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Article
Publication date: 21 October 2019

Jenny Billings, Rasa Mikelyte, Anna Coleman, Julie MacInnes, Pauline Allen, Sarah Croke and Kath Checkland

The purpose of this paper is to investigate the perceptions of key informants on a national support programme for the development of new care models (NCM) in England…

Abstract

Purpose

The purpose of this paper is to investigate the perceptions of key informants on a national support programme for the development of new care models (NCM) in England (2015/2016–2017/2018). It focuses on the perceived facilitators and barriers affecting the development and implementation of the NCM programme and offers some insight into the role of national level support in enabling local integration initiatives.

Design/methodology/approach

A set of 29 interviews were carried out with a variety of respondents at the national level (including current and past programme leads, strategic account managers, advisors to the programme and external regulators) between October 2017 and March 2018, and analysed thematically.

Findings

A set of facilitative elements of the programme were identified: the development of relationships and alliances, strong local and national leadership, the availability of expert knowledge and skills, and additional funding. Challenges to success included perceived expectations from the national Vanguard programme, oversight and performance monitoring, engagement with regulators, data availability and quality, as well as timetables and timescales. Crucially, the facilitators and challenges were found to interact in dynamic and complex ways, which resulted in significant tensions and ambiguities within the support programme.

Research limitations/implications

While the sample was drawn from a range of different senior players and the authors ensured a diverse sample associated with the NCM support programme, it inevitably cannot be complete and there may have been valuable perspectives absent.

Originality/value

The paper demonstrates that the analysis of facilitators and challenges with respect to the national support of implementation of integrated care initiatives should move beyond the focus on separate influencing factors and address the tensions that the complex interplay among these factors create.

Details

Journal of Integrated Care, vol. 28 no. 1
Type: Research Article
ISSN: 1476-9018

Keywords

Content available
Article
Publication date: 7 November 2019

Rod Sheaff, Joyce Halliday, Mark Exworthy, Alex Gibson, Pauline W. Allen, Jonathan Clark, Sheena Asthana and Russell Mannion

Neo-liberal “reform” has in many countries shifted services across the boundary between the public and private sector. This policy re-opens the question of what structural…

Abstract

Purpose

Neo-liberal “reform” has in many countries shifted services across the boundary between the public and private sector. This policy re-opens the question of what structural and managerial differences, if any, differences of ownership make to healthcare providers. The purpose of this paper is to examine the connections between ownership, organisational structure and managerial regime within an elaboration of Donabedian’s reasoning about organisational structures. Using new data from England, it considers: how do the internal managerial regimes of differently owned healthcare providers differ, or not? In what respects did any such differences arise from differences in ownership or for other reasons?

Design/methodology/approach

An observational systematic qualitative comparison of differently owned providers was the strongest feasible research design. The authors systematically compared a maximum variety (by ownership) sample of community health services; out-of-hours primary care; and hospital planned orthopaedics and ophthalmology providers (n=12 cases). The framework of comparison was the ownership theory mentioned above.

Findings

The connection between ownership (on the one hand) and organisation structures and managerial regimes (on the other) differed at different organisational levels. Top-level governance structures diverged by organisational ownership and objectives among the case-study organisations. All the case-study organisations irrespective of ownership had hierarchical, bureaucratic structures and managerial regimes for coordinating everyday service production, but to differing extents. In doctor-owned organisations, the doctors’, but not other occupations’, work was controlled and coordinated in a more-or-less democratic, self-governing ways.

Research limitations/implications

This study was empirically limited to just one sector in one country, although within that sector the case-study organisations were typical of their kinds. It focussed on formal structures, omitting to varying extents other technologies of power and the differences in care processes and patient experiences within differently owned organisations.

Practical implications

Type of ownership does appear, overall, to make a difference to at least some important aspects of an organisation’s governance structures and managerial regime. For the broader field of health organisational research, these findings highlight the importance of the owners’ agency in explaining organisational change. The findings also call into question the practice of copying managerial techniques (and “fads”) across the public–private boundary.

Originality/value

Ownership does make important differences to healthcare providers’ top-level governance structures and accountabilities and to work coordination activity, but with different patterns at different organisational levels. These findings have implications for understanding the legitimacy, governance and accountability of healthcare organisations, the distribution and use power within them, and system-wide policy interventions, for instance to improve care coordination and for the correspondingly required foci of healthcare organisational research.

Details

Journal of Health Organization and Management, vol. 33 no. 7/8
Type: Research Article
ISSN: 1477-7266

Keywords

Content available
Article
Publication date: 9 March 2015

Pauline Rafferty and Allen Foster

Abstract

Details

New Library World, vol. 116 no. 3/4
Type: Research Article
ISSN: 0307-4803

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Article
Publication date: 21 September 2015

Ailsa Cameron, Pauline Allen, Lorraine Williams, Mary Alison Durand, Will Bartlett, Virginie Perotin and Andrew Hutchings

The purpose of this paper is to explore government efforts to enhance the autonomy of community health services (CHS) in England through the creation of Foundation Trusts…

Abstract

Purpose

The purpose of this paper is to explore government efforts to enhance the autonomy of community health services (CHS) in England through the creation of Foundation Trusts status. It considers why some CHS elected to become nascent Community Foundation Trusts (CFTs) while others had not and what advantages they thought increased levels of autonomy offered.

Design/methodology/approach

Data are drawn from the evaluation of the Department of Health’s CFT pilot programme. Participants were purposively selected from pilot sites, as well as from comparator non-pilot organisations. A total of 44 staff from 14 organisations were interviewed.

Findings

The data reveals that regardless of the different pathways that organisations were on, they all shared the same goal, a desire for greater autonomy, but specifically within the NHS. Additionally, irrespective of their organisational form most organisations were considering an almost identical set of initiatives as a means to improve service delivery and productivity.

Research limitations/implications

Despite the expectations of policy makers no CFTs were established during the course of the study, so it is not possible to find out what the effect of such changes were. Nevertheless, the authors were able to investigate the attitudes of all the providers of CHS to the plans to increase their managerial autonomy, whether simply by separating from PCTs or by becoming CFTs.

Originality/value

As no CFTs have yet been formed, this study provides the only evidence to date about increasing autonomy for CHS in England.

Details

Journal of Health Organization and Management, vol. 29 no. 6
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 1 February 2002

Pauline Allen, Bronwyn Croxson, Jennifer Roberts, Shirley Crawshaw, Kate Archibald and Lynda Taylor

This paper reports a national study which investigated the involvement of infection control professionals in (and their views about) the formal processes of contracting…

Abstract

This paper reports a national study which investigated the involvement of infection control professionals in (and their views about) the formal processes of contracting for health care in the NHS internal market. Health care professionals needed to be involved contracting, if it was to be effective. The study found that many infection control professionals were not, in fact, involved in contracting, while the importance of both contracts and informal professional networks were recognised. But respondents did not think that their professional networks entirely compensated for their lack of involvement in contracting. As formal agreements continue to be central to achieving quality of care in the post‐internal market NHS, infection control professionals need to be involved in specification and implementation of these arrangements.

Details

Journal of Management in Medicine, vol. 16 no. 1
Type: Research Article
ISSN: 0268-9235

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Article
Publication date: 31 December 2008

Samuel Annor and Pauline Allen

The promotion of public mental health is a challenging endeavour for policy actors and stakeholders. In particular, the implementation of public mental health initiatives…

Abstract

The promotion of public mental health is a challenging endeavour for policy actors and stakeholders. In particular, the implementation of public mental health initiatives highlighted in Standard One of the National Service Framework for Mental Health has been poor and patchy (Department of Health, 2004a). This paper attempts to illuminate the complex process of public mental health policy implementation at local level through the exploration of stakeholders' actions.An exploratory case study design was selected, focusing on one local health and social care community within inner London. A conceptual framework about policy implementation and the concept of partnership working are used to shape the analysis of the empirical findings.This paper addresses the challenges associated with the promotion of public mental health initiatives within one local NHS health and social care community. It attempts to increase the understanding and insights into public mental health policy and practice at local level from a policy implementation standpoint. Using an empirical case study of public mental health in an English locality, some of the key issues explored in this paper are about perceptions of public mental health concepts among key policy actors and also stakeholders' behaviour in Local Implementation team (LIT) partnerships. Furthermore, the authors address the issue of how local policy actors engage the local community in supporting the needs of vulnerable groups such as service users and black and minority ethnic (BME) groups.Although functional partnership are essential for the promotion of public mental health initiatives, the interdependencies of the stakeholders, competition for resources, power dynamics and the difficulty of engaging a diverse range of voices have a significant limiting effect on achieving successful policy implementation on the ground.

Details

Journal of Public Mental Health, vol. 7 no. 4
Type: Research Article
ISSN: 1746-5729

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Abstract

Details

Library Review, vol. 61 no. 3
Type: Research Article
ISSN: 0024-2535

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Article
Publication date: 11 July 2016

Reidar J. Mykletun and Krista Himanen

The purpose of this paper is to examine the antecedents of volunteer commitment and intention to remain volunteering for the same event in the future, in the context of…

Abstract

Purpose

The purpose of this paper is to examine the antecedents of volunteer commitment and intention to remain volunteering for the same event in the future, in the context of two annually held Norwegian cycling race events.

Design/methodology/approach

A cross-sectional design was used, applying a questionnaire that was developed and distributed to the cycling events volunteers both in hard copies and as online format by QuestBack.

Findings

The volunteers were motivated by egoistic, altruistic, connection to the sport, and external factors. They were highly committed and intended to remain as a volunteers in the future events. Older age; satisfaction from their own contribution and type of work, from recognition; and motivation as personal connections to the sport predicted commitment. Higher levels of education, commitment, and motivation by personal connections to the sport predicted intention to remain as a volunteer for future events. A factor-based structure of sport event volunteer satisfaction was presented, which, to the best of the knowledge is the first of its kind.

Research limitations/implications

The study should be replicated across several events to test the external validation of the models.

Practical implications

This understanding of motivation and satisfaction can be beneficial for the management of volunteers in order to retain the experienced and motivated volunteers and to ensure the continuation of the event in the future.

Originality/value

The study adds new knowledge to the research field by presenting an extensive, updated literature review, development of a fist factor-analysed scale for volunteer satisfaction, and the first application of the model including volunteer demographics, satisfaction, motivation, and commitment in predicting intention to remain volunteers for the biking event in the future.

Details

Sport, Business and Management: An International Journal, vol. 6 no. 3
Type: Research Article
ISSN: 2042-678X

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Article
Publication date: 1 March 1985

CHIH WANG

INTRODUCTION Computers and new information technologies have beyond question brought tremendous advancement in information storage and retrieval. In recent years, the…

Abstract

INTRODUCTION Computers and new information technologies have beyond question brought tremendous advancement in information storage and retrieval. In recent years, the traditional card catalog has given way first to the COM (computer output on microform) catalog, then to the online catalog. Now, many libraries are shifting to the new capability in order to provide better and faster services to their patrons.

Details

Library Review, vol. 34 no. 3
Type: Research Article
ISSN: 0024-2535

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Article
Publication date: 5 June 2017

Helen Brown and Fiona Howlett

The purpose of this paper is to critically evaluate an innovative collaboration between health, housing and social care by exploring the “short stay project” apartments…

Abstract

Purpose

The purpose of this paper is to critically evaluate an innovative collaboration between health, housing and social care by exploring the “short stay project” apartments from service users’ perspectives and considering the effectiveness of this service model as part of enabling provision locally.

Design/methodology/approach

The qualitative methodology for this evaluation was interpretative phenomenological analysis (Smith, 2011), critically exploring service users’ personal lived experience of the “short stay project”. Three service users (n=3) participated in semi-structured interviews.

Findings

This study has identified the “short stay project” can prevent admission into and facilitate discharge from care and health services by offering a temporary stay in self-contained, adapted accommodation. Service users found value in staying at the apartments for differing reasons. However, practitioners must address service users’ emotional and social needs as well as physical needs to reduce the risk of occupational deprivation.

Research limitations/implications

Sample size is not fully representative of the total population making transferability limited.

Practical implications

This research found there is demand for temporary housing provision for service users with health, housing and/or social care needs.

Social implications

Key drivers of demand for the service are social inequalities relating to homelessness, poverty and gender-based violence rather than the health-related issues that could have been expected. Further research into the development of effective integrated services which maximise service users’ wellbeing and occupational performance is recommended.

Originality/value

Service models which integrate health, housing and social care can be innovative and maintain service users’ independence and wellbeing in the community. Commissioners across health, housing and social care could utilise the Better Care Fund to deliver integrated services to meet rising demands.

Details

Housing, Care and Support, vol. 20 no. 2
Type: Research Article
ISSN: 1460-8790

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