scholarly journals UK Healthcare Workers’ Experiences of Major System Change in Elective Surgery During the COVID-19 Pandemic: Reflections on Rapid Service Adaptation

2021 ◽  
Author(s):  
Georgina Singleton ◽  
Anna Dowrick ◽  
Louisa Manby ◽  
Harrison Fillmore ◽  
Aron Syverson ◽  
...  
Keyword(s):  
Decision Making ◽  
United Kingdom ◽  
Elective Surgery ◽  
Rapid Change ◽  
Surgical Care ◽  
System Level ◽  
Framework Analysis ◽  
Surgical Services ◽  
The United Kingdom ◽  
Service Adaptation

Background: The coronavirus disease 2019 (COVID-19) pandemic disrupted the delivery of elective surgery in the United Kingdom. The majority of planned surgery was cancelled or postponed in March 2020 for the duration of the first wave of the pandemic. We investigated the experiences of staff responsible for delivering rapid changes to surgical services during the first wave of the pandemic in the United Kingdom, with the aim of developing lessons for future major systems change (MSC). Methods: Using a rapid qualitative study design, we conducted 25 interviews with frontline surgical staff during the first wave of the pandemic. Framework analysis was used to organise and interpret findings. Results: Staff discussed positive and negative experiences of rapid service organisation. Clinician-led decision-making, the flexibility of individual staff and teams, and the opportunity to innovate service design were all seen as positive contributors to success in service adaptation. The negative aspects of rapid change were inconsistent guidance from national government and medical bodies, top-down decisions about when to cancel and restart surgery, the challenges of delivering emergency surgical care safely and the complexity of prioritising surgical cases when services re-started. Conclusion: Success in the rapid reorganisation of elective surgical services can be attributed to the flexibility and adaptability of staff. However, there was an absence of involvement of staff in wider system-level pandemic decision-making and competing guidance from national bodies. Involving staff in decisions about the organisation and delivery of MSC is essential for the sustainability of change processes.

scholarly journals UK Health Care Workers' Experiences of Major System Change in Elective Surgery during the COVID-19 Pandemic: Reflections on Rapid Service Adaptation

2021 ◽  
Author(s):  
Georgina Singleton ◽  
Anna Dowrick ◽  
Louisa Manby ◽  
Harrison Fillmore ◽  
Aron Syversen ◽  
...  
Keyword(s):  
Decision Making ◽  
Elective Surgery ◽  
Rapid Change ◽  
Surgical Care ◽  
Systems Change ◽  
System Level ◽  
Framework Analysis ◽  
Surgical Services ◽  
The Uk ◽  
Service Adaptation

Background The COVID-19 pandemic disrupted the delivery of elective surgery in the UK. The majority of planned surgery was cancelled or postponed in March 2020 for the duration of the first wave of the pandemic. We investigated the experiences of staff responsible for delivering rapid changes to surgical services during the first wave of the pandemic in the UK, with the aim of developing lessons for future major systems change. Methods Using a rapid qualitative study design, we conducted 25 interviews with frontline surgical staff during the first wave of the pandemic. We also carried out a policy review of the guidance developed for those delivering surgical services in pandemic conditions. We used framework analysis to organise and interpret findings. Results Staff discussed positive and negative experiences of rapid service organisation. Clinician-led decision making, the flexibility of individual staff and teams, and the opportunity to innovate service design were all seen as positive contributors to success in service adaptation. The negative aspects of rapid change were inconsistent guidance from national government and medical bodies, top-down decisions about when to cancel and restart surgery, the challenges of delivering emergency surgical care safely and the complexity of prioritising surgical cases when services re-started. Conclusion Success in the rapid reorganisation of elective surgical services can be attributed to the flexibility and adaptability of staff. However, there was an absence of involvement of staff in wider system-level pandemic decision-making and competing guidance from national bodies. Involving staff in decisions about the organisation and delivery of major systems change is essential for the sustainability of change processes.

scholarly journals A qualitative systematic review of factors influencing parents’ vaccination decision-making in the United Kingdom

2016 ◽  
Vol 2 ◽  
pp. 603-612 ◽  
Author(s):  
Alice S. Forster ◽  
Lauren Rockliffe ◽  
Amanda J. Chorley ◽  
Laura A.V. Marlow ◽  
Helen Bedford ◽  
...  
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
United Kingdom ◽  
The United Kingdom ◽  
Factors Influencing ◽  
Qualitative Systematic Review ◽  
Vaccination Decision

Pelaksanaan Sistem Tribunal di Malaysia: Ke Arah Penambahbaikan

2020 ◽  
Vol 32 (2) ◽  
pp. 223-242
Author(s):  
Fariza Romli ◽  
◽  
Harlida Abdul Wahab
Keyword(s):  
Decision Making ◽  
Sustainable Development ◽  
United Kingdom ◽  
Sustainable Development Goals ◽  
Basic Principles ◽  
Administration System ◽  
The Sustainable Development ◽  
The United Kingdom ◽  
Development Goals ◽  
Administrative Body

The existence of a tribunal system, in addition to helping to smooth the administration system, is considered as sharing power with the judiciary in making decisions. Thus arose the question of decision- making power and prevention of abuse by the administrative body. In line with the Sustainable Development Goals 2030 to ensure justice in support of effective, responsible and inclusive institutions, transparent and fair practices are essential for ensuring people’s trust in the administrative body and government. This paper, therefore, discusses the tribunal system and its implementation in Malaysia. In view of this, tribunal systems that exist in other countries, especially the United Kingdom, are also examined as models for improvement. Matters such as autonomy or control of power and the trial process are among the issues raised. Recommendations for improvement are proposed based on three basic principles—openness, fairness and impartiality—to further strengthen the implementation of the existing tribunal system in line with developments abroad.

Reflections on the Australian Pre-Strike Ballot Model

2020 ◽  
pp. 214-246
Author(s):  
Breen Creighton ◽  
Catrina Denvir ◽  
Richard Johnstone ◽  
Shae McCrystal ◽  
Alice Orchiston
Keyword(s):  
Decision Making ◽  
United Kingdom ◽  
Complex Model ◽  
Industrial Democracy ◽  
Stakeholder Perceptions ◽  
Economic Interests ◽  
The United Kingdom ◽  
Practical Operation ◽  
Formal Recognition

This concluding chapter considers how Australian pre-strike ballot requirements reflect the explicit (furthering industrial democracy) and implicit (inhibiting strike action) objectives that underpinned their introduction. After summarizing the practical operation and impact of the statutory requirements, the chapter describes stakeholder perceptions of the system in practice and in principle, and their views as to how it should be reformed. In conclusion, the chapter suggests the removal of the requirement under the Fair Work Act 2009 (Cth) for a union to apply to an industrial tribunal for permission to run a ballot. It advocates the replacement of the current complex model with a requirement that union rules contain provision for a ballot of members as a pre-condition of taking strike action, with the lawfulness of any subsequent strike being conditional upon being approved in such a ballot and subject to challenge only by the members of that union. So far as union members are concerned, this would do little more than accord formal recognition to the non-legislated democratic processes that are already the norm in Australian unions, but it would at least provide a basis for meaningful, democratic decision-making in relation to taking strike action. As such it would constitute a welcome repudiation of what the chapter describes as the hypocritical posturing that underpins current legislation in Australia (and the United Kingdom) which uses the rhetoric of democracy to deprive workers of their democratic right to take strike action to protect and to promote their legitimate social and economic interests.

The Chilcot Report

2019 ◽  
pp. 273-288
Author(s):  
Stephen Bouwhuis
Keyword(s):  
Decision Making ◽  
United Kingdom ◽  
International Law ◽  
Legal Practice ◽  
Ethical Aspects ◽  
Legal Advice ◽  
The United Kingdom ◽  
General Relevance ◽  
The Government

The inquiry by the United Kingdom into its decision to intervene in Iraq is one of the longest running and most comprehensive examinations of government decision-making. In particular, the inquiry examined in detail the processes by which legal advice was provided to and formed a part of the decision by the Government of the United Kingdom to intervene in Iraq. Through this lens, the current chapter examines what the inquiry illustrates about the general relevance of international law to the decision to intervene in Iraq and more broadly what illustrates about the role of international law in decision-making more generally. In particular, the chapter pertains to the practical and ethical aspects providing international legal advice to government as well as the nature of government legal practice more generally.

Introduction

2020 ◽  
pp. 1-10
Keyword(s):  
United Kingdom ◽  
Surgical Care ◽  
Second World War ◽  
British Association ◽  
Paediatric Surgery ◽  
World War ◽  
Surgical Specialty ◽  
The United Kingdom ◽  
Second World

Paediatric surgery is the surgical care of children from fetus to adolescent. It is a comparatively new surgical specialty, only formally recognized after the Second World War. This chapter provides a history and overview of the specialty, including the associations related to paediatric surgery, and biographies of famous surgeons who contributed to the field throughout their careers. The main organization in the United Kingdom is the British Association of Paediatric Surgeons (BAPS) founded in 1953 with Sir Denis Browne as the first president. Though based in London, it now has many international contacts and, through its conferences and symposia inside and outside the United Kingdom, is a leading educational provider in the specialty.

Analysing Public Expenditure: (I) Planning, Control and Price

1981 ◽  
Vol 1 (3) ◽  
pp. 289-306 ◽  
Author(s):  
Harold Copeman
Keyword(s):  
Decision Making ◽  
United Kingdom ◽  
Public Expenditure ◽  
White Paper ◽  
Future Issue ◽  
Policy Makers ◽  
Policy Problem ◽  
Advantages And Disadvantages ◽  
The United Kingdom ◽  
Cash Basis

ABSTRACTThis paper analyses the different cost bases in which public expenditure can be analysed as a policy problem related to the differing requirements of planning, authorising and controlling the various components of public expenditure. The analysis is applied to the United Kingdom, where in 1981 changes were announced in the method of making public expenditure decisions which had evolved over the previous two decades. The various components of public expenditure in the United Kingdom are described, and the decision-making process which led to the March 1981 Public Expenditure White Paper is outlined. The significance of the different price bases used in public expenditure (cash (at current or at expected prices), volume, cost, and constant) is then explored. The advantages and disadvantages for policy-makers of attempting to reduce the number of price bases used are analysed; it is shown that there is no cost-free route to reducing complexity. The significance of government's decision in 1981 to make greater use of the cash basis in decision-making is assessed. The analysis is applied specifically to the United Kingdom, but the issues raised are of policy relevance to the choice of price bases for public expenditure decision-making in any country in a time of inflation.(A second paper in a future issue of the Journal will examine the political purposes behind gross or net measurement, the earmaking of receipts, and the more precise relationships between figures used in the planning of public expenditure, in macro-economic analysis and forecasting and in Parliamentary and local control.)

scholarly journals An Exploratory Study of Speech and Language Therapy Intervention for Children Born With Cleft Palate ± Lip

2020 ◽  
pp. 105566562095473
Author(s):  
Caroline Williams ◽  
Sam Harding ◽  
Yvonne Wren
Keyword(s):  
Decision Making ◽  
United Kingdom ◽  
Service Delivery ◽  
Cleft Palate ◽  
Speech And Language ◽  
Language Therapy ◽  
Speech And Language Therapy ◽  
Service Delivery Models ◽  
The United Kingdom ◽  
Delivery Models

Introduction: Children born with a cleft palate ± lip are at risk of developing speech and language difficulties, which may require intervention from a speech and language therapist (SLT). To date, there is no strong evidence to support one approach to intervention over another, neither is it clear which approaches or methods of provision are commonly used. Objectives: To describe the range of speech and language therapy interventions being used with children born with cleft palate in the United Kingdom up to 5 years of age. To explore the different ways, interventions are being delivered. Design: A prospective study to conduct 9 semi-structured focus groups. Iterative content analysis was completed. Setting: Regional Cleft Lip and Palate Centers in the United Kingdom. Participants: Sixty-two speech and language therapy professionals from specialist cleft teams and community services. Results: Four main codes were identified: “intervention approaches,” “service delivery models,” “decision-making and rationale,” and “patient-centered care.” Participants frequently discussed how they adopt an eclectic style when delivering intervention, the importance of an individualized approach for each child and service delivery constraints, such as a lack of resources. Conclusion: Insight into the multitude of intervention approaches used by SLTs, aspects which influence their decision-making and the variability of service delivery models were gained. Uncertainty regarding which intervention approaches and methods for delivery are most effective provides rationale for future research, to improve the effectiveness of speech and language intervention for children with cleft palate ± lip.

scholarly journals ‘Battle of the sixes’: Investigating print media representations of female professional golfers competing in a men’s tour event

2019 ◽  
Vol 55 (6) ◽  
pp. 664-684 ◽  
Author(s):  
Ali Bowes ◽  
Niamh Kitching
Keyword(s):  
Decision Making ◽  
United Kingdom ◽  
Thematic Analysis ◽  
Media Coverage ◽  
Print Media ◽  
Female Athletes ◽  
Media Representations ◽  
Media Representation ◽  
The United Kingdom ◽  
Professional Golfers

In May 2018, the men’s European Tour invited five female professional golfers to compete in its GolfSixes event in England, against 27 professional male players. This was significant, particularly given the female struggle for equality of access, participation, employment and decision making in golf settings. This research investigates the print media representation of these five female professional golfers competing in this male domain. Using the Nexis database, data were collected from print newspapers in the United Kingdom and Ireland over six days before, during and after the event. Following thematic analysis, findings highlight a double-edged sword with regard to media coverage of female athletes competing against men: women received greater media coverage when in the male sport spotlight, but the coverage was framed by gendered discourses. The results document a slow shift towards more equal and equitable print media coverage of female athletes, whilst drawing attention to the problematic ways in which sportswomen are represented.

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