Developing the public health function of locum pharmacists under the auspices of the new pharmacy contract

Focal Point - There are reduced opportunities for locum pharmacists to access training and education that meets their needs and enables them to play a full role under the new pharmacy contract - Eighty-six per cent of locums consider themselves to be more health professional than business person, compared to just 48% of pharmacy owners - Forty per cent of locums believe that a lack of access to training is a major barrier to the development of their public health function - While locum pharmacists are arguably more likely to embrace 'professionalising', patient-care-based roles, they are also the group least likely to be able to access the necessary training to fulfill such roles Introduction It has been suggested that locum pharmacists do not want the business-based responsibilities (e.g. staff management, meeting targets, etc) that come with pharmacy management.1 Research also suggests that locums derive great satisfaction from the health-professional aspects of the pharmacists’ role (e.g. patient contact, the provision of advice, etc).1 However, upon the introduction of the new pharmacy contract (April 2005), concerns were expressed that it was becoming increasingly difficult for locum pharmacists to access training and education that would meet their needs and enable them to play a full role under the new framework.2,3 Method After piloting, in August 2006 a self-completion postal questionnaire was sent to a random sample of practising community pharmacists, stratified for country and sex, within Great Britain (n = 1998), with a follow-up to non-responders 4 weeks later. Data were analysed using SPSS (v12.0). A final response rate of 51% (n = 1023/1998) was achieved. Respondents were asked ‘indicate how you view yourself as a pharmacist’ – in terms of their relative focus on the health-professional and business aspects of their role. Respondents were also asked ‘do you consider a lack of training opportunities to be a barrier to the development of the public health role of community pharmacists?’. Results Locums were significantly more likely than owners or employees to consider each factor a major barrier. Discussion Four in 10 locums consider a lack of training opportunities to constitute a major barrier to the development of their public health function. Pharmacy may not be able to provide the services required of it by the policy agenda if pharmacists are unable to be involved in extended role activities through a lack of training opportunities. Therefore, the paradox that needs to be addressed is that while locum pharmacists are arguably more likely to embrace ‘professionalising’, patient-care-based roles, they are also the group least likely to be able to access training to fulfil such roles. The training needs of this large subset of the pharmacist population need to be assessed and met if the whole community pharmacy workforce is going to maximise its contribution to public health under the new contractual framework. References 1 Shann P, Hassell K. An exploration of the diversity and complexity of the pharmacy locum workforce. London: Royal Pharmaceutical Society of Great Britain; 2004. 2 Almond M. Locums – key players in workforce – cast adrift as contract launched. Pharm J 2005;274:420. 3 Bishop DH. A lack of appreciation of what really happens. Pharm J 2005;274:451.

What do public values mean for public action? Putting public values in their plural place

Public values are moving from a research concern to policy discourse and management practice. There are, though, different readings of what public values actually mean. Reflection suggests two distinct strands of thinking: a generative strand that sees public value emerging from processes of public debate; and an institutional interpretation that views public values as the attributes of government producers. Neither perspective seems to offer a persuasive account of how the public gains from strengthened public values. Key propositions on values are generated from comparison of influential texts. A provisional framework is presented of the values base of public institutions and the loosely coupled public propositions flowing from these values. Value propositions issue from different governing contexts, which are grouped into policy frames that then compete with other problem frames for citizens’ cognitive resources. Vital democratic commitments to pluralism require public values to be distributed in competition with other, respected, frames.

Whole life performance bid evaluation in the Korean public sector

Korea has increasingly adopted design-build for public construction projects in the last few years. There is a much greater awareness of the need to change a system based on ‘Value for Money’ which is high on the government's agenda. A whole life performance bid evaluation model is proposed to aid decision makers in the selection of a design-builder. This is based on the integration of a framework using an analytic hierarchy process as the bid awarding system is being changed from one based on lowest price, to one based on best value over the life-cycle. Key criteria like whole life cost, service life planning and design quality are important through the key stages of evaluation process. The model uses a systematic and holistic approach which enables a public sector to make better decisions in design-builder selection, which will deliver whole life benefits, based on long term cost-effectiveness and whole life.

Strategies for public engagement on environmental matters:you can lead a horse to water, but can you make it drink?

With no tangible evidence of widespread public engagement in the UK on matters relating to the environment, this article assesses the benefits of adopting the principles of key theoretical models on learning (e.g., Kolb's Experiential Model) in environmental campaigns. In addition, in order to facilitate the transition from environmental knowledge/awareness, to the adoption of proenvironmental behavior, the article reviews some of the key internal and external drivers to achieving sustained behavioral change.

Municipal benchmarking:organisational learning and network performance in the public sector

The main purpose of this dissertation is to assess the relation between municipal benchmarking and organisational learning with a specific emphasis on benchlearning and performance within municipalities and between groups of municipalities in the building and housing sector in the Netherlands. The first and main conclusion is that this relation exists, but that the relative success of different approaches to dimensions of change and organisational learning are a key explanatory factor for differences in the success of benchlearning. Seven other important conclusions could be derived from the empirical research. First, a combination of interpretative approaches at the group level with a mixture of hierarchical and network strategies, positively influences benchlearning. Second, interaction among professionals at the inter-organisational level strengthens benchlearning. Third, stimulating supporting factors can be seen as a more important strategy to strengthen benchlearning than pulling down barriers. Fourth, in order to facilitate benchlearning, intrinsic motivation and communication skills matter, and are supported by a high level of cooperation (i.e., team work), a flat organisational structure and interactions between individuals. Fifth, benchlearning is facilitated by a strategy that is based on a balanced use of episodic (emergent) and systemic (deliberate) forms of power. Sixth, high levels of benchlearning will be facilitated by an analyser or prospector strategic stance. Prospectors and analysers reach a different learning outcome than defenders and reactors. Whereas analysers and prospectors are willing to change policies when it is perceived as necessary, the strategic stances of defenders and reactors result in narrow process improvements (i.e., single-loop learning). Seventh, performance improvement is influenced by functional perceptions towards performance, and these perceptions ultimately influence the elements adopted. This research shows that efforts aimed at benchlearning and ultimately improved service delivery, should be directed to a multi-level and multi-dimensional approach addressing the context, content and process of dimensions of change and organisational learning.

Promoting competitive markets:the role of public procurement

The study presented here examines how public procurement agencies address establishing and maintaining competitive markets; a topic still in its academic infancy. Cases are used to address impediments and improve understanding of strategic priorities in managing for competitive markets. Public policy academics have observed many competing policies in the wider public sector. Specifically, this paper identifies a need for research on supplier incentives at a market level, on the post contract management of suppliers and as an important sub-set, key supplier relationship management, along with professional development.

Public procurement:international cases and commentary

In many countries and sectors, public procurement is developing from a functional orientation to an effective socio-economic policy lever. There is a great interest among managers and academics to learn from other countries’ and other sectors’ change initiatives and how they dealt with the challenges they encountered. This text provides such learning opportunities, presenting case studies of public procurement, covering diverse nations, sectors and issues. The cases are combined with editorial commentary and contextualizing chapters to assist the student reader in understanding this complex topic. The text combines descriptions of cases of public procurement with cross case analysis to draw out the key dimensions to enable further examination of the central themes. Each case study concludes with three questions to aid its use as a teaching and training text. Edited by a team of internationally recognised experts in the field this innovative text illustrates the strategies and innovations within public procurement on a global scale and highlights common problems that all countries encounter. Public Procurement is vital reading for anyone with an interest in this topical area.

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.

The unequal segmentation of public preparedness for mass evacuation:a cross-national perspective

This thesis is concerned with understanding how Emergency Management Agencies (EMAs) influence public preparedness for mass evacuation across seven countries. Due to the lack of cross-national research (Tierney et al., 2001), there is a lack of knowledge on EMAs perspectives and approaches to the governance of public preparedness. This thesis seeks to address this gap through cross-national research that explores and contributes towards understanding the governance of public preparedness. The research draws upon the risk communication (Wood et al., 2011; Tierney et al., 2001) social marketing (Marshall et al., 2007; Kotler and Lee, 2008; Ramaprasad, 2005), risk governance (Walker et al., 2010, 2013; Kuhlicke et al., 2011; IRGC, 2005, 2007; Renn et al., 2011; Klinke and Renn, 2012), risk society (Beck, 1992, 1999, 2002) and governmentality (Foucault, 1978, 2003, 2009) literature to explain this governance and how EMAs responsibilize the public for their preparedness. EMAs from seven countries (Belgium, Denmark, Germany, Iceland, Japan, Sweden, the United Kingdom) explain how they prepare their public for mass evacuation in response to different types of risk. A cross-national (Hantrais, 1999) interpretive research approach, using qualitative methods including semi-structured interviews, documents and observation, was used to collect data. The data analysis process (Miles and Huberman, 1999) identified how the concepts of risk, knowledge and responsibility are critical for theorising how EMAs influence public preparedness for mass evacuation. The key findings grounded in these concepts include: - Theoretically, risk is multi-functional in the governance of public preparedness. It regulates behaviour, enables surveillance and acts as a technique of exclusion. - EMAs knowledge and how this influenced their assessment of risk, together with how they share the responsibility for public preparedness across institutions and the public, are key to the governance of public preparedness for mass evacuation. This resulted in a form of public segmentation common to all countries, whereby the public were prepared unequally.  - EMAs use their prior knowledge and assessments of risk to target public preparedness in response to particular known hazards. However, this strategy places the non-targeted public at greater risk in relation to unknown hazards, such as a man-made disaster. - A cross-national conceptual framework of four distinctive governance practices (exclusionary, informing, involving and influencing) are utilised to influence public preparedness. - The uncertainty associated with particular types of risk limits the application of social marketing as a strategy for influencing the public to take responsibility and can potentially increase the risk to the public.

Key Aspects and Approaches of Open Access, Open Data and Open Science

Overview of the key aspects and approaches to open access, open data and open science, emphasizing on sharing scientific knowledge for sustainable progress and development.

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.

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.

Networked governance and the regulation of expression on the Internet:the blurring of the role of public and private actors as content regulators

This editorial provides an overview of the themes of network governance and content regulation that are expanded upon in the subsequent articles, identifying key issues and concerns that are prevalent in the literature in this field. In particular, this text considers governance not as an Internet-specific phenomenon, but as a global phenomenon, identifying and discussing literature pertaining to governance both online and offline, and providing examples of theories that seek to explain these forms of governance. Focusing on the interaction between public and private actors in content regulation, this editorial highlights that content regulation is a complex and contested issue that cannot be separated from its social and cultural contexts, and provides an overview of the articles contained.

Better queue management in a busy public hospital of a developing country without appointment system::an application using data envelopment analysis

Queuing is a key efficiency criterion in any service industry, including Healthcare. Almost all queue management studies are dedicated to improving an existing Appointment System. In developing countries such as Pakistan, there are no Appointment Systems for outpatients, resulting in excessive wait times. Additionally, excessive overloading, limited resources and cumbersome procedures lead to over-whelming queues. Despite numerous Healthcare applications, Data Envelopment Analysis (DEA) has not been applied for queue assessment. The current study aims to extend DEA modelling and demonstrate its usefulness by evaluating the queue system of a busy public hospital in a developing country, Pakistan, where all outpatients are walk-in; along with construction of a dynamic framework dedicated towards the implementation of the model. The inadequate allocation of doctors/personnel was observed as the most critical issue for long queues. Hence, the Queuing-DEA model has been developed such that it determines the ‘required’ number of doctors/personnel. The results indicated that given extensive wait times or length of queue, or both, led to high target values for doctors/personnel. Hence, this crucial information allows the administrators to ensure optimal staff utilization and controlling the queue pre-emptively, minimizing wait times. The dynamic framework constructed, specifically targets practical implementation of the Queuing-DEA model in resource-poor public hospitals of developing countries such as Pakistan; to continuously monitor rapidly changing queue situation and display latest required personnel. Consequently, the wait times of subsequent patients can be minimized, along with dynamic staff scheduling in the absence of appointments. This dynamic framework has been designed in Excel, requiring minimal training and work for users and automatic update features, with complex technical aspects running in the background. The proposed model and the dynamic framework has the potential to be applied in similar public hospitals, even in other developing countries, where appointment systems for outpatients are non-existent.

A közérdek védelmének intézményei Public-Private Partnership esetében = Institutional approaches to protecting public interest in Public-Private Partnership projects

A tanulmány a Public-Private Partnership (PPP) egyik nagy kérdésének megközelítéseit vizsgálja: miként védhető a közérdek e projektekben. Piaci és nem piaci megoldásokat tesz az elemzés mérlegre, valamint kitér arra, hogy miért különleges a PPP projektek esetében a közérdek védelmének kérdése. A szabályozott verseny körülményeinek kialakítása több megközelítésben is perdöntő kérdés a PPP értéknövelésének előmozdításához, bár a létező megoldások nem mentesek anomáliáktól. A képviseleti demokrácia intézményi működésének támogatására pedig a társadalmi részvétel megoldásait javasolja az irodalom. E megközelítés is több formájában, többféle céllal és szintén kihívásokkal segítheti az értéknövelő PPP projekteket. A tanulmány az elvi lehetőségek értékelő elemzését követően a megvalósítás realitásait is mérlegre teszi. = This study focuses on a key issue in Public-Private Partnership (PPP) projects: how may public interest be protected. It assesses market based and non market based approaches, and also explains why PPP projects are peculiar when addressing the protection of public interest. Setting up the conditions for simulated competition is of paramount importance for different reasons in order to enable value creating PPP projects. Existing solutions however are not without anomalies. To promote the institutions of democracy, participatory solutions are recommended in the literature. That approach may help value creating PPP projects in various forms, with a range of objectives and challenges. The study concludes the analytical assessment of options by highlighting the realistic conditions of implementation.