Search results

The purpose of this paper is to describe the experiences of Manchester Primary Care Trust (PCT) of driving improvement in quality and patient safety as commissioners in the English National Health Service (NHS). After the PCT's establishment in late 2006, considerable work was undertaken to develop and promote the role of Commissioner as the custodian of standards of services for its resident population. This required engagement with internal PCT stakeholders and a range of external stakeholders locally, regionally and nationally. The authors' experience should be of interest in the UK, and beyond given that many health systems have, or are moving towards, a commissioner: provider model.

This is a case study using self‐reported observational approach.

The authors' experience showed that commissioners can and should provide the leadership in driving quality improvements and patient safety, within their health systems. However, the challenges must not be underestimated, and the authors share some of the methods they used and lessons they learned.

There is a considerable interest in promoting quality through better commissioning of health care services. However, there is limited research into the impact and effectiveness of using commissioning as a lever. Given that in the NHS, and elsewhere in the world, commissioning is seen as the organising principle for health systems, such research and evaluation should be a priority.

This case study has valuable lessons for the new NHS and the findings are relevant to other health systems. There is a danger that the new NHS will repeat some of the mistakes of the past, and hopefully this case study can help avoid, or limit, the risks.

To the authors' knowledge there is no comparable piece of work, and the data/findings have not been published or reported comprehensively before. The paper should be of value to not just the NHS but to health systems generally, since commissioning seems to be the prevailing model for organising them.

Across the globe, every organization is striving to enhance the productivity and growth rate, but the prosperity and success of an organization is determined by the type of work environment in which it operates. To address this apprehension, this paper aims to determine the effect of toxic workplace environment on job stress that can badly affect the job productivity of an employee.

As an independent variable, toxic workplace environment was used as a complete spectrum consisting multiple dimensions named as workplace ostracism, workplace incivility, workplace harassment and workplace bullying. Job stress was used as a mediating variable between the spectrum of toxic workplace environment and job productivity. In this regard, self-administered close-ended questionnaire was used to collect the data from 267 employees of the health sector (HS) of Lahore region in Pakistan. For analysis purpose, we used confirmatory factor analysis to ensure the convergent and discriminant validity of the factors. AMOS 22 was used to check the direct and indirect effect of selected variables. Hayes mediation approach was used to check the mediating role of job stress between four dimensions of toxic workplace environment and job productivity.

The output demonstrated that the dimensions of toxic workplace environment have a negative significant relationship with job productivity, while job stress was proved as a statistical significant mediator between dimensions of toxic workplace environment and job productivity. Finally, we conclude that organizations need to combat/cleanse the roots of toxic workplace environment to ensure their prosperity and success.

This study aims to determine the effect of toxic workplace environment on job stress that can badly affect the job productivity of an employee. An empirical study in the context of the HS of Pakistan. This study, which is based on HS, has never been reported before in literature.