Cutting cost in service systems: Are you running with scissors?

A rigorous link between the domains of cost estimation, systems theory and accident investigation reveals fundamental epistemological limitations of commonly employed cost models when dealing with the characteristics of systems, particularly service systems, which may hinder the ability to take appropriate action for cost reductions.Key points:1.The ability to take action, in particular related to cost reductions in service systems, is strongly influenced by the understanding (epistemological assumptions) underlying a decision-support tool, in this case a cost estimate.2.There is a conflict in the underlying epistemological assumptions about what is and can be known in such a socio-technical system as a service system.3.A managerial perspective of cost estimation which neglects the essential characteristics of service systems may drive behaviour which is locally optimised but creates tension or failure at the system level.4.Cost cutting decisions that are based on a flawed understanding of the situation can lead to counter-intuitive outcomes for organisations; hence practical guidance is needed to help managers consciously consider the underlying epistemological assumptions in a given situation

Transactions costs in rural decision-making: The cases of funding and monitoring in rural development in England

Public domain decisions in rural England have become more complex as the number of stakeholders having a say in them has increased. Transactions costs can be used to explore this increasing complexity. The size and distribution of these costs are higher in rural areas. Grouping transactions costs into four - organizations, belief systems, knowledge and information, and institutions - two of the latter are evaluated empirically: growth in the bid culture, and monitoring and evaluation. Amongst 65 Agents of Rural Governance (ARGs) in Gloucestershire, both were found to be increasing over time, but those relating to finance were a greater burden than those of monitoring: the latter can improve ARG performance. Increasing transactions costs in rural decision-making appears to be at variance with ambitions of achieving 'smaller government' through, for example, the Big Society. Smaller government is likely to be shifting the incidence of these costs, rather than reducing them. © 2011 Blackwell Publishing Ltd

National Health Service National Staff Survey, 2010

Abstract copyright UK Data Service and data collection copyright owner.Background The Commission for Health Improvement (CHI), in conjunction with the Department of Health (DH), appointed Aston University to develop and pilot a new national National Health Service (NHS) staff survey, commencing in 2003, and to establish an advice centre and web site to support that process. Administration of the programme was taken over by the Healthcare Commission in time for the 2004 series. On the 1st April 2009, the Care Quality Commission (CQC) was formed which replaced the Healthcare Commission (users should note that some of the surveys in the series conducted prior to this date will still be attributed to the Healthcare Commission). In 2011 the Department of Health took over management of the survey. Since 2013 NHS England (NHSE) have been in charge of the survey programme. Researchers at Aston University were responsible for the initial development of the survey questionnaire instrument, and for the setting up of the NHS National Staff Survey Advice Centre. From 2011, Picker Institute Europe took over from Aston University as survey contractors. All organisations concerned worked in partnership to consult widely with NHS staff about the content of the new national survey. The work was conducted under the guidance of a stakeholder group, which contained representatives from the staff side, CQC, DH, human resources directors, Strategic Health Authorities and the NHS workforce. Aims and conduct of the survey The purpose of the annual NHS staff survey is to collect staff views about working in their local NHS trust. The survey has been designed to replace trusts' own annual staff surveys, the DH '10 core questions', and the HC 'Clinical Governance Review' staff surveys. It is intended that this one annual survey will cover the needs of HC, DH and trusts. Thus, it provides information for deriving national performance measures (including star ratings) and to help the NHS, at national and local level, work towards the 'Improving Working Lives' standard. The design also incorporates questions relating to the 'Positively Diverse Programme'. Trusts will be able to use the findings to identify how their policies are working in practice. The survey enables organisations, for the first time, to benchmark themselves against other similar NHS organisations and the NHS as a whole, on a range of measures of staff satisfaction and opinion. From 2013, the NHS Staff Survey went out to all main trust types - social enterprises, clinical commissioning groups and clinical support units were able to opt themselves in to the survey. Organisations were allowed to conduct the survey electronically and to submit data for an entire census or extended sample of their organisation. Previously the sample was restricted to 850 staff. The collection of data (i.e. the survey fieldwork) is conducted by a number of independent survey contractors (see documentation for individual survey information). The contractors are appointed directly by each NHS trust in England and are required to follow a set of detailed guidance notes supplied by the Advice Centre (see web site link above), which covers the methodology required for the survey. For example, this includes details on how to draw the random sample, the requirements for printing of questionnaires, letters to be sent to respondents, data entry and submission. At the end of the fieldwork, the data are then sent to the Advice Centre. From the data submitted, each participating NHS trust in England receives a benchmarked 'Feedback Report' from the Advice Centre, which also produces (on behalf of the Department of Health) a series of detailed spreadsheets which report details of each question covered in the survey for each participating trust in England, and also a 'Key Findings' summary report covering the survey findings at national level. Further information about the survey series and related publications are available from the Advice Centre web site (see link above). As in previous years, the 2010 survey contained different versions of the core questionnaire for each of the four main sectors (acute, ambulance, mental health and primary care). The majority of the content is the same across the different versions of the core questionnaire but there are a few sector-specific questions. A few questions were dropped and some added for 2010 - see Appendix 9 of the Guidance Notes document for details of changes. Main Topics:Topics covered in the survey include: work-life balance; appraisal; training, learning and development; team working; health and safety; errors and incidents witnessed; job characteristics and arrangements; management and supervision; perceptions of organisation worked for; harassment, bullying and violence; and respondents' demographic characteristics.Sector-specific questions include: (acute) - infection control; (ambulance) - communication and distance between trust headquarters and ambulance stations; safe working environment; (mental health) - mental health specific training; partnership working.<br

Managing social and community development programmes in rural areas An evaluation of the Rural Development Commission's Social Programme

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Towards a framework of IT and managerial innovation in Korea

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Regina v. the Greenpeace 28 Volunteer participation in direct action advocacy

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