No / The National Health Service (NHS) in England must improve productivity by 6% per annum if projected savings of £21 billion are to be attained by 2014, while simultaneously improving or at least maintaining the quality of care (Department of Health (DH), 2009; 2010a). Given that staff costs represent 60% of the current NHS budget, it is likely that both the number and composition of the 1.7 million strong workforce will need to be changed to meet these targets. In the Department of Health's draft Structural Reform Plan (2010b), the emphasis is on shifting resources to promote better healthcare outcomes, to which end a review of working practices and role relationship must take place, with increased delivery of services by community nurses.

There are 353 NHS hospitals in the United Kingdom, and within these hospitals there is wide variation in the electronic prescribing systems applied. Indeed, only one hospital uses a single system in all of its clinical areas. Medication error is the biggest issue in the health care profession in respect to patient safety—

Yes / This article presents midwives’ views and experiences of flexible working and work-life balance. Both flexible working and work-life balance are important contemporary agendas within midwifery and can have both positive and negative consequences for midwives. Full-time midwives and those without caring commitments feel disadvantaged by flexible working and work-life balance policies as they have to fit when they work around part-time midwives and are increasingly expected to cover extra work. They feel their work-life balance is marginalised and this is fuelling discontent and resentment among midwives and leading to divisions between full and part-time staff that reinforce flexibility stigma. Although flexible working and work-life balance are important for recruiting and retaining midwives they are part of the ongoing tensions and challenges for midwives and the midwifery profession. Keywords flexibility stigma, flexible working, full-time work, marginalisation, midwives, National Health Service,

Yes / Even prior to the conclusion of the European Union (EU) referendum (Brexit), the NHS was showing tremendous signs of strain. Immediately after the outcome was announced, promises of major re-investment of funds saved from payments to the EU were retracted. Since then, hospital closures, cuts and changes to health and social care have been revealed, with regular news broadcasts highlighting the crisis facing the NHS. The uncertainties about post-Brexit relationships, economy, politics and security are likely to further significantly impact the NHS and its sustainability. Higher Education Institutions (HEIs) and the NHS are inextricably linked through research and education of health and social care professionals – changes therefore having implications for both.

No / Purpose The purpose of this paper is to determine those factors perceived by users to influence the successful on-going use of e-commerce systems in business-to-business (B2B) buying and selling transactions through examination of the views of individuals acting in both purchasing and selling roles within the UK National Health Service (NHS) pharmaceutical supply chain. Design/methodology/approach Literature from the fields of operations and supply chain management (SCM) and information systems (IS) is used to determine candidate factors that might influence the success of the use of e¿commerce. A questionnaire based on these is used for primary data collection in the UK NHS pharmaceutical supply chain. Factor analysis is used to analyse the data. Findings The paper yields five composite factors that are perceived by users to influence successful e-commerce use. "System quality," "information quality," "management and use," "world wide web - assurance and empathy," and "trust" are proposed as potential critical success factors. Of these, all respondents ranked information quality, system quality, and trust as being of most importance, but differences in the rankings between purchasing and selling respondents are evident. Research limitations/implications The empirical study is limited to a single supply network, and although the findings seem intuitively to be of relevance to other sectors and supply contexts, there remains an opportunity to test this through further research. There is also an opportunity to extend the survey research, particularly into the wholesaler organisations that operate in the sector of study. Practical implications The managerial implications that result from this research provide practical guidance to organisations in this sector on how to ensure that e¿commerce systems for B2B buying and selling are used successfully. Originality/value This paper furthers knowledge and understanding in the fields of operations management, IS, and SCM, by suggesting potential determinants of successful e¿commerce use in both buying and selling organisations within supply networks.

There is still very little known about network dynamics (Bell et al., 2006), especially when focusing on interorganisational networks (Provan et al., 2007). There is also limited empirical evidence on leadership within these complex network contexts (Davenport, 2005; Osborn et al., 2002). This thesis addresses these limitations by developing a theoretical framework for process leadership in the complex, often unpredictable and turbulent context of the interorganisational networked ecosystem. Understanding the complexity of networks and leadership is crucial to advancing network research, which this study aims to accomplish. Although previous studies indicate leader characteristics and behaviours (Huxham & Vangen, 2000), less evidence on the processes and dynamics of leadership within networks exists. Few studies have longitudinally examined the multiple boundaries and multi-level interactions within a complex interorganisational network, as the unit of analysis, as this thesis achieves. Moreover, little research has been conducted to understand network leadership processes, which represents a major gap in the network theory and complexity leadership literatures. In order to address these gaps as well as the gap between the two literatures, this thesis presents a comprehensive, longitudinal case investigation of network process leadership (NPL) within an interorganisational network embedded in the British National Health Service (NHS). By analysing processual dynamics, this thesis’s contribution is the foundation of a preliminary NPL framework. Based on analysing a public sector healthcare network over time, the findings emphasise four dominant thematic constructs surrounding NPL that emerged as highly significant: leveraging strategic system stressors and turbulence; adopting focal and non-focal roles; maximising social proximity; and the complementary, reciprocal formal and informal coproduction of leadership. These constructs provide the empirical and analytical grounds to help explain the critical leadership processes that drive a complex, interorganisational public sector network. Significantly, social capital dimensions underlie these interrelated higher order themes; thereby affecting wider inter-organisational network processes. As a primary contribution of this thesis, I argue that social capital is the critical concept linking network and complexity leadership theories, in order to provide a better understanding of NPL. The findings suggest network leadership calls for NPL and its relational, collective, facilitative approach involving social capital among multiple participants in a complex interorganisational network context. This is highly differentiated from studying unidirectional effects of a hierarchical, central leader within a single organisation. Theoretically, I argue the importance of social capital in the complex nature of leadership processes within interorganisational networked contexts. The research contributes to an understanding of how networks and social capital can be adapted or created by formal and informal leaders within networks to reflect changing processes to shape practices and network-wide development over time. Finally, I offer several operational mechanisms policymakers and network leaders could pragmatically employ to manage, lead, and facilitate interorganisational network processes. Overall, the significance of this study involves: filling gaps in the literature, offering a longitudinal case study on an interorganisational network over time, providing a foundation for theoretical development on leading in networks, illuminating insights into professional leadership within networks, and identifying policy and practical implications for leaders and managers.

This thesis explores the theme of leadership in the NHS, specifically focusing on nursing. Leadership has become an important area in recent years, particularly in relatiion to improving efficiency, effectiveness and quality of services. As nurses provide 80% of care in the NHS, their role is pivotal in achieving any change. Despite the importance placed on leadership in the NHS, literature shows little is known about perceptions of leadership, how leaders function or what importance staff place on the culture and context in which they work. This study is based on the findings of 28 qualitative interviews with leaders in two health boards in Scotland. Through the presentation of informants' perceptions, beliefs and collective accounts, the study illustrates how staff view leadership in the NHS and provides some significant results. Firstly, it proposes that leadership is comprised of two elements; one relating to individuals and one relating to how individuals function in organisations. Secondly, it indicates three models of leadership are particularly relevant and how these differ according to role and hierarchy. Thirdly, it reveals leadership and management as disticnct components. In nursing a number of complexities make these roles challenging, and the culture and context of health borads influence how these fundtion in practice. Finally, this research concludes that staff value a clear set of characteristics, styles and behaviours not related to vision and change but which centre on character, values, integrity and engagement. The study has considerable impolication for emerging work on leadership in the NHS and for the future development of leadership roles in nursing.

Magister Public Health - MPH / Objectives: To document the distribution of medical doctors between the National Health System (NHS), NGOs and the Private Sector over the period 2000-2010; (2) To explore the perceptions of medical doctors (MDs) and human resources managers (HRMs) regarding factors that influence MD internal brain drain in Maputo city, Mozambique, more specifically, the movement of doctors from the Mozambican NHS to NGOs and the private sector within Mozambique.

No / Worldwide healthcare systems are facing immense changes in the demand of care with vast cost explosions caused by aging populations and the increase in chronic and mental diseases. The move towards patient-centered healthcare seems to be an ideal approach to meet future challenges but still clashes with reality. Patient Advice and Liaison Service (PALS) in the UK is one of the unique examples of patient empowerment to influence changes in healthcare systems like the National Health Service (NHS). The purpose of this paper is to look at user-driven organizational change management in PALS in retrospect to learn from its ‘best’ and ‘worst’ practices. In conclusion, patient-centered healthcare becomes more realistic if healthcare users and workers are empowered at the same time. The vision of patient, public, and staff involvement in the move towards patient-centered health needs to be backed up by adequate and secure resources as well as consistent organizational leadership and change management. Organizational change processes in general should be seen as biological continuous cycles with unpredictable evolutionary turning points rather than linear progressions. This helps to stay optimistic and embrace change as challenging, exciting, and difficult all the way through the change process.

The history of psychiatry is littered with serious failures of governance, to the detriment of mentally disordered people, especially those resident in psychiatric hospitals. Current mental health providers, increasingly focussed on community care, have also struggled to develop effective internal governance systems. Nine peer-reviewed research papers, published by the author (mostly with others) and the wider literature, reveal deficits in mental health governance at a jurisdictional, professional, and corporate level. In this thesis new governance solutions are developed against this background, built on contemporary principles in mental health and healthcare management. A new model of mental health governance is presented, based on the key demands of the strategic and regulatory environment, articulated as rights, risks and recovery. This integrated healthcare governance approach, covering provider policy, staff training and service audit, can monitor and ensure the protection of patients’ rights, as well as those of others; it also promotes the management of clinical risks, and of patients’ recovery outcomes. Rights-based risk-reduction training is the core interventional element of the model, whilst the monitoring element can be formalised as part of a Balanced Scorecard reporting system. This thesis makes a contribution to research methodology, theory and practice in mental health, human rights, healthcare management and governance. The model generates specific propositions for testing in mental health governance, with the potential for application in wider settings of service provision.