International lessons on austerity strategyJ. Gordon Murray; Andrew Erridge; Neil Rimmer
2012 International Journal of Public Sector Management
doi: 10.1108/09513551211244089
Purpose – This paper aims to report lessons learnt from six countries in addressing financial crises; what they have done and the impact. It is intended that these lessons are constructive in shaping responses to the current and future financial crises. Design/methodology/approach – A multiple, mini case study approach is taken which makes use of social media. Findings – The findings suggest that the strategy being pursued within the UK for addressing the financial crisis is generally untested and therefore high‐risk. The evidence cautions that local recovery can be expected to be significantly longer than one political cycle, that social impacts will be greater than expected, and there is over‐optimism in some of the strategic tools being adopted in the UK's deficit recovery. Research limitations/implications – Those participating, while in senior roles, were being asked to answer big questions, and although there is no reason to believe they were not answering truthfully, there are limits to what they could have reasonably been expected to know. Practical implications – The research provides lessons for local government on how their international peers have responded to the financial crises. The intention is these international lessons will help central and local government shape timely, effective and appropriate responses, while minimising costly mistakes. It is also hoped the lessons will serve as a “reality check” for policy makers. Social implications – The research also suggests there is a high risk that existing policy may be ambitious and have unintended adverse social implications. Originality/value – The research approach is innovative in its use of social media. The research probes the impact on councils of financial crises at a local level and reports unintended consequences which might not otherwise have been identified. Lessons from other countries' responses may also be of benefit in developing future responses.
Does patient‐centred care mean risk aversion and risk ignoring? Unintended consequences of NPM reformsThomas Andersson; Roy Liff
2012 International Journal of Public Sector Management
doi: 10.1108/09513551211244098
Purpose – This article aims to describe and analyze the results of efforts to improve patient‐centered care (PCC) in psychiatric healthcare. Design/methodology/approach – Using the methodology of a qualitative case study, the authors studied three Swedish child and adolescent psychiatric care (CAP) units in order to describe how patient‐centered actions are performed. They conducted 62 interviews, made 11 half‐day observations, and shadowed employees for two days. Findings – The article shows that the increased focus on accountability for unit performance and medical risks results in unintended consequences. The patient's medical risk is transformed to a personal risk for the psychiatrist and the resource risk is transformed to a personal risk for the unit manager. Patients become risk objects for both psychiatrists and unit managers, which creates an alignment between them to try to send patients elsewhere. New public management (NPM) reforms may consequently lead to the institutionalization of unintended healthcare practices. Practical implications – The article shows that accountability pressure to reduce patient risk may create new risks for patients. Originality/value – The study uses theoretical concepts of risk tradeoffs (risk substitution and risk transformation), which were developed for the macro level, to explain the unintended consequences of NPM reforms at the micro level.
A (new) model of board of directors: evidence from the National Health ServiceGianluca Veronesi; Kevin Keasey
2012 International Journal of Public Sector Management
doi: 10.1108/09513551211244106
Purpose – The paper aims to investigate the collective behaviour of boards of directors in 22 English National Health Service trusts and how this impacts on the exercise of their role and functions. Furthermore, it aims to shed light on the governance model characterising boards of health sector organisations. Design/methodology/approach – The data were gathered using a range of qualitative techniques (96 semi‐structured interviews, focus groups, workshops and document analysis) with a multiple case study approach. Findings – Owing to the existence of overlapping governance ideologies, health care boards are characterised by different internal dynamics, processes and levels of engagement in the exercise of their tasks. Post‐new public managment driven boards emphasise a pronounced collective approach in their internal proceedings, a wider perspective in strategising and a greater stakeholder involvement in decision‐making processes. These characteristics are particularly evident in boards of foundation trusts, in which network driven governance principles and mechanisms receive a more comprehensive implementation through a collective leadership approach. Practical implications – The model of the board shared by foundation trusts moves these health care organisations closer to the idea of social enterprises. Additionally, the evidence shows similar behavioural characteristics between these boards and the best practice examples of private sector boards. Originality/value – The foundation trust model of the board provides new meaningful connotations and significance to the traditional understanding of health care boards, offering a more comprehensive notion of their role and functions in terms of leadership provision, strategy formulation, monitoring and reporting.
Intra‐organisational collaboration in one UK university: potential for change or missed opportunityJohn Diamond; Linda Rush
2012 International Journal of Public Sector Management
doi: 10.1108/09513551211244115
Purpose – The paper aims to examine the promotion of intra‐organisational collaboration within a university setting. Design/methodology/approach – An ethnographic approach influenced by a phenomenographic framework of analysis was used. Findings – Content analysis of qualitative data resulted in 11 overlapping themes being identified in respect of collaboration. Final analysis led to the identification of four hierarchically inclusive degrees of collaboration. Research limitations/implications – The research, whilst based within one UK university, raises important conceptual as well as practical questions. Practical implications – The implications of this paper have relevance for the ways in which universities and other agencies promote intra‐ as well as inter‐departmental (or agency) working. Originality/value – By using the framework developed it is possible to see parallels across different professional and agency settings.
Swimming against the current Understanding how a positive organisational training climate can enhance training participation and transfer in the public sectorMartin McCracken; Travor C. Brown; Paula O'Kane
2012 International Journal of Public Sector Management
doi: 10.1108/09513551211244124
Purpose – This paper aims to examine the personal and organisational factors that affected public sector managers' participation in leadership training programmes and their ability to transfer learning to their workplace. Design/methodology/approach – In‐depth interviews were conducted with five Canadian and five Northern Irish managers who participated in one‐day leadership training programmes. Findings – The uncertain environment throughout the public sector was the greatest inhibitor to training participation and transfer. However, other training characteristics and training design features were also noted (e.g. motivation, trainer influence). Practical implications – Public sector organisations must take concrete steps to address current environmental challenges to fully benefit from leadership training programmes. The paper highlights pre‐, during, and post‐training strategies that can be implemented. Originality/value – The findings illustrate that leaders in both public sector jurisdictions face similar issues and these have been exacerbated by the current turbulent climate. The authors suggest that to maximise return on training investment the public sector must create an environment supportive of training participation and transfer and suggest recommendations to help organisations in the future. These findings were facilitated by the use of qualitative training evaluation methods, not traditionally used in training transfer research.