Yes / The NHS will need to make real term cost savings whilst maintaining and, where possible, enhancing the quality of essential services. The require-ment for efficiency savings to enable reinvestment in quality is estimated to be up to £21.1 billion by 2014 (Department of Health, 2010; Appleby, 2009.). This requires the NHS to increase productivity by 6 percent per annum (Appleby, 2010) while the Office of National Statistics estimates that productivity1 actually fell by approximately 0.3 percent per annum over the period 1995-2008 (ONS, 2010). Productivity is highly variable within the NHS and even within trusts (NHS Institute for Innovation and Improvement, 2004). Given these pressures, the productivity of healthcare organiza-tions is an incredibly salient topic; lean management is a particular pertinent and topical issue.

No

No / The NHS has always been a bargaining chip for politicians. Cuts to budgets; an ageing population; and more complex, comorbid long-term conditions have placed greater demands on health and care services. There continues to be pressure on GPs, community services, and the voluntary and social care sectors. Now that the political parties have presented their manifestos for the NHS, we need to consider what is right for patients and local communities.

The potential impact of the autumn statement on the future healthcare workforce.

Yes / In March, the Department of Health (DH) released the Learning from Mistakes League, in which NHS organisations are ranked by levels of openness and transparency (DH, 2016). While a welcome first step toward the centralised and open promotion of learning since the publication of the Francis and Berwick reports three years earlier, unfortunately, the league can be considered misleading for a number of reasons.

Yes

Yes / There is increasing recognition among policymakers that health systems are no longer fit for purpose. Our hospital-centred systems, originally created to deal with communicable disease epidemics, are now faced with the challenge of delivering care to the exponentially increasing number of people living with (typically multiple)≈non-communicable disorders (NCDs). Global economic stagnation has also contributed to the pressures facing health systems – such that there is an imperative to develop new models of care.

No / The rise in non-communicable disease as a principal cause of premature mortality and a continuing failure to address health inequalities requires a critical examination of prevailing paradigms in health. In this paper, we offer ecology as an alternative way to view health need and as a guide to action to enhance human health and model a healthy economy. After describing the shortcomings of the prevailing biophysical approach to health, we describe an ecological approach to health that brings to the forefront social and environmental determinants and empowers health workers together with their communities to achieve a health-affirming society and economy.

Yes / This report presents a detailed account of a major educational initiative in the British health service, the organisation with the largest workforce in Europe. The initiative was to set up a `university for the National Health Service¿, an aspiration that gave birth to `NHSU¿. Work began in 2001, but the project ended abruptly in 2005. This paper is based on the analysis of a series of in-depth interviews with senior managerial staff and a review of policy documents. Our analysis explores both the political and the organisational aspects of NHSU. We conclude that two aspects of the initiative are key to understanding its demise: its politically-led nature and its challenge to the idea of a `university¿. Finally, we attempt to draw conclusions from the experience of NHSU to inform other state-sponsored education and training interventions.

Yes / The role of the pharmacist as we know it has altered substantially over recent years. No longer is the expectation that they are a dispenser of pills and potions and nothing else (Richardson and Pollock, 2010). Skills/competencies mapping and associated performance have been examined from a supply chain perspective e.g. Kauppi et al., 2013; Sohal, 2013; but there is limited evidence of such exploration within the pharmacy profession and healthcare operations management. The aim of this study is to explore the critical management skills needed by pharmacists to effectively perform their role within the National Health Service (UK).