Paediatric 'care closer to home':stake-holder views and barriers to implementation

In this study we explore the views of NHS stakeholders on providing paediatric ‘care closer to home’ (CCTH), in community-based outpatient clinics delivered by consultants. Design: Semi-structured interviews and thematic framework analysis. Setting: UK specialist children's hospital and surrounding primary care trusts. Participants: 37 NHS stakeholders including healthcare professionals, managers, commissioners and executive team members. Results: Participants acknowledged that outreach clinics would involve a change in traditional ways of working and that the physical setting of the clinic would influence aspects of professional practice. Different models of CCTH were discussed, as were alternatives for improving access to specialist care. Participants supported CCTH as a good principle for paediatric outpatient services; however the challenges of setting up and maintaining community clinics meant they questioned how far it could be achieved in practice. Conclusions: The place of service delivery is both an issue of physical location and professional identity. Policy initiatives which ignore assumptions about place, power and identity are likely to meet with limited success.

Strategic positioning of manufacturing operations within global supply chains

In global environment, a company has to make many decisions that impact upon its position in global supply chain networks such as outsourcing, offshoring, joint venture, vertical/horizontal integration, etc. All these decisions impact on the company’s strategic position, and hence on competitive space and performance. Therefore, it is important for a company to carefully manage strategic positioning by making careful decisions about the adoption of alternative manufacturing and supply chain activities. Unfortunately, there is no complete process studied in strategic positioning of manufacturing operations within global supply chain. Therefore, the work presented in this paper has investigated leading research and industrial practices to create a formal and rational decision process. An analysis of previous literature, industrial practices, and the resulting decision process are all presented in this paper.

Success factors in a forming strategic positioning of manufacturing operations within global supply chains

Managing supply chains effectively has become a critical element in enhancing company profitability and has been identified as the new frontier of competitive advantage. An important element of effective supply chain management is the strategic positioning of the company. The strategic positioning process is concerned with the choice of production-centred activities a company carries out internally and those provided externally. Strategic positioning within manufacturing supply chains however is a relatively recent research topic with apparently few articles currently available that explicitly address associated issues directly. Moreover there is no previous research working strategic positioning of manufacturing operations in global context. Therefore the purpose of this paper is to explore strategic positioning within global supply chains. This paper is based on three cases drawn from the cross industry sector manufacturing companies. It describes an exploratory analysis which is aimed at gaining insight into the success factor to form a strategic positioning within global supply chains.

The right time and place:strategic positioning for competitive manufacture

Increasingly in the UK, companies that have traditionally considered themselves as manufacturers are being advised to now see themselves as service providers and to reconsider whether to have any production capability. A key challenge is to translate this strategy into a selection of product and service-centred activities within the company's supply chain networks. Strategic positioning is concerned with the choice of business activities a company carries out itself, compared to those provided by suppliers, partners, distributors and even customers. In practice, strategic positioning is directly impacted by such decisions as outsourcing, off-shoring, partnering, technology innovation, acquisition and exploitation. If companies can better understand their strategic positioning, they can make more informed decisions about the adoption of alternative manufacturing and supply chain activities. Similarly, they are more likely to reject those that, like off-shoring, are currently en vogue but are highly likely to erode competitive edge and business success. Our research has developed a new concept we call 'competitive space' as a means of appreciating the strategic positioning of companies, along with a structured decision process for managing competitive space. Our ideas about competitive space, along with the decision process itself, have been developed and tested on a range of manufacturers. As more and more manufacturers are encouraged to move towards system integration and a serviceable business model, the challenge is to identify the appropriate strategic position for their organisations, or in other words, to identify their optimum competitive space for manufacture.

Vertical and horizontal scope economies in the regulated US electricity power industry

This paper investigates vertical economies between generation and distribution of electric power, and horizontal economies between different types of power generation in the U.S. electric utility industry. Our quadratic cost function model includes three generation output measures (hydro, nuclear and fossil fuels), which allows us to analyze the effect that generation mix has on vertical economies. Our results provide (sample mean) estimates of vertical economies of 8.1% and horizontal economies of 5.4%. An extensive sensitivity analysis is used to show how the scope measures vary across alternative model specifications and firm types. © 2012 Blackwell Publishing Ltd and the Editorial Board of The Journal of Industrial Economics.

A firm's capability to calibrate supply chain knowledge-antecedents and consequences

This paper proposes a conceptual model for a firm's capability to calibrate supply chain knowledge (CCK). Knowledge calibration is achieved when there is a match between managers' ex ante confidence in the accuracy of held knowledge and the ex post accuracy of that knowledge. Knowledge calibration is closely related to knowledge utility or willingness to use the available ex ante knowledge: a manager uses the ex ante knowledge if he/she is confident in the accuracy of that knowledge, and does not use it or uses it with reservation, when the confidence is low. Thus, knowledge calibration attained through the firm's CCK enables managers to deal with incomplete and uncertain information and enhances quality of decisions. In the supply chain context, although demand- and supply-related knowledge is available, supply chain inefficiencies, such as the bullwhip effect, remain. These issues may be caused not by a lack of knowledge but by a firm's lack of capability to sense potential disagreement between knowledge accuracy and confidence. Therefore, this paper contributes to the understanding of supply chain knowledge utilization by defining CCK and identifying a set of antecedents and consequences of CCK in the supply chain context.

Techno-economic assessment and uncertainty analysis of thermochemical processes for second generation biofuels

Biomass-To-Liquid (BTL) is one of the most promising low carbon processes available to support the expanding transportation sector. This multi-step process produces hydrocarbon fuels from biomass, the so-called “second generation biofuels” that, unlike first generation biofuels, have the ability to make use of a wider range of biomass feedstock than just plant oils and sugar/starch components. A BTL process based on gasification has yet to be commercialized. This work focuses on the techno-economic feasibility of nine BTL plants. The scope was limited to hydrocarbon products as these can be readily incorporated and integrated into conventional markets and supply chains. The evaluated BTL systems were based on pressurised oxygen gasification of wood biomass or bio-oil and they were characterised by different fuel synthesis processes including: Fischer-Tropsch synthesis, the Methanol to Gasoline (MTG) process and the Topsoe Integrated Gasoline (TIGAS) synthesis. This was the first time that these three fuel synthesis technologies were compared in a single, consistent evaluation. The selected process concepts were modelled using the process simulation software IPSEpro to determine mass balances, energy balances and product distributions. For each BTL concept, a cost model was developed in MS Excel to estimate capital, operating and production costs. An uncertainty analysis based on the Monte Carlo statistical method, was also carried out to examine how the uncertainty in the input parameters of the cost model could affect the output (i.e. production cost) of the model. This was the first time that an uncertainty analysis was included in a published techno-economic assessment study of BTL systems. It was found that bio-oil gasification cannot currently compete with solid biomass gasification due to the lower efficiencies and higher costs associated with the additional thermal conversion step of fast pyrolysis. Fischer-Tropsch synthesis was the most promising fuel synthesis technology for commercial production of liquid hydrocarbon fuels since it achieved higher efficiencies and lower costs than TIGAS and MTG. None of the BTL systems were competitive with conventional fossil fuel plants. However, if government tax take was reduced by approximately 33% or a subsidy of £55/t dry biomass was available, transport biofuels could be competitive with conventional fuels. Large scale biofuel production may be possible in the long term through subsidies, fuels price rises and legislation.

Strategic logistics outsourcing: an integrated QFD and AHP approach

Third-party logistics service providers (3PLs) play a vital role in contemporary supply chain management. Evaluation and selection of the right 3PLs depends on a wide range of quantitative and qualitative criteria rather than cost-based factors. Although various multi-criteria decision making approaches have been proposed, they have not considered the impact of business objectives and requirements of company stakeholders on the evaluating criteria. To enable the "voice" of company stakeholders is considered, this paper develops an integrated approach for selecting 3PL strategically. In the approach, multiple evaluating criteria are derived from the requirements of company stakeholders using a series of house of quality (HOQ). The importance of evaluating criteria is prioritized with respect to the degree of achieving the stakeholder requirements using analytic hierarchy process (AHP). Based on the ranked criteria, alternative 3PLs are evaluated and compared with each other using AHP again to make an optimal selection.