Cost-based pricing in the NHS internal market : accounting choices and the achievement of economic efficiency

Since 1988, quasi-markets have been introduced into many areas of social policy in the UK, the NHS internal market is one example. Markets operate by price signals. The NHS Internal Market, if it is to operate efficiently, requires purchasers and providers to respond to price signals. The research hypothesis is - cost accounting methods can be developed to enable healthcare contracts to be priced on a cost-basis in a manner which will facilitate the achievement of economic efficiency in the NHS internal market. Surveys of hospitals in 1991 and 1994 established the cost methods adopted in deriving the prices for healthcare contracts in the first year of the market and three years on. An in-depth view of the costing for pricing process was gained through case studies. Hospitals had inadequate cost information on which to price healthcare contracts at the inception of the internal market: prices did not reflect the relative performance of healthcare providers sufficiently closely to enable the market's espoused efficiency aims to be achieved. Price variations were often due to differing costing approaches rather than efficiency. Furthermore, price comparisons were often meaningless because of inadequate definition of the services (products). In April 1993, the NHS Executive issued guidance on costing for contracting to all NHS providers in an attempt to improve the validity of price comparisons between alternative providers. The case studies and the 1994 survey show that although price comparison has improved, considerable problems remain. Consistency is not assured, and the problem of adequate product definition is still to be solved. Moreover, the case studies clearly highlight the mismatch of rigid, full-cost pricing rules with both the financial management considerations at local level and the emerging internal market(s). Incentives exist to cost-shift, and healthcare prices can easily be manipulated. In the search for a new health policy paradigm to replace traditional bureaucratic provision, cost-based pricing cannot be used to ensure a more efficient allocation of healthcare resources.

Cost models for engineering services

This thesis describes the procedure and results from four years research undertaken through the IHD (Interdisciplinary Higher Degrees) Scheme at Aston University in Birmingham, sponsored by the SERC (Science and Engineering Research Council) and Monk Dunstone Associates, Chartered Quantity Surveyors. A stochastic networking technique VERT (Venture Evaluation and Review Technique) was used to model the pre-tender costs of public health, heating ventilating, air-conditioning, fire protection, lifts and electrical installations within office developments. The model enabled the quantity surveyor to analyse, manipulate and explore complex scenarios which previously had defied ready mathematical analysis. The process involved the examination of historical material costs, labour factors and design performance data. Components and installation types were defined and formatted. Data was updated and adjusted using mechanical and electrical pre-tender cost indices and location, selection of contractor, contract sum, height and site condition factors. Ranges of cost, time and performance data were represented by probability density functions and defined by constant, uniform, normal and beta distributions. These variables and a network of the interrelationships between services components provided the framework for analysis. The VERT program, in this particular study, relied upon Monte Carlo simulation to model the uncertainties associated with pre-tender estimates of all possible installations. The computer generated output in the form of relative and cumulative frequency distributions of current element and total services costs, critical path analyses and details of statistical parameters. From this data alternative design solutions were compared, the degree of risk associated with estimates was determined, heuristics were tested and redeveloped, and cost significant items were isolated for closer examination. The resultant models successfully combined cost, time and performance factors and provided the quantity surveyor with an appreciation of the cost ranges associated with the various engineering services design options.

Development of multiphase and multiscale mathematical models for thermal spray process

High velocity oxyfuel (HVOF) thermal spraying is one of the most significant developments in the thermal spray industry since the development of the original plasma spray technique. The first investigation deals with the combustion and discrete particle models within the general purpose commercial CFD code FLUENT to solve the combustion of kerosene and couple the motion of fuel droplets with the gas flow dynamics in a Lagrangian fashion. The effects of liquid fuel droplets on the thermodynamics of the combusting gas flow are examined thoroughly showing that combustion process of kerosene is independent on the initial fuel droplet sizes. The second analysis copes with the full water cooling numerical model, which can assist on thermal performance optimisation or to determine the best method for heat removal without the cost of building physical prototypes. The numerical results indicate that the water flow rate and direction has noticeable influence on the cooling efficiency but no noticeable effect on the gas flow dynamics within the thermal spraying gun. The third investigation deals with the development and implementation of discrete phase particle models. The results indicate that most powder particles are not melted upon hitting the substrate to be coated. The oxidation model confirms that HVOF guns can produce metallic coating with low oxidation within the typical standing-off distance about 30cm. Physical properties such as porosity, microstructure, surface roughness and adhesion strength of coatings produced by droplet deposition in a thermal spray process are determined to a large extent by the dynamics of deformation and solidification of the particles impinging on the substrate. Therefore, is one of the objectives of this study to present a complete numerical model of droplet impact and solidification. The modelling results show that solidification of droplets is significantly affected by the thermal contact resistance/substrate surface roughness.

Going green: prospects for SME's to attain ISO 14001 and the challenges they face in the process

This research aimed to identify any common factors that have enabled and/or motivated SMEs to successfully implement ISO 14001 whilst the majority have not. It also identified what challenges and barriers SMEs face in doing so and how some have overcome these. The existing literature suggests that the majority of SMEs perceive their environmental impacts to be proportional to their size; have a poor understanding of environmental issues; have a poor awareness of environmental regulations; do that have the necessary expertise or leadership to address environmental issues and that SMEs with an environmental management system such as ISO 14001 are very much the minority. The main factors that influenced whether an SME had implemented ISO 14001 were: competitive advantage, regulatory compliance, supply chain pressures, leadership, expertise, resources and external support. This research used qualitative analysis of interviews with managers and directors from 8 SMEs with ISO 14001 and 4 without. All of the SMEs were based in the West Midlands or Staffordshire. Interviews were also conducted with 3 organisations offering support to businesses on environmental issues and with 1 large business who was engaging their suppliers (which included SMEs within this sample) on environmental issues. The research found that there were four main factors that enabled or motivated the SMEs to implement ISO 14001, these were: leadership, supply chain pressures, external support and SMEs' history and experience of accredited management systems. The main challenges that these business had to overcome and that prevented the other SMEs from achieving ISO 14001 were: achieving regulatory compliance, perceived financial cost, lack of perceived competitive advantage, access to relevant and affordable support and for those SMEs without ISO 14001 there was very little perceived external pressure or need for them to do so.

Computer aided design and manufacture of form-rolls

Cold roll forming of thin-walled sections is a very useful process in the sheet metal industry. However, the conventional method for the design and manufacture of form-rolls, the special tooling used in the cold roll forming process, is a very time consuming and skill demanding exercise. This thesis describes the establishment of a stand-alone minicomputer based CAD/CAM system for assisting the design and manufacture of form-rolls. The work was undertaken in collaboration with a leading manufacturer of thin-walled sections. A package of computer programs have been developed to provide computer aids for every aspect of work in form-roll design and manufacture. The programs have been successfully implemented, as an integrated CAD/CAM software system, on the ICL PERQ minicomputer with graphics facilities. Thus, the developed CAD/CAM system is a single-user workstation, with software facilities to help the user to perform the conventional roll design activities including the design of the finished section, the flower pattern, and the form-rolls. A roll editor program can then be used to modify, if required, the computer generated roll profiles. As far as manufacturing is concerned, a special-purpose roll machining program and postprocessor can be used in conjunction to generate the NC control part-programs for the production of form-rolls by NC turning. Graphics facilities have been incorporated into the CAD/CAM software programs to display drawings interactively on the computer screen throughout all stages of execution of the CAD/CAM software. It has been found that computerisation can shorten the lead time in all activities dealing with the design and manufacture of form-rolls, and small or medium size manufacturing companies can gain benefits from the CAD/CM! technology by developing, according to its own specification, a tailor-made CAD/CAM software system on a low cost minicomputer.

Cost effectiveness of production control systems

This thesis deals with the problems associated with the planning and control of production, with particular reference to a small aluminium die casting company. The main problem areas were identified as: (a) A need to be able to forecast the customers demands upon the company's facilities. (b) A need to produce a manufacturing programme in which the output of the foundry (or die casting section) was balanced with the available capacity in the machine shop. (c) The need to ensure that the resultant system enabled the company's operating budget to have a reasonable chance of being achieved. At the commencement of the research work the major customers were members of the automobile industry and had their own system of forecasting, from which they issued manufacturing schedules to their component suppliers, The errors in the forecast were analysed and the distributions noted. Using these distributions the customer's forecast was capable of being modified to enable his final demand to be met with a known degree of confidence. Before a manufacturing programme could be developed the actual manufacturing system had to be reviewed and it was found that as with many small companies there was a remarkable lack of formal control and written data. Relevant data with regards to the component and the manufacturing process had therefore to be collected and analysed. The foundry process was fixed but the secondary machining operations were analysed by a technique similar to Component Flow Analysis and as a result the machines were arranged in a series of flow lines. A system of manual production control was proposed and for comparison, a local computer bureau was approached and a system proposed incorporating the production of additional management information. These systems are compared and the relative merits discussed and a proposal made for implementation.

Public sector investment appraisal:the place of flexibility in the decision making process

This thesis reviews the main methodological developments in public sector investment appraisal and finds growing evidence that appraisal techniques are not fulfilling their earlier promise. It is suggested that an important reason for this failure lies in the inability of these techniques to handle uncertainty except in a highly circumscribed fashion. It is argued that a more fruitful approach is to strive for flexibility. Investment projects should be formulated with a view to making them responsive to a wide range of possible future events, rather than embodying a solution which is optimal for one configuration of circumstances only. The distinction drawn in economics between the short and the long run is used to examine the nature of flexibility. The concept of long run flexibility is applied to the pre-investment range of choice open to the decisionmaker. It is demonstrated that flexibility is reduced at a very early stage of decisionmaking by the conventional system of appraisal which evaluates only a small number of options. The pre-appraisal filtering process is considered further in relation to decisionmaking models. It is argued that for public sector projects the narrowing down of options is best understood in relation to an amended mixed scanning model which places importance on the process by which the 'national interest ' is determined. Short run flexibility deals with operational characteristics, the degree to which particular projects may respond to changing demands when the basic investment is already in place. The tension between flexibility and cost is noted. A short case study on the choice of electricity generating plant is presented. The thesis concludes with a brief examination of the approaches used by successive British governments to public sector investment, particularly in relation to the nationalised industries

A low-cost remote sensing system for agricultural applications

This research develops a low cost remote sensing system for use in agricultural applications. The important features of the system are that it monitors the near infrared and it incorporates position and attitude measuring equipment allowing for geo-rectified images to be produced without the use of ground control points. The equipment is designed to be hand held and hence requires no structural modification to the aircraft. The portable remote sensing system consists of an inertia measurement unit (IMU), which is accelerometer based, a low-cost GPS device and a small format false colour composite digital camera. The total cost of producing such a system is below GBP 3000, which is far cheaper than equivalent existing systems. The design of the portable remote sensing device has eliminated bore sight misalignment errors from the direct geo-referencing process. A new processing technique has been introduced for the data obtained from these low-cost devices, and it is found that using this technique the image can be matched (overlaid) onto Ordnance Survey Master Maps at an accuracy compatible with precision agriculture requirements. The direct geo-referencing has also been improved by introducing an algorithm capable of correcting oblique images directly. This algorithm alters the pixels value, hence it is advised that image analysis is performed before image georectification. The drawback of this research is that the low-cost GPS device experienced bad checksum errors, which resulted in missing data. The Wide Area Augmented System (WAAS) correction could not be employed because the satellites could not be locked onto whilst flying. The best GPS data were obtained from the Garmin eTrex (15 m kinematic and 2 m static) instruments which have a highsensitivity receiver with good lock on capability. The limitation of this GPS device is the inability to effectively receive the P-Code wavelength, which is needed to gain the best accuracy when undertaking differential GPS processing. Pairing the carrier phase L1 with the pseudorange C/A-Code received, in order to determine the image coordinates by the differential technique, is still under investigation. To improve the position accuracy, it is recommended that a GPS base station should be established near the survey area, instead of using a permanent GPS base station established by the Ordnance Survey.

Developing and evaluating a methodology for business process improvement

Purpose – There appears to be an ever-insatiable demand from markets for organisations to improve their products and services. To meet this, there is a need to provide business process improvement (BPI) methodologies that are holistic, structured and procedural. Therefore, this paper describes research that has formed and tested a generic and practical methodology termed model-based and integrated process improvement (MIPI) to support the implementation of BPI; and to validate its effectiveness in organisations. This methodology has been created as an aid for practitioners within organisations. Design/methodology/approach – The research objectives were achieved by: reviewing and analysing current methodologies, and selecting a few frameworks against key performance indicators. Using a refined Delphi approach and semi-structured interview with the “experts” in the field. Intervention, case study and process research approach to evaluating a methodology. Findings – The BPI methodology was successfully formed and applied by the researcher and directly by the companies involved against the criteria of feasibility, usability and usefulness. Research limitations/implications – The paper has demonstrated a new knowledge on how to systematically assess a BPI methodology in practice. Practical implications – Model-based and integrated process improvement methodology (MIPI) methodology offers the practitioner (experienced and novice) a set of step-by-step aids necessary to make informed, consistent and efficient changes to business processes. Originality/value – The novelty of this research work is the creation of a holistic workbook-based methodology with relevant tools and techniques. It extends the capabilities of existing methodologies.

Minimizing nasty surprises with better informed decision-making in self-adaptive systems

Designers of self-adaptive systems often formulate adaptive design decisions, making unrealistic or myopic assumptions about the system's requirements and environment. The decisions taken during this formulation are crucial for satisfying requirements. In environments which are characterized by uncertainty and dynamism, deviation from these assumptions is the norm and may trigger 'surprises'. Our method allows designers to make explicit links between the possible emergence of surprises, risks and design trade-offs. The method can be used to explore the design decisions for self-adaptive systems and choose among decisions that better fulfil (or rather partially fulfil) non-functional requirements and address their trade-offs. The analysis can also provide designers with valuable input for refining the adaptation decisions to balance, for example, resilience (i.e. Satisfiability of non-functional requirements and their trade-offs) and stability (i.e. Minimizing the frequency of adaptation). The objective is to provide designers of self adaptive systems with a basis for multi-dimensional what-if analysis to revise and improve the understanding of the environment and its effect on non-functional requirements and thereafter decision-making. We have applied the method to a wireless sensor network for flood prediction. The application shows that the method gives rise to questions that were not explicitly asked before at design-time and assists designers in the process of risk-aware, what-if and trade-off analysis.

Solar thermal collectors for use in hybrid solar-biomass power plants in India

This thesis examined solar thermal collectors for use in alternative hybrid solar-biomass power plant applications in Gujarat, India. Following a preliminary review, the cost-effective selection and design of the solar thermal field were identified as critical factors underlying the success of hybrid plants. Consequently, the existing solar thermal technologies were reviewed and ranked for use in India by means of a multi-criteria decision-making method, the Analytical Hierarchy Process (AHP). Informed by the outcome of the AHP, the thesis went on to pursue the Linear Fresnel Reflector (LFR), the design of which was optimised with the help of ray-tracing. To further enhance collector performance, LFR concepts incorporating novel mirror spacing and drive mechanisms were evaluated. Subsequently, a new variant, termed the Elevation Linear Fresnel Reflector (ELFR) was designed, constructed and tested at Aston University, UK, therefore allowing theoretical models for the performance of a solar thermal field to be verified. Based on the resulting characteristics of the LFR, and data gathered for the other hybrid system components, models of hybrid LFR- and ELFR-biomass power plants were developed and analysed in TRNSYS®. The techno-economic and environmental consequences of varying the size of the solar field in relation to the total plant capacity were modelled for a series of case studies to evaluate different applications: tri-generation (electricity, ice and heat), electricity-only generation, and process heat. The case studies also encompassed varying site locations, capacities, operational conditions and financial situations. In the case of a hybrid tri-generation plant in Gujarat, it was recommended to use an LFR solar thermal field of 14,000 m2 aperture with a 3 tonne biomass boiler, generating 815 MWh per annum of electricity for nearby villages and 12,450 tonnes of ice per annum for local fisheries and food industries. However, at the expense of a 0.3 ¢/kWh increase in levelised energy costs, the ELFR increased saving of biomass (100 t/a) and land (9 ha/a). For solar thermal applications in areas with high land cost, the ELFR reduced levelised energy costs. It was determined that off-grid hybrid plants for tri-generation were the most feasible application in India. Whereas biomass-only plants were found to be more economically viable, it was concluded that hybrid systems will soon become cost competitive and can considerably improve current energy security and biomass supply chain issues in India.

When cost-efficient technologies meet politics:a case study of radical wireless network implementation

Cost efficiency has been a dominant perspective in the traditional IT literature. However, in complex technology and business environment, the widely recognized cost efficient assumption of information technology has been increasingly challenged. Drawing from a case study of wireless network implementation situated in a politically sensitive workplace, this paper provided practice insights for IT managers in today’s networked economy. More specifically, stories experienced in the case study illustrated that despite well-calculated cost efficiency of wireless network infrastructure, the radical implementation process in the case organization encountered enormous challenges and opposition due to the fact that administrators failed to consider various stakeholders’ positions and interests. Eventually, the implementation objectives and outcome were considerably undermined. Implications from this empirical case research reemphasized the significance of understanding political forces situated in any business environment where different stakeholders hold conflicting interests. Lessons learned from the case story further encouraged IT managers and policy makers to better strategize emerging information technology in general and wireless networks in particular as the whole global society and business environment are increasingly facing an emerging wireless world.

Public participation by appeal - insights from empirical evaluation in Finland

Environmental law increasingly provides for participatory rights, including appeal rights, to ensure informed, legitimate decision-making. Despite consensus around the general need for participatory rights, including strong ones such as a right to appeal, public participation in environmental decision-making is often criticised. The critics' main argument is that the negative side effects resulting particularly from the use of strong participatory rights outweigh their benefits. Recent regulatory trends arising from better regulation policy to make environmental decision-making more cost-efficient tend to pay special attention to such arguments despite limited empirical evidence. This article provides evidence using material-concerning appeals against pollution permits in Finland and suggests that judicial review is a necessary and effective process for both protecting citizens' rights and improving the quality of environmental protection. © The Author [2008]. Published by Oxford University Press. All rights reserved.

Fiber bragg gratings:advances in fabrication process and tools

Successful commercialization of a technology such as Fiber Bragg Gratings requires the ability to manufacture devices repeatably, quickly and at low cost. Although the first report of photorefractive gratings was in 1978 it was not until 1993, when phase mask fabrication was demonstrated, that this became feasible. More recently, draw tower fabrication on a production level and grating writing through the polymer jacket have been realized; both important developments since they preserve the intrinsic strength of the fiber. Potentially the most significant recent development has been femtosecond laser inscription of gratings. Although not yet a commercial technology, it provides the means of writing multiple gratings in the optical core providing directional sensing capability in a single fiber. Femtosecond processing can also be used to machine the fiber to produce micronscale slots and holes enhancing the interaction between the light in the core and the surrounding medium. © 2011 Bentham Science Publishers Ltd. All rights reserved.

B2B e-marketplaces in the airline industry:process drivers and performance indicators

Competitive pressures are increasing within and between different strategically oriented groups of airlines. This paper focuses on the level of efficiency improvements gained by using e-Marketplaces in the procurement process. Findings from a survey among 88 international airlines reveal that the use of Business-to-Business (B2B) e-Marketplaces does play different roles across the various airline groupings. Airlines that are involved in strategic alliances show higher joint procurement activities than airlines that are not involved in strategic alliances. However, alliances are probably viewed as loose arrangements and thus airlines may be reluctant to share information on procurement prices and processes with another airline that could also be acting as a competitor. The financial involvement in or initiation of e-Marketplaces by airlines is very low. Low cost airlines show high use of e-Marketplaces, but demonstrate little financial involvement in contrast. Overall, the categories of spares and repairs, office supplies, tools and ground support equipment (GSE) show the greatest potential for reducing costs and increasing procurement process efficiencies. The intense competitive pressures facing carriers will make their search for tools to realise even incremental savings and efficiency gains ever more urgent. There is evidence that e-Marketplaces are one tool to improve such performance indicators.