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This thesis examines the development of nursing at University College Hospital, London, between 1862, the year in which the All Saints Sisters assumed responsibility for the provision of nursing services at the hospital, and the introduction of the National Health Service in July 1948. Although the care provided by the sisters marked a considerable improvement on what had gone before, in 1899 they were replaced by nurses whose motivation was professional rather than vocational. The profession of nursing was confirmed by the Registration Act of 1919. Following an introduction, the initial chapters of the thesis are concerned with defining and developing the themes of Christian vocation and secular profession. Chapter four is devoted to nursing management across the period, and the following chapter to patterns of care. Prior to 1919 a system of primary care was in operation; this was superseded by task allocation. Chapters six and seven outline the introduction of nurse training in some of the London teaching hospitals in comparison to the training of nurses at U.C.H. An analysis of the probationer records from 1890 - 1948 demonstrates recruitment and retention through these years. With the departure of the All Saints Sisters from U.C.H. in 1899 the school of nursing was established. A preliminary training school was introduced in 1926; ten years later University College Hospital school of nursing pioneered the block system of training which became the norm for all schools of nursing after the Second World War. The next two chapters concentrate upon nursing developments in wartime. The All Saints Sisters were part of the British Red Cross team that served in the Franco-Prussian War of 1870 and the hospital and its nurses were fully involved in the two World Wars. Although this period saw the transformation of nursing at U.C.H. from a Christian vocation to a secular profession, this thesis is as much concerned with continuity as with change - for example in noting the similarities between rules for the probationers and for the novitiates, which had continuing influence throughout the years of this study.

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Counselling psychology springs from humanistic and existential/phenomenological values arguing for the need to see human beings in a holistic manner. This value system is a move towards well-being rather than pathology and sickness. The philosophical underpinning of counselling psychology gives a unique identity to the profession, raising different questions for counselling psychologists’ working within NHS settings, which is governed by the medical model. At a time that our profession faces enormous challenges and questions about its future, this study explored the experience of seven chartered counselling psychologists working within different NHS settings using the Interpretative Phenomenological Analysis (IPA) method.︣The analysis of the study revealed six major themes: (1)The process of creating a therapeutic identity; (2) Valuing the counselling psychology founding principles in practice; (3) Working within the medical model;(4) Experiencing tensions: the power of the context; (5) Dealing with the tensions; (6) Current changes and the future of counselling psychology in the NHS.︣The results showed in greater detail that the participants held a strong therapeutic identity; practiced in accordance with the counselling psychology values; experienced different tensions while working within the NHS, but have found different ways to deal with these tensions, including holding a pluralistic stance, assimilating the medical model with their own value base system and prioritizing the clients’ needs over the NHS guidelines. Lastly, the analysis indicated that the recent changes have contributed additional feelings of anxiety and uncertainty to the participants regarding the future of the profession.

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yes / The on-going changes in England and Wales health policy that aimed to promote competition, provide enhanced performance information and create small health organisations produce significant attention within management. As the organisation of health system has moved from what a ‘loose-coupled’ system to an integration control system, there is an issue regarding the roles of healthcare providers as professionals and mangers roles as leaders of healthcare organisations. It could be concluded that the financial challenge for staff and the institution besides the pressure of expectation influence the healthcare leadership. This resulted in involves them fully and without bias in this process whilst being pragmatic enough to develop ideas, theories and techniques despite pronounced resistance. Therefore to engage with these changes and the policy, which underpins it, this paper explore the behavioural aspect of leadership style and its effect on management practice. It also considers the management of change and the impact of leadership during the change process. / From email attached when submitting to Bradford Scholars on 10th Mar 2017: 22-Feb-2017 Dear Dr. McIntosh: Thank you for submitting a paper to Health Services Management Research. I am emailing to confirm that your manuscript entitled "The crisis of management in the NHS - The absence of leadership" has been successfully submitted online and is presently being given full consideration for publication in Health Services Management Research. We aim to complete peer review and make a decision on papers within 12 weeks". 10/03/2017 - sm / Val queried this is not in the journal yet. If it isn't we can discuss with Satu whether we keep the entry. Pre-prints are allowed by the publisher, but are we keeping them in Bradford Scholars. - sm 08/12/2017 / Pre-print submitted for peer-review.