Provider diversity in the NHS: impact on quality and innovation

The overall objective of the research project has been to assess the impact of provider diversity on quality and innovation in the NHS. The specific research aims were to identify the differences in performance between non-profit Third Sector organisations, for-profit private enterprises, and incumbent public sector institutions within the NHS as providers of health care services, as well as the factors that affect the entry and growth of new private and Third Sector providers. The study used both qualitative and quantitative methods based on case studies of four Local Health Economies (LHEs). Qualitative methods included documentary analysis and interviews with key informants and managers of both commissioning and provider organisations. To provide a focus to the study, two tracer conditions were followed: orthopaedic surgery and home health care for frail older people. In the case of hospital inpatient care, data on patient characteristics were also collected from the HES database. The analysis of this data provided preliminary estimates of the effects of provider type on quality, controlling for client characteristics and case mix. In addition, a survey of patient experience in diverse provider organisations was analysed to compare the different dimensions of quality of provision of acute services between incumbent NHS organisations and new independent sector treatment centres. The research has shown that, in respect of inpatient hospital services, diverse providers supply health services of at least as good quality as traditional NHS providers, and that there is ample opportunity to expand their scale and scope as providers of services commissioned by the NHS. The research used patient experience survey data to investigate whether hospital ownership affects the quality of services reported by NHS patients in areas other than clinical quality. The raw survey data appear to show that private hospitals provide higher quality services than the public hospitals. However, further empirical analysis leads to a more nuanced understanding of the performance differences. Firstly, the analysis shows that each sector offers greater quality in certain specialties. Secondly, the analysis shows that differences in the quality of patients’ reported experience are mainly attributable to patient characteristics, the selection of patients into each type of hospital, and the characteristics of individual hospitals, rather than to hospital ownership as such. Controlling for such differences, NHS patients are on average likely to experience a similar quality of care in a public or privately-run hospital. Nevertheless, for specific groups of patients and for specific types of treatments, especially the more straightforward ones, the private sector provides an improved patient experience compared to the public sector. Elsewhere, the NHS continues to provide a high quality service and outperforms the private sector in a range of services and for a range of clients.

Creative participation in construction firms: bridging creativity and innovation

An intricate evolution of mainstream theories follows the growing need to explain employees’ commitment and engagement. Our understanding of these work-related phenomena and behaviour has improved but creativity and innovation as desired indicators are still often treated as coexisting constructs with very little attention given to a state of willingness of an individual to even consider contributing ideas. In this research we investigate the influence of knowledge and understanding, perceived radicality, personality dimensions, and favouring of ideas on employee willingness to creatively participate in order to trace its existence in propagation of ideas. A total of 76 construction and non-construction professionals participated in between-subject quasi-experiments. We also proposed IPO-based radicality of ideas construct from the viewpoint of employees involved in the processes of transformation. The research findings show that experts with deep understanding of the work are more likely to contribute highly radical ideas to decision-makers than less knowledgeable employees. Furthermore, personal factors that impact employee willingness to creatively participate have been valued higher than organisational factors. Personality dimensions by The BigFive Inventory have shown no effect on willingness to contribute ideas, while favouring of ideas showed a significant effect. In general, the findings show similarities with some studies of consumer willingness to participate in co-creation processes and thus indicate that firms may be studied as dynamic internal markets of ideas.

Made in Italy. Made in Britain. Quality, brands and innovation in the European poultry market, 1950-1980.

This paper compares the development of the poultry industry in Italy with the UK. Earlier research has suggested that the UK poultry industry developed a symbiotic relationship with the emerging supermarket retailers. Italy had a retarded supermarket sector. Its distribution system favoured small-scale, independent butchers rather than chains of self-service supermarkets. Despite this the Italian poultry industry also modernised, adopting US technologies. The catalyst for this modernisation was technological innovation in refrigeration technologies that enabled Italian consumers and independent retailers to be persuaded of the merits of the new ‘technological’ chicken. While the Italian market has become dominated by AIA and Amadori in recent years, the key innovators were the entrepreneurs that created the company called Arena.

Best practice in the training, appointment and remuneration of members of dispute boards for large infrastructure projects

This paper reports part of a qualitative study into evolving practice in the implementation of the Dispute Adjudication Board (DAB) construction dispute resolution technique, a variant of the Dispute Review Board (DRB) concept used in the US and Canada. Data was collected through a focus group interview of 20 highly experienced dispute resolution practitioners from engineering and the law. The group was assembled from members of FIDIC-NET with direct experience of project DABs. The part reported here concerns practice and procedure for establishing DABs. The main findings are that: constitution of the DABs is often delayed because of either project owners' ignorance of the DAB process or deterrence by the cost of the DABs; such owners also tend to insist on appointing DAB members from local engineers and lawyers without sufficient understanding of the DAB process; rates of remuneration of DAB members vary widely; the training provision for DAB membership and advocacy skills is inadequate; the process of selecting candidates for DAB membership and negotiating the tripartite agreement between each member and the contractual parties needs to be navigated with great care to avoid raising ethical problems. The research contribution is threefold. First, it highlights the importance of realistic fees for DAB members within a standard framework in achieving timely establishment of a board that works well as a team. Second, it illustrates the use of qualitative focus group interview to study the impact of new contract terms from multiple stakeholder perspectives. Finally, it identifies areas where further research is needed.

What Tenants Want: UK occupiers’ requirements when renting commercial property and strategic implications for landlords

Businesses need property in order to generate turnover and profits. If real estate owners are to be able to provide properties and related services that are desirable, it is crucial that they understand tenants’ requirements and preferences. Changes in the way businesses operate might well lead to an overall reduction in space requirements in all sectors. Faced with reductions in demand, landlords will find themselves in an increasingly competitive marketplace for tenants. Of the array of strategies available to landlords, what strategies should they employ for maximum effect? This paper examines what United Kingdom tenants want from commercial property (retail, industrial and office). The first part provides an analysis of data from several hundred interviews with occupiers of commercial properties owned by some of the largest UK real estate investment companies. Results are presented for each of the asset classes separately. The second part compares the findings with previous research and discusses the strategic implications for landlords.

Follow the leaders? An analysis of convergence and innovation of faculty recruiting practices in US business schools

The debate associated with the qualifications of business school faculty has raged since the 1959 release of the Gordon–Howell and Pierson reports, which encouraged business schools in the USA to enhance their legitimacy by increasing their faculties’ doctoral qualifications and scholarly rigor. Today, the legitimacy of specific faculty qualifications remains one of the most discussed topics in management education, attracting the interest of administrators, faculty, and accreditation agencies. Based on new institutional theory and the institutional logics perspective, this paper examines convergence and innovation in business schools through an analysis of faculty hiring criteria. The qualifications examined are academic degree, scholarly publications, teaching experience, and professional experience. Three groups of schools are examined based on type of university, position within a media ranking system, and accreditation by the Association to Advance Collegiate Schools of Business. Data are gathered using a content analysis of 441 faculty postings from business schools based in the USA over two time periods. Contrary to claims of global convergence, we find most qualifications still vary by group, even in the mature US market. Moreover, innovative hiring is more likely to be found in non-elite schools.