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Based on the premiss that the extent of change taking place in health care presents a continuous stream of new ideas, concepts and management tools of which managers and staff must be aware and which they must possibly adopt. Draws an analogy with the difficulty of ordering wine, in that the wine waiter, who is the expert, could make it easier for customers to identify and choose their requirements. Offers a number of tips, including the development of staff and the retention of expertise in‐house, to help make effective use of the experts who can beneficially assist NHS managers.

NHS managers must think of health care in a much wider sense than equating it solely with the National Health Service. Health care should rather be viewed as a continuum of businesses and services, including research and development, manufacturing, distribution and actual service delivery. Presents these and places them along a health‐care continuum, which represents a systematic way by which the health care industry can be analysed through its discrete, yet integrated, segments. Manpower, along with finance and estate, are the key resource areas. Manpower resources must be managed effectively in order to maximize value for money, and ultimately ensure health gain for the patient.

Addresses the severe criticism by the Health Service Commissioner of NHS trusts for their handling of patient complaints, particularly the attitude of managers and the new NHS trust culture, which emphasized that patients should be considered as more than just customers. Argues that the word “customer” should not be thrown out because managers are uncomfortable with it; takes the view that, while they may have tried to adopt the term, they have failed to appreciate its meaning. Makes a comparison between customer and consumer and presents a case for regarding patients as customers. Concludes that lessons can be learned from private business in developing the provider‐customer relationship and that attitude and behaviour changes can be brought about by a long‐term cultural change programme.

Anyone who has tried to review studies relating to use of academic libraries may argue that a great deal of research exists on college students and how they use their libraries. Studies of reading habits and library use among college students have been appearing for more than fifty years, and the diligent student can compile an impressive bibliography of these studies. In spite of all we have learned about student interaction with library resources, there is still much we do not know.

Given the complex nature of integrated care systems (ICSs), the geographical spread and the large number of organisations involved in partnership delivery, the importance of leadership cannot be overstated. This paper aims to present novel findings from a rapid realist review of ICS leadership in England. The overall review question was: how does leadership in ICSs work, for whom and in what circumstances?

Development of initial programme theories and associated context–mechanism–outcome configurations (CMOCs) were supported by the theory-gleaning activities of a review of ICS strategies and guidance documents, a scoping review of the literature and interviews with key informants. A refined programme theory was then developed by testing these CMOCs against empirical data published in academic literature. Following screening and testing, six CMOCs were extracted from 18 documents. The study design, conduct and reporting were informed by the Realist And Metanarrative Evidence Syntheses: Evolving Standards (RAMESES) training materials (Wong et al., 2013).

The review informed four programme theories explaining that leadership in ICSs works when ICS leaders hold themselves and others to account for improving population health, a sense of purpose is fostered through a clear vision, partners across the system are engaged in problem ownership and relationships are built at all levels of the system.

Despite being a rigorous and comprehensive investigation, stakeholder input was limited to one ICS, potentially restricting insights from varied geographical contexts. In addition, the recent establishment of ICSs meant limited literature availability, with few empirical studies conducted. Although this emphasises the importance and originality of the research, this scarcity posed challenges in extracting and applying certain programme theory elements, particularly context.

This review will be of relevance to academics and health-care leaders within ICSs in England, offering critical insights into ICS leadership, integrating diverse evidence to develop new evidence-based recommendations, filling a gap in the current literature and informing leadership practice and health-care systems.

The establishment of NHS trust boards on a business format was a recent innovation resulting from the NHS reforms. In order to realize benefits for patients, it is essential that boards operate effectively. Explores within the framework of corporate governance, the practical implications of board member roles. Drawing on experience of strategy formulation at board level, analyses and clarifies the roles, and presents recommendations to increase board effectiveness.

This paper presents a realist evaluation of leadership within an integrated care system (ICS) in England. This paper aims to examine which aspects of leadership are effective, for whom, how and under what circumstances.

Realist evaluation methodology was used, adopting prior realist review findings as the theoretical framework to refine explanations of how and why leadership within an ICS is effective. Between January and November 2023, 23 interviews with ICS leaders took place, alongside 7 meeting observations and documentary analysis. The Realist And Metanarrative Evidence Syntheses: Evolving Standards (RAMESES) guidance informed the study design, conduct and reporting.

The findings highlight two overarching infrastructural contexts influencing leadership in ICSs: the impact of the post-COVID-19 pandemic legacy and the differences between health and social care regulatory and financial environments. Findings demonstrate that ICS leaders identified a strong sense of purpose as crucial for guiding decisions and creating a psychologically safe environment for open, honest discussions, fostering calculated risk-taking. Whilst a shared vision directed priority setting, financial pressures led to siloed thinking. Leadership visibility was linked to workforce morale, with supportive leadership boosting morale amidst evolving ICS landscapes and confidence in data-driven decisions supported prevention activities. However, financial constraints hindered responsiveness and innovation in addressing health inequalities.

By examining ICS leadership post-COVID-19 pandemic and amidst varying regulatory and financial environments, this study contributes to the emerging literature on systems leadership and offers practical guidance for leaders navigating the complexities of integrated care.

The critical budgetting month of March is over, and we are at liberty to glance at the general position of libraries in regard to finance. As we anticipated, certain retrenchments have been effected in the form of reduced contributions from municipal rates, but while these have been regrettable they have in no case been so drastic as utterly to cripple the libraries involved. The unfortunate circumstance in the matter is the haphazard way in which reductions are made. An example worth quoting of this kind occurred at Ealing, where a councillor moved successfully that the appropriation for libraries be reduced to £1,500, without specifying in what directions economies were to be effected, or troubling himself about the working of a system of libraries upon this manifestly inadequate sum; but, after all, to tilt at haphazard methods is to tilt at British character. Naturally, the old exploded arguments against public libraries were advanced in various discussions, as at Croydon, where a councillor stated that the librarian's hours were spent “in handing novels to servant girls, who had nothing better to do,” a statement which he must have known to be untrue; but such arguments have met with small success, and on the whole the libraries have been supported.

The purpose of this paper is to examine the relationship between marketing strategy types – aggressive marketing, price leadership and product specialization strategies – and the extent of relationalism in marketing channels.

Data were collected using a self‐administered survey from managers responsible for marketing and channels management in US pharmaceutical firms. The responses to the questions capturing focal constructs were measured using a five‐point Likert type scale. Data were analyzed using Principal Component Analysis and Structural Equation Modeling procedures.

Aggressive marketing strategy and price leadership strategy are positively associated with the level of relationalism in marketing channels. In contrast, product specialization (focus) strategy is negatively associated with the level of relationalism in marketing channels.

The relationship between marketing strategy and the emergent relationalism among marketing channel intermediaries is critical for the firm's ability to meet objectives. This relationship has not been investigated so far and, from a managerial perspective, managing marketing channels is critical for successful implementation of marketing strategies.

The purpose of this paper is to present the results of exploratory research designed to develop an awareness of healthcare behaviors, with a view toward improving the customer satisfaction with healthcare services. It examines the relationship between healthcare providers and their consumers/patients/clients.

The study uses a critical incident methodology, with both effective and ineffective behavioral specimens examined across different provider groups.

The effects of these different behaviors on what Berry (1999) identified as the common core values of service organizations are examined, as those values are required to build a lasting service relationship. Also examined are categories of healthcare practice based on the National Quality Strategy priorities.

The most obvious is the retrospective nature of the method used. How accurate are patient or consumer memories? Are they capable of making valid judgments of healthcare experiences (Berry and Bendapudi, 2003)? While an obvious limitation, such recollections are clearly important as they may be paramount in following the healthcare practitioners’ instructions, loyalty for repeat business, making recommendations to others and the like. Further, studies have shown retrospective reports to be accurate and useful (Miller et al., 1997).

With this information, healthcare educators should be in a better position to improve the training offered in their programs and practitioners to better serve their customers.

The findings would indicate that the human values of excellence, innovation, joy, respect and integrity play a significant role in building a strong service relationship between consumer and healthcare provider.

Berry (1999) has argued that the overriding importance in building a lasting service business is human values. This exploratory study has shown how critical incident analysis can be used to determine both effective and ineffective practices of different medical providers. It also provides guidelines as to what are effective and ineffective behaviors in healthcare.