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This chapter reviews three analytical perspectives – ‘structural’, ‘network’ and ‘cultural’ – on the study of power and their implications for theorizing elites. It builds on this initial theoretical review by developing a critical realist approach to the study of organizational elites out of the structurally based perspective identified in the first section of the chapter. The explanatory potential of this critical realist approach is then illustrated through two case studies of ruling elites embedded in contrasting historical, political and social contexts. The final section of the chapter provides a discussion of the wider implications of these case study analyses for understanding and explaining the ‘new feudalism’ which is emerging in advanced political economies and societies.

In an emerging global economy the ability of the telecommunications sector to provide an internationally competitive network for transferring information has significant implications for trade and economic growth. Because of recent large world‐wide investments in telecommunications infrastructure, quantifying the impact of telecommunications in economic growth has received much attention. However, economic analysts, in the absence of investment data for many developing countries, adopt the International Telecommunications (ITU) practice of using main telephone lines to measure the stock of telecommunications capital. The accuracy of this proxy has not been subject to careful statistical scrutiny. This study develops a supply‐side growth model which employs teledensity and the share of telecommunications investment in national income as telecommunications capital proxies. Estimation results suggest a significant positive cross‐country relationship between telecommunications capital and economic growth, when using alternative measures of telecommunications capital.

The purpose of this paper is to consider the ways in which certain occupational, organizational and political positions become active sites of leadership construction. Taking as their example the introduction of the Modern Matron in the English National Health Service (NHS) this paper considers how new forms of gender transcending leadership are constituted relationally through a dynamic interplay of historical, nostalgic, social, political and organizational forces.

The research was conducted within an interpretive paradigm of social constructivism and draws on data from semi‐structured interviews with a purposive sample of 16 Modern Matrons working in a single English NHS Trust. In keeping with inductive, qualitative research practice, data has been analysed thematically and ordered using descriptive, hierarchical and relational coding.

Their contention is that the Modern Matron presents as a site for relational leadership in respect of both self and other. This paper argues that the construction of Modern Matron usefully points to the ways in which multiple discourses, practices and relations may be intertwined in defining what it is to lead in contemporary organizations. This paper highlights the extent to which leadership is an on‐going relational co‐construction based – in this instance – in the interplay of four factors: nostalgic authority, visibility, praxis and order negotiation. Together, these produce a mode of leading that is neither heroic nor popularist.

Further research might consider how competing temporal, political and organizational imperatives encourage the development of particular sites for leadership, and how such leadership is then re‐performed in practice, as well as the affects/effect on individual and organisational performance.

The data provides opportunity to consider the “lived experience” of leaders in sites that are traditionally gendered female in non‐standard/public sector settings. Moreover, this paper presents empirical evidence in support of leadership as socially constructed and relational, borne of tension between different temporal, spatial and experiential factors, the on‐going negotiation of which both utilises and transcends masculinized and feminized gender performances. The result is a form of “leading” which is often subtle, difficult to identify and self‐effacing.

The purpose of this paper is to explore leadership effectiveness, with reference to nurses in the UK National Health Service (NHS).

The paper is literature based. It explores the history and policy background to nurse leadership. It reviews a range of approaches to leadership and applies the theoretical findings to the case study of nurse leaders

The paper suggests there are several inter‐related aspects to consider in relation to developing the effectiveness of nurse leaders – these may be grouped around: developing core competencies; developing emotional intelligence; developing readiness and motivation; developing contextual sensitivity; and developing clinical innovation and change.

The paper discusses the implications of the findings for the leadership development of nurses and makes recommendations.

The paper attempts to incorporate the insights from a variety of different approaches to leadership and apply them to nurse leaders in the UK NHS.

The purpose of this paper is to show how competency models can be used to govern the increased autonomy of advanced practitioners in nursing, and to assist in workforce development.

The study shows how competency frameworks for advanced nurse practitioners (ANPs) have evolved in the UK. It compares the current thinking in the UK to the latest competency models from the USA. The article uses the authors' own adaptation of Benner's novice‐to‐expert framework to derive a framework from the current approaches. The authors then demonstrate how the resulting framework can be deployed to target development of new ANPs to address workforce development and governance issues over ensuring the right skill mix for safe autonomous practice. Finally, they argue for registration of advanced practitioners as a distinct professional group to address medico‐legal concerns over increased autonomy.

The study shows that there are currently limited numbers of ANPs constraining the development of new nurse‐led services, for example paediatrics. The study argues that current developments in the UK are unhelpful to the development of new nurse‐led initiatives that could flourish under the new commissioning arrangements. The study demonstrates how an enhanced framework can be used to target potential new ANPs for bespoke training, to assure that existing role holders have the correct level of competency for safe autonomous practice, and could form the basis of professional registration of advanced practitioners.

The small numbers of existing ANPs and the early stage of development of nurse‐led services limit the opportunities for evaluation.

This study suggests that competency modelling can contribute to the effectiveness of ANP education, help to address workforce planning issues and provide re‐assurance for commissioners in terms of governance and safety.

Competency modelling for ANPs in the UK is in its infancy, but the lack of a safe and competent workforce is a barrier to innovation for commissioners of services.

The purpose of this paper is to explore the incidence of “extreme jobs” among middle managers in acute hospitals, and to identify individual and organizational implications.

The paper is based on interviews and focus groups with managers at six hospitals, a “proof of concept” pilot with an operations management team, and a survey administered at five hospitals.

Six of the original dimensions of extreme jobs, identified in commercial settings, apply to hospital management: long hours, unpredictable work patterns, tight deadlines with fast pace, broad responsibility, “24/7 availability”, mentoring and coaching. Six healthcare-specific dimensions were identified: making life or death decisions, conflicting priorities, being required to do more with fewer resources, responding to regulatory bodies, the need to involve many people before introducing improvements, fighting a negative climate. Around 75 per cent of hospital middle managers have extreme jobs.

This extreme healthcare management job model was derived inductively from a qualitative study involving a small number of respondents. While the evidence suggests that extreme jobs are common, further research is required to assess the antecedents, incidence, and implications of these working practices.

A varied, intense, fast-paced role with responsibility and long hours can be rewarding, for some. However, multi-tasking across complex roles can lead to fatigue, burnout, and mistakes, patient care may be compromised, and family life may be adversely affected.

As far as the authors can ascertain, there are no other studies exploring acute sector management roles through an extreme jobs lens.

This chapter documents an exchange between Leonard Savage, founder of the subjective probability approach to decision-making, and Karl Popper, advocate of the so-called propensity approach to probability, of which there is no knowledge in the literature on probability theory. Early in 1958, just after being informally tested by Daniel Ellsberg with a test of consistency in decision-making processes that originated the so-called Ellsberg Paradox, Savage was made aware that a similar argument had been put forward by Popper. Popper found it paradoxical that two apparently similar events should be attributed the same subjective probability even though evidence supporting judgment in one case was different than in the other case. On this ground, Popper rejected the subjective probability approach. Inspection of the Savage Papers archived at Yale University Library makes it possible to document Savage’s reaction to Popper, of which there is no evidence in his published writings. Savage wrote to Popper denying that his criticism had paradoxical content and a brief exchange followed. The chapter shows that while Savage was unconvinced by Popper’s argument he was not hostile to an axiomatically founded generalization of his theory.