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Article
Publication date: 1 June 1990

C. Pollitt, S. Harrison, D.J. Hunter and G. Marnoch

A summary of the project examining the impact of general management on the NHS, based on field work in England and Scotland between 1986‐1989. Implications of further change and…

54

Abstract

A summary of the project examining the impact of general management on the NHS, based on field work in England and Scotland between 1986‐1989. Implications of further change and clinical audit are discussed.

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International Journal of Health Care Quality Assurance, vol. 3 no. 6
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 1 April 1997

Angus Laing, Gordon Marnoch, Lorna McKee, Rita Joshi and John Reid

The concept of the primary health‐care team involving an increasingly diverse range of health care professionals is widely recognized as central to the pursuit of a primary…

773

Abstract

The concept of the primary health‐care team involving an increasingly diverse range of health care professionals is widely recognized as central to the pursuit of a primary care‐led health service in the UK. Although GPs are formally recognized as the team leaders, there is little by way of policy prescription as to how team roles and relationships should be developed, or evidence as to how their roles have in fact evolved. Thus the notion of the primary health‐care team while commonly employed, is in reality lacking definition with the current contribution of practice managers to the operation of this team being poorly understood. Focusing on the career backgrounds of practice managers, their range of responsibilities, and their involvement in innovation in general practice, presents a preliminary account of a chief scientist office‐funded project examining the role being played by practice managers in primary health‐care innovation. More specifically, utilizing data gained from the ongoing study, contextualizes the role played by practice managers in the primary health‐care team. By exploring the business environment surrounding the NHS general practice, the research seeks to understand the evolving world of the practice manager. Drawing on questionnaire data, reinforced by qualitative data from the current interview phase, describes the role played by practice managers in differing practice contexts. This facilitates a discussion of a set of ideal type general practice organizational and managerial structures. Discusses the relationships and skills required by practice managers in each of these organizational types with reference to data gathered to date in the research.

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Journal of Management in Medicine, vol. 11 no. 2
Type: Research Article
ISSN: 0268-9235

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Article
Publication date: 1 June 1999

Paul C.S. Lian and Gordon Marnoch

This paper describes a study of the knowledge and attitudes of a sample of private medical practitioners in Malaysia in relation to questions posed on guidelines‐based medicine…

4975

Abstract

This paper describes a study of the knowledge and attitudes of a sample of private medical practitioners in Malaysia in relation to questions posed on guidelines‐based medicine. The study was conducted through a postal questionnaire sent to a sample of 2,000 private practitioners. Placing the research in context, a description of Malaysia and its health‐care system is provided. Issues surrounding guidelines‐based medicine in the Malaysian context are discussed. An analysis of the sample population’s personal and professional characteristics is presented. Key research findings include identifying a substantial knowledge deficit – less than half of the respondents claimed to understand “guidelines”. A majority of doctors (64 per cent) think guidelines are useful. Only 29 per cent of respondents knew where to find guidelines, with 22 per cent claiming to have used guidelines. The paper concludes with a discussion of issues in the implementation of guidelines‐based medicine in Malaysia based on the study’s findings.

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Journal of Management in Medicine, vol. 13 no. 3
Type: Research Article
ISSN: 0268-9235

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Article
Publication date: 1 February 2002

Necia France, Graham Francis, STEWART LAWRENCE and Sydney Sacks

The motivation for this paper is to better understand the strengths and limitations of quantitative performance measures in a changing environment. The context is one of…

229

Abstract

The motivation for this paper is to better understand the strengths and limitations of quantitative performance measures in a changing environment. The context is one of organisational change and innovative management. Using a case study approach, the paper presents a history of organisational change and focuses on attempts to drive and assess efficiency through performance measures in a public hospital‐based pathology laboratory. The various financial and non‐financial performance measures used in the laboratory are presented. A discrepancy between accounting reports and laboratory management analyses of costs is reported. The notorious difficulties of costing health services are examined through the dispute that arose about whether the mean cost‐per‐test was increasing or decreasing over a three‐year period. Competing representations of performance are analysed. Whilst the case study looks at a New Zealand example, many of the pressures facing pathology services are typical of medical laboratories worldwide. General issues of performance measurement are discussed.

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Pacific Accounting Review, vol. 14 no. 2
Type: Research Article
ISSN: 0114-0582

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Article
Publication date: 23 August 2011

Garth den Heyer

The purpose of this paper is to examine the use of new public management (NPM) as a major strategy for democratic police reform in transitioning, developing and post‐conflict…

7220

Abstract

Purpose

The purpose of this paper is to examine the use of new public management (NPM) as a major strategy for democratic police reform in transitioning, developing and post‐conflict nations.

Design/methodology/approach

The paper reviews the literature and history of the use of NPM in the public sector and policing in Western nations and considers its use in programs of police reform.

Findings

The review identifies that NPM can be used as a strategy in police reform and is able to be used in conjunction with policing approaches such as community‐oriented policing. However, the adoption of NPM must be culturally specific and implemented within local capability constraints.

Practical implications

Police reform, transparency and accountability are an important concern for all post‐conflict and transitioning police agencies; therefore, the findings of this research are useful for implementation or planning of police reform and restructuring programs.

Originality/value

With its focus on police management accountability in post‐conflict or transitioning nations, this article expands research on strategies of democratic police reform and capacity development.

Details

Policing: An International Journal of Police Strategies & Management, vol. 34 no. 3
Type: Research Article
ISSN: 1363-951X

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Article
Publication date: 27 June 2023

Vicky Lambert and Irvine Lapsley

There is a longstanding debate over the role of modern business methods in the contemporary non-profit organisation (NPO). Critics of business practices assert that they may…

649

Abstract

Purpose

There is a longstanding debate over the role of modern business methods in the contemporary non-profit organisation (NPO). Critics of business practices assert that they may undermine the missions of NPOs. The aim of this paper is to contribute to this debate. Many accounting researchers have shifted research focus to concepts such as trust and crises. These are important topics. But they may overshadow practices which are taken for granted as accepted practice which does not merit re-examination.

Design/methodology/approach

This qualitative project is based on an initial survey followed by comparative case studies of three NPOs. The researchers have used both interviews and documentary analysis in this study.

Findings

The contention that the adoption of business-like practices undermines the fundamental aim of altruism of NPOs is challenged by the findings of this paper. The very concept of altruism is not a single unifying concept in NPOs – it is a contested idea. However, and most importantly, in this research there is no evidence of mission drift by NPOs which adopt business practices. This research highlights the way many NPO CEOs are mission-driven but also pragmatic bricoleurs in their consideration of new business practices. Most importantly, these case studies demonstrate a variation in practices within the participating organisations. This raises challenging questions about a receptive context for the adoption of new business practices which are explored in this paper.

Research limitations/implications

The case studies in this paper are from the UK, and further studies in different operating contexts in other countries would be useful. In particular, the finding that the fundamental ethos of NPOs is not challenged by being business-like merits further research. There is also scope for further research on what constitutes a receptive context for the adoption of new business practices by NPOs.

Practical implications

This study reveals the potential significance of NPO boards, particularly non-executive directors, in the shaping of organisational practices. There is evidence in this study of NPOs recruiting business experts for purposes of legitimation. But this study also shows how business expertise can be mobilised to enhance NPO performance by bricoleurs in NPO who are highly motivated individuals who will adopt useful business practices to hand if they improve charity outcomes.

Social implications

The NPO organisations are motivated by the desire to make a difference to the lives of people who are vulnerable or disadvantaged. This study has interesting implications for managers and directors of NPOs on their effectiveness.

Originality/value

This study challenges the critical view that becoming more business-like undermines the fundamental ethos of altruism in NPOs. This is an important finding, but this study also reveals the recruitment of business expertise by NPOs purely for purposes of legitimation. However, these legitimating practices differ from the well-established view of isomorphism in the field of NPOs and suggests that, on the contrary, there is a variation in practice within the NPO field which has important implications for donors, regulators, directors and managers of NPOs.

Details

Qualitative Research in Accounting & Management, vol. 20 no. 4
Type: Research Article
ISSN: 1176-6093

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Article
Publication date: 8 February 2008

Jeffrey Braithwaite

The purpose of this paper is to examine the case that health service leadership is more than the sum total of all the health service management activity observed; and to advocate…

1482

Abstract

Purpose

The purpose of this paper is to examine the case that health service leadership is more than the sum total of all the health service management activity observed; and to advocate for improved leadership in health services through an examination of top‐down management structures and processes which “crowd out” leadership behaviours.

Design/methodology/approach

Application of historical and contemporary contexts to health service management and health service leadership approaches.

Findings

The neglect of leadership is discussed and the case is put for a tightly‐crafted position on how leadership should be emphasised and raised to greater prominence. Formulae for conceptualising leadership are presented in order to show the constituent elements underpinning clear descriptions of leadership.

Research limitations/implications

Further research on leadership, and more targeted education for leaders, is needed.

Practical implications

One way to build leadership capacity is to create a sustainable partnership between health service academics and leaders in the field.

Originality/value

Developing formulae for framing leadership is not reductionist per se but specifies with precision the essential elements needed to express health services leadership success.

Details

Leadership in Health Services, vol. 21 no. 1
Type: Research Article
ISSN: 1751-1879

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