An evaluation of Lean and Six Sigma methodologies in the national health service

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jiju Antony ◽  
James Lancastle ◽  
Olivia McDermott ◽  
Shreeranga Bhat ◽  
Ratri Parida ◽  
...  
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Empirical Study ◽  
National Health ◽  
Six Sigma ◽  
Qualitative Interviews ◽  
Second Primary ◽  
Content Type ◽  
Tools And Techniques ◽  
Levels Of Service

PurposeThe purpose of this paper is to conduct an empirical study derived from the previous literature from the perspective of benefits, tools and techniques, continuous improvement (CI) and quality improvement (QI) methodologies and critical failure factors (CFFs) of Lean and Six Sigma (SS) in the national health service (NHS).Design/methodology/approachA literature review was carried out to identify previous findings, empirical data and critical variables concerning Lean and SS in healthcare for over ten years. Second, primary research in quantitative surveys and qualitative interviews was carried out with 110 participants who have experience using Lean and SS in the NHS.FindingsLean and SS have evolved into common practices within the NHS and now have an established list of tools and techniques frequently employed by staff. Lean and SS are considered robust CI methodologies capable of effectively delivering extensive benefits across many different categories. The NHS must overcome a sizable amount of highly important CFFs and divided organizational culture.Originality/valueThis paper has developed the most extensive empirical study ever produced on Lean and SS in the NHS and has expanded on previous works to create new and updated research. The findings produced in this paper will assist NHS medical directors and practitioners in obtaining up-to-date insight into Lean and SS status in the NHS. The paper will also guide the NHS to critically evaluate their current CI strategy to ensure long-term sustainability and deliver improved levels of service to patients.

scholarly journals Guardians of public interest: the expectation and experience of non-executive directors in National Health Service commissioning boards in England

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Joy Tweed ◽  
Louise M. Wallace
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Public Interest ◽  
Open Systems ◽  
Executive Directors ◽  
Goal Model ◽  
Content Type ◽  
The Public ◽  
Systems Model

PurposeThe purpose of the study is to examine how Non-Executive Directors (NEDs) in the English National Health Service (NHS) commissioning bodies experienced their role and contribution to governance.Design/methodology/approachSemi-structured interviews were conducted with a purposive sample of 31 NEDs of Primary Care Trusts (PCTs) and 8 Clinical Commissioning Group (CCG) NEDs. Framework analysis was applied using a conceptualisation of governance developed by Newman, which has four models of governance: the hierarchy, self-governance, open systems and rational goal model.FindingsNEDs saw themselves as guardians of the public interest. NEDs’ power is a product of the explicit levers set out in the constitution of the board, but also how they choose to use their knowledge and expertise to influence decisions for, as they see it, the public good. They contribute to governance by holding to account executive and professional colleagues, acting largely within the rational goal model. CCG NEDs felt less powerful than in those in PCTs, operating largely in conformance and representational roles, even though government policy appears to be moving towards a more networked, open systems model.Originality/valueThis is the first in-depth study of NEDs in English NHS local commissioning bodies. It is of value in helping to inform how the NED role could be enhanced to make a wider contribution to healthcare leadership as new systems are established in the UK and beyond.

scholarly journals Newly professionalised physiotherapists: symbolic or substantive change?

2019 ◽  
Vol 42 (2) ◽  
pp. 300-314
Author(s):  
Pauline Anderson ◽  
Chris Warhurst
Keyword(s):  
Qualitative Research ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Design Methodology ◽  
Content Type ◽  
Formal Classification ◽  
Mixed Outcomes

Purpose There is renewed interest in the professions as a range of occupations pursue professionalisation projects. The purpose of this paper is turn analysis to an important omission in current research – the skills deployed in the work of these professions. Such research is necessary because skills determine the formal classification of occupations as a profession. Design/methodology/approach Drawing on qualitative research, this paper explores the deployment of skills in work of one newly professionalised occupation in the UK’s National Health Service – physiotherapists. Findings The findings point to a disconnect between how this occupation has become a profession (the skills to get the job, and related political manoeuvring by representative bodies) and the mixed outcomes for their skills deployment (the skills to do the job) in work as a profession. Originality/value The paper provides missing empirical understanding of change for this new profession, and new conceptualisation of that change as both symbolic and substantive, with a “double hybridity” around occupational control and skill deployment for physiotherapists as a profession.

scholarly journals Complete Genome Sequence of Staphylococcus aureus PS/BAC/169/17/W, Isolated from a Contaminated Platelet Concentrate in England

2021 ◽  
Vol 10 (45) ◽  
Author(s):  
Carina Paredes ◽  
Sylvia Ighem Chi ◽  
Annika Flint ◽  
Kelly Weedmark ◽  
Carl McDonald ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
National Health Service ◽  
Health Service ◽  
Genome Sequence ◽  
National Health ◽  
Complete Genome Sequence ◽  
Complete Genome ◽  
Platelet Concentrate ◽  
Content Type

We report the genome sequence of Staphylococcus aureus PS/BAC/169/17/W, which was isolated in 2017 from a contaminated platelet concentrate at the National Health Service Blood and Transplant. Assessment of the genome sequence of this strain showed the presence of a 2,753,746-bp chromosome and a plasmid of 2,762 bp.

Place, Space and Time: Contextualizing Workplace Subjectivities

2006 ◽  
Vol 27 (5) ◽  
pp. 657-676 ◽  
Author(s):  
Susan Halford ◽  
Pauline Leonard
Keyword(s):  
Organizational Change ◽  
National Health Service ◽  
Health Service ◽  
Empirical Study ◽  
National Health ◽  
Organizational Life ◽  
Organizational Power ◽  
Space And Time ◽  
Alternative Discourses ◽  
British National Health

This paper explores the relations between management discourse and employee subjectivity in the process of organizational change, drawing on a new empirical study of doctors and nurses working in the British National Health Service (NHS). It builds on recent critiques of more muscular accounts of discourse to examine the manoeuvres made by working subjects in response to managerialist discourses of the entrepreneurial self. While others have shown that alternative discourses including gender, age and profession are important here, this paper argues that we must pay attention to the spatial and temporal contexts within which such generic discourses are received and understood in order to interpret the practices of subjectivity and power in organizational life. We suggest that this approach allows new insights to policy concerns in the NHS; to our understanding of the nature of work subjectivities; and to sociological understandings of organizational power.

The entrepreneur: a new breed of health service leader?

2008 ◽  
Vol 22 (3) ◽  
pp. 208-222 ◽  
Author(s):  
Rosemary Exton
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Power Structures ◽  
Content Type ◽  
Working Lives ◽  
Service Leader ◽  
Private And Public ◽  
Uk National Health Service ◽  
The Uk

PurposeThis paper aims to critically examine the notion of entrepreneurship in the UK National Health Service (NHS), promoted by government ministers and senior civil servants as part of the rhetoric of the modernisation agenda.Design/methodology/approachThe paper explores literature on entrepreneurship in the private and public sector and qualitative case study evidence on the emergence (and non‐emergence) of “entrepreneurs” who led the improving working lives (IWL) initiative in the UK National Health Service and discusses the issues involved.FindingsThe rhetoric serves an essentially ideological function, obscuring the real difficulty of securing effective and sustainable change, in organisations with deeply engrained power structures and as complex and intransient as the NHS in particular and health services more generally.Practical implicationsA “new breed of entrepreneurial leaders” may eventually appear but they face the challenge of surviving in the hierarchical NHS culture and in a climate of turbulent change created by the volatility of government policy.Originality/valueThe paper shows that efforts to pursue entrepreneurship in the UK NHS have to overcome obstacles involving the interplay of power, gender and language.

scholarly journals Experiences and expectations of refugee doctors

2006 ◽  
Vol 189 (1) ◽  
pp. 74-78 ◽  
Author(s):  
S. Cohn ◽  
J. Alenya ◽  
K. Murray ◽  
D. Bhugra ◽  
J. De Guzman ◽  
...  
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
English Language ◽  
Qualitative Interviews ◽  
Psychological Impact ◽  
Valuable Resource ◽  
The Uk

BackgroundRefugee doctors constitute a potentially valuable resource for reducing the recruitment crisis in psychiatry. However, various hurdles make their route into the National Health Service (NHS) difficult.AimsTo explore the perceptions and experiences of refugee doctors trying to practise psychiatry in the UK.MethodThirty-one refugee doctors participated in qualitative interviews designed to elicit their experiences in trying to practise as doctors in the UK. Twenty were re-interviewed about 6 months later.ResultsDoctors identified a range of practical problems that made it difficult for them to take the required steps towards practising in the UK. These included lack of appropriate information, lack of a clear route through the system and feelings of isolation. The English language examination was seen as a particular bottleneck, as were finding clinical attachments. The psychological impact of the experience was profound.ConclusionsThese findings have important implications for how refugee doctors are introduced to the practice of psychiatry in the NHS.

Enterprising behaviour in the UK’s National Health Service (NHS)

2014 ◽  
Vol 30 (9) ◽  
pp. 29-30
Author(s):  
Rosemary Exton
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Service Improvement ◽  
Content Type ◽  
Entrepreneurial Behaviour ◽  
Working Lives ◽  
Managerial Culture ◽  
Sustained Change ◽  
Strategic Goals

Purpose – This study by Rosemary Exton aims to examine the Improving Working Lives (IWL) programme and finds significant variation in outcomes between 11 National Health Service (NHS) Trusts. Each Trust was required to reach identical standards in improving HR practice over a set period. Achievement of the standards was validated by external peer review, and outcomes contributed significantly to overall performance ratings. Design/methodology/approach – In each organisation, implementation was driven by a “lead” from line management, and three of these individuals form the focus of the study. Findings – When visited 18 months after the end of the IWL initiative, most Trusts had failed to demonstrate any sustained change despite more than four years’ effort. The ability to achieve effective and sustainable outcomes varies considerably even between NHS Trusts faced with comparable challenges in implementing nationally prescribed targets. This variance is explained in terms of an organisation’s ability to generate structures, processes, individual competence and motivation to enable employees at all levels to act entrepreneurially, with the ability and legitimacy to achieve strategic goals by working creatively in the spaces between formal organisational structures. Originality/value – While evidence highlights the importance of entrepreneurial behaviour in the transformation of the NHS, two of the “leads” studied demonstrated in different ways that managerial culture and working practices can inhibit the full engagement of staff, and the use of their knowledge and experience in service improvement and innovation.

Peer supported open dialogue in a UK NHS trust – a qualitative exploration of clients’ and network members’ experiences

2020 ◽  
Vol 15 (2) ◽  
pp. 95-103
Author(s):  
Corrine Hendy ◽  
Mark Pearson
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Focus Groups ◽  
National Health ◽  
Qualitative Evaluation ◽  
Evidence Base ◽  
Content Type ◽  
Dialogue Model ◽  
Open Dialogue ◽  
The Uk

Purpose As the evidence base in relation to open dialogue continues to grow and develop, this paper contributes to the growing evidence base within the UK. The purpose of this paper is to focus on the experiences of those who have received the service and reports a qualitative evaluation of an open dialogue service operating within the National Health Service of the UK. Design/methodology/approach The opportunity to participate was offered to all those who had received open dialogue within this particular National Health Service (NHS) trust. In total, seven participants, from four different social networks, participated in the research and attended semi-structured focus groups. The audio recordings of all focus groups were transcribed and the data as subjected to inductive thematic analysis. Findings The results provide an insight into the lived experience of the individuals who received open dialogue. The analysis of the data gathered in the focus groups revealed three major themes: relational mutuality, dichotomy with other mental health services and dialogical freedom. Practical implications The results suggest that individuals and networks positively experienced receiving open dialogue, particularly in relation to the way in which they were able to relate to, and work with practitioners. However, the results did also raise some issues in relation to the complications of introducing the open dialogue model into existing NHS structures. Originality/value This research contributes to the emerging evidence base in relation to open dialogue, especially considering the current lack of existing research undertaken within the UK.

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