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Inter-organisational collaboration (IOC) across healthcare settings has been put forward as a solution to mounting financial and sustainability challenges. Whilst ingredients for successful IOC have been explored, there remains limited understanding of the development of IOCs over time.

The authors systematically reviewed the literature to identify models applied to IOCs in healthcare across databases such as Healthcare Management Information Consortium (HMIC) and MEDLINE, identifying 2,763 titles and abstracts with 26 final papers included. The authors then used a “best fit” framework synthesis methodology to synthesise fourteen models of IOC in healthcare and the wider public sector to formulate an applied composite model describing the process through which collaborations change over time. This synthesis comprised extracting stages and behaviours from included models, selecting an a priori framework upon which to code these stages and behaviours and then re-coding them to construct a new composite model.

Existing models often did not consider that organisations may undergo many IOCs in the organisations' lifetime nor included “contemplation” stages or those analogous to “dissolution”, which might negatively impact papers using such models. The formulated' composite model utilises a life-cycle design comprising five non-linear phases, namely Contemplating, Connecting, Planning, Implementation and Maintenance or Dissolution and incorporates dynamic elements from Complex Adaptive Systems thinking to reflect the dynamic nature of collaborations.

This is the first purpose-built model of the lifecycles of IOCs in healthcare. The model is intended to inform implementers, evaluators and researchers of IOCs alike.

The National Health Service (NHS) is facing unprecedented financial strain. These significant economic pressures have coincided with concerns regarding the quality and safety of the NHS provider sector. To make the necessary improvements to performance, policy interest has turned to encouraging greater collaboration and partnership working across providers.

Using a purposive search of academic and grey literature, this narrative review aimed (1) to establish a working typology of partnering arrangements for improvement across NHS providers and (2) inform the development of a plausible initial rough theory (IRF) of partnering to inform an ongoing realist synthesis.

Different types of partnership were characterised by degree of integration and/or organisational change. A review of existing theories of partnering also identified a suitable framework which incorporated key elements to partnerships, such as governance, workforce, leadership and culture. This informed the creation of an IRF of partnerships, which proposes that partnership “interventions” are proposed to primarily cause changes in governance, leadership, IT systems and care model design, which will then go on to affect culture, user engagement and workforce.

Further realist evaluation, informed by this review, will aim to uncover configurations of mechanisms, contexts and outcomes in various partnering arrangements and limitations. As this is the starting point for building a programme theory, it draws on limited evidence.

This paper presents a novel theory of partnering and collaborating in healthcare with practical implications for policy makers and practitioners.

The purpose of this paper is to explore whether official inquiries are an effective method for holding the medical profession to account for failings in the quality and safety of care.

Through a review of the theoretical literature on professions and documentary analysis of key public inquiry documents and reports in the UK National Health Service (NHS) the authors examine how the misconduct of doctors can be understood using the metaphor of professional wrongdoing as a product of bad apples, bad barrels or bad cellars.

The wrongdoing literature tends to present an uncritical assumption of increasing sophistication in analysis, as the focus moves from bad apples (individuals) to bad barrels (organisations) and more latterly to bad cellars (the wider system). This evolution in thinking about wrongdoing is also visible in public inquiries, as analysis and recommendations increasingly tend to emphasise cultural and systematic issues. Yet, while organisational and systemic factors are undoubtedly important, there is a need to keep in sight the role of individuals, for two key reasons. First, there is growing evidence that a small number of doctors may be disproportionately responsible for large numbers of complaints and concerns. Second, there is a risk that the role of individual professionals in drawing attention to wrongdoing is being neglected.

To the best of the authors’ knowledge this is the first theoretical and empirical study specifically exploring the role of NHS inquiries in holding the medical profession to account for failings in professional practice.

The purpose of this paper is to review existing research on whistleblowing in healthcare in order to develop an evidence base for policy and research.

A narrative review, based on systematic literature protocols developed within the management field.

The authors identify valuable insights on the factors that influence healthcare whistleblowing, and how organizations respond, but also substantial gaps in the coverage of the literature, which is overly focused on nursing, has been largely carried out in the UK and Australia, and concentrates on the earlier stages of the whistleblowing process.

The review identifies gaps in the literature on whistleblowing in healthcare, but also draws attention to an unhelpful lack of connection with the much larger mainstream literature on whistleblowing.

Despite the limitations to the existing literature important implications for practice can be identified, including enhancing employees’ sense of security and providing ethics training.

This paper provides a platform for future research on whistleblowing in healthcare, at a time when policymakers are increasingly aware of its role in ensuring patient safety and care quality.

The purpose of the paper is to examine the metaphors used by senior managers and clinicians in the delivery of healthcare reform.

A study of healthcare reform in England carried out a series of semi structured interviews with senior managers and clinicians leading primary and secondary care organisations. Qualitative data analysis examines instances where metaphorical language is used to communicate how particular policy reforms are experienced and the implications these reforms have for organisational contexts.

The findings show how metaphorical language is used to explain the interactions between policy reform and organisational contexts. Metaphors are used to illustrate both the challenges and opportunities associated with the reform proposals for organisational change.

The authors provide the first systematic study of patterns and meanings of metaphors within English healthcare contexts and beyond. The authors argue that these metaphors provide important examples of “generative” dialogue in their illustration of the opportunities associated with reform. Conversely, these metaphors also provide examples of “degenerative” dialogue in their illustration of a demarcation between the reform policy proposals and existing organisational contexts.

The purpose of this paper is to examine the motivations behind public sector spin outs, focusing on the Right to Request policy, which enabled NHS staff to set up their own social enterprises to deliver healthcare services.

The paper draws on empirical data gathered from 16 in‐depth interviews with individuals who had led a Right to Request proposal.

Motivations to spin out of the NHS into a social enterprise were often “empathetic” in nature, built around the good of the service for staff and users. Alongside this, some felt “pushed” out of the NHS as a result of government restructuring policy, with social enterprise offering the only hope to survive as an organisation.

The study captures a particular point in time and there may be other perspectives that have not been included.

The paper is of use to academics, policy makers and practitioners. It provides an important contribution in thinking about how to motivate public sector staff, especially those from a health profession, to consider spinning out into social enterprises.

The paper is the first to look at the motivations of healthcare spin outs through the Right to Request programme. The findings are related to previous literature on social entrepreneurship within public sector settings.

The purpose of this paper is to reflect on social enterprise as an organisational form in health organisation and management.

The paper presents a critique of the underlying assumptions associated with social enterprise in the context of English health and social care.

The rise of social enterprise models of service provision reflects increasingly hybrid organisational forms and functions entering the health and social care market. Whilst at one level this hybridity increases the diversity of service providers promoting innovative and responsive services, the paper argues that further inspection of the assumptions associated with social enterprise reveal an organisational form that is symbolic of isomorphic processes pushing healthcare organisations toward greater levels of homogeneity, based on market‐based standardisation and practices. Social enterprise forms part of isomorphic processes moving healthcare organisation and management towards market “norms”.

In line with the aim of the “New Perspectives section”, the paper aims to present a provocative perspective about developments in health and social care, as a spur to further debate and research in this area.

The purpose of this paper is to present a study of how quality improvement tools and techniques are framed within healthcare settings.

The paper employs an interpretive approach to understand how quality improvement tools and techniques are mobilised and legitimated. It does so using a case study of the NHS Modernisation Agency Improvement Leaders' Guides in England.

Improvement Leaders' Guides were framed within a service improvement approach encouraging the use of quality improvement tools and techniques within healthcare settings. Their use formed part of enacting tools and techniques across different contexts. Whilst this enactment was believed to support the mobilisation of tools and techniques, the experience also illustrated the challenges in distributing such approaches.

The paper provides an important contribution in furthering our understanding of framing the “social act” of quality improvement. Given the ongoing emphasis on quality improvement in health systems and the persistent challenges involved, it also provides important information for healthcare leaders globally in seeking to develop, implement or modify similar tools and distribute leadership within health and social care settings.