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This paper examines the contested value of healthy life and wellbeing in a context of severe austerity, exploring how the value of “Public Health” is constructed through and with material-discursive practices and accounting representations. It seeks to explore the political and ethical implications of constructing the valuable through a shared consensus over the “facts” when addressing complex, multi-agency problems with long time horizons and outcomes that are not always easily quantifiable.

The theorisation, drawing on science and technology studies (STS) scholars and Karen Barad's (2007) agential realism, opens up the analysis to the performativity of both material and discursive practices in the period following a major re-organisation of activity. The study investigates two case authorities in England and the national regulator through interviews, observations and documentary analysis.

The paper demonstrates the deeply ethical and political entanglements of accounting representations as objectivity, consensus and collective action are constructed and resisted in practice. It goes on to demonstrate the practical challenges of constructing “alternative accounts” and “intelligent accountabilities” through times of austerity towards a shared sense of public value and suggests austerity measures make such aims both more challenging and all the more essential.

Few studies in the accounting literature have explored the full complexity of valuation practices in non-market settings, particularly in a public sector context; this paper, therefore, extends familiar conceptual vocabulary of STS inspired research to further explore how value(s), ethics and identity all play a crucial role in making things valuable.

The purpose of this study is to present a quality improvement approach titled “Picture-Understanding-Action” used in Ireland to enhance the role of healthcare boards in the oversight of healthcare quality and its improvement.

The novel and practical “Picture-Understanding-Action” approach was implemented using the Model for Improvement to iteratively introduce changes across three quality improvement projects. This approach outlines the concepts and activities used at each step to support planning and implementation of processes that allow a board to effectively achieve its role in overseeing and improving quality. This approach matured over three quality improvement projects.

The “Picture” included quantitative and qualitative aspects. The quantitative “Picture” consisted of a quality dashboard/profile of board selected outcome indicators representative of the health system using statistical process control (SPC) charts to focus discussion on real signals of change. The qualitative picture was based on the experience of people who use and work in health services which “people-ised” the numbers. Probing this “Picture” with collective grounding, curiosity and expert training/facilitation developed a shared “Understanding”. This led to “Action(s)” from board members to improve the “Picture” and “Understanding” (feedback action), to ask better questions and make better decisions and recommendations to the executive (feed-forward action). The Model for Improvement, Plan-Do-Study-Act cycles and a co-design approach in design and implementation were key to success.

To the authors’ knowledge, this is the first time a board has undertaken a quality improvement (QI) project to enhance its own processes. It addresses a gap in research by outlining actions that boards can take to improve their oversight of quality of care.

During the 2014 independence referendum in Scotland, there was much debate about the future broader political direction of the country but little discussion about its impact on Scottish tourism. The purpose of this paper is to explore and discuss the impact of the different future political options from a tourism perspective.

From the literature, four main political drivers were identified, and using Scotland as a reference, they were used in discussions with six experts to explore how tourism could develop under different political options. The outcomes from these discussions were combined by the researcher to develop in conjunction with the experts an agreed discussion note. This discussion note formed the basis for the exploration of the impact on tourism under four different future political options.

Of the four political options (devolution limited, devolution plus, devolution max/fiscal autonomy/federation and full independence), it is clear that all options had different positive and negative impacts for tourism. The devolution max option, however, was perceived as most damaging to tourism, because tourism would not be considered a priority, relative to other policy issues. The study concludes with six key lessons that destination management organisations (DMOs) should contemplate when considering the impacts of different political futures.

Being focussed on one country with a strong political party whose raison d'être is independence makes it difficult to extrapolate the results. Nevertheless, given the strong commonality of agreement of the impacts within the experts consulted, this study suggests that DMOs can and should engage in political debates about the future of tourism in their destination.

The 2014 independence referendum in Scotland failed to achieve its primary aim of independence for Scotland, but it did provide space for other political options to be explored. This paper provides a perspective on how tourism could develop under different political options, and so help raise its profile in any future debates, both in Scotland and other destinations.