Health and Care Infrastructure Research and Innovation Centre final report 2014

Improving healthcare, while containing costs, demands sophisticated understanding of three core elements in healthcare systems: infrastructure, technology and services. Their tripartite relationship is extremely complex, not least because the pace of change for each is different. That creates considerable challenges in planning for future needs and makes the management of innovation and change difficult. [Continues.

An investigation into health and safety management by SMEs and the risk of corporate manslaughter prosecution

A thesis submitted in partial fulfilment of the requirements of the University of Wolverhampton for the degree of Doctor of Philosophy.The construction industry is consistently considered one of the most dangerous industries in the United Kingdom (UK) and the rest of the world due to reported work-related fatalities and injuries. The majority of these incidents are attributed to Small and Medium Enterprises (SMEs) as they perform a significant role in the UK construction supply chain. There is a common belief that safety performance in these types of organisations is strongly linked to the effectiveness of the implementation of safety management systems. Whilst the industry has made an outstanding effort to improve health and safety (H&S) practices, there are some areas which still need refinement. The legal system is one of the approaches considered for the improvement of H&S management in the industry. The Corporate Manslaughter and Corporate Homicide Act 2007 (CMCHA) was passed with the intention of improving the law on corporate criminal liability for poor H&S management. Since the Act came to force in 2008, over 30 percent of the convictions are attributable to the construction industry. Interestingly, all convictions for corporate manslaughter are attributable to SMEs. This therefore suggests that the size of the company is a major factor in the degree of exposure to corporate criminal liability. Since SMEs are labelled as risky in terms of exposure to hazards and death in the workplace, it is of importance to investigate their H&S management practices. However, not much attention has been given to the way SMEs manage H&S in the working environment and how they are influenced by recent H&S regulations. This study employed a mixed methods approach over two stages to investigate the level of implementation of the basic elements of a Plan-Do-Check-Act (PDCA) H&S management system UK construction SMEs and assess to what extent they were aware of the legal obligations towards their employees. The study also seeks to explore how the CMCHA influences their management activities. The first stage conducted a questionnaire survey to gather relevant data from construction SMEs in the UK. From the analysis of data, it was found that these types of organisations are currently implementing, albeit to a certain level, a structured health and safety management system in the workplace. However, there was evidence of a lack of balance between the different stages of the PDCA cycle, showing potential room for improvement. This research revealed that SMEs should put more attention into seeking a fair balance between H&S, time, cost and quality as well as involving workers in H&S matters and monitoring ill-health. There were also causal interactions between the implementation of a H&S management system in SMEs and the level of awareness of their duties of care to their employees and persons other than employees. Furthermore, it was concluded that the CMCHA had ‘some’ influence in the way SMEs manage H&S. During the second stage, the study looked further into these results by conducting interviews to experts in the senior management level of SMEs. Findings from this stage added that morality and the wellbeing of the employees is one of the main factors that drive SMEs to improve their safety performance. Interviewees highlighted that significant change is yet to be seen from the CMCHA as prosecuting large organisations remains a challenge. In the view of the findings, organisations should devote resources to orientate and motivate their senior level to improve their H&S management systems in respect of the flaws identified. It is also important that they monitor their H&S practices, thus it would be possible to identify possible areas of improvement and ensure compliance with legislation