The role, organisation and contribution of community enterprise to urban regeneration policy in the UK

This monograph investigates the organisation, constitution and delivery of community-based organisations which are normally called community enterprises in the UK. These are organisations which emerge from local communities at the neighbourhood level, work in partnership with the public and private sectors, and provide a range of services to meet social, economic and environmental needs. The main focus of the paper is to explore how these organisations contribute to local regeneration strategies, generate social capital and contribute towards the promotion of civil society in general. The main emphasis is on organisations in England and Wales but comparisons are made with the USA and other countries where relevant literature is available. The key questions to be answered relate to the organisation and management of these bodies; the extent to which they engage with and contribute to local regeneration strategies; and the impact they have particularly in acquiring and managing assets. The diversity of the sector, and the range, scale and level of benefits it can deliver is illustrated through five detailed case studies of community enterprises established at different times, in different geographical locations and with different objectives and funding regimes. But, whilst the UK political economy is moving towards less state intervention and more community self-help, the community development corporations in the USA provide an indication of the future direction community enterprises might take in the UK as part of a broad trend towards civic capacity building.

Organisational and systems factors impacting on patient safety in acute care organisations: lessons from four multi-site research studies

Background Patient safety is concerned with preventable harm in healthcare, a subject that became a focus for study in the UK in the late 1990s. How to improve patient safety, presented both a practical and a research challenge in the early 2000s, leading to the eleven publications presented in this thesis. Research question The overarching research question was: What are the key organisational and systems factors that impact on patient safety, and how can these best be researched? Methods Research was conducted in over 40 acute care organisations in the UK and Europe between 2006 and 2013. The approaches included surveys, interviews, documentary analysis and non-participant observation. Two studies were longitudinal. Results The findings reveal the nature and extent of poor systems reliability and its effect on patient safety; the factors underpinning cases of patient harm; the cultural issues impacting on safety and quality; and the importance of a common language for quality and safety across an organisation. Across the publications, nine key organisational and systems factors emerged as important for patient safety improvement. These include leadership stability; data infrastructure; measurement capability; standardisation of clinical systems; and creating an open and fair collective culture where poor safety is challenged. Conclusions and contribution to knowledge The research presented in the publications has provided a more complete understanding of the organisation and systems factors underpinning safer healthcare. Lessons are drawn to inform methods for future research, including: how to define success in patient safety improvement studies; how to take into account external influences during longitudinal studies; and how to confirm meaning in multi-language research. Finally, recommendations for future research include assessing the support required to maintain a patient safety focus during periods of major change or austerity; the skills needed by healthcare leaders; and the implications of poor data infrastructure.