Leadership of healthcare commissioning networks in England : a mixed-methods study on clinical commissioning groups

Objective: To explore the relational challenges for general practitioner (GP) leaders setting up new network-centric commissioning organisations in the recent health policy reform in England, we use innovation network theory to identify key network leadership practices that facilitate healthcare innovation. Design: Mixed-method, multisite and case study research. Setting: Six clinical commissioning groups and local clusters in the East of England area, covering in total 208 GPs and 1 662 000 population. Methods: Semistructured interviews with 56 lead GPs, practice managers and staff from the local health authorities (primary care trusts, PCT) as well as various healthcare professionals; 21 observations of clinical commissioning group (CCG) board and executive meetings; electronic survey of 58 CCG board members (these included GPs, practice managers, PCT employees, nurses and patient representatives) and subsequent social network analysis. Main outcome measures: Collaborative relationships between CCG board members and stakeholders from their healthcare network; clarifying the role of GPs as network leaders; strengths and areas for development of CCGs. Results: Drawing upon innovation network theory provides unique insights of the CCG leaders’ activities in establishing best practices and introducing new clinical pathways. In this context we identified three network leadership roles: managing knowledge flows, managing network coherence and managing network stability. Knowledge sharing and effective collaboration among GPs enable network stability and the alignment of CCG objectives with those of the wider health system (network coherence). Even though activities varied between commissioning groups, collaborative initiatives were common. However, there was significant variation among CCGs around the level of engagement with providers, patients and local authorities. Locality (sub) groups played an important role because they linked commissioning decisions with patient needs and brought the leaders closer to frontline stakeholders. Conclusions: With the new commissioning arrangements, the leaders should seek to move away from dyadic and transactional relationships to a network structure, thereby emphasising on the emerging relational focus of their roles. Managing knowledge mobility, healthcare network coherence and network stability are the three clinical leadership processes that CCG leaders need to consider in coordinating their network and facilitating the development of good clinical commissioning decisions, best practices and innovative services. To successfully manage these processes, CCG leaders need to leverage the relational capabilities of their network as well as their clinical expertise to establish appropriate collaborations that may improve the healthcare services in England. Lack of local GP engagement adds uncertainty to the system and increases the risk of commissioning decisions being irrelevant and inefficient from patient and provider perspectives

Authentication and authorisation in entrusted unions

This paper reports on the status of a project whose aim is to implement and demonstrate in a real-life environment an integrated eAuthentication and eAuthorisation framework to enable trusted collaborations and delivery of services across different organisational/governmental jurisdictions. This aim will be achieved by designing a framework with assurance of claims, trust indicators, policy enforcement mechanisms and processing under encryption to address the security and confidentiality requirements of large distributed infrastructures. The framework supports collaborative secure distributed storage, secure data processing and management in both the cloud and offline scenarios and is intended to be deployed and tested in two pilot studies in two different domains, viz, Bio-security incident management and Ambient Assisted Living (eHealth). Interim results in terms of security requirements, privacy preserving authentication, and authorisation are reported

Dancing to the Partisan Beat: A First Analysis of Political Communication on TikTok

TikTok is a video-sharing social networking service, whose popularity is increasing rapidly. It was the world's second-most downloaded app in 2019. Although the platform is known for having users posting videos of themselves dancing, lip-syncing, or showcasing other talents, user-videos expressing political views have seen a recent spurt. This study aims to perform a primary evaluation of political communication on TikTok. We collect a set of US partisan Republican and Democratic videos to investigate how users communicated with each other about political issues. With the help of computer vision, natural language processing, and statistical tools, we illustrate that political communication on TikTok is much more interactive in comparison to other social media platforms, with users combining multiple information channels to spread their messages. We show that political communication takes place in the form of communication trees since users generate branches of responses to existing content. In terms of user demographics, we find that users belonging to both the US parties are young and behave similarly on the platform. However, Republican users generated more political content and their videos received more responses; on the other hand, Democratic users engaged significantly more in cross-partisan discussions.Comment: Accepted as a full paper at the 12th International ACM Web Science Conference (WebSci 2020). Please cite the WebSci version; Second version includes corrected typo

Towards Identifying and closing Gaps in Assurance of autonomous Road vehicleS - a collection of Technical Notes Part 1

This report provides an introduction and overview of the Technical Topic Notes (TTNs) produced in the Towards Identifying and closing Gaps in Assurance of autonomous Road vehicleS (Tigars) project. These notes aim to support the development and evaluation of autonomous vehicles. Part 1 addresses: Assurance-overview and issues, Resilience and Safety Requirements, Open Systems Perspective and Formal Verification and Static Analysis of ML Systems. Part 2: Simulation and Dynamic Testing, Defence in Depth and Diversity, Security-Informed Safety Analysis, Standards and Guidelines

ISO and Social Standardisation: Uncomfortable compromises in Global Policy-Making

This paper intends to explore the involvement of ISO, the world’s most iconic standard-setting institution, in the field of social responsibility, leading to the publication of the ISO26000 standard in November, 2010. Through several aspects of this experience, an almost decade-long process, I will show how ISO developed a new political structure aimed specifically at creating global policy, originating one the most sophisticated frameworks in existence to consensualise "universal" sociopolitical principles and infuse them with the legitimacy of a "global" technocracy and liberal institutions. Moreover, I will use the latest ISO26000 experience to argue that conceptual and institutional minimalism, which favours "soft" approaches towards global policy-making, paradoxically results from combining a technocratic aim for global compatibility with more participatory decision-making arrangements involving previously excluded socio-political actors. In that sense, ISO’s upgraded participatory mechanisms solved certain deadlocks suffered by previous initiatives only to affront and spark a new round of contradictions and consequences. Thus, I will conclude commenting on the intrinsic relationship between global standards, governance and complexity, and the difficulties of politically articulating programmes with dissimilar functional differentiation

Innovative public governance through cloud computing: Information privacy, business models and performance measurement challenges

Purpose: The purpose of this paper is to identify and analyze challenges and to discuss proposed solutions for innovative public governance through cloud computing. Innovative technologies, such as federation of services and cloud computing, can greatly contribute to the provision of e-government services, through scaleable and flexible systems. Furthermore, they can facilitate in reducing costs and overcoming public information segmentation. Nonetheless, when public agencies use these technologies, they encounter several associated organizational and technical changes, as well as significant challenges. Design/methodology/approach: We followed a multidisciplinary perspective (social, behavioral, business and technical) and conducted a conceptual analysis for analyzing the associated challenges. We conducted focus group interviews in two countries for evaluating the performance models that resulted from the conceptual analysis. Findings: This study identifies and analyzes several challenges that may emerge while adopting innovative technologies for public governance and e-government services. Furthermore, it presents suggested solutions deriving from the experience of designing a related platform for public governance, including issues of privacy requirements, proposed business models and key performance indicators for public services on cloud computing. Research limitations/implications: The challenges and solutions discussed are based on the experience gained by designing one platform. However, we rely on issues and challenges collected from four countries. Practical implications: The identification of challenges for innovative design of e-government services through a central portal in Europe and using service federation is expected to inform practitioners in different roles about significant changes across multiple levels that are implied and may accelerate the challenges' resolution. Originality/value: This is the first study that discusses from multiple perspectives and through empirical investigation the challenges to realize public governance through innovative technologies. The results emerge from an actual portal that will function at a European level. © Emerald Group Publishing Limited