more than a decade to create a failure regime for National Health Service (NHS) hospitals. These attempts commenced with the Health and Social Care Act 2003, which drew explicitly on the Insolvency Act 1986. This promised a “failure regime” for NHS Foundation Trusts modeled on the corporate sector. Shortly after the financial crash, and in the middle of one of the biggest scandals to face NHS hospitals, these proposals were abandoned in favor of a regime based initially on the notion of “de-authorization.” The notion of de-authorization was then itself abandoned, in favor of the notion of “unsustainable provider,” most recently also called the Trust Special Administrators regime. The authors suggest that these repeated attempts to devise a failure regime for NHS hospitals have lessons that go beyond the domain of health care, and that they highlight important issues concerning the role that “exit” models and associated calculative infrastructures may play in the economizing and regulating of public services and the social sphere more broadly.

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Abstract

Details

Health Policy, Power and Politics: Sociological Insights
Type: Book
ISBN: 978-1-83909-394-4

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Article
Publication date: 18 May 2020

Babak Hayati and Sandeep Puri

Extant sales management literature shows that holding negative headquarters stereotypes (NHS) by salespeople is harmful to their sales performance. However, there is a…

Abstract

Purpose

Extant sales management literature shows that holding negative headquarters stereotypes (NHS) by salespeople is harmful to their sales performance. However, there is a lack of research on how managers can leverage organizational structures to minimize NHS in sales forces. This study aims to know how social network patterns influence the flow of NHS among salespeople and sales managers in a large B2B sales organization.

Design/methodology/approach

The authors hypothesize and test whether patterns of social networks among salespeople and sales managers determine the stereotypical attitudes of salespeople toward corporate directors and, eventually, impact their sales performance. The authors analyzed a multi-level data set from the B2B sales forces of a large US-based media company.

Findings

The authors found that organizational social network properties including the sales manager’s team centrality, sales team’s network density and sales team’s external connectivity moderate the flow of NHS from sales managers and peer salespeople to a focal salesperson.

Research limitations/implications

First, the data was cross-sectional and did not allow the authors to examine the dynamics of social network patterns and their impact on NHS. Second, The authors only focused on advice-seeking social networks and did not examine other types of social networks such as friendship and trust networks. Third, the context was limited to one company in the media industry.

Practical implications

The authors provide recommendations to sales managers on how to leverage and influence social networks to minimize the development and flow of NHS in sales forces.

Originality/value

The findings advance existing knowledge on how NHS gets shared and transferred in sales organizations. Moreover, this study provides crucial managerial insights with regard to controlling and managing NHS in sales forces.

Details

Journal of Business & Industrial Marketing, vol. 35 no. 12
Type: Research Article
ISSN: 0885-8624

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