Public-private partnerships and efficiency in public procurement of primary healthcare infrastructure: a qualitative research in the NHS UK

Aim There is growing interest in the contribution of public-private partnerships (PPPs) bridging the shortage of financial resources and management expertise in developing public healthcare infrastructure. However, few studies have evidenced PPPs’ ability in increasing efficiency in public procurement of primary healthcare infrastructure. The aim of this study was to assess to what extent PPPs would increase efficiency in public procurement of primary healthcare facilities. Subject and Methods A qualitative analysis, adopting a realistic research evaluation method, used data collected from a purposive sample of public (n=23) and private sector staff (n=2) directly involved in the UK National Health Service Local Improvement Finance Trust (LIFT). Results We find a positive association of LIFT helping to bridge public sector capital shortages for developing primary care surgeries. LIFT is negatively associated with inefficient procurement because it borrows finance from private banks, leaving public agencies paying high interest rates. The study shows that some contextual factors and mechanisms in LIFT play a major part in obstructing public staff from increasing procurement efficiency. Conclusion PPP’s ability to increase efficiency may be determined by contextual factors and mechanisms that restrict discretion over critical decisions by frontline public sector staff. Developing their capacity in monitoring PPP activities may make partnerships more efficient.

Grounded Theory methods in child psychotherapy research

This article considers the place of qualitative research in psychoanalysis and child psychotherapy. It discusses why research methodology for many years occupied so small a place in these fields, and examines the cultural and social developments since the 1960s which have changed this situation, giving formal methods of research much greater significance. It reflects on the different pressures to develop formal research methods which arise both from outside the psychoanalytic field, as a condition of its continued professional survival, and from within it, where its main aim is the development of fundamental psychoanalytic knowledge, It suggests that the conduct of mainly quantitative research into treatment outcomes is largely a response to these external pressures, whilst the main benefits to be gained from the development of qualitative research methods, such as Grounded Theory, are in facilitating the knowledge-generating capacities and achievements of child psychotherapists themselves. The paper describes Grounded Theory methods, and explains how they can be valuable in the recognition of hitherto unrecognised meanings and patterns as these are made visible in clinical practice. Finally, it briefly describes five different examples of completed doctoral studies, all of which have added significantly to the knowledge-base of child psychotherapy, and which demonstrate how much can be accomplished using this method of research.

A Scalable Design Framework for Variability Management in Large-Scale Software Product Lines

Variability management is one of the major challenges in software product line adoption, since it needs to be efficiently managed at various levels of the software product line development process (e.g., requirement analysis, design, implementation, etc.). One of the main challenges within variability management is the handling and effective visualization of large-scale (industry-size) models, which in many projects, can reach the order of thousands, along with the dependency relationships that exist among them. These have raised many concerns regarding the scalability of current variability management tools and techniques and their lack of industrial adoption. To address the scalability issues, this work employed a combination of quantitative and qualitative research methods to identify the reasons behind the limited scalability of existing variability management tools and techniques. In addition to producing a comprehensive catalogue of existing tools, the outcome form this stage helped understand the major limitations of existing tools. Based on the findings, a novel approach was created for managing variability that employed two main principles for supporting scalability. First, the separation-of-concerns principle was employed by creating multiple views of variability models to alleviate information overload. Second, hyperbolic trees were used to visualise models (compared to Euclidian space trees traditionally used). The result was an approach that can represent models encompassing hundreds of variability points and complex relationships. These concepts were demonstrated by implementing them in an existing variability management tool and using it to model a real-life product line with over a thousand variability points. Finally, in order to assess the work, an evaluation framework was designed based on various established usability assessment best practices and standards. The framework was then used with several case studies to benchmark the performance of this work against other existing tools.