Health services across the world increasingly face pressures on use of expensive hospital services. Better organisation and delivery primary care has potential to manage demand reduce costs for services, but routine are not open during evenings weekends. Extended access (evening weekend opening) is hypothesized pressure from emergency department visits. However, existing evidence-base weak, largely focused out-of-hours analysed using a before-and after-methodology without effective...

ABSTRACT Although there is much written on the emotional labour of nursing, little research grounded in experience so-called ‘unqualified’ care assistants. This paper drawn from an ethnographic study conducted with assistants three dementia wards one mental health trust within United Kingdom National Health Service (NHS). We describe carried out by their attempts to provide personalised for people whose cognitive degeneration renders conventional relationship-building very difficult,...

Rising dementia incidence is likely to increase pressures on healthcare services, making effective well coordinated care imperative. Yet, barriers this approach exist which, we argue, might be understood by focussing identity dynamics at the frontlines of care. In article, draw upon findings from an ethnographic study assistants (HCAs) three wards across one National Health Service mental health trust. Data revealed that HCAs are a close-knit 'in-group' who share low group status and norms...

While hybrid managers are increasingly important in contemporary organizations (especially the public sector), we know little about why or how they become managers, this is shaped by interplay of professional experience and organizational circumstances. In pursuit a more variegated, contextualized dynamic understanding management, article focuses on individuals transition into managerial hybrids, emphasizing emergent nature management identity. Studying English healthcare, employ concept...

The social positioning and treatment of persons with dementia reflects dominant biomedical discourses progressive inevitable loss insight, capacity, personality. Proponents person-centred care, by contrast, suggest that such can be mitigated within environments preserve rather than undermine personhood. In formal organisational settings, approaches place particular responsibility on 'empowered' direct-care staff to translate these principles into practice. These provide the majority hands-on...

In spite of their widespread use in policy making the UK and elsewhere, there is a relatively sparse literature specifically devoted to pilots. Recent research on piloting has focused role pilots work accordance with national agendas. Taking this as point departure, present paper develops notion doing work. It does by situating within established theories formulation implementation, illustrating using an empirical case. Our case drawn from qualitative ethnography local government pilot...

The economic downturn that began in 2008 led to massive cuts spending targeted at managerial activities the UK National Health Service (NHS). Although appellation “manager” once conferred status NHS, managers have borne brunt of reform and term itself is danger falling into disrepute. Drawing upon perspectives on leadership emphasize its constitutive nature, we examine growing alternative emergent culture “leaderism” NHS how this relates practices identity. Empirical case study research from...

This paper presents the results of a pilot study on possible advantages utilizing strategy based drama/role play in developing understanding basic ecological concepts Key Stage 2 pupils (7‐ to 11‐year‐olds). A sample approximately 100 Year 6 four classes followed common half‐term topic 'habitat studies', half whom received input. All completed questionnaire designed reveal level their after topic. The are presented and discussed with view stimulating further research.

Abstract Research has demonstrated that pilots contain multiple shifting purposes, not all of which relate to simple policy testing or refinement. Judging the success is therefore complex, requiring more than a judgment against declared goals. Marsh and McConnell provide framework can be judged, distinguishing program from process political success. We adapt Boven's modification this apply it pilots, arguing pilot process, outcomes longer‐term effects judged in both terms. test new English...

Good access to primary care is an important determinant of population health. While the academic literature on emphasises its complexity, policies aimed at improving general practice in UK have tended focus measurable aspects, such as timeliness or number appointments.To fill gap between complex understanding and narrow definition assumed policies.Qualitative, community-based participatory case study within geographic footprint a clinical commissioning group north west England. Data...

Background The Additional Roles Reimbursement Scheme (ARRS) provides funding to Primary Care Networks (PCNs) in England recruit additional staff into specified roles. intention was support general practice by recruiting an extra 26 000 2024, increasing access and easing workload pressures. Aim To explore the establishment of ARRS as part PCNs’ development understand their role supporting practice. Design setting A longitudinal, qualitative case study involving seven geographically dispersed...

The short report describes the development from page to stage of a work theatre based on an ethnographic study. originating research focused health care assistants (nurse's aides) whose direct impact quality life highly dependent people is often overlooked. followed hospital personnel wards specialising in 'challenging behaviour' associated with dementia central England. Conventional outputs failed engage themselves, so we turned remedy this. field notes into was characterised by artistic...

Objectives English general practice is suffering a workforce crisis, with practitioners retiring early and trainees reluctant to enter the profession. To address this, additional funding has been offered, but only through participation in collaborations known as primary care networks (PCNs). This study explored national policy objectives underpinning PCNs mechanisms expected help achieve these, from perspective of those driving policy. Design Qualitative semistructured interviews document...

Abstract Public-Private Innovation Partnerships (PPIPs) are increasingly used as a tool for addressing ‘wicked’ public sector challenges. ‘Innovation’ is, however, frequently treated ‘magic’ concept: unreflexively, taken to be axiomatically ‘good’, and left undefined within policy programmes. Using McConnell’s framework of success failure case study multi-level PPIP in the English health service (NHS Test Beds), this paper critically explores implications mobilisation innovation practice. We...

The history of ADHD is in part a children who have not fitted at school. Yet until recently, surges diagnostic levels had prompted questioning the school's complicity trend. Through an analysis Diagnostic and Statistical Manual for Mental Disorders (DSM), principal guideline relating to ADHD, this paper seeks deconstruct some techniques practices by which 'the truth disorderly subjects', as mentioned V. Harwood, told within It will be argued that focus on risk early childhood promotes...

Algorithms are increasingly being adopted in healthcare settings, promising increased safety, productivity and efficiency. The growing sociological literature on algorithms shares an assumption that introduced to ‘support’ decisions within interactive order is predominantly human-oriented. This article presents a different argument, calling attention the manner which organisations can end up introducing non-negotiable disjuncture between human-initiated care work supports algorithms, authors...

Recent changes within UK healthcare have had dramatic consequences for management and put managerial capabilities firmly under the spotlight. Yet, despite extensive research on managers, comparatively little is known about how they acquire apply their knowledge this influenced by professional background organizational context. Drawing upon work that distinguishes between different forms of knowledge, managers’ mobilization examined in light recent healthcare. Case study evidence presented...

Abstract Recent health care reforms in England, combined with financial austerity, have accelerated both corporatization and commercialization the English National Health Service (NHS) this has encouraged greater public sector entrepreneurialism (PSE). We advance argument by examining meaning experience of sector, illustrating our qualitative data from a specialist hospital at forefront trend. demonstrate how policy practice is entangled increased commercialism shapes more entrepreneurial...

Background Understanding how managers in the NHS access and use management knowledge to help improve organisational processes promote better service delivery is of pressing importance health-care research. While past research has examined some depth perform their roles, we have only limited understanding they knowledge, interpret it adapt apply own settings. Objectives This study aims investigate middle encounter, working practices examine factors [particularly context, career background...

Background Despite longstanding problems of access to general practice, attempts understand and address the issues do not adequately include perspectives people providing or using care, nor they use established theories complexity. Aim To practice from multiple service users staff an applied theory access. Design setting A qualitative participatory case study in area northwest England. Method community-based approach was used with interviews, focus groups, observation about accessing...