Public Money and Management, 31(5), September 2011, pp.363-370.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA
A combination of economic pressures and increasing demands on health care budgets has resulted in a resurgence of the rationing debate. Although leadership is a potentially important component of priority-setting there has been little written about this topic. This article offers some suggestions for the development of leadership in priority-setting, with the intention of encouraging further...
A combination of economic pressures and increasing demands on health care budgets has resulted in a resurgence of the rationing debate. Although leadership is a potentially important component of priority-setting there has been little written about this topic. This article offers some suggestions for the development of leadership in priority-setting, with the intention of encouraging further discussion and debate. In particular, it looks at the role and value of leadership in addressing problems of a lack perceived legitimacy and governance that have been raised in connection with the rationing enterprise. The article considers the following key leadership concepts in the context of rationing: technical and relational aspects of priority-setting; sense-making and the framing of priority-setting as a ‘wicked issue’; and leading with political astuteness. The article concludes by considering the challenges facing management before they can adopt these outlined strategies.
Leadership and management are increasingly considered important drivers in terms of organisational performance. Yet, despite being viewed as essential components of partnership working, there is relatively little thoughtful work analysing the relationship between the two sets of ideas - posing practical difficulties for leaders and managers of partnerships who are looking for evidence or guidance...
Leadership and management are increasingly considered important drivers in terms of organisational performance. Yet, despite being viewed as essential components of partnership working, there is relatively little thoughtful work analysing the relationship between the two sets of ideas - posing practical difficulties for leaders and managers of partnerships who are looking for evidence or guidance. This book provides a robust guide to the leadership and management of partnerships. It summarises recent trends in policy, establishes what we can learn from research and practice and sets out useful frameworks and approaches to address a range of problems that partnerships face. It will be an essential aid to policy makers, managers and practitioners, providing a realistic account of the main characteristics and expectations of leadership and management in partnerships.
This updated edition provides a guide to the leadership and management of inter-agency collaborative endeavours. Although leadership and management are seen as central to developing effective integrated working, there is relatively little thoughtful work analysing the relationship between the two sets of ideas. The book summarises recent trends in policy, establishes what we can learn from
(Edited publisher abstract)
This updated edition provides a guide to the leadership and management of inter-agency collaborative endeavours. Although leadership and management are seen as central to developing effective integrated working, there is relatively little thoughtful work analysing the relationship between the two sets of ideas. The book summarises recent trends in policy, establishes what we can learn from research and practice, and uses international evidence to set out useful frameworks and approaches to address a range of problems that collaborations face.
(Edited publisher abstract)
Journal of Interprofessional Care, 21(5), October 2007, pp.503-513.
Publisher:
Taylor and Francis
This paper describes an action research study which focused on an exploration of the aspirations for and initial achievements of Stratham Mental Health NHS and Social Care Trust. Local leaders perceived that Stratham had a good history of health and social care partnership working and as such, adopted an integrationist view of culture to help shape the context of the new structural form. In doing so, consistency remained a key message to staff throughout this organizational transition and the change did not appear to cause the distraction to core business which the literature suggests it would do so. However, this continuity may have come at a cost, at least initially. In the process of formalizing the previous partnership into a Care Trust, Stratham may not have produced all the beneficial effects of synergy which are usually (albeit eventually) associated with mergers in the private sector. Certainly, local actors could see opportunities that had been missed. By focusing on the structural manifestation of the relationship, the opportunities to broaden informal horizontal linkages may have been underexploited. The study of Stratham serves to confirm that the integrationist conception of culture is limited and that the differentiation of professional groupings and the ambiguity of individual experience will always make contested the meanings that are attributed to organizational change.
This paper describes an action research study which focused on an exploration of the aspirations for and initial achievements of Stratham Mental Health NHS and Social Care Trust. Local leaders perceived that Stratham had a good history of health and social care partnership working and as such, adopted an integrationist view of culture to help shape the context of the new structural form. In doing so, consistency remained a key message to staff throughout this organizational transition and the change did not appear to cause the distraction to core business which the literature suggests it would do so. However, this continuity may have come at a cost, at least initially. In the process of formalizing the previous partnership into a Care Trust, Stratham may not have produced all the beneficial effects of synergy which are usually (albeit eventually) associated with mergers in the private sector. Certainly, local actors could see opportunities that had been missed. By focusing on the structural manifestation of the relationship, the opportunities to broaden informal horizontal linkages may have been underexploited. The study of Stratham serves to confirm that the integrationist conception of culture is limited and that the differentiation of professional groupings and the ambiguity of individual experience will always make contested the meanings that are attributed to organizational change.
Subject terms:
joint working, leadership, organisational structure, change management, care trusts;
International Journal of Integrated Care, 21(S2), 2021, p.6. Online only
Publisher:
International Foundation for Integrated Care
Introduction: As part of major policy reforms begun in 2010, England introduced a wave of initiatives to encourage more integrated care between health and social care. These built on previous attempts which sought to achieve similar objectives through a focus on better partnership working. This article provides an overview and critical commentary on integrated care policy in England from 2010–2020 based on reviews by regulators, parliamentary committees and the national audit office. Overview of Policy: Integrated care became a priority through the work of the Future Forum, a group of leading stakeholders established due to concerns about greater competition in public health care. This led to a public statement of shared commitment to integrated care by national health and social care bodies. Early mechanisms included a pooled fund to achieve nationally set objectives, the creation of local authority led partnership boards, and high profile innovation programmes. Later in the 2010’s, new health led partnerships became more dominant vehicles to achieve integrated care at regional level. Impact of Policy: Despite progress within a few local areas, and reduction in delayed discharges from hospital the overall picture from national reviews was that expected improvements were not achieved. Emergency admissions to hospital continued to grow, patients within primary care reported being less involved in their care, and health inequalities worsened. The initial response to COVID-19 was health-centric contributing to outbreaks in care homes and inadequate supplies of protective personal equipment. The ability of leaders to look beyond their organisations’ interests was reported as vital for local progress. National government performance frameworks discouraged system based working and chronic underfunding of social care led to major capacity and workforce challenges. Conclusion: The experience of England suggests that greatest progress is made when integrated care focusses on tangible issues and when there is a clear understanding of how success will be measured. Even with considerable investment and intent progress should be expected to be slow and difficult. Layering of numerous policy initiatives provides confusion and can distract from the important work of relationship building. And ultimately, integrated care cannot by itself address major inadequacies in the underlying resources and structural inequalities.
(Edited publisher abstract)
Introduction: As part of major policy reforms begun in 2010, England introduced a wave of initiatives to encourage more integrated care between health and social care. These built on previous attempts which sought to achieve similar objectives through a focus on better partnership working. This article provides an overview and critical commentary on integrated care policy in England from 2010–2020 based on reviews by regulators, parliamentary committees and the national audit office. Overview of Policy: Integrated care became a priority through the work of the Future Forum, a group of leading stakeholders established due to concerns about greater competition in public health care. This led to a public statement of shared commitment to integrated care by national health and social care bodies. Early mechanisms included a pooled fund to achieve nationally set objectives, the creation of local authority led partnership boards, and high profile innovation programmes. Later in the 2010’s, new health led partnerships became more dominant vehicles to achieve integrated care at regional level. Impact of Policy: Despite progress within a few local areas, and reduction in delayed discharges from hospital the overall picture from national reviews was that expected improvements were not achieved. Emergency admissions to hospital continued to grow, patients within primary care reported being less involved in their care, and health inequalities worsened. The initial response to COVID-19 was health-centric contributing to outbreaks in care homes and inadequate supplies of protective personal equipment. The ability of leaders to look beyond their organisations’ interests was reported as vital for local progress. National government performance frameworks discouraged system based working and chronic underfunding of social care led to major capacity and workforce challenges. Conclusion: The experience of England suggests that greatest progress is made when integrated care focusses on tangible issues and when there is a clear understanding of how success will be measured. Even with considerable investment and intent progress should be expected to be slow and difficult. Layering of numerous policy initiatives provides confusion and can distract from the important work of relationship building. And ultimately, integrated care cannot by itself address major inadequacies in the underlying resources and structural inequalities.
(Edited publisher abstract)
Subject terms:
integrated care, joint working, leadership, health care, social care, government policy;
British Journal of Leadership in Public Services, 2(3), September 2006, pp.4-14.
Publisher:
Pier Professional
Within accounts of and frameworks for organisational leadership, especially in the public sector, there is continuing enthusiasm for the distinction between transformational and transactional models, where the latter is typically compared unfavourably with the former. This paper reports on a review of the literature on organisation transition (that is mergers and acquisitions), which found...
Within accounts of and frameworks for organisational leadership, especially in the public sector, there is continuing enthusiasm for the distinction between transformational and transactional models, where the latter is typically compared unfavourably with the former. This paper reports on a review of the literature on organisation transition (that is mergers and acquisitions), which found this distinction helpful in ordering the material considered. The review found that more of the advice contained within the papers examined focused on interventions that could be broadly categorised as transactional rather than transformational. This seems an important finding in a context where the distinction continues to have salience and when transformational characteristics are often seen as being essential to leadership and transactional attributes are perceived as merely being suggestive of management.
Health and Social Care in the Community, 30(2), 2022, pp.509-518.
Publisher:
Wiley
...relationships between clinicians and consumers of health services in the Australian setting. The King's Fund Collaborative Pairs program is a leadership development program that brings together a consumer, patient or community leader to work together in pairs with a service provider clinician or manager to develop new ways of working together. The trial involved 88 participants paired together undertaking one
(Edited publisher abstract)
The need to reorient the health system to ensure greater involvement of consumers in healthcare has, in recent years, been highlighted as a priority in both literature and policy. This change requires renegotiating power relations among health organisations, health professionals and health consumers. This study presents findings from a trial of a program designed to foster collaborative relationships between clinicians and consumers of health services in the Australian setting. The King's Fund Collaborative Pairs program is a leadership development program that brings together a consumer, patient or community leader to work together in pairs with a service provider clinician or manager to develop new ways of working together. The trial involved 88 participants paired together undertaking one of seven programs conducted from October 2018 to August 2019. Participants were guided through a series of activities in five face-to-face sessions run by facilitators trained by the King's Fund. A qualitative evaluation was undertaken via semi-structured interviews (n = 40) with organisations involved, facilitators and participants. A brief review of program documentation was also included. Thematic analysis was undertaken to evaluate program acceptability, implementation and to identify program impacts. The evaluation, although limited in scope, found the program changed the way some participants understood the nature of consumer and provider relationships and how collaborative working relationships could be developed. The impact of the program on organisations sponsoring participants was less evident as numbers of participants from each organisation were limited and the time required for cultural change to develop is typically longer than the evaluation period allowed for. This paper highlights key recommendations addressing program recruitment, facilitation and format to inform future iterations of the program.
(Edited publisher abstract)
Subject terms:
leadership, collaboration, qualitative research, evaluation, staff-user relationships, intervention, health care, user participation, relationships;
NEEDHAM Catherine, MANGAN Catherine, DICKINSON Helen
Publisher:
University of Birmingham
Publication year:
2014
Pagination:
12
Place of publication:
Birmingham
...and the ability to work with compassion in highly stressful care environments; adapting to the impact of austerity; and development of new types of leadership style. It also highlights the need for more interprofessional training and development, as the same challenges are occurring across a range of professions.
(Edited publisher abstract)
Summarises the findings from a review of academic and grey literature to investigate the changing roles undertaken by staff in public services, the new competencies and skills these roles require and to identify any support and training needs. The review took an inclusive view of public service roles, and covered staff working in both the public sector and people fulfilling these roles in for-profit or not-for-profit organisations. The main findings of the review are discussed in eight key areas, which include: need for staff to adopt co-production approaches with citizens and service users; importance of generic skills such as interpersonal and communication skills; changes in ethics and values, and the need for staff share the person-centred agenda ; importance of emotional labour and the ability to work with compassion in highly stressful care environments; adapting to the impact of austerity; and development of new types of leadership style. It also highlights the need for more interprofessional training and development, as the same challenges are occurring across a range of professions.
(Edited publisher abstract)
Subject terms:
leadership, professional role, public sector, skills, values, ethics, co-production, staff, social care, local authorities;
WILLIAMS Iestyn, ROBINSON Suzanne, DICKINSON Helen
Publisher:
Policy Press
Publication year:
2012
Pagination:
159p., bibliog.
Place of publication:
Bristol
...discussed include: the ethics of priority setting; public participation in priority setting; priority setting and economic evaluation; multi criteria decision analysis and priority setting processes; the politics of priority setting; leadership in priority setting; and disinvestment as a priority setting case study.
Although the argument about whether or not rationing in health care is inevitable has largely been settled, there is far less consensus over how, and by whom, this should be carried out. There remain tensions in many parts of the health care system between government rhetoric and the realities of resource allocation at the local level. The challenges faced by those rationing scarce health care resources have intensified following the economic downturn. This book focuses mainly on the local priority setter and is designed to provide both a summary of the major relevant debates and strategies for improving and enhancing practice. It brings together theories, practice and evidence from a wide range of disciplines and provides practical, evidence-based prescriptions for decision makers. Topics discussed include: the ethics of priority setting; public participation in priority setting; priority setting and economic evaluation; multi criteria decision analysis and priority setting processes; the politics of priority setting; leadership in priority setting; and disinvestment as a priority setting case study.
Subject terms:
leadership, local authorities, NHS, policy, priorities, resource allocation, user participation, decision making, ethics, health care;