Implementing Strategy: the politics of healthcare commissioning

North, Nancy

doi:10.1332/030557398782018301

Cited by 4 publications

(4 citation statements)

References 8 publications

(15 reference statements)

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“…Similar work on the NHS in England (North, 1997(North, , 1998Redmayne, 1992Redmayne, , 1995Redmayne, , 1996 did not uncover substantially differing ®ndings. The study shows itself to have resonance with previous studies both evaluating the internal market (LeGrand et al, 1998) and prior to the introduction of the internal market (Ham, 1980;Haywood and Renade, 1985;Haywood and Alaszewski, 1980).…”

Section: Health Policy In Wales ± Distinctive or Derivative?mentioning

confidence: 78%

Health Policy in Wales – Distinctive or Derivative?

McClelland¹

2002

Social Policy & Society

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This article examines the policy process in Wales prior to the introduction of a National Assembly for Wales and uses this as a framework for assessing the potential impact of devolution. Health and social services form the largest part of the budget of the National Assembly for Wales and the article focuses on health policy as a key area of interest for Assembly Members. The period 1992 to 1997 demonstrates an emphasis on managing both demand and finances thereby promoting the continued dominance, in terms of both resource allocation and prioritisation, of the acute hospital sector. The article then explores how far this has changed and what potential there is for changing this assumptive reality in a New Labour and devolved NHS.

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Section: Health Policy In Wales ± Distinctive or Derivative?mentioning

confidence: 78%

Health Policy in Wales – Distinctive or Derivative?

McClelland¹

2002

Social Policy & Society

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“…This work brings mechanisms such as power more to the fore and suggests that, while collaboration can and does take place in NHS networks, the nature of power relations is an important factor in when and where it occurs. 180,184,192,[217][218][219] l Evidence on operational delivery in the NHS is often discussed in terms of concepts drawn from the integrated SCM literature. Ideas such as lean, agile and total quality management are seen as relevant and useful in a context where resources are constrained, but high standards of quality (related to patient safety and dignity) and speed and responsiveness (related to patient satisfaction) have to be maintained.…”

Section: Discussionmentioning

confidence: 99%

“…217 In both cases, they conclude that the providers were considerably more powerful than the district health authorities. North 218 examines a district health authority's efforts to implement a purchasing strategy for stroke care services. She observes that the district health authority attempted to stick closely to the ideals of the internal market by dealing with the local hospital trusts on a formal arm's length basis, even though there was no real competition for the providers in the area of acute stroke care.…”

Section: Evidence On Relationship Management In the Nhsmentioning

confidence: 99%

Towards a framework for enhancing procurement and supply chain management practice in the NHS: lessons for managers and clinicians from a synthesis of the theoretical and empirical literature

Sanderson

Lonsdale

Mannion

et al. 2015

Health Services and Delivery Research

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BackgroundThis review provides intelligence to NHS managers and clinicians involved in commissioning and procurement of non-pay goods and services. It does this in the light of ongoing pressure for the NHS to save money through a combination of cost cutting, productivity improvements and innovation in service delivery, and in the context of new commissioning structures developing as a result of the Health and Social Care Act 2012 (Great Britain.Health and Social Care Act 2012. Chapter 7. London: The Stationery Office; 2012).ObjectivesWe explore the main strands of the literature about procurement and supply chain management (P&SCM); consider the extent to which existing evidence on the experiences of NHS managers and clinicians involved in commissioning and procurement matches these theories; assess how the empirical evidence about different P&SCM practices and techniques in different countries and sectors might contribute to better commissioning and procurement; and map and evaluate different approaches to improving P&SCM practice.Review methodWe use a realist review method, which emphasises the contingent nature of evidence and addresses questions about what works in which settings, for whom, in what circumstances and why. Adopting realist review principles, the research questions and emerging findings were sense-checked and refined with an advisory group of 16 people. An initial key term search was conducted in October 2013 across relevant electronic bibliographic databases. To ensure quality, the bulk of the search focused on peer-reviewed journals, though this criterion was relaxed where appropriate to capture NHS-related evidence. After a number of stages of sifting, quality checking and updating, 879 texts were identified for full review.ResultsFour literatures were identified: organisational buying behaviour; economics of contracting; networks and interorganisational relationships; and integrated supply chain management (SCM). Theories were clustered by their primary explanatory focus on a particular phase in the P&SCM process. Evidence on NHS commissioning and procurement practice was found in terms of each of these phases, although there were also knowledge gaps relating to decision-making roles, processes and criteria at work in commissioning organisations; the impact of power on collaborative interorganisational relationships over time; and the scope to apply integrated SCM thinking and techniques to supply chains delivering physical goods to the NHS. Evidence on P&SCM practices and techniques beyond the NHS was found to be highly fragmented and at times contradictory but, overall, demonstrated that matching management practice appropriately with context is crucial.ConclusionsWe found that the P&SCM process involves multiple contexts, phases and actors. There are also a wide variety of practices that can be used in each phase of the P&SCM process. Thinking about how practice might be improved in the NHS requires an approach that enables the simplification of the complex interplay of factors in the P&SCM process. Portfolio-based approaches, which provide a contingent approach to considering these factors, are recommended. Future work should focus on conflicting preferences in NHS commissioning and procurement and the role of power and politics in conflict resolution; the impact of power on the scope for collaboration in health-care networks; and the scope to apply integrated SCM practices in NHS procurement organisations.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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“…With decentralization, health authorities were supposed to identify local needs and implement plans to improve health by contracting effective health care with efficient providers and what occurred was a complexity of relationships where the power assumed by district authorities as buyers failed to induce change, the failure was due to the neglect of local market policy, the importance of reciprocity in market exchanges and the presence of cooperation in commercial markets (North, 1998). Aidemark (2001) reports in his case study on a local health organization with financial difficulties subjected to two major reforms that inserted responsibility accounting and a local market system.…”

Section: Methodsmentioning

confidence: 99%

Strategic change in the health sector: a literature review and future challenges

Pereira

Ferreira

Rammal

et al. 2023

JOCM

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PurposeThe health sector is increasingly dynamic and complex, in which (strategic) change has become a constant in the sector's adaptation to different challenges. This study aims to meet the need to understand which trends in the literature on strategic change in the health sector and which elements comprise it.Design/methodology/approachTo advance research in this area, the authors systematically review 285 articles collected from the Scopus database. The authors conducted a bibliometric analysis using the VOSviewer software by applying the bibliographic matching method to understand how these articles were grouped and thus characterise the literature trends.FindingsThrough a systematic literature review (SLR), this study analyses the various lenses of literature on strategic change in the context of the health sector, classifying and conceptually mapping existing research into four thematic groups: key factors in strategic change, theories and models underlying strategic change, decentralisation in strategic change and the challenges to strategic change in this millennium.Research limitations/implicationsThe trends in the literature on strategic change in the health sector explore strategic change from different perspectives. Key features in strategic change suffered reciprocal influence from the theories/models of strategic change and decentralisation of health care so that the health sector could define strategies to respond to the challenges it faced.Originality/valueThe health sector has been in great prominence worldwide, specifically due to the recent events that have occurred on a planetary scale. Therefore, a systematic review is essential to help understand the strategic changes that have occurred in the health sector and their impact. The authors did not find any SLR that focuses on global strategic changes in the health sector, so this study will fill this gap, systematising the main topics on strategic change in the health sector. The authors also suggest an integrative research framework and a future research agenda.

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Implementing Strategy: the politics of healthcare commissioning

Cited by 4 publications

References 8 publications

Health Policy in Wales – Distinctive or Derivative?

Health Policy in Wales – Distinctive or Derivative?

Towards a framework for enhancing procurement and supply chain management practice in the NHS: lessons for managers and clinicians from a synthesis of the theoretical and empirical literature

Strategic change in the health sector: a literature review and future challenges

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