The corporatization of community pharmacy:implications for service provision, the public health function, and pharmacy's claims to professional status in the United Kingdom

Background Pharmacy has experienced both incomplete professionalization and deprofessionalization. Since the late 1970s, a concerted attempt has been made to re-professionalize pharmacy in the United Kingdom (UK) through role extension—a key feature of which has been a drive for greater pharmacy involvement in public health. However, the continual corporatization of the UK community pharmacy sector may reduce the professional autonomy of pharmacists and may threaten to constrain attempts at reprofessionalization. Objectives The objectives of the research: to examine the public health activities of community pharmacists in the UK; to explore the attitudes of community pharmacists toward recent relevant UK policy and barriers to the development of their public health function; and, to investigate associations between activity, attitudes, and the type of community pharmacy worked in (eg, supermarket, chain, independent). Methods A self-completion postal questionnaire was sent to a random sample of practicing community pharmacists, stratified for country and sex, within Great Britain (n = 1998), with a follow-up to nonresponders 4 weeks later. Data were analyzed using SPSS (SPSS Inc., Chicago, IL, USA) (v12.0). A final response rate of 51% (n = 1023/1998) was achieved. Results The level of provision of emergency hormonal contraception on a patient group direction, supervised administration of medicines, and needle-exchange schemes was lower in supermarket pharmacies than in the other types of pharmacy. Respondents believed that supermarkets and the major multiple pharmacy chains held an advantageous position in terms of attracting financing for service development despite suggesting that the premises of such pharmacies may not be the most suitable for the provision of such services. Conclusions A mixed market in community pharmacy may be required to maintain a comprehensive range of pharmacy-based public health services and provide maximum benefit to all patients. Longitudinal monitoring is recommended to ensure that service provision is adequate across the pharmacy network.

Internationalization in a business school:co-existing and entwined professional and organizational narratives

This empirical paper adopts a narrative approach to explain how a strategic goal of internationalization within a UK business school developed over a three year period and in particular how two conflicting institutional logics - a market logic and a professional logic - were given meaning and played out within a specific organizational context. The paper is in four parts. First, the theoretical framework explains the business school as characteristic of a professional organization, with a professional academic workforce, ambiguous strategic goals and multiple competing but legitimate demands. We then frame our methodological approach of narrative as a means of understanding how professional actors are co-opted into enabling organizational goals, even where these are perceived as antithetical to professional interests. We do this by showing how actors within organizations that exist with multiple, potentially competing institutional logics draw upon those logics and embed them in narratives to give meaning to their actions. Second, the research design, which followed the pursuit of an internationalization goal within a UK business school over three years, based on a dataset of three rounds of interviews, documentary analysis and meeting observations is explained, showing how we used a narrative approach for analysis. Third the results are presented as a series of co-existing and entwined narratives: organizational/managerial narratives, professional narratives of resistance, and professional narratives of engagement. Finally our findings show that narrative is a useful theoretical lens for explaining how multiple, ambiguous and conflicting strategic goals within professional organizations may coexist, enabling the organization to act both as a collective unit and also to fulfil the sometimes contradictory professional interests of its constituents. These findings contribute to understanding about strategy in professional organizations and also to narrative theory by showing how organizations may comprise multiple, entwined narratives, in which actors change roles according to their varying interests in the 'central' narrative.

Can accreditation help a leopard change its spots? Social accountability and stakeholder engagement in business schools

Purpose: Neo-institutional theory suggests that organisations change occurs when institutional contradictions, caused by exogenous and endogenous dynamics, increase over time to the point where change can no longer be resisted. Human praxis will result, but only when sufficiently powerful interests are motivated to act. This paper aims to examine the role that the accreditation of business schools can play in increasing institutional contradictions and hence fostering organisational change towards stakeholder engagement and engagement with social responsibility and sustainability issues. Numerous accreditations are promulgated within the higher education and business school contexts and a number of these relate to, or have aspects that relate to, ethics, social responsibility and sustainability. Design/methodology/approach: The paper first analyses the take up of accreditations across UK business schools and then uses a case study to illustrate and explore stakeholder engagement and changes related to ethics, social responsibility and sustainability linked to accreditation processes. Findings: Accreditations are found to be an increasingly common interest for UK business schools. Further, a number of these accreditations have evolved to incorporate issues related to ethics, social responsibility and sustainability that may cause institutional contradictions and may, therefore, have the potential to foster organisational change. Accreditation alone, however, is not sufficient and the authors find that sufficiently powerful interests need to be motivated to act and enable human praxis to affect change. Research limitations/implications: This paper draws on previous research that considers the role of accreditation in fostering change that has also been carried out in healthcare organisations, public and professional bodies. Its findings stem from an individual case study and as such further research is required to explore whether these findings can be extended and apply more generally in business schools and universities in different contexts. Practical implications: This paper concludes by recommending that the newly established UK & Ireland Chapter of PRME encourages and supports signatory schools to further embed ethics, social responsibility and sustainability into all aspects of university life in the UK. This also provides an opportunity to engage with the accrediting bodies in order to further support the inclusion of stakeholder engagement and issues related to this agenda in their processes. Originality/value: This paper contributes by introducing accreditation as an institutional pressure that may lead indirectly to organisational change and supports this with new evidence from an illustrative case study. Further, it draws on the role of institutional contradictions and human praxis that engender organisational change. © Emerald Group Publishing Limited.

Professionalism within pharmacy – the thoughts of Professional Leaders

To ascertain the thoughts of selected professional leaders on matters relating to pharmacist professionalism. These views will help build a picture of the professional status of pharmacy. Methods - Semi-structured interviews were conducted between July and November 2013 with representatives from eight UK pharmacy leadership bodies. The bodies were selected for their roles in pharmacy policy development, regulation and professional representation. The interviews were recorded and transcribed verbatim. Analysis by constant comparison identified a number of emerging themes. Results - The following emerging themes were identified from the interview data: Influence of the Pharmacy Landscape: Participants highlighted the role that pharmacy plays within the National Health Service and wider society and how future developments may affect the professional status currently afforded to pharmacists. Vocalising Pharmacy: Communication within the profession and also with those external to the profession, including other healthcare professionals and the general public, is important to ensure a high professional standing. The Impact of Commercialism: Professionalism and commercialism were generally seen to be antithetical and a rise in commercialism may adversely impact on external perceptions of the professionalism of pharmacy. Responsibility for Professionalism: The professional image of pharmacy is maintained by the individuals operating within it regardless of their scope of practice. It is the responsibility of all those individuals to ensure that they actively demonstrate ‘professional’ behaviours. The Journey to Professionalism: Acquiring a professional ethos is a continual process but there are stages in a pharmacist’s development that are considered particularly important. These include upbringing, undergraduate education and pre-registration training. Conclusions - Pharmacy’s professional status in the UK remains open to challenge and vital to retaining that status is the public perception of pharmacists. Future research examining pharmacy’s claims to professional status should focus on exploring the attitudes of the general public in addition to the views of pharmacists.

Exploring how social workers experience and cope with public perception of their profession

The public’s perception of the social work profession is a rarely considered perspective, and yet a topic that is a concern to front Thepublic’sperceptionofthesocialworkprofessionisararelyconsideredperspective and yet a topic that is a concern to front line professionals. This paper explores how social workers experience and attempt to cope with public perception of their profession. It highlights the impact of these concerns on social workers’ personal experiences and professional practice. Using semi-structured interviews with sixteen UK social workers, from local authorities and private organisations,we explore the experiences of this group.Thematic analysis of the data identified four concerns: the experience of public perception, drivers of public perception, coping with public perception, and mechanisms to raise the professions profile. Examining public perception through the eyes of social workers provides valuable insights into the lived experiences of these professionals, and offers practical implications at both the micro and macro levels. It reveals two key ways in which the profession can begin to address the prevailing negative perception considered to be emanating from the public: through developing a more co-operative relationship with external sources of public perception (e.g. government and the media) and by engaging in more pro-active self-promotion of the service.

Web designers, social e-value creation and e-business planning:understanding resistance from conflicting demands

This chapter investigates the conflicting demands faced by web designers in the development of social e-atmospherics that aim to encourage e-value creation, thus strengthening and prolonging market planning strategies. While recent studies have shown that significant shifts are occurring concerning the importance of users’ generated content by way of social e-communication tools (e.g. blogs), these trends are also creating expectations that social and cultural cues ought to become a greater part of e-atmospherics and e-business strategies. Yet, there is growing evidence that organizations are resisting such efforts, fearing that they will lose control of their e-marketing strategy. This chapter contributes to the theory and literature on online cross-cultural understanding and the impact website designers (meso-level) can have on improving the sustainability of e-business planning, departing from recent studies that focus mainly on firms’ e-business plans (macro-level) or final consumers (micro-level). A second contribution is made with respect to online behavior regarding the advancement of technologies that facilitate the development and shaping of new social e-atmospherics that affect users’ behavior and long term e-business strategies through the avoidance of traditional, formal decision making processes and marketing strategy mechanisms implemented by firms. These issues have been highlighted in the literature on the co-production and co-creation of value, which few organizations have thus far integrated in their strategic and pragmatic e-business plans. Drawing upon fifteen online interviews with web designers in the USA, as key non-institutional actors at the meso-level who are developing what future websites will be like, this chapter analyzes ways in which identifying points of resistance and conflicting demands can lead to engagement with the debate over the online co-creation of value and more sustainable future e-business planning. A number of points of resistance to the inclusion of more e-social atmospherics are identified, and the implications for web designers’ roles and web design planning are discussed along with the limitations of the study and potential future research for e-business studies.

Corporate social responsibility reporting in the mining sector of Tanzania:(Lack of) government regulatory controls and NGO activism

Purpose – The purpose of this paper is to contribute to the ongoing debate on governance, accountability, transparency and corporate social responsibility (CSR) in the mining sector of a developing country context. It examines the reporting practices of the two largest transnational gold-mining companies in Tanzania in order to draw attention to the role played by local government regulations and advocacy and campaigning by nationally organised non-governmental organisations (NGOs) with respect to promoting corporate social reporting practices. Design/methodology/approach – The paper takes a political economy perspective to consider the serious implications of the neo-liberal ideologies of the global capitalist economy, as manifested in Tanzania’s regulatory framework and in NGO activism, for the corporate disclosure, accountability and responsibility of transnational companies (TNCs). A qualitative field case study methodology is adopted to locate the largely unfamiliar issues of CSR in the Tanzanian mining sector within a more familiar literature on social accounting. Data for the case study were obtained from interviews and from analysis of documents such as annual reports, social responsibility reports, newspapers, NGO reports and other publicly available documents. Findings – Analysis of interviews, press clips and NGO reports draws attention to social and environmental problems in the Tanzanian mining sector, which are arguably linked to the manifestation of the broader crisis of neo-liberal agendas. While these issues have serious impacts on local populations in the mining areas, they often remain invisible in mining companies’ social disclosures. Increasing evidence of social and environmental ills raises serious questions about the effectiveness of the regulatory frameworks, as well as the roles played by NGOs and other pressure groups in Tanzania. Practical implications – By empowering local NGOs through educational, capacity building, technological and other support, NGOs’ advocacy, campaigning and networking with other civil society groups can play a pivotal role in encouraging corporations, especially TNCs, to adopt more socially and environmentally responsible business practices and to adhere to international and local standards, which in turn may help to improve the lives of many poor people living in developing countries in general, and Tanzania in particular. Originality/value – This paper contributes insights from gold-mining activities in Tanzania to the existing literature on CSR in the mining sector. It also contributes to political economy theory by locating CSR reporting within the socio-political and regulatory context in which mining operations take place in Tanzania. It is argued that, for CSR reporting to be effective, robust regulations and enforcement and stronger political pressure must be put in place.