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This thesis examines the role of the stately home hospital during the First World War. It assesses the social and cultural importance of these institutions, as well as the place that they, and their patients, held within wartime society. It argues that the establishment of a hospital in a stately home communicated a high level of patient care, reminding people all over the Empire how much Britain valued the sacrifices of its wounded. However, some members of the soldiery misinterpreted the value bestowed upon them by their status as war heroes. Consequently, the stately home hospital became a site of physical and emotional clashes between the wounded and the medical authorities. By placing these medical establishments in their social, cultural, political, and imperial contexts, this thesis delineates the myriad of ways that the space of the stately home hospital affected the experience of wounding and how a number of different people interacted with the institution and utilised it for many different purposes. The domestic nature of these private residences meant that they straddled the military and civilian spheres, which convoluted the position of the wounded soldier, the medical staff, and ancillary workers within. In addition, the space was home to a variety of non-military personnel who presented the wounded with a variety of different opportunities that transcended normal military spaces. This thesis explores these opportunities to discuss the important position stately home hospitals held within First World War Britain. Due to the historic role of the stately home in British social, cultural and political life, the experience of recovering within these walls was socially loaded. This thesis argues that the establishment of hospitals in these buildings was an important statement to the wounded and their families.

This paper describes a three-year action research project, aimed to support staff in recognising and responding to loss of personhood in a continuing care setting. The context of this study was a National Health Service (NHS) nursing home for the long term care of older people. Interventions used to support this development included the collection and sharing of residents' life histories, weekly team supervision meetings for staff, an action learning set for managers, and monthly external supervised meetings for both the action researcher and senior manager. This paper reports on the processes and outcomes of change achieved and the learning gained from working in a collaborative way with staff. Given that current policy indicates the need for person-centred care (Department of Health 2001a), this study provides a possible mechanism for putting it into practice, through a systems and psychodynamically informed approach.

The purpose of this research is to determine the information to be collected for aseptic dispensing in NHS hospitals, and its use for management and business purposes in relation to capacity, demand, performance and efficiency. Mixed methodologies were adopted on an exploratory basis. Qualitative methods included: regular expert input; workshops; out-turn questionnaires; Affinity Analysis; surveys; and structured interviews. Quantitative methods included: activity data surveys; targeted surveys; and Delphi methods. The research systematised the collection and collation of the required data and determined novel ways of analysing and manipulating it to aid decision-making. These were used to evaluate the impact of major capital investment and variations in practices between different parts of the country. A benchmarking approach should be applied in utilising the data and statistical indicators. Nomenclature issues can influence data quality. Therefore clear, unambiguous guidance was developed for data collection. Existing pharmaceutical information systems will be the main sources of the data for the foreseeable future. The research focused on the North West of England, with successful application in the West Midlands. Its transferability to non-NHS and foreign hospitals is inferred, as long as similar operational arrangements apply. The research enables: the measurement of progress towards implementing the Breckenridge (1996) recommendations; the evaluation of performance for aseptic production and usage to inform capacity planning; and the presentation of the degree of collaboration between hospitals. The research addresses the absence of set data for an important hospital support service, and applies relevant lessons from other fields and industries. It enables a systematic approach to capacity planning and performance evaluation, at a time when the contribution of the service to support clinical governance is being fully recognised.