Background In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation <92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov ( NCT04381936 ). Findings Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p<0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p<0·0001). Interpretation In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids. Funding UK Research and Innovation (Medical Research Council) and National Institute of Health Research.

Purpose The purpose of this paper is to challenge service researchers to design for service inclusion, with an overall goal of achieving inclusion by 2050. The authors present service inclusion as an egalitarian system that provides customers with fair access to a service, fair treatment during a service and fair opportunity to exit a service. Design/methodology/approach Building on transformative service research, a transformative, human-centered approach to service design is proposed to foster service inclusion and to provide a platform for managerial action. This conceptual study explores the history of service exclusion and examines contemporary demographic trends that suggest the possibility of worsening service exclusion for consumers worldwide. Findings Service inclusion represents a paradigm shift to higher levels of understanding of service systems and their fundamental role in human well-being. The authors argue that focused design for service inclusion is necessary to make service systems more egalitarian. Research limitations/implications The authors propose four pillars of service inclusion: enabling opportunity, offering choice, relieving suffering and fostering happiness. Practical implications Service organizations are encouraged to design their offerings in a manner that promotes inclusion and permits customers to realize value. Originality/value This comprehensive research agenda challenges service scholars to use design to create inclusive service systems worldwide by the year 2050. The authors establish the moral imperative of design for service inclusion.

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Purpose This paper aims to present two updated typologies of service failures and recoveries in the omni-channel context. These typologies are based on customer complaints and recoveries collected from the corporate Facebook pages of four omni-channel department stores, two operating in Australia and two in the UK. Design/methodology/approach A document review is used of 400 customer complaints and recoveries. Content analysis is used to condense the Facebook data into categories of failures and recoveries. Findings Customer complaints on Facebook were triggered by a multitude of varying failures in the omni-channel context, given that it is the service brand that customers are experiencing, not just retail channels. The most prevalent failures were “bricks and mortar” shopping, delivery, marketing activities including communications and pricing, quality of goods and customer service. For service recoveries on Facebook, the four-dimensional justice framework appears valid. Research limitations/implications Study limitations include potentially missing details about the nature of the service failures and recoveries, including customer satisfaction with service recovery. Practical implications The typologies offer guidance to omni-channel retailers by showing the range of online and offline situations, including those unrelated to actual transactions that trigger customer complaints on Facebook and the tactics of recovering. Originality/value The authors contribute to the service domain by updating failure and recovery typologies to reflect the emerging omni-channel context, jointly exploring failures and recoveries on Facebook and applying a four-dimensional justice framework for recoveries on Facebook.