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Since 1948 the Health Service has been a subject of policy on which Labour has consistently rated higher than the Tories in public opinion. But the standard of care within the National Health Service is seen as falling. What difference will the new plan make? There are undoubted good intentions, but also the potential for confusion as commissioning and service delivery are put in the structural mixer once again.

In prior articles in both volume 8 (number 4) and volume 10 (numbers 3/4) of Collection Building, bibliographies of U.S. government publications on AIDS were covered. The first bibliography covered both executive branch and legislative branch materials from 1981 to September 1986. The second bibliography covered only legis‐lative materials from 1986 to 1989. This article complements the second bibliography in its coverage of executive branch materials from 1986 to 1989 and also updates the first work. While 1986 to 1989 is the framework, some items inadvertently omitted from the earlier work are included here.

The challenge of developing leadership in a mass public service where previous notions of leadership have been narrow and limited only to senior positions is being taken up by the National Skills Academy for Social Care. This article describes the leadership development challenge in the English adult care sector, which is undergoing major policy and organisational change as a result of greater control of resources passing directly to people who need care support. The author sets out the initial guiding principles of the Skills Academy for Social Care and their approach to leadership development rooted in the values of the care sector and the reality of care and support work ‐ dispersed, low status, highly skilled and with a strong commitment to rights, entitlements and empowerment. In particular the Academy is adopting an emphasis on behaviours and personal attributes in its leadership approach that are informed by people who use care services who demand more responsive and personalised support. The article sets out a number of key principles on which the Academy will seek partnerships and collaboration to deliver greater engagement with leadership development across all who work in the sector.

The existing social care system is riddled with complexity ‐ an unfair system of means testing to determine payment plus a postcode lottery of funding and standards ‐ providing little support for family carers. It is important that the principle of having a tax‐funded national care service is properly considered by the newly established Dilnot Commission on the Funding of Care and Support as a future option, but it will not be enough to simply look at the issue of funding without also addressing the quality, standards and availability of care services.

This chapter reports on a hybrid sector of disability provision in Australia and the changes to the sector due to the shift to person-centred care in Australia. It explains the significant changes to the way the sector will respond to government and to client demands and how the organisations are responding to this by re-structuring and building new performance measurement systems including Social Return on Investment.

The first part of the chapter is descriptive of the change to person-centred care in the Australian disability sector using public reports. The second part of the chapter looks at the change at a micro level using an analysis of the literature.

Findings illustrate how the National Disability Insurance Scheme has brought about significant change between sectors of government and between providers, both government and non-government. Organisations have had to make significant changes to adapt to the government’s policy and especially funding change. This includes setting new governance and leadership models, changed human resource management practices and performance measurement systems.

The paper is a report relatively early in the transition phases, and therefore, more evidence is needed as the system change progresses. Still, the Australian disability sector provides a powerful example of significant hybridisation changes as a result of a shift to person-centred care.

This is a dramatic change from the Australian government to impose person-centred care. The adaptations of Australian organisations provide an interesting insight for the international community.

This paper analyses the value of information and advice for older people in making decisions about housing and care, drawing on an evaluation of FirstStop, a new national information and advice service. The paper discusses the housing problems often faced in older age, and the pressures on public finances of housing an ageing population. The Government is trying to engender a shift to early preparation, prevention and self‐help, so that older people make changes to their housing and care arrangements before encountering a crisis. The paper considers how older people can resolve their housing issues in more satisfactory and empowering ways, and at lower cost to the state, after receiving appropriate and timely information and advice. It also discusses the problems of funding this type of initiative, given the need to ‘prove’ the value for money of publicly funded services in quantitative terms, when the benefits of information and advice are difficult to monetarise.

The purpose of this paper is to understand value cocreation in service ecosystems from a multilevel perspective, uncovering value cocreation factors and outcomes at the micro, meso, and macro levels.

A Grounded Theory approach based on semi-structured interviews is adopted. The sample design was defined to enable the ecosystem analysis at its different levels. At the macro level was the Portuguese Health Information ecosystem. Embedded meso level units of analysis comprised eight health care organizations. A total of 48 interviews with citizens and health care practitioners were conducted at the micro level.

Study results enable a detailed understanding of the nature and dynamics of value cocreation in service ecosystems from a multilevel perspective. First, value cocreation factors are identified (resource access, resource sharing, resource recombination, resource monitoring, and governance/institutions generation). These factors enable actors to integrate resources in multiple dynamic interactions to cocreate value outcomes, which involve both population well-being and ecosystem viability. Study results show that these value cocreation factors and outcomes differ across levels, but they are also embedded and interdependent.

The findings have important implications for organizations that are ecosystem actors (like the Portuguese Ministry of Health) for understanding synergies among value cocreation factors and outcomes at the different levels. This provides orientations to better integrate different actor roles, technology, and information while facilitating ecosystem coordination and co-evolution.

This study responds to the need for a multilevel understanding of value cocreation in service ecosystems. It also illuminates how keystone players in the ecosystem should manage their value propositions to promote resource integration for each actor, fostering resource density and ecosystem viability. It also bridges the high-level conceptual perspective of Service-Dominant logic with specific empirical findings in the very important context of health care.

The UK Government has been planning changes to mental health legislation for at least eight years. On 23 March 2006, the Department of Health announced that many of these plans would proceed ‐ although through amendments to the 1983 Mental Health Act rather than a substantive Bill. These proposed reforms are significant but controversial. This paper sets out some of the reasons for welcoming the proposed changes. It is argued that the proposals to replace the responsible medical officer with a clinical supervisor are in keeping with best quality mental health care, and allow for proper multidisciplinary practice. Such an approach explicitly permits proper use of the skills and competencies of the workforce ‐ including psychologists. A second controversial aspect of the proposed reforms ‐ supervised community treatment orders, permitting compulsory care outside of hospitals ‐ represent not a violation of human rights, but a specific defence of ‘Article 8’ rights to protection of family and personal life. Finally, it is argued that the proposed amendments are important because mental health legislation dominates mental health care and the present 1983 Mental Health Act inappropriately consolidates the status of the medical model and the role of the responsible medical officer (and hence psychiatry). It is argued that the proposed changes are imperfect; in particular they lack inclusion of an ‘impaired judgement’ criterion, but it is suggested that necessary role and service redesign needs such amendments to allow the new ways of working programme to ‘bite’.

National evidence shows that around 60% of patients would prefer to receive end of life care and die at home, but in 2005 in North Derbyshire only 20% of patients were supported to do so. This article discusses the tools used to improve end of life care services in the community and explores the enablers and barriers.