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1 – 8 of 8Steve Gillard, Kati Turner, Kathleen Lovell, Kingsley Norton, Tom Clarke, Rachael Addicott, Gerry McGivern and Ewan Ferlie
The purpose of this paper is to describe a recent experiment in research coproduction in an evaluation of service planning at a London Mental Health NHS Trust. The paper aims to…
Abstract
Purpose
The purpose of this paper is to describe a recent experiment in research coproduction in an evaluation of service planning at a London Mental Health NHS Trust. The paper aims to consider whether members of the research team who have themselves been users of mental health services are able to contribute to the research process as “experts by experience”, or if their experiential knowledge is “colonized” within the academic research team.
Design/methodology/approach
A qualitative, comparative case study approach was adopted, using structured observations and semi‐structured interviews. Researchers' reflective accounts and a reflective focus group were employed to explore the process of coproduction.
Findings
The paper concludes that, far from “colonising” expertise by experience, the experiment builds local capacity in research coproduction and usefully informs a service planning process that reflects the priorities and concerns of a range of stakeholders.
Research limitations/implications
The paper describes a small, local experiment in research coproduction and so findings are limited in their scope. However, the study demonstrates an effective methodological approach to evaluating, empirically, the impact of coproduction on the health services research (HSR) process.
Practical implications
The paper demonstrates the potential for repeated exercises in coproduction to build capacity in collaborative approaches to both HSR and service planning.
Originality/value
The involvement of experts by experience is increasingly a policy requirement in the domains of both health service planning and HSR in the UK. There are very few empirical studies that evaluate the impact of that coproduction.
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Rachael Addicott and Ewan Ferlie
The purpose of this paper is to show that networks are emerging as a new, innovative organisational form in the UK public sector. The emergence of more network‐based modes of…
Abstract
Purpose
The purpose of this paper is to show that networks are emerging as a new, innovative organisational form in the UK public sector. The emergence of more network‐based modes of organisation is apparent across many public services in the UK but has been particularly evident in the health sector or NHS. Cancer services represent an important and early example, where managed clinical networks (MCNs) for cancer have been established by the UK National Health Service (NHS) as a means of streamlining patient pathways and fostering the flow of knowledge and good practice between the many different professions and organisations involved in care. There is very little understanding of the role of power in public sector networks, and in particular MCNs. This paper aims to explore and theorise the nature of power relations within a network model of governance.
Design/methodology/approach
The paper discusses evidence from five case studies of MCNs for cancer in London.
Findings
The findings in this paper demonstrate that a model of bounded pluralism can be used to understand power relations within London MCNs. However, power over the development of policy and strategic direction is instead exerted in a top‐down manner by the government (e.g. Department of Health) and its associated national bodies.
Practical implications
The paper supports the argument that the introduction of rhetoric of a more collaborative approach to the management of public services has not been enough to destabilise the embedded managerialist framework.
Originality/value
This paper uses empirical data from five case studies of managed clinical networks to theorise the nature of power relations in the development and implementation of network reform in cancer services. Also, there is limited understanding of the nature of power relations in network relationships, particularly in relation to the public sector.
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The aim of this paper is to show that there has been an increasing focus on networks as a model of service delivery and governance in the UK public sector. As an early example…
Abstract
Purpose
The aim of this paper is to show that there has been an increasing focus on networks as a model of service delivery and governance in the UK public sector. As an early example, managed clinical networks for cancer were initially considered to represent an ideological move towards a softer model of governance, with an emphasis on moving across the vertical lines that were strengthened or established during the new public management (NPM) movement of the 1990s. The NPM ideology of the 1990s emphasised the role of Boards and powerful non‐executives in governing public services. This paper seeks to explore the role of the Board in the UK health sector under the apparent emerging “post‐NPM” ideological framework of accountability.
Design/methodology/approach
The paper is based on findings from five comparative case studies of managed clinical networks for cancer in London.
Findings
The paper finds that cancer network boards have had limited strategic influence as these networks are constrained by a continued emphasis of centralised performance management and structural reconfiguration, which become dominant during the NPM era.
Practical implications
The inability of the post‐NPM governance ideology to make a significant impact in the UK, and the resulting confused and conflictual framework, have hindered the initial intention of cancer networks as a forum for spreading best practice across organisational boundaries.
Originality/value
There is only limited research on the emergent remit, structure or strategy of public sector Boards in the UK, and very limited research on the role of Boards in health care networks: the paper provides some illumination on this limited area of study.
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– The purpose of this paper was to understand the experience of those living with the Imprisonment for Public Protection (IPP) sentence.
Abstract
Purpose
The purpose of this paper was to understand the experience of those living with the Imprisonment for Public Protection (IPP) sentence.
Design/methodology/approach
Interpretative Phenomenological Analysis (IPA) was used to analyse seven interviews with Young Offenders aged 18-21 who were serving an IPP sentence. Two participants were past their tariff expiry date, two had less than a year until their tariff date and three had more than a year until their tariff date.
Findings
Several themes were found, each with their own subthemes: Injustice of the Justice System, Not Knowing, Coping, Change and Walking on Eggshells. Participants still detailed negative aspects of the sentence but within this was one, important, positive aspect, namely the inspiration the sentence gave for them to change their offending behaviour. However, this has come at a cost with participants feeling as though they have been treated unfairly, finding it difficult to cope, feeling victimised and finding it difficult to see a future.
Practical implications
Lapses in motivation do not necessarily reflect the risk of the person but the difficulty of the sentence. Motivation can be fostered and developed through motivational interviewing, praise and peer support IPPs should be given more credit for the way they manage themselves daily and more understanding when they struggle. IPPs could be victimised by determinate prisoners or by staff. Establishments should be aware of this and help IPPs resolve situations without feeling like they are a victim. Consideration should be given to converting IPP sentences to determinate sentences.
Originality/value
Previous research focused on the negative aspects of the sentence, the purpose was therefore to approach the situation with an open mind and by using a method that allows those with an IPP sentence to share their experience of the sentence. IPA allowed for exploration of the effects of the sentence on those serving it and therefore gains a further understanding of the impact of the sentence.
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Alan Boyd, Shilpa Ross, Ruth Robertson, Kieran Walshe and Rachael Smithson
The purpose of this paper is to understand how inspection team members work together to conduct surveys of hospitals, the challenges teams may face and how these might be…
Abstract
Purpose
The purpose of this paper is to understand how inspection team members work together to conduct surveys of hospitals, the challenges teams may face and how these might be addressed.
Design/methodology/approach
Data were gathered through an evaluation of a new regulatory model for acute hospitals in England, implemented by the Care Quality Commission (CQC) during 2013-2014. The authors interviewed key stakeholders, observed inspections and surveyed and interviewed inspection team members and hospital staff. Common characteristics of temporary teams provided an analytical framework.
Findings
The temporary nature of the inspection teams hindered the conduct of some inspection activities, despite the presence of organisational citizenship behaviours. In a minority of sub-teams, there were tensions between CQC employed inspectors, healthcare professionals, lay people and CQC data analysts. Membership changes were infrequent and did not appear to inhibit team functioning, with members displaying high commitment. Although there were leadership authority ambiguities, these were not problematic. Existing processes of recruitment and selection, training and preparation and to some extent leadership, did not particularly lend themselves to addressing the challenges arising from the temporary nature of the teams.
Research limitations/implications
Conducting the research during the piloting of the new regulatory approach may have accentuated some challenges. There is scope for further research on inspection team leadership.
Practical implications
Issues may arise if inspection and accreditation agencies deploy temporary, heterogeneous survey teams.
Originality/value
This research is the first to illuminate the functioning of inspection survey teams by applying a temporary teams perspective.
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