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The purpose of the paper is to examine the policy and organizational implications of gender imbalance in management, which research suggests exists in the NHS.
Abstract
Purpose
The purpose of the paper is to examine the policy and organizational implications of gender imbalance in management, which research suggests exists in the NHS.
Design/methodology/approach
The research in this paper involved a qualitative approach with an analysis of élite interviews conducted with a non‐random sample of officials involved in health policy and interviews with a random sample of senior managers in NHS Scotland. The research formed part of a larger study, which explored the enablers and inhibitors to female career progression in various Scottish sectors.
Findings
The paper finds that gender imbalance in management exists in the NHS. This is manifested in a masculine organizational context, leadership and policy decision‐making process, which have implications for female career advancement opportunities and subsequently access to macro policy decisions.
Research limitations/implications
The paper involved a sample (30 percent) of senior managers and examined policy processes in NHS Scotland. To improve the external validity of the findings further research should be conducted in NHS organizations in England and Wales.
Practical implications
The findings in the paper suggest that gender imbalance in management and a masculine organizational context and leadership style within the NHS create a less than conducive environment for female employees. This has practical implications in terms of levels of part‐time employment, career progression and attrition rates.
Originality/value
The paper adds to the debate of gender and organizational studies by examining the health sector, which has high levels of female employment but low levels of female representation at senior management levels. The paper therefore adds to an often‐neglected area of study, women in leadership and senior managerial positions. The paper is original in its approach by examining the micro and meso organizational dimensions which impact on women's ability to influence macro health policy.
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Brian Howieson and Claire Fenwick
– The purpose of this paper is to explore the leadership implications of a mutual health service in National Health Service (NHS) Scotland.
Abstract
Purpose
The purpose of this paper is to explore the leadership implications of a mutual health service in National Health Service (NHS) Scotland.
Design/methodology/approach
Analysis of extant government policy and suggestions of leadership considerations for practice.
Findings
Moving towards a mutual health system will require new ways of thinking about health care and existing leadership practices in NHS Scotland. The leadership implications at the strategic, operational and tactical levels of delivery in NHS Scotland will need to be thought through. At present, it is not clear how this will be done, either from the available health-related literature or from policy. “Mutuality” will require a complex and multi-layered effort to embed it within the culture of the organisation, which will require inspirational leadership and sustained management from the government, the NHS and the wider public to make the change happen.
Research limitations/implications
This paper suggests that more leadership research is still required to understand fully – and implement – a mutual health service in Scotland. A theoretical framework and/or empirical reference points have yet to be developed.
Practical implications
This paper highlights the practical implications in operationalising government policy.
Originality/value
Little – if any – has been written about the leadership implications of a mutual and public health service.
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Neill Simpson, Margaret Whoriskey and Michael McCue
Service systems for people with learning disabilities in Scotland have developed in the context of the Scottish legal system and devolved policy for health. Scottish organisations…
Abstract
Service systems for people with learning disabilities in Scotland have developed in the context of the Scottish legal system and devolved policy for health. Scottish organisations are responding to the spectrum of mental health needs by working in partnership to improve quality. This article describes this system and the key organisations, and presents some findings of the National Overview Report of services undertaken by NHS Quality Improvement Scotland.
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The Public Bodies (Joint Working) (Scotland) Act 2014 set the framework for the integration of adult health and social care services. Teams, organisations and sectors are now…
Abstract
Purpose
The Public Bodies (Joint Working) (Scotland) Act 2014 set the framework for the integration of adult health and social care services. Teams, organisations and sectors are now required to work in partnership and interdependently to deliver shared outcomes for the people they serve. The purpose of this paper is to explore any features, practices and behaviours that could influence effective partnership working across sectors.
Design/methodology/approach
A questionnaire was designed and distributed to a range of stakeholders working in health, social care and the third sector. With reference to the changing health and social care reform agenda, the aims of the survey were to gather views, experiences and perceptions of working across sectors, and any workforce development needs.
Findings
The majority of respondents were from the NHS (80.3 per cent, 118/147), and experiences were largely drawn from those working with the third sector. The utility of working with the third sector was positively highlighted; however, there were limited opportunities to fully engage. Whilst formal education and training was welcomed, workforce development needs were mostly related to fostering relationships and building mutual trust.
Originality/value
This paper highlights views, perceptions, enablers and barriers to integrated care in Scotland. Whilst the Scottish integration landscape is currently not fully fledged, insights into prevailing attitudes towards integrated care, by a cohort of the Scottish health and care workforce, are offered. In particular, reflections by the NHS workforce to working with third sector services are discussed.
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Jennifer Smith‐Merry, Richard Freeman and Steve Sturdy
This paper reports the first phase of a research project on mental health policy in Scotland that investigates the way knowledge is mobilised in the policy process. In this first…
Abstract
This paper reports the first phase of a research project on mental health policy in Scotland that investigates the way knowledge is mobilised in the policy process. In this first phase of the project, the authors' concern has been to map the organisational domain of mental health policy in Scotland, paying attention to the form and structure of agencies and organisations as well as to the relationships between them. The paper describes a set of organisations in which central government is dominant but notes also a range of organisational forms and functions, and a diversity of sources of knowledge, expertise and information on which they draw. A dense network of linkages between agencies is identified.
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Fiona Borrowman and Sarah Dempster
No one knows how to improve mental health and well‐being in later life better than older people themselves, according to the authors of our first article. That is why the…
Abstract
No one knows how to improve mental health and well‐being in later life better than older people themselves, according to the authors of our first article. That is why the underpinning ethos of NHS Health Scotland's Mental Health and Wellbeing in Later Life Programme is about working with older people to ensure that their voices are heard.
This paper outlines the development of legislative and policy frameworks in Scotland with a particular focus following political devolution. The impact of these changes and…
Abstract
This paper outlines the development of legislative and policy frameworks in Scotland with a particular focus following political devolution. The impact of these changes and developments on the lives of people with learning disabilities are discussed.
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This article briefly outlines some of the debates and discussions currently taking place in public health with regards to what ‘counts’ as evidence, as well as evidence use. This…
Abstract
This article briefly outlines some of the debates and discussions currently taking place in public health with regards to what ‘counts’ as evidence, as well as evidence use. This provides the context for describing a new programme of work currently being developed in Scotland by the national health improvement agency, as one of several support functions for the implementation of the Scottish Executive National Programme for Improving Mental Health and Well‐Being. This programme of work is aiming to support evidence into practice and practice into evidence in mental health improvement in Scotland.
The purpose of this paper is twofold. First, the paper considers the level of congruence between contribution analysis and public value. Second, based on the Scottish context, the…
Abstract
Purpose
The purpose of this paper is twofold. First, the paper considers the level of congruence between contribution analysis and public value. Second, based on the Scottish context, the paper examines how contribution analysis can be used as a method to support public managers to demonstrate value within partnership contexts in times of acute governance challenges (including in times of austerity).
Design/methodology/approach
The empirical underpinning of the paper emerges from strands of applied public sector experience and consultancy with national agencies. The author was a public manager (up to 2013) within a national government agency – NHS Health Scotland. The research is also informed by data gathered as an academic consultant in contribution analysis with national partnership-based agencies (Healthcare Improvement Scotland and Education Scotland, 2013-present) through a series of workshops as part of consultancy activity on capacity building in relation to evaluation methodology and practice.
Findings
Based on research and experience with three national public sector agencies in Scotland, the paper demonstrates how public managers, despite difficult challenges, have adopted contribution analysis and how this has served to facilitate public value.
Originality/value
In a time when public managers are facing acute challenges in demonstrating the impact of their programmes and services due to the dynamics of complex governance systems coupled with the pressure of austerity, this research helps to equip public managers with strategies to enable the demonstration of public value in pragmatic terms.
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Silvia Anton, Lorna McKee, Stephen Harrison and Shelley Farrar
The purpose of this paper is to report the findings of a study that examined the development of an assessment framework for public involvement.
Abstract
Purpose
The purpose of this paper is to report the findings of a study that examined the development of an assessment framework for public involvement.
Design/methodology/approach
The paper has adopted a multi‐method approach that includes: a focused review of literature relating to tools that might be used to provide valid and reliable assessments of public involvement; key informant interviews with people with experience from various perspectives of efforts to involve the public in the planning and development of health services; and a detailed study of a specific public involvement initiative involving a range of “stakeholder” interviews.
Findings
The paper finds that there are uncertainty and a lack of consensus about how assessment of public involvement should be undertaken. The findings emphasise the need to recognise the diverse nature of public involvement, which may require assessment to be employed flexibly at each individual NHS Board level.
Research limitations/implications
The paper is a small‐scale study, in which it was only possible to probe a limited number of stakeholders' views due to practical and time restrictions.
Originality/value
The paper adds value to the discussions taking place at Scottish Government level as to the best approach in assessing public involvement in health service decision making.
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