Good dog SPOT? Single pot funding of local voluntary and community groups

This paper reports on a recent pilot project by the English government aimed at introducing 'single pot' funding for local voluntary and community groups. It finds that implementation difficulties undermined the success of the scheme. Moreover, whilst local voluntary and community groups were initially enthusiastic about the scheme, this was eroded both by the shortfall in funding for the initiative and by conflicting priorities for it from its national and regional flinders and from local groups.

An investigation of medicines returned to general practitioners and community pharmacies

Focal points: All returned medicines were monitored in eight community pharmacies and five general medical practices over a four-week period Returns were analysed for the type, quantity, absolute cost of the medicines, original quantity and date dispensed together with the reason for return A total of 298 items was returned to pharmacists and the reason for the return was a change or stop of therapy in 56 per cent of cases; 66 per cent of these were prescribed in a quantity of one month or greater A total of 42 items was returned to GPs and the reason for the return involved a change or stop of the therapy in 54 per cent of cases; 69 per cent of these were prescribed in a quantity of one month or greater Measures to implement a procedure to limit prescribed quantities upon initiation of therapy should help to reduce medicines wastage

Why organizational and community diversity matter:the emergence of incivility and organizational outcomes

Integrating sociological and psychological perspectives, this research considers the value of organizational ethnic diversity as a function of community diversity. Employee and patient surveys, census data, and performance indexes relevant to 142 hospitals in the United Kingdom suggest that intraorganizational ethnic diversity is associated with reduced civility toward patients. However, the degree to which organizational demography was representative of community demography was positively related to civility experienced by patients and ultimately enhanced organizational performance. These findings underscore the understudied effects of community context and imply that intergroup biases manifested in incivility toward out-group members hinder organizational performance.

Undermining patient and public engagement and limiting its impact:the consequences of the Health and Social Care Act 2012 on collective patient and public involvement

Patient and public involvement has been at the heart of UK health policy for more than two decades. This commitment to putting patients at the heart of the British National Health Service (NHS) has become a central principle helping to ensure equity, patient safety and effectiveness in the health system. The recent Health and Social Care Act 2012 is the most significant reform of the NHS since its foundation in 1948. More radically, this legislation undermines the principle of patient and public involvement, public accountability and returns the power for prioritisation of health services to an unaccountable medical elite. This legislation marks a sea-change in the approach to patient and public involvement in the UK and signals a shift in the commitment of the UK government to patient-centred care. © 2013 John Wiley & Sons Ltd.

A comparison of the provision of the My Choice Weight Management Programme via general practitioner practices and community pharmacies in the United Kingdom

This study aimed to assess the effectiveness of a novel, community-based weight management programme delivered through general practitioner (GP) practices and community pharmacies in one city in the United Kingdom. This study used a non-randomized, retrospective, observational comparison of clinical data collected by participating GP practices and community pharmacies. Subjects were 451 overweight or obese men and women resident in areas of high socioeconomic deprivation (82% from black and minority ethnic groups, 86% women, mean age: 41.1 years, mean body mass index [BMI]: 34.5 kg m−2). Weight, waist circumference and BMI at baseline, after 12 weeks and after 9 months were measured. Costs of delivery were also analysed. Sixty-four per cent of participants lost weight after the first 12 weeks of the My Choice Weight Management Programme. There was considerable dropout. Mean percentage weight loss (last observation carried forward) was 1.9% at 12 weeks and 1.9% at final follow-up (9 months). There was no significant difference in weight loss between participants attending GP practices and those attending pharmacies at both 12 weeks and at final follow-up. Costs per participant were higher via community pharmacy which was attributable to better attendance at sessions among community pharmacy participants than among GP participants. The My Choice Weight Management Programme produced modest reductions in weight at 12 weeks and 9 months. Such programmes may not be sufficient to tackle the obesity epidemic.

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.

The MG Rover closure and policy response: an evaluation of the Task Force model in the UK

In recent years there have been a number of high-profile plant closures in the UK. In several cases, the policy response has included setting up a task force to deal with the impacts of the closure. It can be hypothesised that task force involving multi-level working across territorial boundaries and tiers of government is crucial to devising a policy response tailored to people's needs and to ensuring success in dealing with the immediate impacts of a closure. This suggests that leadership, and vision, partnership working and community engagement, and delivery of high quality services are important. This paper looks at the case of the MG Rover closure in 2005, to examine the extent to which the policy response to the closure at the national, regional and local levels dealt effectively with the immediate impacts of the closure, and the lessons that can be learned from the experience. Such lessons are of particular relevance given the closure of the LDV van plant in Birmingham in 2009 and more broadly – such as in the case of the downsizing of the Opel operation in Europe following its takeover by Magna.

Rekindling community spirit and identity:the role of ecoprotestors

One of the features of current society is that of protest against environmental issues and this paper considers protest against road building and the ecoprotest movement. In doing so it considers both the local inhabitants and new age travellers who are involved in such protest to show that not only does ecoprotest, as a form of protest, raise the profile of environmental issues within public discourse but also opens up space for such discourse. Of greater significance is the effect which the ecoprotest, movement has upon a local sense of identity and community. Indeed the travellers themselves, through their action and engagement, demonstrate that the key determinant of community identity is grounded in self-belief and shared aspirations rather than in an externally imposed definition or in any economic imperatives. This paper shows that the migration of this sense of self-belief into mainstream society serves to demonstrate that community spirit and identity are extant in modern society but need a catalyst for their re-emergence. In doing so the role of ecoprotest points towards a possible mechanism for the re-emergence of an active and participatory sense of community identity within society as a whole.

Business and social entrepreneurs in the UK:gender, context and commitment

Purpose – The purpose of this paper is to investigate what sort of people become social entrepreneurs, and in what way they differ from business entrepreneurs. More importantly, to investigate in what socio-economic context entrepreneurial individuals are more likely to become social than business entrepreneurs. These questions are important for policy because there has been a shift from direct to indirect delivery of many public services in the UK, requiring a professional approach to social enterprise. Design/methodology/approach – Evidence is presented from the Global Entrepreneurship Monitor (GEM) UK survey based upon a representative sample of around 21,000 adults aged between 16 and 64 years interviewed in 2009. The authors use logistic multivariate regression techniques to identify differences between business and social entrepreneurs in demographic characteristics, effort, aspiration, use of resources, industry choice, deprivation, and organisational structure. Findings – The results show that the odds of an early-stage entrepreneur being a social rather than a business entrepreneur are reduced if they are from an ethnic minority, if they work ten hours or more per week on the venture, and if they have a family business background; while they are increased if they have higher levels of education and if they are a settled in-migrant to their area. While women social entrepreneurs are more likely than business entrepreneurs to be women, this is due to gender-based differences in time commitment to the venture. In addition, the more deprived the community they live in, the more likely women entrepreneurs are to be social than business entrepreneurs. However, this does not hold in the most deprived areas where we argue civic society is weakest and therefore not conducive to support any form of entrepreneurial endeavour based on community engagement. Originality/value – The paper's findings suggest that women may be motivated to become social entrepreneurs by a desire to improve the socio-economic environment of the community in which they live and see social enterprise creation as an appropriate vehicle with which to address local problems.

Medicines optimisation for young people with juvenile arthritis and other long-term conditions:system-level barriers to engagement

To explore the views of pharmacy and rheumatology stakeholders about system-related barriers to medicines optimisation activities with young people with long-term conditions. A three-phase consensus-building study comprising (1) focus groups with community and hospital pharmacists; (2) semi-structured telephone interviews with lay and professional adolescent rheumatology stakeholders and pharmacy policymakers, and (3) multidisciplinary discussion groups with community and hospital pharmacists and rheumatology staff. Qualitative verbatim transcripts from phases 1 and 2 were subjected to framework analysis. Themes from phase 1 underpinned a briefing for phase 2 interviewees. Themes from phases 1 and 2 generated elements of good pharmacy practice and current/future pharmacy roles for ranking in phase 3. Results from phase 3 prioritisation and ranking exercises were captured on self-completion data collection forms, entered into an Excel spreadsheet and subjected to descriptive statistical analysis. Institutional ethical approval was given by Aston University Health and Life Sciences Research Ethics Committee. Four focus groups were conducted with 18 pharmacists across England, Scotland and Wales (7 hospital, 10 community and 1 community/public health). Fifteen stakeholders took part in telephone interviews (3 pharmacist commissioners; 2 pharmacist policymakers; 2 pharmacy staff members (1 community and 1 hospital); 4 rheumatologists; 1 specialist nurse, and 3 lay juvenile arthritis advocates). Twenty-five participants took part in three discussion groups in adolescent rheumatology centres across England and Scotland (9 community pharmacists; 4 hospital pharmacists; 6 rheumatologists; 5 specialist nurses, and 1 physiotherapist). In all phases of the study, system-level issues were acknowledged as barriers to more engagement with young people and families. Community pharmacists in the focus groups reported that opportunities for engaging with young people were low if parents collected prescriptions alone, which was agreed by other stakeholders. Moreover, institutional/company prescription collection policies – an activity largely disallowed for a young person under 16 without an accompanying parent - were identified by hospital and community pharmacists as barriers to open discussion and engagement. Few community pharmacists reported using Medicines Use Review (England/Wales) or Chronic Medication Service (Scotland) as a medicines optimisation activity with young people; many were unsure about consent procedures. Despite these limitations, rheumatology stakeholders ranked highly the potential of pharmacists empowering young people with general health care skills, such as repeat prescription ordering. The pharmacy profession lacks vision for its role in the care of young people with long-term conditions. Pharmacists and rheumatology stakeholders identified system-level barriers to more engagement with young people who take medicines regularly. We acknowledge that the modest number of participants may have had a specific interest and thus bias for the topic, but this underscores their frank admission of the challenges. Professional guidance and policy, practice frameworks and institutional/company policies must promote flexibility for pharmacy staff to recognise and empower young people who are able to give consent and take responsibility for medicines activities. This will increase mutual confidence and trust, and foster pharmacy’s role in teaching general health care skills. In this way, pharmacists will be able to build long-term relationships with young people and families.