Torbay Care Trust has been widely promoted as an effective model of integrated health and social care, and yet the impact of reforms introduced by the previous and current…
Abstract
Purpose
Torbay Care Trust has been widely promoted as an effective model of integrated health and social care, and yet the impact of reforms introduced by the previous and current governments has been to destabilise its partnership coherence and its organisational form. This paper seeks to explain why this is the case, highlighting the potentially damaging consequences for the local, currently productive, system of care; and to indicate the local adaptations necessary to maintain progress, which are seen as under continuing threat in the current financial environment.
Design/methodology/approach
This is a personal reflection by the chief executive of Torbay Care Trust, reviewing the documented progress made since 2005.
Findings
The model of partnership, collaboration and risk sharing carefully nurtured over 15 years in Torbay has been proven to be beneficial not only for local people, but for NHS financial and clinical performance generally, and for social care performance. This is now paradoxically being undermined by the more commercially‐minded policy approaches of Labour's Transforming Community Services programme and by the current NHS reforms. New tensions have arisen across the “health and social care divide”.
Originality/value
The current government is unequivocally committed to integrated care, and specifically to integrated health and social care. The Torbay experience gives insight firstly into the care and attention which may be needed by government to secure this over forthcoming years; and secondly to the way in which integrated commissioning will have to be conceived and organised in the new system, and how integrated services will have, in turn, to be commissioned, and operated.
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José Ramón Cardona and María Dolores Sánchez-Fernández
The seasonality in the behavior of travelers is something that goes back to the origin of the trips themselves. This seasonality is due to multiple factors, some easy to…
Abstract
The seasonality in the behavior of travelers is something that goes back to the origin of the trips themselves. This seasonality is due to multiple factors, some easy to counteract and others difficult to solve. But, regardless of the causes, it is a phenomenon that generates significant negative impacts on society and the environment in which the phenomenon of tourist seasonality occurs. All tourist destinations have seasonality, but in some cases, it is very high and in others it has a minimal incidence. The objective of this chapter is to ponder the impacts and consequences of seasonality in regions with a strong tourism development, allowing to put into context the aspects of society impacted by this phenomenon and the positive implications that the reduction of seasonality would have. For this, an analysis of a theoretical model with two regions in opposite situations is carried out, raising the possible effects of a high seasonality. The cases of the Balearic Islands and the Canary Islands are also reviewed, as real examples of the regional typologies taken into consideration in the theoretical model. This seeks to ponder the problems attributable to seasonality. As a final reflection, the enormous typology of negative impacts generated and the need to continue analyzing the seasonality and its impacts are emphasized.
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Aim of the present monograph is the economic analysis of the role of MNEs regarding globalisation and digital economy and in parallel there is a reference and examination of some…
Abstract
Aim of the present monograph is the economic analysis of the role of MNEs regarding globalisation and digital economy and in parallel there is a reference and examination of some legal aspects concerning MNEs, cyberspace and e‐commerce as the means of expression of the digital economy. The whole effort of the author is focused on the examination of various aspects of MNEs and their impact upon globalisation and vice versa and how and if we are moving towards a global digital economy.
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John E. Tyler, Evan Absher, Kathleen Garman and Anthony Luppino
This chapter demonstrates that social business models do not meaningfully prioritize or impose accountability to “social good” over other purposes in ways that (a) best protect…
Abstract
This chapter demonstrates that social business models do not meaningfully prioritize or impose accountability to “social good” over other purposes in ways that (a) best protect against owners changing their minds or entry of new owners with different priorities and (b) enable reliable accountability over time and across circumstances. This chapter further suggests a model – a “social primacy company” – that actually prioritizes “social good” and meaningful accountability to it. This chapter thus clarifies circumstances under which existing models might be most useful and are not particularly useful, especially as investors, entrepreneurs, employees, regulators, and others pursue shared, common understandings about purposes, priorities, and accountability.
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Tae-Youn Park, Reed Eaglesham, Jason D. Shaw and M. Diane Burton
Incentives are effective at enhancing productivity, but research also suggests that performance incentives can have “unintended negative consequences” including increases in…
Abstract
Incentives are effective at enhancing productivity, but research also suggests that performance incentives can have “unintended negative consequences” including increases in hazard/injuries, increases in errors, and reduction in cooperation, prosocial behaviors, and creativity. Relatively overlooked is whether, when, and how incentives can be designed to prevent such negative consequences. The authors review literature in several disciplines (construction, healthcare delivery, economics, psychology, and [some] management) on this issue. This chapter, in toto, sheds a generally positive light and suggests that, beyond productivity, incentives can be used to improve other outcomes such as safety, quality, prosocial behaviors, and creativity, particularly when the incentives are thoughtfully designed. The review concludes with several potential fruitful areas for future research such as investigations of incentive-effect duration.