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The purpose of this paper is to explore issues of medical engagement in the management and leadership of health services in the English National Health Service (NHS). The literature suggests that this is an important component of high performing health systems, although the NHS has traditionally struggled to engage doctors and has been characterised as a professional bureaucracy. This study explored the ways in which health care organisations structure and operate medical leadership processes to assess the degree to which professional bureaucracies still exist in the English NHS.

Drawing on the qualitative component of a research into medical leadership in nine case study sites, this paper reports on findings from over 150 interviews with doctors, general managers and nurses. In doing so, the authors focus specifically on the operation of medical leadership in nine different NHS hospitals.

Concerted attention has been focussed on medical leadership and this has led to significant changes to organisational structures and the recruitment and training processes of doctors for leadership roles. There is a cadre of doctors that are substantially more engaged in the leadership of their organisations than previous research has found. Yet, this engagement has tended to only involve a small section of the overall medical workforce in practice, raising questions about the nature of medical engagement more broadly.

There are only a limited number of studies that have sought to explore issues of medical leadership on this scale in the English context. This represents the first significant study of this kind in over a decade.

Although medical leadership and management (MLM) is increasingly being recognised as important to improving healthcare outcomes, little is understood about current training of medical students in MLM skills and behaviours in the UK. The paper aims to discuss these issues.

This qualitative study used validated structured interviews with expert faculty members from medical schools across the UK to ascertain MLM framework integration, teaching methods employed, evaluation methods and barriers to improvement.

Data were collected from 25 of the 33 UK medical schools (76 per cent response rate), with 23/25 reporting that MLM content is included in their curriculum. More medical schools assessed MLM competencies on admission than at any other time of the curriculum. Only 12 schools had evaluated MLM teaching at the time of data collection. The majority of medical schools reported barriers, including overfilled curricula and reluctance of staff to teach. Whilst 88 per cent of schools planned to increase MLM content over the next two years, there was a lack of consensus on proposed teaching content and methods.

There is widespread inclusion of MLM in UK medical schools’ curricula, despite the existence of barriers. This study identified substantial heterogeneity in MLM teaching and assessment methods which does not meet students’ desired modes of delivery. Examples of national undergraduate MLM teaching exist worldwide, and lessons can be taken from these.

This is the first national evaluation of MLM in undergraduate medical school curricula in the UK, highlighting continuing challenges with executing MLM content despite numerous frameworks and international examples of successful execution.

The purpose of this paper is to develop and provide initial validation for the new E-Work Life (EWL) Scale. This measure assesses a range of theoretically relevant aspects of the e-working experience related to four main areas: job effectiveness, relationship with the organisation, well-being and work-life balance.

This study presents structured item development. Internal validity and reliability were tested on a sample of 260 e-workers (65 per cent female, age range 25–74). Correlations of the EWL scale with a measure of general health were tested on a subsample of 119 workers to provide initial evidence of construct validity.

Exploratory factor analysis supported a 17-item scale assessing four factors: work-life interference, productivity, organisational trust and flexibility. Individual well-being was measured and a pattern of significant correlations against four factors as indicators of general health were found, including mental health and vitality.

A new sample would confirm the strength of the EWL scale alongside further tests of validity. Coping strategies related to the scale would aid mapping of individual competencies for remote e-working to promote e-workers’ self-management, management style and organisational policy.

The EWL scale helps organisations to evaluate and support the well-being of remote e-workers. It provides measurement on three levels: individual, supervisory and organisational, whereby practical strategies for improvement can be linked to the scale.

The EWL scale completes a gap in the research by providing a measure aiding organisations to evaluate and support remote e-worker well-being.

The purpose of this paper is to explore the impact of remote e‐working on the key research areas of work‐life balance, job effectiveness and well‐being. The study provides a set of generalisable themes drawn from the key research areas, including building trust, management style and the quality of work and non‐working life.

The paper is an exploratory study into the psychological factors affecting remote e‐workers using qualitative thematic analysis of eleven in‐depth interviews with e‐workers, across five organisations and three sectors. All participants worked remotely using technology independent of time and location for several years and considered themselves to be experts.

The paper provides insights into the diverse factors affecting remote e‐workers and produces ten emerging themes. Differentiating factors between e‐workers included access to technology, ability to work flexibly and individual competencies. Adverse impacts were found on well‐being, due to over‐working and a lack of time for recuperation. Trust and management style were found to be key influences on e‐worker effectiveness.

Because of the exploratory nature of the research and approach the research requires further testing for generalisability. The emerging themes could be used to develop a wide‐scale survey of e‐workers, whereby the themes would be further validated.

Practical working examples are provided by the e‐workers and those who also manage e‐workers based on the ten emerging themes.

This paper identifies a number of generalisable themes that can be used to inform the psychological factors affecting remote e‐worker effectiveness.

While the need for leadership in health care is well recognised, there is still the need to better understand how leadership contributes to improving healthcare services. The body of knowledge concerning improvement has grown significantly in recent years, but evidence about links between leadership and health services improvement remains poor, especially within the UK National Health Service. It remains unclear how and why leadership is important to service improvement, and how leadership development can optimise service improvement.This paper describes a study commissioned by The Health Foundation, exploring the links between leadership behaviours reported by clinicians and managers in NHS organisations and their service improvement work. The study highlights leadership behaviours that appear to be positively associated with NHS improvement work. This paper provides insights into which aspects of leadership are used for different types of improvement work and considers lessons for leadership development.

Identifies key activities that network users can perform in order to use the network effectively. Offers recommended reading, from beginner to expert user status. Explains some commonly used terms (e.g. Turbo Gopher with Veronica!). Lists useful Internet resources.

This issue is a selected bibliography covering the subject of leadership.

The role of the chief executive in a transformed organisation is an extremely challenging one. The development of vision, building a commitment to it and communicating it constantly are key skills for a chief executive. However, the need to build and empower the stakeholders within and outside the organisation to support the changes required to deliver the vision requires leaders who can connect with a wide range of people and build alliances and partnerships to secure organisational success. A passion for understanding human intervention and behaviour is needed to encourage, cajole and drive teams and individuals to own and commit to change and a new direction. This requires leaders who have imagination and creativity ‐ who seek connections and thread them together to create order out of incoherence. These skills are not taught in schools or textbooks, but are probably innate. They are what separate leaders from the rest. These skills need to be developed. A movement towards encouraging experimentation, career transfers and more individuality is needed if capable leaders of the future are to appear.

Employees have gained increased flexibility in organizing their work in time and space, that is boundaryless work. Managing the boundaries between work and personal life would seem to be crucial if one is to psychologically detach from work during leisure in order to unwind and get sufficient sleep. Drawing from a sample of Swedish professional workers (N = 3,846), a theoretical model was proposed testing the inter-relationships between boundaryless work in time and space, weekly work hours, psychological detachment, sleeping problems and sleep duration using a structural equation modelling (SEM) analysis. Findings showed that working boundlessly in time, that is spread out during the working day and week, was directly associated with both long weekly work hours and lack of psychological detachment. In contrast, working boundlessly in space, that is at several different places, was inversely associated with weekly work hours and had no association with psychological detachment. Psychological detachment, in turn, was directly associated with sleeping problems and inversely associated with sleep duration. Sleeping problems were inversely associated with sleep duration. Employees with long weekly work hours had a low degree of sleeping problems. There was also no association between long weekly work hours and sleep duration. These findings contradict earlier research, however, we interpret these findings as that if one works a great deal but is able to mentally detach from work-related feelings and thoughts during free time, then sleep will not be hampered because perseverative cognitions associated with prolonged biological activation will have been interrupted. As such, psychological detachment can be regarded as the mechanism that mediates the relationships between working ‘anytime’ and long weekly work hours, and sleep. It was concluded working boundlessly in time increases the likelihood for long weekly work hours and lack of psychological detachment. Hence, employees working ‘anytime – all the time’ run the risk of ‘always being on’ resulting in disturbed sleep.

The development of NHS trusts has been a major part of the NHS reforms in the United Kingdom. The creation of trust boards has coincided with significant pressures from the combined forces for change and consolidation within publicly financed health care in the UK. The development of a long‐term strategic vision for trusts to ensure long‐term survival is imperative. Considers evidence from international researchers and translates this into the context of NHS trusts. Discusses how they define and identify vision and ensure that vision building can be communicated and understood by key stakeholders within and outside the organization. Offers several practical suggestions on how their vision can be monitored and evaluated within the organization.