Search results

The purpose of the study is to explore how the duty of candour got onto the agenda of the British National Health Service.

The conceptual approach is based on multiple streams approach, with the methodology being interpretive content analysis, which uses a deductive approach that focuses on both manifest and latent content.

The duty of candour got onto the NHS agenda as a result of the Mid Staffordshire inquiry report and the long-term “interest group” campaign associated with Robbie's Law. It is argued that the “focusing event” of the Mid Staffordshire Inquiry Report opened the “policy window”. It also highlights the importance of “policy entrepreneur” Sir Robert Francis whose “claim to a hearing”, “political connections” and “persistence” was vital.

Analysis was confined to published documents.

It highlights some of the factors that suggested why the duty of candour got onto the NHS agenda when it did.

The purpose of this paper is to critically explore hybrid organisations in health care. It examines the broad literature on hybrids focusing on issues of perspective, definition, sub-type and level. It then presents the results of the literature review of hybrid health care organisations, exploring which organisations have been viewed as hybrids, and then examining studies in more detail with respect to the research questions.

It critically explores the literature on hybrid organisations in health care through a structured search.

It is found that a wide variety of hybrid forms exist, but not clear what they combine or how they combine it. However, the level of depth from some of these studies is rather limited, with little consensus on definition, and relatively few drawing on any explicit conceptual perspective. It seems that the wider hybridity literatures have limited influence of studies of hybrid health care organisations.

As far as the authors are aware, this paper is the first attempt to critically review the literature on hybrid organisations in health care. It is concluded that it is difficult to define and explain hybrid health care organisations. Health care hybrids appear to be chameleons as they appear to be able to change their form to different observers.

Many governments stress the importance of “learning from abroad”. An analysis of official documents over a period of some 20 years examines learning from abroad in the case of funding long-term care in England through the lens of prospective policy transfer.

The paper analyses the eight “official” documents in England that examined funding LTC from 1999 to 2019. It uses interpretive content analysis in a deductive approach that focuses on both manifest and latent content.

Only four of the eight documents gave more than a token level of attention to other nations, and of the remaining four, none fully satisfied the criteria or followed the recommendations of prospective policy transfer. Moreover, a rather limited pool of lessons from other nations is examined. Much of the material is rather descriptive, with limited explicit attention towards goals, problems, settings and policy performance, and a clear recommendation explicitly associated with a clear lesson or policy recommendation is rare.

This is the first analysis of the eight official documents that have discussed funding long-term care in England.

This paper revisits the claim of Vinten (1993) in this journal that whistleblowing is achieving prominence as a question of social policy.

It examines literature from social and health policy to focus on the importance of whistleblowing and the policies that may encourage whistleblowing. However, it finds little extant academic literature in social policy, and so it turns to examine documents on whistleblowing in the British National Health Service such as NHS Inquiries, Parliamentary Debates, Parliamentary Committee Reports and government documents.

It is found that whistleblowing has not achieved prominence as a question of social policy in nearly 30 years since Vinten's argument. However, it argues that whistleblowing should be an issue for social policy as it is clear that whistleblowing can save lives.

It supports the growing Parliamentary agenda for legislative change for whistleblowers.

This is one of the first articles on whistleblowing in a Social Policy journal for nearly 30 years and provides an argument that the discipline should pay more attention to a topic that can save lives.

This paper examines different perspectives on the broad umbrella term of organisational silence. It identifies ten perspectives on organisational silence from the previous literature on inquiries into failings of British National Health Service providers. The purpose of this paper is to address these issues.

Using content analysis, it applies ten perspectives on organisational silence to the report of the inquiry into the Gosport Hospital.

There is some overlap between the perspectives in that they draw on the same authors, and stress similar issues. There is some evidence for most of the perspectives in the report, but some perspectives appear stronger than others. However, none of the perspectives seem to cover the full spectrum of behaviour and place differential emphasis on different processes. It is not clear whether all ten perspectives add independent analytical value. This suggests that some might be extended or combined with the umbrella term of organisational silence more fully opened.

This is the first study in healthcare to review perspectives on organisational silence and apply them to a case study.

This article brings together the literatures on policy learning and lesson drawing with the intra-crisis learning literature in order to assess “learning lessons” in the COVID-19 pandemic.

It carries out a structured review of articles that seek to provide lessons for the pandemic. It examines these articles using interpretative content analysis to apply the criteria of prospective policy transfer to the material.

Application of the criteria of prospective policy transfer suggests that lesson drawing was fairly limited. It is often not fully clear why nations were selected. Many articles were brief and provided limited detail, meaning that there was little depth on issues such as problems and goals and on policy performance or policy success or failure. There was limited discussion of transferability of lessons, and few clear lessons could be drawn. Finally, the extent to which it was possible to learn lessons in a “non-routine” or “less routine” crisis, under conditions of threat, uncertainty and urgency was generally not discussed.

The criteria within the framework of prospective policy transfer provide a template for policy makers to assess lessons.

This article indicates the problems of attempting to draw lessons from the past or from other nations to an unprecedented crisis, where decision-making is characterized by elements of threat, urgency and uncertainty.

This article explores to what extent the long debate in England over the funding of long-term care (LTC) has involved learning from abroad.

It draws on Mossberger and Wolman’s (2003) framework which proposes criteria for assessing policy transfer as a form of prospective policy evaluation: awareness; assessment and application. The documents examined are the sources cited by the reports that examined funding LTC in England since 1999. The study uses interpretive content analysis in a deductive approach (applying the framework) that focuses on both manifest and latent content.

It finds that both the reports and the cited studies tend to focus on a fairly narrow range of nations, with most attention on Germany, Japan and Scotland. Most studies broadly do not provide much in the way of a clear rationale, and the level of details provided varies. There is relatively little focus on problems. Aims, objectives and goals are little mentioned in some studies, but they tend to be fairly abstract or “high level.” Similarly, there is limited detail on settings. Finally, only a few studies provide a clear recommendation.

It focuses on the neglected topic of the evidence behind reports which are intended to provide recommendations for policy change. The Mossberger and Wolman’s (2003) framework has been used in a small-scale but appears to be well-suited for this purpose.

The purpose of this paper is to explore whether official inquiries are an effective method for holding the medical profession to account for failings in the quality and safety of care.

Through a review of the theoretical literature on professions and documentary analysis of key public inquiry documents and reports in the UK National Health Service (NHS) the authors examine how the misconduct of doctors can be understood using the metaphor of professional wrongdoing as a product of bad apples, bad barrels or bad cellars.

The wrongdoing literature tends to present an uncritical assumption of increasing sophistication in analysis, as the focus moves from bad apples (individuals) to bad barrels (organisations) and more latterly to bad cellars (the wider system). This evolution in thinking about wrongdoing is also visible in public inquiries, as analysis and recommendations increasingly tend to emphasise cultural and systematic issues. Yet, while organisational and systemic factors are undoubtedly important, there is a need to keep in sight the role of individuals, for two key reasons. First, there is growing evidence that a small number of doctors may be disproportionately responsible for large numbers of complaints and concerns. Second, there is a risk that the role of individual professionals in drawing attention to wrongdoing is being neglected.

To the best of the authors’ knowledge this is the first theoretical and empirical study specifically exploring the role of NHS inquiries in holding the medical profession to account for failings in professional practice.

The purpose of this study is to draw on multiple streams analysis (MSA) and to investigate how policy change emerged from two inquiries into allegations of abusive hospital care in National Health Service (NHS) hospitals in the United Kingdom (UK) in the 1960s.

The methodology of this study is regarding a historical case study of two inquiries.

The Sans Everything and Ely inquiries had the same legal standing and terms of reference, but the second put psychiatric hospital reform on the agenda, while the first did not. The main factor making Ely rather than Sans Everything the turning point seems to have been concerned with “agency”, linked with a few key individuals.

A study of 1960s event necessarily relies heavily on documentary and archival sources, and cannot draw on interviews which are an important ingredient of many case studies.

The originality of the study is to examines inquiries, which have been largely neglected in MSA, despite their obvious potential role in placing issues on the agenda. Previous studies of MSA have devoted little attention to the ability of the media to provide the focus on “focusing events”.

This article applies the whistleblowing stages model to whistleblowing journeys as seen in British National Health Service (NHS) Inquiries.

It provides a qualitative analysis of Inquiry Reports since 2001, using Interpretive Content Analysis to allocate material to stages.

It is found that the Inquiry Reports show a wide variety of reporting mechanisms, but that most persons initially report internally. It seems to confirm recent suggestions that WB is often not a “one off” or simple and linear process, but a protracted process. While the simple stages model may be appropriate for individual “whistle-blowing incident” by a single whistleblower, it needs to be revised for the protracted process of raising concerns in a variety of ways by different people as shown in the Inquiry Reports.

The evidence is confined to the publicly available material that was presented in the Inquiry Reports.

It provides a template to apply to cases of whistleblowing, and provides some baseline material.

This paper is one of the first to explore the whistleblowing stages model using qualitative material to one setting over time.