Accounting for voluntary hospices in England: A business model perspective

Abstract

This paper accounts for the sustainability of voluntary hospices in England that provide palliative end of life care for patients. A critical evaluation of the challenges facing hospices in England can be located within a 'descriptive business model' that makes visible stakeholder relations. Changes to these stakeholder relations, and how they impact upon the viability of the hospice business model, can be captured within a 'narratives and numbers' investigative framework. Interviews with senior clinical and non-clinical managers in four hospices provide rich 'narratives' that reveal how the hospice business model is evolving. Whilst financial disclosures extracted from hospice financial statements generate 'numbers' which can be employed to explore the impact of changes in stakeholder relations upon financial viability. Our argument is that the hospice business model depends upon sustaining a complex network of stakeholder relations in order to maintain operational and financial viability. Response to Reviewers: Editor comments The paper has addressed the comments of the editor and referee quite well so I would recommend it be accepted. I have noticed quite a few grammatical issues though so it needs a very careful proofreading. To give a few examples: On line 13 of page 3 there is an 'of' missing; On line 22 on page 3 there is a bracket missing; On lines 21 and 25 of page 4 there should be an apostrophe in entities; On line 9 of page 5 there should be an s at the end of stakeholder. There are many other similar minor problems. We would like to thank you for these comments and we have now been through the paper tidying it up and clarifying the text throughout.

Understanding barriers and facilitators to palliative and end-of-life care research: a mixed method study of generalist and specialist health, social care, and research professionals

“…They should protect research time and resources, recognise talent, and reward positive research related behaviours [ 48 ]. This may be a particular challenge for those palliative care organisations that are charitably funded due to the uncertainty and volatility of their funding [ 49 , 50 ], and business models that may not account for research activity [ 51 ]. The focus is also set nationally, with the recently launched Hospice UK 2024–29 strategy having no overt mention of research [ 52 ].…”

The income gap reporting framework in public not-for-profit organizations: the British Museum case

“…In a public and not-for-profit environment, this implies structuring a narrative account by first looking at the income gap's determinants, thus reading the scheme 'from above', identifying the main activities and their financial impact, and then understanding the final institutional agreement on how to cover the income gap, therefore looking at the scheme 'from below'. The structure of revenue and expenses for areas of activity, the intermediate margins, and the overall notion of an income gap contribute, therefore, to a better understanding of financial viability, more than simply referring to 'streams of revenue and costs' as is usual in business-model related literature (Baden-Fuller & Morgan, 2010;Beattie & Smith, 2013;Haslam et al, 2018;ICAEW, 2010;Nielsen & Roslender, 2015;Page, 2014;Shafer et al, 2005;Singleton-Green, 2014;Teece, 2010).…”

Fostering performance management in healthcare: insights into the role of big data

“…More specifically, the contribution of the study lies in the fact that, unlike previous research, the current paper puts forward the view that Big Data – and arguably other digital technologies – because of their ability to improve clinical processes and outcomes, can be relied upon as a way forward to raise the attention of health-care professionals on the relevance and usefulness of PMS in their domain. The paper allows us to assert that digital technologies in health care, such as Big Data, may well play a prominent role in acting upon PMS discourses at both the organizational and the individual levels, opening a brand-new field for further investigations and re-thinking broadly health-care business models (see also Haslam, 2018).…”

“…From this picture, it emerges that not only there are some unexplored concerns but also that PMS and Big Data may interact and shape each other towards a re-shaped business model for health-care delivery, a theme that is currently heating the debate in health care (Haslam et al , 2018).…”