Supporting the case for “progressive universalism” in health visiting: Scottish mothers and health visitors’ perspectives on targeting and rationing health visiting services, with a focus on the Lothian Child Concern Model.

Aims. To explore parents and professionals’ experience of family assessment in health visiting (public health nursing), with a focus on the Lothian Child Concern Model (LCCM). Background. Health visitors (HVs) currently assess families as requiring core, additional or intensive support, and offer support at a corresponding level. The majority of families are assessed as core and receive no pro-active support beyond the early days. Previous assessment tools, consisting of checklists, have been criticised as being ineffective in identifying a range of health needs and unacceptable to parents and HVs. The LCCM model was developed and introduced in the study area to promote a partnership approach with parents and assess strengths as well as difficulties in parents’ capacity to care for their child. Methods. Qualitative methods were used. Ten mothers and twelve HVs took part in individual semi-structured interviews. Results. Most mothers were aware of the assessment process but some felt that they were not involved in the decision making process. Explaining the assessment process to parents is problematic and not all HVs do so. The assessment process was stressful for some mothers. HVs find the model useful for structuring and documenting the assessment process. Many believe that most families benefit from some support, using public health approaches. Families are often assessed as core because there are insufficient resources to support all those who meet the criteria of the additional category, and managers assess caseloads in terms of families with child protection concerns. Conclusions. The study findings support the concept of “progressive universalism” which provides a continuum of intensity of support to families, depending on need. Mothers would like better partnership working with HVs. Relevance to clinical practice. The study endorses proposed policy changes to re-establish the public health role of HVs and to lower the threshold for families to qualify for support.

The impact of interconnectedness in a triadic relationship between a financial services provider, IFAs, and customers.

The aim of this study is to investigate the impact of interconnectedness between a long-term savings and investments provider, Independent Financial Advisers (IFAs) and customers. Ritter’s (2000) framework of the effect of interconnectedness was used to analyse this triadic relationship. Conceptual studies of triadic business relationships are scarce in marketing and organisational research (Blakenburg & Johanson, 1992; Havila, Johnson & Thilenius, 2004; Ritter, 2000). However, the applicability of a triadic relationship has been tested in a number of case studies (Andersson & Mattsson, 2004; Cunningham & Pyatt, 1989; Jaaskelainen, Kuivalainen & Saarenketo, 2000; Narayandas, 2002; Odorici & Corrado, 2004; Pardo & Salle, 1994; Trimachi, 2002). This study was conducted in collaboration with one of the UK’s largest long-term savings and investments providers. A substantial proportion of the provider’s business is conducted through IFAs and thus their significance as a major stakeholder. Indeed, the majority of sales in the long-term savings and investments industry in the UK are realised through IFAs. Academic studies (Gough, 2005; Gough & Nurullah, 2009) have indicated that IFAs are the strongest distribution channel in the industry. Thus, by analysing the impact of the interconnectedness in this relationship, a strategy that can increase the relationship performance can be proposed. However, to the best of the authors’ knowledge, a study that investigates the effect of the interconnectedness in this triadic relationship has not been established. In addition, the regulatory environment which continues to face change such as the recent implementation of Retail Distribution Review (RDR) on 1st January 2013 will make the relationship more rather than less complex.

A framework for the transformation of the creative industries in a digital age.

The creative industries sector faces a constantly changing context characterised by the speed of the development and deployment of digital information systems and Information Communications Technologies (ICT) on a global scale. This continuous digital disruption has had significant impact on the whole value chain of the sector: creation and production; discovery and distribution; and consumption of cultural goods and services. As a result, creative enterprises must evolve business and operational models and practices to be sustainable. Enterprises of all scales, type, and operational model are affected, and all sectors face ongoing digital disruption. Management consultancy practitioners and business strategy academics have called for new strategy development frameworks and toolkits, fit for a continuously changing world. This thesis investigates a novel approach to organisational change appropriate to the digital age, in the context of the creative sector in Scotland. A set of concepts, methods, tools, and processes to generate theoretical learning and practical knowing was created to support enterprises to digitally adapt through undertaking journeys of change and organisational development. The framework is called The AmbITion Approach. It was developed by blending participatory action research (PAR) methods and modern management consultancy, design, and creative practices. Empirical work also introduced to the framework Coghlan and Rashford’s change categories. These enabled the definition and description of the extent to which organisations developed: whether they experienced first order (change), second order (adaptation) or third order (transformation) change. Digital research tools for inquiry were tested by a pilot study, and then embedded in a longitudinal study over two years of twentyone participant organisations from Scotland’s creative sector. The author applied and investigated the novel approach in a national digital development programme for Scotland’s creative industries. The programme was designed and delivered by the author and ran nationally between 2012-14. Detailed grounded thematic analysis of the data corpus was undertaken, along with analysis of rich media case studies produced by the organisations about their change journeys. The results of studies on participants, and validation criteria applied to the results, demonstrated that the framework triggers second (adaptation) and third order change (transformation) in creative industry enterprises. The AmbITion Approach framework is suitable for the continuing landscape of digital disruption within the creative sector. The thesis contributes to practice the concepts, methods, tools, and processes of The AmbITion Approach, which have been empirically tested in the field, and validated as a new framework for business transformation in a digital age. The thesis contributes to knowledge a theoretical and conceptual framework with a specific set of constructs and criteria that define first, second, and third order change in creative enterprises, and a robust research and action framework for the analysis of the quality, validity and change achieved by action research based development programmes. The thesis additionally contributes to the practice of research, adding to our understanding of the value of PAR and design thinking approaches and creative practices as methods for change.