The article contributes to the literature on multi-level welfare governance and public accountability in context of recent European hospital reforms. Focusing changing dynamics between regional central hospitals Germany, Norway Denmark, we raise concerns about reshaping traditional mechanisms. We argue that, triggered by growing financial pressures, corporatization professionalization have increasingly removed decision-making power from political bodies funding planning. National governments...

Doctoral students have often been described as apprentices engaged in workplace learning. Further, assumptions are frequently made the literature about common nature of such learning experiences, e.g., sciences, research-related practices learned a lab within supervisor’s program and team. A few recent studies science doctoral experience challenged this view arguing may overlook considerable variation. This longitudinal study, using completed activity logs an interview, reports on twelve UK...

Hospital mergers are common in the United Kingdom and internationally. However, rarely achieve their intended benefits often damaging. This study builds on existing literature by presenting a case evaluating merger of two hospitals Oxford, with three distinct characteristics: between university hospitals, generalist specialist hospital differing size. In doing so, draws practical lessons for other healthcare organisations.Mixed-methods single-case evaluation. Qualitative data from 19...

Disappointment is common in many organizations. Yet little known about how individuals’ talk their workplace disappointment shapes identification with We conducted an analysis of 104 academics a prestigious British university to make two contributions our understanding the discursive constitution organizational (OID). First, we show individuals used different types disappointment-talk narrate and respond dilemmas distinct ways. Our findings extend existing research by showing that discourses...

Background Health care professionals face greater uncertainty in their careers as traditional jobs wither and new, organizationally controlled proliferate, reducing economic security professional autonomy. Purpose We apply psychological contract self-efficacy theory to examine the career agency of early-career physicians. ask following: (a) What are unfulfilled expectations emotions experienced by young physicians at training early stages? (b) forms exhibited response unfulfillment?...

Background: Changing health care systems depend on strong organizational leadership that realizes the collaborative potential of both physician and nonphysician leaders. Purpose: The aim this study was to seek insight into everyday leader experience by examining 24 leaders working in U.K. National Health Service. We explored (a) how they make sense act with respect specific tensions their interactions (b) which aspects contexts heighten probability for producing resolving such tensions....

Notre article entend enrichir la littérature sur gouvernance à niveaux multiples des services de santé et l’imputabilité publique dans le contexte récentes réformes européennes hôpitaux. C’est en nous intéressant l’évolution dynamique entre régionale centrale hôpitaux Allemagne, Norvège au Danemark que allons examiner les questions réorganisation mécanismes d’imputabilité traditionnels. Nous soutenons sous l’effet du renforcement pressions financières, corporatisation professionnalisation...

Healthcare systems across the world face dual challenge of balancing between provision affordable, good quality and timely healthcare on one hand; while innovating constantly to enhance efficiency amid increasing resource shortfalls, other. Their success is contingent upon presence strong organisational leadership that harnesses inherent collaborative potential both physician non-physician executives. This study sought insight into day-to-day experiences leaders in NHS. We conducted 24...

The organisations that make up the NHS are subject to frequent change, either as a result of top-down restructuring, or internal reorganisation. There is considerable evidence one key success such change lies in understanding culture organisation undergoing with various authors suggesting cultural audits be undertaken means achieving this. Cultural described current literature can complex, time-consuming and resource-intensive, which may reason that, our experience, they not often conducted....

Elite professions such as doctors, lawyers, and engineers are undergoing profound change. Career trajectories among these highly-skilled workers can be construed an emergent process characterized by a high degree of agency. This paper examines how psychological contract violations their associated emotions shape young doctors’ career Such agency-oriented careers perspective focused on individual sensemaking is missing in the study elite at present. Using evidence from interviews focus...