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Article
Publication date: 2 September 2019

Challenges and insights in inter-organizational collaborative healthcare networks: An empirical case study of a place-based network

Kieran Mervyn, Nii Amoo and Rebecca Malby

Public sectors have responded to grand societal challenges by establishing collaboratives – new inter-organizational partnerships to secure better quality health services…

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Abstract

Purpose

Public sectors have responded to grand societal challenges by establishing collaboratives – new inter-organizational partnerships to secure better quality health services. In the UK, a proliferation of collaboration-based healthcare networks exists that could help to enhance the value of investments in quality improvement programs. The nature and organizational form of such improvements is still a subject of debate within the public-sector literature. Place-based collaboration has been proposed as a possible solution. In response, the purpose of this study is to present the results and findings of a place-based collaborative network, highlighting challenges and insights.

Design/methodology/approach

This study adopted a social constructionist epistemological approach, using a qualitative methodology. A single case study was used and data collected in three different stages over a two-year period.

Findings

The study finds that leadership, data-enabled learning through system-wide training and development, and the provision of an enabling environment that is facilitated by an academic partner, can go a long way in the managing of healthcare networks for improving quality.

Research limitations/implications

Regardless of the tensions and challenges with place-based networks, they could still be a solution in maximizing the public value required by government investments in the healthcare sector, as they offer a more innovative structure that can help to address complex issues beyond the remit of hierarchical structures. This study is limited by the use of a single case study.

Practical implications

Across countries health systems are moving away from markets to collaborative models for healthcare delivery and from individual services to population-based approaches. This study provides insights to inform leaders of collaborative health models in the design and delivery of these new collaborations.

Social implications

As demand rises (as a result of increasing complexity and demographics) in the western world, health systems are seeking to redefine the boundaries between health service provision and community self-reliance and resilience. This study provides insights into the new partnership between health institutions and communities, providing opportunities for more social- and solidarity-based healthcare models which place patients and the public at the heart of change.

Originality/value

The city place-based network is the first of such organizational form in healthcare collaboration in the UK.

Details

International Journal of Organizational Analysis, vol. 27 no. 4
Type: Research Article
DOI: https://doi.org/10.1108/IJOA-05-2018-1415
ISSN: 1934-8835

Keywords

  • Healthcare
  • Qualitative study
  • Leadership
  • Case study
  • Inter-organizational collaboration
  • Place-based network

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Article
Publication date: 17 September 2018

Darzi Clinical Leadership Fellows: an activity theory perspective

Rebecca Malby, Kieran Mervyn and Terry J. Boyle

The purpose of this paper is to review the impact of the clinical leadership programme, in enabling the Darzi fellows to lead change projects in health and care services…

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Abstract

Purpose

The purpose of this paper is to review the impact of the clinical leadership programme, in enabling the Darzi fellows to lead change projects in health and care services, and to secure quality healthcare in the NHS beyond the lifetime of the programme.

Design/methodology/approach

A longitudinal empirical investigation of clinical leaders (n=80) over an eight-year period was framed through an activity theory (AT)-driven research methodology using a mixed-methods approach.

Findings

AT illuminated how change was sustained in the NHS in London through the Darzi Clinical Leadership Fellowship. By any reasonable measurement, this programme excels, with learning and positive behavioural change sustained after the Fellowship across the NHS. Further recognition is needed of the continuing development needs of fellows as they take on more responsible leadership roles in their careers.

Research limitations/implications

Darzi fellows are a hard-to-reach group. The sample represents a response rate of 34 per cent. In total, 77 per cent of respondents emanated from cohorts 5 to 8 programmes.

Practical implications

The investment in a clinical leadership programme focused on systems leadership for quality generates value for the NHS.

Social implications

Countless interventions flowed through London’s healthcare community and beyond as a result of the Fellowship. This research exposed how Darzi fellows continue to lead innovation for alternative healthcare outcomes. Many proactive fellows employ a suite of learned skills and capabilities to lead systemic change.

Originality/value

This research is the first known longitudinal clinical leadership development study undertaken. The Darzi programme has created a unique clinical network of mutually supportive, team-centric systems thinkers and doers, with an evidence-based approach to systems change. Many fellows are catalysing sustainable change in the healthcare environment.

Details

Journal of Health Organization and Management, vol. 32 no. 6
Type: Research Article
DOI: https://doi.org/10.1108/JHOM-05-2018-0133
ISSN: 1477-7266

Keywords

  • Innovation
  • Leadership
  • Healthcare
  • Change management
  • Interprofessional
  • Clinical leadership

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Article
Publication date: 12 February 2018

Introducing a People’s Academy into Higher Education: A coproduction approach to sustained well-being

Sally Elizabeth Hardy, Rebecca Malby, Nina Hallett, Anam Farooq, Carol Chamley, Gwendoline Young, Xavier Hilts White and Warren Turner

The introduction of a People’s Academy (PA) within the School of Health and Social Care (HSC) at London South Bank University has created ripples across the pond that is…

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Abstract

Purpose

The introduction of a People’s Academy (PA) within the School of Health and Social Care (HSC) at London South Bank University has created ripples across the pond that is Higher Education. The paper aims to discuss this issue.

Design/methodology/approach

Working as a coproduction innovation hub, the PA celebrates inclusion of those with a lived experience of HSC services into the academic community as valued members of the teaching and learning team. In its second year the PA has gained attention and achieved a “highly commended” status from external regulating bodies.

Findings

In this paper the authors report on aspects arising from an entrepreneurial education approach. First, is the work-based learning experience students achieve within the Higher Education Institution (HEI) setting, preparing them for clinical placements and client encounters. Second are ripples of activity the PA work streams have sent throughout the academic staff via critically creative working practices as a process of entrepreneurial education. Conclusions focus on a sustainable approach to recovery and resilience (whether physical or psychological) and overall well-being that PA members recognise as a raised level of compassion for sustainable health and well-being for all.

Social implications

The work and enthusiasm of the PA as an authentic social engagement process rippling across the “University” experience; whether for students in the classroom or when working alongside academic staff, is identifiable in all aspects of academic activities. Most importantly is a positive gain in terms of knowledge, skills and confidence for the PA members themselves and their own well-being enhancement.

Originality/value

The PA approach to entrepreneurial education and work-based learning across the HEI setting is one of the first of its kind. This paper outlines core practices to achieve innovative coproduction approach that others may wish to replicate.

Details

Higher Education, Skills and Work-Based Learning, vol. 8 no. 1
Type: Research Article
DOI: https://doi.org/10.1108/HESWBL-10-2017-0075
ISSN: 2042-3896

Keywords

  • Coproduction
  • Higher education
  • Work-based learning
  • Entrepreneurial education
  • People’s Academy

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Article
Publication date: 11 November 2013

How professionals can lead networks in the NHS

Rebecca Malby, Kieran Mervyn and Luca Pirisi

The largest organisation in the western world, the UK National Health Service (NHS), might be best viewed as a network of interdependent organisations. However, the public…

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Abstract

Purpose

The largest organisation in the western world, the UK National Health Service (NHS), might be best viewed as a network of interdependent organisations. However, the public has only recently begun to see it as a living network. Public reforms and financial crises have increased the need for professionals to innovate and improve their role. The overarching question is how this new clinical leadership can positively affect the functioning of the system and its performance. Therefore, the purpose of this paper is to clarify how leaders can be most effective in managing health networks.

Design/methodology/approach

A pragmatic approach was taken because of the topical and strategic importance of networks and leadership in the current climate, and hence a need for greater understanding of this largely unknown phenomenon. A focus group interview with Organisational Development experts from the Centre for Innovation and Health Management (CIHM) at Leeds University Business School was followed by three scoping reviews and high-level follow-up conversations with CIHM members, network leaders from the NHS and third sectors.

Findings

Issues that have emerged include: how networks are designed; which factors enhance its likelihood of success and predicate its failure; discussions of illuminating effective leadership.

Research limitations/implications

The Stories of Effective Leadership Networks were provided by the network founders, who may have sought to emphasise the benefits (as opposed to downside) of their network. An ideal scenario would have been the inclusion of patients and carers and perhaps administrative staff to reduce bias.

Originality/value

Considering the limited evidence base from the literature about medical leadership for network management, the involvement of network leaders and the ability to draw-upon CIHMs knowledge and expertise has been fundamental for determining lessons that may enhance the leadership function of the UK's health system network.

Details

The International Journal of Leadership in Public Services, vol. 9 no. 1/2
Type: Research Article
DOI: https://doi.org/10.1108/IJLPS-05-2013-0012
ISSN: 1747-9886

Keywords

  • Leadership
  • Innovation
  • Networks
  • Healthcare
  • NHS
  • Outcomes

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