Purpose Public sectors have responded to grand societal challenges by establishing collaboratives – new inter-organizational partnerships to secure better quality health services. In the UK, a proliferation of collaboration-based healthcare networks exists that could help to enhance the value of investments in quality improvement programs. The nature and organizational form of such improvements is still a subject of debate within the public-sector literature. Place-based collaboration has been proposed as a possible solution. In response, the purpose of this study is to present the results and findings of a place-based collaborative network, highlighting challenges and insights. Design/methodology/approach This study adopted a social constructionist epistemological approach, using a qualitative methodology. A single case study was used and data collected in three different stages over a two-year period. Findings The study finds that leadership, data-enabled learning through system-wide training and development, and the provision of an enabling environment that is facilitated by an academic partner, can go a long way in the managing of healthcare networks for improving quality. Research limitations/implications Regardless of the tensions and challenges with place-based networks, they could still be a solution in maximizing the public value required by government investments in the healthcare sector, as they offer a more innovative structure that can help to address complex issues beyond the remit of hierarchical structures. This study is limited by the use of a single case study. Practical implications Across countries health systems are moving away from markets to collaborative models for healthcare delivery and from individual services to population-based approaches. This study provides insights to inform leaders of collaborative health models in the design and delivery of these new collaborations. Social implications As demand rises (as a result of increasing complexity and demographics) in the western world, health systems are seeking to redefine the boundaries between health service provision and community self-reliance and resilience. This study provides insights into the new partnership between health institutions and communities, providing opportunities for more social- and solidarity-based healthcare models which place patients and the public at the heart of change. Originality/value The city place-based network is the first of such organizational form in healthcare collaboration in the UK.

In this implementation phase of the European Cancer Patient’s Bill of Rights (BoR), we confirm the following three patient-centred principles that underpin this initiative:The right of every European citizen to receive the most accurate information and to be proactively involved in his/her care.The right of every European citizen to optimal and timely access to a diagnosis and to appropriate specialised care, underpinned by research and innovation.The right of every European citizen to receive care in health systems that ensure the best possible cancer prevention, the earliest possible diagnosis of their cancer, improved outcomes, patient rehabilitation, best quality of life and affordable health care. The key aspects of working towards implementing the BoR are:Agree our high-level goal. The vision of 70% long-term survival for patients with cancer in 2035, promoting cancer prevention and cancer control and the associated progress in ensuring good patient experience and quality of life.Establish the major mechanisms to underpin its delivery. (1) The systematic and rigorous sharing of best practice between and across European cancer healthcare systems and (2) the active promotion of Research and Innovation focused on improving outcomes; (3) Improving access to new and established cancer care by sharing best practice in the development, approval, procurement and reimbursement of cancer diagnostic tests and treatments.Work with other organisations to bring into being a Europe based centre that will (1) systematically identify, evaluate and validate and disseminate best practice in cancer management for the different countries and regions and (2) promote Research and Innovation and its translation to maximise its impact to improve outcomes.

Purpose -The largest organisation in the western world, the UK National Health Service (NHS), might be best viewed as a network of interdependent organisations. However, the public has only recently begun to see it as a living network. Public reforms and financial crises have increased the need for professionals to innovate and improve their role. The overarching question is how this new clinical leadership can positively affect the functioning of the system and its performance. Therefore, the purpose of this paper is to clarify how leaders can be most effective in managing health networks. Design/methodology/approach -A pragmatic approach was taken because of the topical and strategic importance of networks and leadership in the current climate, and hence a need for greater understanding of this largely unknown phenomenon. A focus group interview with Organisational Development experts from the Centre for Innovation and Health Management (CIHM) at Leeds University Business School was followed by three scoping reviews and high-level follow-up conversations with CIHM members, network leaders from the NHS and third sectors. Findings -Issues that have emerged include: how networks are designed; which factors enhance its likelihood of success and predicate its failure; discussions of illuminating effective leadership.Research limitations/implications -The Stories of Effective Leadership Networks were provided by the network founders, who may have sought to emphasise the benefits (as opposed to downside) of their network. An ideal scenario would have been the inclusion of patients and carers and perhaps administrative staff to reduce bias. Originality/value -Considering the limited evidence base from the literature about medical leadership for network management, the involvement of network leaders and the ability to draw-upon CIHMs knowledge and expertise has been fundamental for determining lessons that may enhance the leadership function of the UK's health system network.

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Purpose The purpose of this paper is to review the impact of the clinical leadership programme, in enabling the Darzi fellows to lead change projects in health and care services, and to secure quality healthcare in the NHS beyond the lifetime of the programme. Design/methodology/approach A longitudinal empirical investigation of clinical leaders (n=80) over an eight-year period was framed through an activity theory (AT)-driven research methodology using a mixed-methods approach. Findings AT illuminated how change was sustained in the NHS in London through the Darzi Clinical Leadership Fellowship. By any reasonable measurement, this programme excels, with learning and positive behavioural change sustained after the Fellowship across the NHS. Further recognition is needed of the continuing development needs of fellows as they take on more responsible leadership roles in their careers. Research limitations/implications Darzi fellows are a hard-to-reach group. The sample represents a response rate of 34 per cent. In total, 77 per cent of respondents emanated from cohorts 5 to 8 programmes. Practical implications The investment in a clinical leadership programme focused on systems leadership for quality generates value for the NHS. Social implications Countless interventions flowed through London’s healthcare community and beyond as a result of the Fellowship. This research exposed how Darzi fellows continue to lead innovation for alternative healthcare outcomes. Many proactive fellows employ a suite of learned skills and capabilities to lead systemic change. Originality/value This research is the first known longitudinal clinical leadership development study undertaken. The Darzi programme has created a unique clinical network of mutually supportive, team-centric systems thinkers and doers, with an evidence-based approach to systems change. Many fellows are catalysing sustainable change in the healthcare environment.

This article reviews the current literature on change in nursing audit in order to develop a strategy for nursing staff. It suggests that the model for change will affect the nature of the measurement phase of audit, and proposes that an open systems model be adopted and a change agent incorporated to manage the audit cycle.

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