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Following publication of a new vision for the English National Health Service (NHS) in 2014, known as the NHS Five-Year Forward View, a Vanguard programme was introduced by NHS England charged with the task of designing and delivering a range of new care models (NCMs) aimed at tackling deep-seated problems of a type facing all health systems to a greater or lesser degree. Drawing upon recent theoretical developments on the multilevel nature of context, we explore factors shaping the implementation of five NCM initiatives in the North East of England.

Data collection was based on semi-structured interviews (66 in total) between December 2016 and May 2017 with key informants at each site and a detailed review of Trusts' internal documents and policies related to the implementation of each NCM. Our analysis explores factors shaping the implementation of five NCM pilot sites as they touched on the multiple levels of context ranging from the macro policy level to the micro-level setting of workforce redesign.

It is far too early to conclude with any confidence that a successful outcome for the NCM programme will be forthcoming although the NHS Long-Term Plan seeks to build on the earlier vision set out in the Five-Year Forward View. Early indications show some signs of promise, especially where there is evidence of the ground having been prepared and changes already being put in place prior to the official launch of NCM initiatives. At the same time our findings demonstrate that all five pilot sites experienced, and were subject to, unrealistic pressure placed upon them to deliver outcomes.

Our findings demonstrate the need for a deeper understanding of the multilevel nature of context by exploring factors shaping the implementation of five NCMs in the North East of England. Exploring the wider national policy context is desirable as well as understanding the perceptions of front-line staff and service users in order to establish the degree of alignment or, conversely, to identify where policy and practice are at risk of pushing and pulling against each other.

The purpose of this paper is to determine whether some aspects of the distinctive Mayo Clinic care model could be translated into English National Health Service (NHS) hospital settings, to overcome the fragmented and episodic nature of non-emergency patient care.

The authors used a rapid review to assess the literature on integrated clinical care in hospital settings and critical analysis of links between Mayo Clinic’s care model and the organisation’s performance and associated patient outcomes.

The literature directly concerned with Mayo Clinic’s distinctive ethos and approach to patient care is limited in scope and largely confined to “grey” sources or to authors and institutions with links to Mayo Clinic. The authors found only two peer-reviewed articles which offer critical analysis of the contribution of the Mayo model to the performance of the organisation.

Mayo Clinic is not the only organisation to practice integrated, in-hospital clinical care; however, it is widely regarded as an exemplar.

There are barriers to implementing a Mayo-style model in English NHS hospitals, but they are not insurmountable and could lead to much better coordination of care for some patients.

The study shows that there is an appetite among NHS patients and staff for better coordinated, multi-specialty care within NHS hospitals.

In the English NHS integrated care generally aims to improve coordination between primary, community and secondary care, but problems remain of fragmented care for non-emergency hospital patients. Use of a Mayo-type care model, within hospital settings, could offer significant benefits to this patient group, particularly for multi-morbid patients.

Indicates in broad terms the areas which should be considered by valuers of petrol filling stations. Notes that rental values and capital values will involve careful appraisal of the potential fuel throughput and consideration of the costs of running the site. Concludes that there is an overall trend in the oil industry to reduce the number of petrol filling sites and that a valuer must take full account of all known or potential factors in the surrounding area including the impact of hypermarket petrol filling stations.

The purpose of this paper is to examine a bold and ambitious scheme known as the North East transformation system (NETS). The principal aim of the NETS is the achievement of a step-change in the quality of health services delivered to people living in the North East region of England. The paper charts the origins of the NETS and its early journey before describing what happened to it when the UK coalition government published its proposals for unexpected major structural change in the NHS. This had a profound impact on the leadership and direction of the NETS and resulted in it taking a different direction from that intended.

The research design took the form of a mixed methods, longitudinal 3.5-year study aimed at exploring transformational change in terms of content, context, process and outcomes. The sample of study sites comprised 14 NHS trusts in the North East region chosen to provide geographical coverage of the area and to reflect the scale, scope and variety of the bodies that formed part of the NETS programme. The qualitative component of the research, which the paper draws upon, included 68 semi-structured interviews, observational studies and focus groups. Data analysis made use of both deductive and inductive frameworks. The deductive framework adopted was Pettigrew et al.’s “receptive contexts for change” and four of the eight factors stood out as especially important and form the basis of the paper.

The fate of the NETS was shaped and influenced by the eight factors comprising the Pettigrew et al. receptive contexts for change framework but four factors in particular stood out as being especially significant: environmental pressure, quality and coherence of policy, key people leading change, supportive organisational culture. Perhaps the most significant lesson from the NETS is that achieving whole systems change is particularly vulnerable to the vicissitudes of politics especially where that system, like the UK NHS, is itself subject to those very same pressures. Yet, despite having an enormous influence on health policy, the political context is frequently avoided in research or not regarded as instrumental in determining the outcomes in respect of transformational change.

The chief limitation is the credibility and authenticity of the interviews captured at particular points in time. These formed the datebase for subsequent analysis. The authors sought to guard against possible bias by supplementing interviews with observational studies and focus groups as well as running two dissemination events at which emerging findings from the study were subjected to independent external scrutiny and comment. These events provided a form of validation for the key study findings.

The research findings demonstrate the importance of context for the likely outcome and success of complex transformational change initiatives. These require time to become embedded and demonstrate results especially when focused on changing culture and behaviour. But, in practice, allowing sufficient time during which the organisation may remain sufficiently stable to allow the change intervention to run its course and become embedded and sustainable is highly problematic. The consequence is that bold and ambitious efforts like the NETS are not given the space and stability to prove themselves. Too often, politics and external environmental pressures intrude in ways that may prove dysfunctional and negative.

Unless a different approach to transformational change and its leadership and management is adopted, then changing the NHS to enable it to appear more responsive to changing health care needs and expectations will remain a cause for concern. Ultimately the public will be the losers if the NHS remains insensitive to changing needs and expectations. The patient experience was at the centre of the NETS programme.

The study is original insofar as no other has sought to evaluate the NETS independently and over a reasonable time period. The research design, based on a mixed-methods approach, is unusual in evaluations of this nature. The study’s conclusions are not so original but their value lies in largely confirming and reinforcing the findings from other studies. It perhaps goes further in stressing the impact of politics on health policy and the negative consequences of constant organisational change on attempts to achieve deep change in the way the NHS is organised and led.

There has been significant investment in NHS research and development aimed at strengthening the knowledge base of decision‐making. But evidence‐based health care is no panacea. What is effective or ineffective is vigorously contested. Nor does evidence‐based decision‐making offer a tidy solution to matters of a more sensitive political nature. In particular, it is not a solution to the rationing dilemma.

This paper aims to present the findings of a government-initiated project that sought to explore the possibility of incorporating cultural connections to land within the federal national accounting system using the United Nations Systems of Environmental-Economic Accounting (UN-SEEA) framework as a basis.

Adopting a critical dialogic approach and responding to the calls for critical accountants to engage with stakeholders, the authors worked with two Indigenous groups of Australia to develop a system of accounts that incorporates their cultural connections to “Country”. The two groups were clans from the Mungguy Country in the Kakadu region of Northern Territory and the Ewamian Aboriginal Corporation of Northern Queensland. Conducting two-day workshops on separate occasions with both groups, the authors attempted to meld the Indigenous worldviews with the worldviews embodied within national accounting systems and the UN-SEEA framework.

The models developed highlight significant differences between the ontological foundations of Indigenous and Western-worldviews and the authors reflect on the tensions created between these competing worldviews. The authors also offer pragmatic solutions that could be implemented by the Indigenous Traditional Owners and the government in terms of developing such an accounting system that incorporates connections to Country.

The paper contributes to providing a contemporary case study of engagement with Indigenous peoples in the co-development of a system of accounting for and by Indigenous peoples; it also contributes to the ongoing debate on bridging the divide between critique and praxis; and finally, the paper delves into an area that is largely unexplored within accounting research which is national accounting.

The purpose of this paper is to consider the effectiveness of partnership working in public health and draws on a systematic review of public health partnerships and original research conducted by the authors. It then considers in the light of research evidence whether the recently established Health and Wellbeing Boards (HWBs) under the 2012 Health and Social Care Act will help agencies to work together more effectively to improve population health or will go the way of previous initiatives and fall short of their original promise.

The paper is based on a systematic literature review conducted by the authors and empirical research focusing upon the ability of public health partnerships to reduce health inequalities and improve population health outcomes. It also draws on recent studies evaluating HWBs.

The paper finds that, hitherto, public health partnerships have had limited impact on improving population health and reducing health inequalities and that there is a danger that HWBs will follow the same path-dependent manner of previous partnership initiatives with limited impact in improving population health outcomes and reducing health inequalities.

The research draws on a systematic literature review and further scoping review of public health partnerships, in addition to empirical research conducted by the authors. It also reviews the current evidence base on HWBs. It is recognised that HWBs are in their early stages and have not as yet had the time to fulfil their role in service collaboration and integration.

The paper gives an overview of how and why public health partnerships in the past have not lived up to the expectations placed upon them. It then offers practical steps that HWBs need to take to take to ensure the mistakes of the past are not replicated in the future.

The research outlines how public health partnerships can operate in a more effective manner, to ensure a more seamless provision for service users. The paper then gives pointers as to how this can benefit HWBs and the wider community they serve.

The paper draws on a comprehensive research study of the effectiveness of public health partnerships on improving health outcomes and a systematic literature review. In addition, it also draws upon the current evidence base evaluating HWBs, to inform the discussion on their future prospects, in regard to partnership working in public health and promoting service integration.

The purpose of this paper is to present a co‐authored reflection on the health improvement leadership development programme and the key evaluation messages derived from piloting in an English National Health Service region. It highlights the specific attributes of this approach to health improvement leadership development and clarifies health improvement development issues.

Appreciative inquiry and soft systems methodology are combined in an evaluation approach designed to capture individual as well as organisation learning and how it impacts on leadership in specific contexts.

The evaluation exposes the health improvement leadership needs of a multi‐organisation cohort, offers some explanations for successful achievement of learning needs while also exposing of the challenges and paradoxes faced in this endeavour.

There are limited reported templates of how to develop leadership for health improvement. This paper details a whole systems approach, acknowledging the impact of context on leadership and an approach to evaluating such complex initiatives.