Provider diversity in the English NHS: a study of recent developments in four local health economies

Objectives: The overall objective of the research was to assess the impact of provider diversity on quality and innovation in the English NHS. The aims were to map the extent of diverse provider activity, identify the differences in performance between Third Sector Organisations (TSOs), for-profit private enterprises, and incumbent organisations within the NHS, and the factors that affect the entry and growth of new private and TSOs. Methods: Case studies of four Local Health Economies (LHEs). Data included: semi-structured interviews with 48 managerial and clinical staff from NHS organizations and providers from the private and Third Sector; some documentary evidence; a focus group with service users; and routine data from the Care Quality Commission and Companies House. Data collection was mainly between November 2008 and November 2009. Results: Involvement of diverse providers in the NHS is limited. Commissioners’ local strategies influence degrees of diversity. Barriers to the entry for TSOs include lack of economies of scale in the bidding process. Private providers have greater concern to improve patient pathways and patient experience, whereas TSOs deliver quality improvements by using a more holistic approach and a greater degree of community involvement. Entry of new providers drives NHS Trusts to respond by making improvements. Information sharing diminishes as competition intensifies. Conclusions: There is scope to increase the participation of diverse providers in the NHS, but care must be taken not to damage public accountability, overall productivity, equity and NHS providers (especially acute hospitals, which are likely to remain in the NHS) in the process.

Shaping children’s mobilities: expectations of gendered parenting in the English rural idyll

This paper explores the impact of local parenting practices and children's everyday use of public space within two villages in the rural South West of England, an issue that has been underexplored in recent research. Drawing upon the concept of hybridity, it explores the interplay between the social, natural and material in shaping local cultures of rural parenting. The paper begins by drawing upon recent research on parenting in the global North, the gendering of rural space and hybridity to show how these bodies of work can be interlinked to better understand rural parenting practices and norms. Through empirical research that focused on the relationships between gendered parenting strategies, idealised notions of rural motherhood and materiality, the paper explores the diverse ways in which a group of working and middle-class mothers construct and define ideas about their children's lives and mobilities. Whilst dominant discourses of rurality focus upon the idyll, and gendered identities of rural women still remain within the domestic sphere, so we examine how these deeply embedded notions of ‘normality’ can be powerful social tools in rural villages, mobilised through discourses of materiality and anxiety. In our conclusions, we argue that the hybrid integration of the material and social provides a useful framework for understanding the everyday geographies of rural parenting.

The status of literature: English teaching and the condition of literature teaching in schools

Although the curriculum subject of English is continually reviewed and revised in all English speaking countries, the status of literature is rarely questioned i.e. that it is of high cultural value and all students should be taught about it. The concerns of any review, in any country, are typically about what counts as literature, especially in terms of national heritage and then how much of the curriculum should it occupy. This article reports on three inter-related pieces of research that examine the views of in-service, and pre-service, English teachers about their experiences of teaching literature and their perceptions of its ‘status’ and significance at official level and in the actual classroom; it draws attention to how England compares to some other English speaking countries and draws attention to the need to learn from the negative outcomes of political policy in England. The findings suggest that the nature of engagement with literature for teachers and their students has been distorted by official rhetorics and assessment regimes and that English teachers are deeply concerned to reverse this pattern.

A framework for English? Or a vehicle for literacy? English teaching in England in the age of the Strategy

This article considers the evolution and impact on schools in England of the "Framework for English" since its introduction in 2001, a national initiative that follows on from the National Literacy Strategy, which focused on primary schools. Whilst acknowledging that the Framework is part of a whole school policy, "The Key Stage Three Strategy", I concentrate on its direct impact on the school subject "English" and on standards within that subject. Such a discussion must incorporate some consideration of the rise of "Literacy" as a dominant term and theme in England (and globally) and its challenge to a politically controversial and much contested curriculum area, i.e. "English". If the Framework is considered within the context of the Literacy drive since the mid-1990s then it can be see to be evolving within a much changed policy context and therefore likely to change substantially in the next few years. In a global context England has been regarded for some time as at the extreme edge of standards-driven policy and practice. It is hoped that the story of "English" in England may be salutary to educators from other countries.

A case study of sea breeze blocking regulated by sea surface temperature along the English south coast

The sensitivity of sea breeze structure to sea surface temperature (SST) and coastal orography is investigated in convection-permitting Met Office Unified Model simulations of a case study along the south coast of England. Changes in SST of 1 K are shown to significantly modify the structure of the sea breeze immediately offshore. On the day of the case study, the sea breeze was partially blocked by coastal orography, particularly within Lyme Bay. The extent to which the flow is blocked depends strongly on the static stability of the marine boundary layer. In experiments with colder SST, the marine boundary layer is more stable, and the degree of blocking is more pronounced. Although a colder SST would also imply a larger land–sea temperature contrast and hence a stronger onshore wind – an effect which alone would discourage blocking – the increased static stability exerts a dominant control over whether blocking takes place. The implications of prescribing fixed SST from climatology in numerical weather prediction model forecasts of the sea breeze are discussed.