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1 – 10 of over 3000Virginia Minogue and Rebecca McCaffry
The Department of Health and the National Health Service (NHS) Future Focused Finance (FFF) programme promotes effective engagement between clinical and finance staff. Surveys…
Abstract
Purpose
The Department of Health and the National Health Service (NHS) Future Focused Finance (FFF) programme promotes effective engagement between clinical and finance staff. Surveys undertaken by the Department of Health between 2013 and 2015 found few NHS Trusts reported high levels of engagement. The purpose of this paper is to gain a better understanding of current working relationships between NHS clinical and finance professionals and how they might be supported to become more effective.
Design/methodology/approach
Ipsos MORI were commissioned by the NHS FFF programme to undertake an online survey of NHS clinical and finance staff between June and August 2015.
Findings
The majority of clinicians had a member of a finance team linked to their speciality or directorate. Clinical and finance professionals have a positive view of joint working preferring face-to-face contact. Clinician’s confidence in their understanding of finance was generally good and finance staff felt they had a good understanding of clinical issues. Effective working relationships were facilitated by face-to-face contact, a professional relationship, and the availability of clear, well presented finance and activity data.
Research limitations/implications
Data protection issues limited the accessibility of the survey team to NHS staff resulting in a relatively low-response rate. Other forms of communication, including social media, were utilised to increase access to the survey.
Originality/value
The FFF programme is a unique programme aimed at making the NHS finance profession fit for the future. The close partnering work stream brings together the finance and clinical perspective to share knowledge, evidence, training, and to develop good practice and engagement.
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Virginia Minogue, Bill Wells and Ashley Brooks
Reducing waste in health care can result in savings that could be used to meet the projected shortfall in NHS funding or to meet the care needs of vulnerable groups. Patients and…
Abstract
Purpose
Reducing waste in health care can result in savings that could be used to meet the projected shortfall in NHS funding or to meet the care needs of vulnerable groups. Patients and their families can contribute to the identification and reduction of waste. To do so their understanding of the costs of health care and treatment needs to be increased. The paper aims to discuss these issues.
Design/methodology/approach
The approach formed part of the Close Partnering work stream of the NHS Future Focused Finance (FFF) programme. Included in this was a review of the literature relating to waste reduction, patient engagement and reference to experts in the field of public and patient engagement. Engagement of the patient voice in the NHS FFF programme to provide the patient perspective and engage in discussions with patients. Discussions with experts in patient and public involvement and clinicians were also undertaken.
Findings
The public and patients have little awareness of NHS finances and generally perceive efforts to reduce costs and achieve efficiencies as impacting on the quality of care. Engaging the public and patients in discussions about the costs of health care is challenging and existing methodologies for patient and public engagement may not be appropriate for what could be termed difficult conversations.
Social implications
Increasing patient awareness of the costs of health care and treatment may result in patients and the public demanding greater involvement in decisions about health care expenditure and use of resources.
Originality/value
Difficult conversations with patients and the public about the costs of health and their role in reducing waste are rarely invited. This paper brings to the fore the issues and challenges that such discussions engender.
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This special “Anbar Abstracts” issue of Journal of Management in Medicine is split into 6 sections covering abstracts under the following headings: General Management; Personnel…
Abstract
This special “Anbar Abstracts” issue of Journal of Management in Medicine is split into 6 sections covering abstracts under the following headings: General Management; Personnel and Training; Quality in Health Care; Health Care Marketing; Financial Management; and Information Technology.
Ahmed Doko Ibrahim, Andrew Price, Malik M. A. Khalfan and Andrew Dainty
In the UK healthcare sector, funding and provision of public care facilities has been primarily the responsibility of government through the National Health Service (NHS). After…
Abstract
In the UK healthcare sector, funding and provision of public care facilities has been primarily the responsibility of government through the National Health Service (NHS). After decades of under-investment and consequent effects on the quality of care, new procurement routes are currently being used to improve the standards of facilities to meet the requirements of modern care services. This paper critically reviews these new procurement routes in terms of concepts and suitable areas of application, and examines how the principal procurement methods have evolved into the forms used for UK healthcare facilities. The paper outlines recommendations for further research in assessing the suitability or otherwise of these new procurement methods, both for construction projects generally and specifically for healthcare facilities.
Jane Broadbent, Jas Gill and Richard Laughlin
This paper seeks to develop a system of how to judge the merit and worth of Private Finance Initiative (PFI) projects in the UK National Health Service (NHS) once they are…
Abstract
This paper seeks to develop a system of how to judge the merit and worth of Private Finance Initiative (PFI) projects in the UK National Health Service (NHS) once they are operational. This concern is couched in relation to whether PFI can be seen to provide long‐term “value for money” (VFM) using a broad definition of this term. This paper does not attempt to further the debate that has focussed on the broader macro economic VFM arguments; rather, the focus is upon developing a model for evaluation at the organisational level where there is a paucity of direction and clarity. Whilst there are many VFM criteria available to guide whether PFI in the NHS should be pursued at the pre‐decision stage, there is little in the way of post‐project evaluation systems to judge VFM once decisions have been taken. Little thought has been given to the design of these post‐project evaluation systems let alone the experiences of how such systems may operate. This paper is addressing these lacunae but only in the sense of suggesting a design for a system for post‐project evaluation. This is drawn from PFI pre‐decision processes, post‐project intentions of some PFI schemes and evaluation theory. It is not about the judgements that come from the use of such a framework which the paper conclude will take some time to be forthcoming.
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Akintola Akintoye and Ezekiel Chinyio
The UK Government has now adopted Private Finance Initiative (PFI) as a major vehicle for the delivery of additional resources to the health sector in order to achieve a greater…
Abstract
Purpose
The UK Government has now adopted Private Finance Initiative (PFI) as a major vehicle for the delivery of additional resources to the health sector in order to achieve a greater investment in healthcare facilities. The purpose of this paper is to examine the trends and risk assessment of the PFI in the healthcare sector.
Design/methodology/approach
The paper employed secondary data and interviews of key participants in two hospital PFI projects to highlight developments in healthcare PFI and the risk management of hospital projects.
Findings
The results show that the use of PFI in the provision of healthcare is increasing in terms of number, capital value and size of projects. What emerged in the healthcare PFI project was a usage of a plethora of risk management techniques, albeit to varying degrees. Experience appeared to be the prime risk assessment technique employed, while risk avoidance was first explored before pricing and allocating any residual risks. “Risk prompts”, such as using checklists and risk registers were also useful in the identification of risks. Among all participants, insurance cover and sub‐contracting appear to be the most prominent strategies employed for managing out the risks.
Originality/value
The negotiations that precede the signing of a healthcare PFI project contract had an impact on the final choice of facilities or their specifications. The two contracting parties sought a balance between an optimal allocation of risks, choice of facilities and project price. Although the risk management techniques being used are generic in nature, there is still no evidence at the moment to show that these are appropriate for PFI projects. It is important that further investigation is undertaken to assess the level of current skills in risk management techniques to deal with PFI projects and the extent to which these techniques are appropriate to tackle complex healthcare PFI projects.
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The Resource Management Initiative (RMI) is a central ingredient inplans to instil market‐based relationships in health care and medicine.However, these plans have not benefited…
Abstract
The Resource Management Initiative (RMI) is a central ingredient in plans to instil market‐based relationships in health care and medicine. However, these plans have not benefited from any adequate assessment of “resource management”. Demonstrates how earlier experience with resource management provides little guidance as to how it might be made to work. While resource management implies that measures of cost and activity were to be related to each other, its purposes are confused and confusing. While seemingly offering a variety of advantages, resource management is characterized by struggles and negotiations over its operational substance. Moreover, the initiative failed to resolve crucial issues over how to account for activities. Experience of tackling these issues as market‐based relationships came into effect during 1992‐3 demonstrates that resource management provides limited assistance to managers of the service.
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Jill Manthorpe, Steve Iliffe, Claire Goodman, Vari Drennan and James Warner
The purpose of this case study is to report and reflect on a recently completed five-year programme of research on dementia care and practice in England. This EVIDEM programme of…
Abstract
Purpose
The purpose of this case study is to report and reflect on a recently completed five-year programme of research on dementia care and practice in England. This EVIDEM programme of research was specifically designed to influence services for people with dementia and their carers; several additional lessons emerged along the way that might shape broader research on ageing that includes older people and those who work with them.
Design/methodology/approach
This case study of the EVIDEM programme presents and discusses four lessons learned by the core research team – covering the implications of newly basing research inside the NHS, multi-disciplinary working across academic disciplines, communicating with diverse practitioners, and the impact of patient and public involvement on the research process. The paper reflects on communication between the NHS and academic communities, and the creation of new research capacity in dementia.
Findings
Collaborative working between academic disciplines is possible, given willing researchers and commitment to participating in frequent opportunities for dialogue and learning. In research in dementia these foundations are probably essential, given the growing scale of the problem and the small size of the research community, if we are to have a beneficial impact on people's lives. Lay expertise is a necessary ingredient of research programmes, not just for its co-design power, but for its ability to redesign projects when major problems arise.
Research limitations/implications
This case study reports the subjective views of the research collaborators. While this raises the potential for bias, it offers an “insider” perspective of the research process and engagement in research leadership.
Originality/value
There are few reflections on research processes and management and this case study may be useful to academic researchers, to those working in the NHS with responsibility for research in different forms, and to older people's organisations who wish to hear of the value of older people's engagement in research advisory activity.
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Espen Solheim-Kile and Andreas Wald
Public–private joint ventures (PPJVs) have a stronger partnership element than standard public–private partnerships (PPPs) but PPJVs are under-researched despite this important…
Abstract
Purpose
Public–private joint ventures (PPJVs) have a stronger partnership element than standard public–private partnerships (PPPs) but PPJVs are under-researched despite this important partnership element. This article derives knowledge of incentives and barriers to goal alignment in healthcare PPJVs.
Design/methodology/approach
An in-depth case study of the UK’s Local Improvement Finance Trust (LIFT) model including three PPJVs and 34 individual projects was conducted.
Findings
The main economic incentives are future opportunities creating a strong shadow of the future. This is supplemented by social incentives such as the ability to have a social impact. Enlarging the shadow of the future can encourage both parties to think long-term, avoiding short-term opportunism.
Practical implications
PPJV is a promising model for partnership. However, complexity through fragmented public sector partners and the financial structure can create barriers for goal alignment.
Originality/value
This study challenges earlier research studies based on PPJV by providing evidence that the long-term nature of PPJV, especially the potential of new projects, enables the public sector to get more engagement from the private sector.
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