The management of physical healthcare assets is vital for efficient delivery of healthcare services along with improving quality and productivity, amidst significant structural and funding re-organisation within the NHS. Capital allocations are under pressure and advanced strategic planning of healthcare infrastructure is required to maintain services. In doing so, the complexity of multiple interacting systems and mixed stakeholder expectations and competencies need to be addressed. The relationship between stakeholder public consultation and estates strategy development in theory and practice is poorly understood and further theoretical development is required to advance our knowledge in Strategic Asset Management (SAM). This thesis adopts an interpretivist paradigm, and an abductive approach with a case study design methodology. Data were collected from six case studies comprising 91 participants (focus groups and workshops); 6 unstructured interviews; 907 questionnaires; and observations resulting in over 30 hours of transcribed data, along with web-based document analyse (desk studies) within 149 NHS Trusts. The data were further analysed using thematic analyses. Findings reveal how localised conditions within individual healthcare Trusts influence the ways in which national initiatives are interpreted and incorporated; these impact existing ways of developing an estates strategy and in some cases, have implications on the usability of associated healthcare infrastructure spaces. This had clear implications on existing SAM practice, which were diverse, driven by individual project team competencies and associated project management practice. In practice, more focus was given to technical competencies (knowledge of SAM datasets and tools) and behavioural competencies were downplayed. Thus, the integrative Strategic Asset Management (iSAM) framework developed in this research, established a unique baseline to develop SAM plans from a complex interaction of care, estates and transport, providing a valuable resource for healthcare planning teams. Stakeholder consultation should be selective (representative sample) and the content of consultation should be appropriate at various SAM stages. Trusts should clearly indicate how their plans have been influenced, given the feedback from stakeholder consultation. Thus, moving it from a tick box exercise, to one that adds value in the decision making process. Empirical findings revealed that although literature promoted tools and methods to facilitate SAM, in practice, these were hardly used and most teams within English healthcare Trusts were not aware of best practice tools and solutions. Structuration theory was further used as a heuristic device to theoretically triangulate the empirical findings and contribute to a nuanced understanding of SAM within healthcare Trusts. In doing so, a middle range theory for integrative SAM (iSAM) was developed. It revealed that a dynamic system of individual action and organisational structure both constrained and enabled SAM. It was evident that the process of SAM is an open, emergent process of sense making rather than a pre-determined and closed process following prescriptive rules. This thesis has advanced knowledge in SAM and has raised the importance of front end project management within English healthcare Trusts. The new integrative and interdisciplinary iSAM framework facilitates the development of estates strategy and stakeholder consultation decision-making within healthcare Trusts.

This dissertation aims to use a system thinking approach to describe and evaluate the Lead-Acid Battery Recycling Program in British Columbia, compare it with other provincial regulated recycling programs and identify strategies on how it can be improved. The research is presented in the manuscript based format, comprised of four interrelated chapters. Following the introduction, chapter 2 describes a multiple regression analysis to assess how various factors identified by informed stakeholders have contributed to recycling rate in 14 transportation zones from 1995 to 2005. This study demonstrates that the existing recycling scheme ineffectively promotes recycling as it has achieved an average of 75% over the past 13 years with large fluctuations among transportation zones. The regression also shows that recycling rate of transportation zones are not highly influenced by LME lead prices and Transportation Incentive (which can be explained by the strong market power of the recycling plants responsible for setting up the price of scrap lead to which the collectors respond). Chapter 3 identifies key components that influence the performance of varied recycling systems based on a comparative analysis of provincial recycling systems informed by expert interviews. In chapter 4, comprehensive evaluation criteria for the lead-acid battery recycling program is developed based on objectives and performance measures elicited through an extensive stakeholder consultation process with various individuals and organizations. Fundamental objectives identified by stakeholders include: reduce environmental impacts, reduce occupational health impacts, reduce net costs, increase equity in resource consumption patterns and increase systematic learning. In chapter 5, we use multiple criteria decision analysis (MCDA) to design and assess effective recycling strategies to meet societal objectives previously identified in the chapter 4. Recycling strategies were compiled using the results of chapter 3. The results reveals that the optimal policy for the lead-acid battery recycling system combines a return to retailer program financed through an advanced disposal fee included in the battery price in combination with increased plant or recycling capacity domestically. This research also provides relevant contributions to the refining and application of value-focused thinking and decision analysis methodologies.

This dissertation aims to use a system thinking approach to describe and evaluate the Lead-Acid Battery Recycling Program in British Columbia, compare it with other provincial regulated recycling programs and identify strategies on how it can be improved. The research is presented in the manuscript based format, comprised of four interrelated chapters. Following the introduction, chapter 2 describes a multiple regression analysis to assess how various factors identified by informed stakeholders have contributed to recycling rate in 14 transportation zones from 1995 to 2005. This study demonstrates that the existing recycling scheme ineffectively promotes recycling as it has achieved an average of 75% over the past 13 years with large fluctuations among transportation zones. The regression also shows that recycling rate of transportation zones are not highly influenced by LME lead prices and Transportation Incentive (which can be explained by the strong market power of the recycling plants responsible for setting up the price of scrap lead to which the collectors respond). Chapter 3 identifies key components that influence the performance of varied recycling systems based on a comparative analysis of provincial recycling systems informed by expert interviews. In chapter 4, comprehensive evaluation criteria for the lead-acid battery recycling program is developed based on objectives and performance measures elicited through an extensive stakeholder consultation process with various individuals and organizations. Fundamental objectives identified by stakeholders include: reduce environmental impacts, reduce occupational health impacts, reduce net costs, increase equity in resource consumption patterns and increase systematic learning. In chapter 5, we use multiple criteria decision analysis (MCDA) to design and assess effective recycling strategies to meet societal objectives previously identified in the chapter 4. Recycling strategies were compiled using the results of chapter 3. The results reveals that the optimal policy for the lead-acid battery recycling system combines a return to retailer program financed through an advanced disposal fee included in the battery price in combination with increased plant or recycling capacity domestically. This research also provides relevant contributions to the refining and application of value-focused thinking and decision analysis methodologies.

This dissertation aims to use a system thinking approach to describe and evaluate the Lead-Acid Battery Recycling Program in British Columbia, compare it with other provincial regulated recycling programs and identify strategies on how it can be improved. The research is presented in the manuscript based format, comprised of four interrelated chapters. Following the introduction, chapter 2 describes a multiple regression analysis to assess how various factors identified by informed stakeholders have contributed to recycling rate in 14 transportation zones from 1995 to 2005. This study demonstrates that the existing recycling scheme ineffectively promotes recycling as it has achieved an average of 75% over the past 13 years with large fluctuations among transportation zones. The regression also shows that recycling rate of transportation zones are not highly influenced by LME lead prices and Transportation Incentive (which can be explained by the strong market power of the recycling plants responsible for setting up the price of scrap lead to which the collectors respond). Chapter 3 identifies key components that influence the performance of varied recycling systems based on a comparative analysis of provincial recycling systems informed by expert interviews. In chapter 4, comprehensive evaluation criteria for the lead-acid battery recycling program is developed based on objectives and performance measures elicited through an extensive stakeholder consultation process with various individuals and organizations. Fundamental objectives identified by stakeholders include: reduce environmental impacts, reduce occupational health impacts, reduce net costs, increase equity in resource consumption patterns and increase systematic learning. In chapter 5, we use multiple criteria decision analysis (MCDA) to design and assess effective recycling strategies to meet societal objectives previously identified in the chapter 4. Recycling strategies were compiled using the results of chapter 3. The results reveals that the optimal policy for the lead-acid battery recycling system combines a return to retailer program financed through an advanced disposal fee included in the battery price in combination with increased plant or recycling capacity domestically. This research also provides relevant contributions to the refining and application of value-focused thinking and decision analysis methodologies. / Applied Science, Faculty of / Mining Engineering, Keevil Institute of / Graduate

This study is a stakeholder consultation about recovery policies and practices in Aotearoa/ New Zealand. Six consumer advocates and five policymakers were interviewed on whether evaluating mental health services’ adherence to recovery philosophy would be useful in facilitating implementation of national recovery policies and the shape and function of such evaluation. Two focus groups and six individual interviews were conducted and transcribed. Textual data was subjected to software-assisted and manual thematic analyses. One of the key findings is participants’ lack of confidence in the current implementation of the recovery paradigm within the New Zealand mental health sector. Participants generally supported the idea of measuring recovery orientation at organisational level, although for different reasons and with reservations. Evaluating the process of service delivery appeared to be preferable to measuring outcomes.

I prodotti fitosanitari sono considerati uno dei principali strumenti di difesa contro le più rilevanti avversità che colpiscono la produzione agricola. Per garantire che il loro utilizzo sia realmente basato su principi di sostenibilità, nel 2009 l’Unione Europea ha introdotto la cosiddetta direttiva sull’Uso Sostenibile dei Pesticidi (EU 128/2009/EC) dove lo sviluppo di appropriati indicatori di rischio insieme all’implementazione di una corretta attività di formazione e sensibilizzazione sono da considerare fondamentali per ridurre l’esposizione. Per contribuire in questa direzione, in questo studio sono stati prodotti: a) un toolbox di pratici indicatori di rischio indiretti per essere utilizzati da parte delle autorità nazionali per monitorare le performance; b) un nuovo strumento e-learning (OpenTEA) di formazione e sensibilizzazione per raccogliere e condividere i più efficienti e consistenti materiali a disposizione. Questi contributi sono stati sviluppati utilizzando un approccio pragmatico basato sia su una consultazione degli stakeholders sia su un’analisi completa del rischio (usando dei modelli previsionali di esposizione e svolgendo un’indagine sistematica “sul campo”). Tutto è stato reso possibile grazie al coinvolgimento nelle attività nel centro di ricerca OPERA, un “think tank” che attraverso il suo approccio innovativo basato su costruire reti con gli stakeholders e ponti tra scienza e politica, permette il raggiungimento di soluzioni pragmatiche condivise. / Pesticides are considered one of the principle tools of defence against the most relevant adversity affecting the agricultural production. To ensure that their use is really based on sustainability principle, in 2009 the European Union introduced the so called Directive on Sustainable Use of Pesticides (EU 128/2009/EC) where the establishment of appropriate risk indicators to monitor the performances together with the implementation of appropriate training and awareness raising to improve behaviours are considered fundamentals. To contribute in this direction, in this study were produced: a) a toolbox of practical indirect risk indicators to be used by EU Member States to monitor the performances; b) a new e-learning tool (OpenTEA) for training and awareness raising to collect and share the most efficient and scientifically sound training and communication material. These contributions were developed using a pragmatic approach focusing either on a complete stakeholder consultation process either on a comprehensive analysis of risk (looking at some exposure models and performing a systematic surveys “on the field”). All the process was possible getting involved in the OPERA research centre, a “think tank” that through its innovative approach based on building network among stakeholders and bridges between science and policy, allow the achievement of pragmatic and agreed solutions.

This research seeks to connect the philosophical focus of the agency-structure debate with the practice of management through a comparative study of organisational decision-making in situations involving stakeholder consultation. Set in the context of decision-making following an airport master plan consultation, the study considers how the stakeholder framework can be integrated within institutional theory using institutional logics as a theoretical link between these two literatures. This thesis, which adopts a critical realist perspective, takes a comparative case approach of four airports, each owned in different ways. Interviews with airport managers are supplemented by discussions with stakeholders and industry experts. Two sets of a priori themes were identified from the literature. The first focuses on the institutional logics prevailing in the field and their influence on managers as they make decisions. The second considers four decision-making strategies managers might employ in this situation. Findings centre on the causal powers acting upon airport managers as they make their decisions. Whilst normative isomorphic pressure enables stakeholder consultation, the coercive pressure on the decision-making process deriving from English planning law, the adversarial and oscillating nature of Central Government policy, and a mimetic response to the nature of local authority development plans constrain the actions of airport managers. Indeed, the current bureaucratic form of capitalism limits stakeholder contribution to final master plans. This research makes four main contributions: Firstly, reflecting upon the agency-structure debate from a critical realist perspective has facilitated development of a model integrating the stakeholder framework within institutional theory. Secondly, it improves our understanding of how stakeholder contribution is managed in master planning. Thirdly, the study adds to the growing body of work that employs a critical realist perspective. Lastly, since reconciling conflicting stakeholder opinions may well be of vital importance to the future of the UK’s airport infrastructure, this work has practical significance for airport managers, government policy-makers and stakeholders as they strive to formulate worthwhile airport consultations.

This research seeks to connect the philosophical focus of the agency-structure debate with the practice of management through a comparative study of organisational decision-making in situations involving stakeholder consultation. Set in the context of decision-making following an airport master plan consultation, the study considers how the stakeholder framework can be integrated within institutional theory using institutional logics as a theoretical link between these two literatures. This thesis, which adopts a critical realist perspective, takes a comparative case approach of four airports, each owned in different ways. Interviews with airport managers are supplemented by discussions with stakeholders and industry experts. Two sets of a priori themes were identified from the literature. The first focuses on the institutional logics prevailing in the field and their influence on managers as they make decisions. The second considers four decision-making strategies managers might employ in this situation. Findings centre on the causal powers acting upon airport managers as they make their decisions. Whilst normative isomorphic pressure enables stakeholder consultation, the coercive pressure on the decision-making process deriving from English planning law, the adversarial and oscillating nature of Central Government policy, and a mimetic response to the nature of local authority development plans constrain the actions of airport managers. Indeed, the current bureaucratic form of capitalism limits stakeholder contribution to final master plans. This research makes four main contributions: Firstly, reflecting upon the agency-structure debate from a critical realist perspective has facilitated development of a model integrating the stakeholder framework within institutional theory. Secondly, it improves our understanding of how stakeholder contribution is managed in master planning. Thirdly, the study adds to the growing body of work that employs a critical realist perspective. Lastly, since reconciling conflicting stakeholder opinions may well be of vital importance to the future of the UK’s airport infrastructure, this work has practical significance for airport managers, government policy-makers and stakeholders as they strive to formulate worthwhile airport consultations.

Les consultations publiques comptent. Elles permettent aux citoyens, aux groupes d’intérêt et aux entreprises de signaler leurs préférences aux administrateurs canadiens. Elles servent également d’espace où les différentes parties prenantes de la règlementation peuvent partager leur savoir et leurs connaissances. Contrairement aux courants théoriques et empiriques dominants, elles ne sont pas qu’un instrument symbolique. Les consultations ne se limitent pas non plus à être une avenue supplémentaire permettant aux intérêts économiques d’exercer une influence indue sur l’articulation des politiques publiques. Cette thèse démontre que l’étendue des consultations publiques a une incidence sur l’importance des changements règlementaires et que la diversité des participants prenant part à celles-ci est positivement corrélée à la sévérité des règlements. Elle argumente également que les administrateurs consultent systématiquement les organismes et individus s’identifiant comme Autochtones lors de l’écriture de leurs règlements. Néanmoins, les résultats des analyses présentées dans cette thèse supportent le fait que les entreprises sont le type de parties prenantes qui participent le plus largement et le plus fréquemment aux consultations publiques. De plus, ces résultats démontrent que les consultations règlementaires restent généralement limitées et que les administrateurs peuvent difficilement incorporer les savoirs autochtones à leurs analyses d’impact. Globalement, cette thèse présente par quel mécanisme les administrateurs peuvent intégrer à leur travail des informations (politiques et/ou techniques) qui leur sont normalement inaccessibles. Elle décrit quel est l’effet d’inclure des informations diversifiées sur la nature des règlements et quel type d’information est recherché et utilisé par l’administration publique canadienne. / Public consultations matter. They allow citizens, interest groups and businesses to express their preferences to Canadian administrators. They also serve as a space where different regulatory stakeholders can share their knowledge and insights. Contrary to prevailing theoretical and empirical views, they are not mostly symbolic tools of inclusion. Nor are consultations limited to being an additional venue for economic interests to exert undue influence on public policy. This thesis demonstrates that the scope of public consultation affects the extent of regulatory change and that the diversity of participants in public consultation is positively correlated with the severity of regulation. It also argues that administrators systematically consult with Indigenous-identifying organizations and individuals when writing regulations. Nevertheless, the results of the analyses presented in this thesis support the fact that businesses are the type of stakeholders that participate most extensively and frequently in public consultations. Furthermore, these results show that regulatory consultations are generally limited and that administrators can hardly incorporate Indigenous Knowledge into their impact assessments. Overall, this thesis presents the mechanism by which administrators can incorporate information (political and/or technical) that is normally inaccessible to them into their work. It describes the effect of including diverse information on the nature of regulations and what type of information is sought and used by the Canadian public administration.