Pharmacy and public health: examining the link between strategy and practice

Despite having been described by the then (2003) Chief Pharmaceutical Officer for England as ·probably the biggest untapped resource for health improvement", the development of the public health function of community pharmacists has been limited. However, devolution of healthcare budgets has led 10 differential rates of development of the public health function in each administration of the UK (England, Scotland, Wales and Northern Ireland). This is measured and reflected upon in this thesis. Two large-scale surveys were conducted, one of key strategic personnel (Directors of Public Health and Chief Pharmacists) in Primary Care Organisations (PCOs) and one of practicing community pharmacists. This research highlights the fact that community pharmacists have developed an individualistic, service-based approach to their engagement with public health that is contrary to the more collective approach adopted by the wider public health movement. The study measures the scope and level of health-improving services through community pharmacy across the UK and shows that the nature of the pharmacy contractor (independent, multiple etc.) may impact on the range and nature of services provided. Survey data also suggest that attitudes towards pharmacy involvement in the public health agenda vary markedly between Directors of Public Health, PCO Chief Pharmacists, and community pharmacists. Furthermore, within the community pharmacist population, attitudes are affected by a wide range of factors including the nature of employment (owner, employee, self-employed) and the type of employing pharmacy (independent, multiple etc.). Implications for policy and areas for further research aimed at maximising the public health function of community pharmacists are suggested.

Organizational commitment profiles and job satisfaction among Greek private and public sector employees

Recent research into organizational commitment has advocated a profiles-based approach. However, with the exception of Wasti, published findings are confined to North American samples. This article examines the relationships between organizational commitment profiles and job satisfaction in Greece. Greek organizations have rarely been the subject of detailed examination, so the study provides baseline information regarding levels of organizational commitment and job satisfaction in Greece. Both private sector (N = 1119) and public sector (N = 476) employees in Greece were surveyed, as this sectoral distinction is regularly associated with different patterns of job-related attitudes. The contrasts between Greek and Anglo-American values present a new challenge to the profiles approach. The results confirm the utility of the profiles approach to the study of organizational commitment. Affective organizational commitment was found to be most influential with respect to levels of intrinsic and extrinsic job satisfaction. This concurs with other studies of the behavioural outcomes of commitment. Copyright © 2007 Sage Publications.

Biologising parenting:neuroscience discourse, English social and public health policy and understandings of the child

In recent years, claims about children's developing brains have become central to the formation of child health and welfare policies in England. While these policies assert that they are based on neuro-scientific discoveries, their relationship to neuroscience itself has been debated. However, what is clear is that they portray a particular understanding of children and childhood, one that is marked by a lack of acknowledgment of child personhood. Using an analysis of key government-commissioned reports and additional advocacy documents, this article illustrates the ways that the mind of the child is reduced to the brain, and this brain comes to represent the child. It is argued that a highly reductionist and limiting construction of the child is produced, alongside the idea that parenting is the main factor in child development. It is concluded that this focus on children's brains, with its accompanying deterministic perspective on parenting, overlooks children's embodied lives and this has implications for the design of children's health and welfare services.

Biologising parenting:neuroscience discourse, English social and public health policy and understandings of the child

In recent years, claims about children's developing brains have become central to the formation of child health and welfare policies in England. While these policies assert that they are based on neuro-scientific discoveries, their relationship to neuroscience itself has been debated. However what is clear is that they portray a particular understanding of children and childhood, one that is marked by a lack of acknowledgment of child personhood. Using an analysis of key government-commissioned reports and additional advocacy documents, this chapter illustrates the ways that the mind of the child is reduced to the brain, and this brain comes to represent the child. It is argued that a highly reductionist and limiting construction of the child is produced, alongside the idea that parenting is the main factor in child development. It is concluded that this focus on children's brains, with its accompanying deterministic perspective on parenting, overlooks children's embodied lives and this has implications for the design of children's health and welfare services.

Health care professionals' views of paediatric outpatient non-attendance:implications for general practice

Background. Non-attendance at paediatric hospital outpatient appointments poses potential risks to children's health and welfare. Prevention and management of missed appointments depends on the perceptions of clinicians and decision makers from both primary and secondary care, including general practitioners (GPs) who are integral to non-attendance follow-up. Objectives. To examine the views of clinical, managerial and executive health care staff regarding occurrence and management of non-attendance at general paediatric outpatient clinics. Methods. A qualitative study using individual semi-structured interviews was carried out at three English Primary Care Trusts and a nearby children's hospital. Interviews were conducted with 37 staff, including GPs, hospital doctors, other health care professionals, managers, executives and commissioners. Participants were recruited through purposive and 'snowball' sampling methods. Data were analysed following a thematic framework approach. Results. GPs focused on situational difficulties for families, while hospital-based staff emphasized the influence of parents' beliefs on attendance. Managers, executives and commissioners presented a broad overview of both factors, but with less detailed views. All groups discussed sociodemographic factors, with non-attendance thought to be more likely in 'chaotic families'. Hospital interviewees emphasized child protection issues and the need for thorough follow-up of missed appointments. However, GPs were reluctant to interfere with parental responsibilities. Conclusion. Parental motivation and practical and social barriers should be considered. Responsibilities regarding missed appointments are not clear across health care sectors, but GPs are uniquely placed to address non-attendance issues and are central to child safeguarding. Primary care policies and strategies could be introduced to reduce non-attendance and ensure children receive the care they require. © The Author 2013.

Outsourcing:assessing the risks and benefits for organisations, sectors and nations

Purpose - This research aims to assess the risks and benefits of outsourcing for organisations, sectors and nations. The literature on outsourcing contains little evidence of research on holistic issues of its impact at systems levels beyond the firm, notably sectors and nations. Design/methodology/approach - A Delphi study with senior strategists from private and public sectors captured perspectives and specific observations on benefits and risks of outsourcing. Emergent issues on outsourcing policy, strategy and decision-making processes were synthesised into a framework for analysing factors associated with outsourcing. Findings - The findings suggest that a more holistic view of outsourcing is needed, linking local, organisational issues with sector and national level actions and outcomes. In this way, aggregate risks and benefits can be assessed at different systems levels. Research limitations/implications - Future research might address the motivations for outsourcing; currently there is little research evidence to assess whether outsourcing is a mechanism for failing to solve internal problems, and moving responsibility and risk out of the firm. Additionally most outsourcing research to date has concentrated on an activity either being "in" or "out"; there is little research exploring the circumstances in which mixed models might be appropriate. Practical implications - The framework provides an aid to research and an aide memoire for managers considering outsourcing. Originality/value - This paper contributes to knowledge on understanding of outsourcing at different systems levels, particularly highlighting the implications of outsourcing for sectors and nations. Previously most research has focused at the level of the firm or dyadic relationship. © Emerald Group Publishing Limited.

Community pharmacists' engagement with public health in Great Britain

Objective - The objective of the research was to examine to what extent community pharmacists in Great Britain believed that their job was concerned with local public health issues. Methods - The project (Pharmacy and Public Health)received ethical approval from the Research Ethics Committee of the School of Life and Health Sciences at Aston University. After piloting, in August 2006 a self-completion postal questionnaire was sent to practicing community pharmacists in Great Britain (n=1998), with a follow-up to non-responders 4 weeks later. A final response rate of 51% (n=1023/1998) was achieved. Results - Respondents were asked to indicate their answer to the question “to what extent is your present job concerned with local public health issues?” on a three-point scale – “highly”, “slightly” or “not at all” concerned with public health. They were also asked to indicate whether they were pharmacy owners, employee pharmacists or self-employed locum pharmacists. Less than half (43%,n=384/898) of respondents answering both questions believed that their job was highly concerned with public health. A relationship was observed between employment status and the level to which a respondent believed that their job was concerned with public health (chi-square test with P=0.001). Over half of pharmacy owners (51%, n=68/134) considered that their job was highly concerned with public health compared to44% (n=193/443) of employee pharmacists and38% (n=123/321) of locum pharmacists. Conclusion - This research suggests that community pharmacists in Great Britain are not ‘fully engaged’ with public health. Pharmacy owners may feel more enfranchised in the public health movement than their employees and locums. Indeed, one-in-ten locums reported that their job was not at all concerned with public health which, as locum pharmacists constitute over a third of actively employed community pharmacists, could be limiting factor in any drive to strengthen the public health function of community pharmacists.

Human resource management in the Indian public and private sectors:an empirical comparison

This study compares human resource management (HRM) practices in Indian public- and private-sector organizations. The investigation is based on a questionnaire survey of 137 large manufacturing firms (public sector = 81: private sector = 56). The key areas of analysis include the structure of human resource (HR) department, the role of HR function in corporate change, recruitment and selection, pay and benefits, training and development, employee relations and emphasis on key HRM strategies. Internal labour markets (ILMs) are used to make the comparative analysis. The statistical results show a number of similarities and differences in the HRM systems of Indian public-and private-sector organizations. Against the established notion, the results of this study reveal that the gap between Indian private- and public-sector HRM practices is not very significant. Moreover, in a few HR functional areas (for example, compensation and training and development), Indian private-sector firms have adopted a more rational approach than their public-sector counterparts. © 2004 Taylor and Francis Ltd.

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.

The link between job satisfaction and organizational commitment:differences between public and private sector employees

Employees in the public and private sectors experience different working conditions and employment relationships. Therefore, it can be assumed that their attitudes toward their job and organizations, and relationships between them, are different. The existing literature has identified the relationship between organizational commitment and job satisfaction as interesting in this context. The present field study examines the satisfaction–commitment link with respect to differences between private and public sector employees. A sample of 617 Greek employees (257 from the private sector and 360 from the public sector) completed standardized questionnaires. Results confirmed the hypothesized relationship differences: Extrinsic satisfaction and intrinsic satisfaction are more strongly related to affective commitment and normative commitment for public sector employees than for private sector ones. The results are discussed, limitations are considered, and directions for future research are proposed.