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This paper seeks to analyse reasons behind the difficulties faced by Northern Rock (NR) and the UK financial system and proposes a return to a more traditional/prudent banking business model, based on a sound balance between sources and uses of funds.

The paper outlines the background to the credit crunch and presents a simple model of a bank and NR's business model. Conclusions and implications are drawn.

It is suggested that credit rating agencies should provide a better assessment of the risks involved in securitised instruments by focusing on clarity and transparency and hence allowing liquidity risk of loan originators to be comprehensively understood. Moreover, the efficacy of the existing regulatory framework requires the tripartite system of supervision (Treasury, Bank of England, and FSA) to assume a more alert role in order to avoid asset bubbles in the first place rather than intervening ex post.

The paper will give rise to a series of new research streams – all of which are much needed, given the fragile state of the financial systems.

Purpose – The chapter aims to understand what kind of policy approach has been more successful in facilitating the involvement of patients and the public in the design and provision of health-care services at the local level and the explanatory factors justifying the implementation outcome.Methodology – By applying Richard Matland's ambiguity/conflict policy implementation model, the chapter analyses the impact of a number of policies introduced after 1997 in the English National Health Service that targeted final users and the local population in decision-making processes.Findings – The evidence shows that policies emphasising the importance of context-specific contingencies can be more effectively implemented when room for interpretation and discretion in selecting the appropriate means for involvement is given. In this way, the overall aims/purposes of health policies can be locally reshaped by allowing the adoption of flexible strategies within the implementation process.Practical implications – A strong leadership at the top of public sector organisations and, in particular, from the board of directors is needed to steer and facilitate a consensus oriented outcome in organisational decision-making processes that aim to incorporate the views and opinions of patients and the public.Social implications – Local initiatives in increasing participation, for specific purposes, are bound to be more successful than a general initiative, expecting comparatively uniform implementation.

The paper aims to investigate the collective behaviour of boards of directors in 22 English National Health Service trusts and how this impacts on the exercise of their role and functions. Furthermore, it aims to shed light on the governance model characterising boards of health sector organisations.

The data were gathered using a range of qualitative techniques (96 semi‐structured interviews, focus groups, workshops and document analysis) with a multiple case study approach.

Owing to the existence of overlapping governance ideologies, health care boards are characterised by different internal dynamics, processes and levels of engagement in the exercise of their tasks. Post‐new public managment driven boards emphasise a pronounced collective approach in their internal proceedings, a wider perspective in strategising and a greater stakeholder involvement in decision‐making processes. These characteristics are particularly evident in boards of foundation trusts, in which network driven governance principles and mechanisms receive a more comprehensive implementation through a collective leadership approach.

The model of the board shared by foundation trusts moves these health care organisations closer to the idea of social enterprises. Additionally, the evidence shows similar behavioural characteristics between these boards and the best practice examples of private sector boards.

The foundation trust model of the board provides new meaningful connotations and significance to the traditional understanding of health care boards, offering a more comprehensive notion of their role and functions in terms of leadership provision, strategy formulation, monitoring and reporting.

This study aims to summarize studies that compared the performance of health-care institutions led by leaders with medical background versus those with no medical background.

A systematic search was conducted on three databases: PubMed, Ovid Medline and Google Scholar to identify relevant peer-reviewed studies using the keywords “performance,” “impact,” “physician,” “medical,” “doctor,” “leader,” “healthcare institutions” and “hospital.” Only quantitative studies that compared the performance of health-care institutions led by leaders with medical background versus non-medical background were included. Articles were screened and assessed for eligibility before the relevant data were extracted to summarize, appraise and make a narrative account of the findings.

A total of eight studies were included, four were based in the USA, two in the UK and one from Germany and one from the Arab World. Half of the studies (n = 4) reported overall better health-care institutional performance in terms of hospital quality ranking such as clinical effectiveness and patient safety under leaders with medical background, whereas one study showed poorer performance. The remaining studies reported mixed results among the different performance indicators, especially financial performance.

While medical background leaders may have an edge in clinical competence to manage health-care institutions, it will be beneficial to equip them with essential management skills to optimize leadership competence and enhance organizational performance.

The exclusive inclusion of quantitative empirical studies that compared health-care institutional performance medical and non-medical leaders provides a clearer link between the relationship between health-care institutional performance and the leaders’ background.