Social impact assessment of a sewerage project in Barbados

This report investigates why a nationally important and internationally funded infrastructural project within the Caribbean island of Barbados — The South Coast Sewerage Project — spurned a substantial level of negative socio-economic externalities. Primary and secondary research evaluated the presence or effectiveness of social impact assessment as a mitigation tool. The mitigation measures suggested within the appraisal report appear to have been considered by the Project Execution Unit (PEU) of Government of Barbados. The primary obstacle seems to have been the implementation of the mitigation process by the contractor. This highlights the need to foster an interconnected and symbiotic relationship between appraisal and implementation, if an initiative is to be conducted efficiently and effectively. Additionally, the South Coast Sewerage Project exemplifies the importance of establishing and sustaining a monitoring/control mechanism as an integral part of project construction.

Dispensing activity in a community pharmacy-based repeat dispensing pilot project

Objective: To measure changes in dispensing activity in a UK repeat dispensing pilot study and to estimate any associated cost savings. Method: Patients were provided with two successive three-monthly repeat prescriptions containing all of the items on their "repeat medicines list" and valid at a study pharmacy. Pharmacists consulted with patients at the time of supply and completed a patient-monitoring form. Prescriptions with pricing data were returned by the UK Prescription Pricing Authority. These data were used to calculate dispensing activity, the cost of dispensed items and an estimate of cost savings on non-dispensed items. A retrospective identification of items prescribed during the six months prior to the project was used to provide a comparison with those dispensed during the project and thus a more realistic estimate of changes. Setting: 350 patients from two medical practices in a large English City, with inner city and suburban locations, and served by seven pharmacies. Key findings: There were methodological challenges in establishing a robust framework for calculating changes. Based on all of the items that patients could have obtained from their repeat list, 23.8% were not dispensed during the intervention period. A correction was then made to allow for a comparison with usage in the six months prior to the study. Based on the corrected data, there was an estimated 11.3% savings in drug costs compared with the pre-intervention period. There was a marked difference in changes between the two practices, the pharmacies and individual patients. The capitation-based remuneration method was acceptable to all but one of the community pharmacists. Conclusion: The repeat dispensing system reduced dispensing volume in comparison with the control period. A repeat dispensing system with a focus on patients' needs and their use of medicines might be cost neutral.

Construction project control in the UK:current practice, existing problems and recommendations for future improvement

The aim of this study is to address the main deficiencies with the prevailing project cost and time control practices for construction projects in the UK. A questionnaire survey was carried out with 250 top companies followed by in-depth interviews with 15 experienced practitioners from these companies in order to gain further insights of the identified problems, and their experience of good practice on how these problems can be tackled. On the basis of these interviews and syntheses with literature, a list of 65 good practice recommendations have been developed for the key project control tasks: planning, monitoring, reporting and analysing. The Delphi method was then used, with the participation of a panel of 8 practitioner experts, to evaluate these improvement recommendations and to establish their degree of relevance. After two rounds of Delphi, these recommendations are put forward as "critical", "important", or "helpful" measures for improving project control practice.