Handbook of Systems Analysis: Volume 1. Overview. Chapter 5. Formulating Problems for Systems Analysis

The International Institute for Applied Systems Analysis is preparing a Handbook of Systems Analysis, which will appear in three volumes: Volume 1: Overview is aimed at a widely varied audience of producers and users of systems analysis studies. Volume 2: Methods is aimed at systems analysts and other members of systems analysis teams who need basic knowledge of methods in which they are not expert; this volume contains introductory overviews of such methods. Volume 3: Cases contains descriptions of actual systems analyses that illustrate the diversity of the contexts and methods of systems analysis. Drafts of the material for Volume 1 are being widely circulated for comment and suggested improvement. This Working Paper is the current draft of Chapter 5. Correspondence is invited. Volume 1 will consist of the following ten chapters: 1. The context, nature, and use of systems analysis 2. The genesis of applied systems analysis; 3. Examples of applied systems analysis 4. The methods of applied systems analysis: An introduction and overview 5. Formulating problems for systems analysis 6. Objectives, constraints, and alternatives 7. Predicting the consequences: Models and modeling 8. Guidance for decision 9. Implementation 10. The practice of applied systems analysis To these ten chapters will be added a glossary of systems analysis terms and a bibliography of basic works in the field

Changing the Ties That Bind? The Emerging Roles and Identities of General Practitioners and Managers in the New Clinical Commissioning Groups in the English NHS

The English National Health Service (NHS) is undergoing significant reorganization following the 2012 Health and Social Care Act. Key to these changes is the shift of responsibility for commissioning services from Primary Care Trusts (PCTs) to general practitioners (GPs) working together in Clinical Commissioning Groups (CCGs). This article is based on an empirical study that examined the development of emerging CCGs in eight case studies across England between September 2011 and June 2012. The findings are based on interviews with GPs and managers, observations of meetings, and reading of related documents. Scott’s notion that institutions are constituted by three pillars—the regulative, normative, and cognitive–cultural—is explored here. This approach helps to understand the changing roles and identities of doctors and managers implicated by the present reforms. This article notes the far reaching changes in the regulative pillar and questions how these changes will affect the normative and cultural–cognitive pillars

Managing action research: the PEArL framework

The difficulty of managing and validating Action Research field studies has been widely discussed. Several different approaches to Action Research have emerged, and one of the most widely used models is Checkland’s FMA model, where a framework is provided to facilitate interested individuals in ‘recovering’ the route of the inquiry. In this paper, I argue that the FMA model is a valuable tool for planning the application of theoretical ideas in a practical situation, but that, as a guide to Action Research, it still fails to provide a sense of the manner in which an inquiry is undertaken. The PEArL mnemonic has been previously offered as a guide to facilitate researchers, participants, and those interested in gaining an appreciation of the manner in which an inquiry is conducted. In this paper, it is argued that applying the PEArL elements does not provide insight into the dynamic nature of collaborative inquiry. In order to gain a sense of the manner in which an inquiry was undertaken it is necessary to apply the PEArL mnemonic alongside a framework that facilitates the flow of the action research cycle. To illustrate the framework, an Action Research field study is described that was undertaken with residents and key workers in a shelter for the homeless, where the aim was to create a shared understanding of complex needs and support requirements

Formulating Problems for Systems Analysis

The International Institute for Applied Systems Analysis is preparing a "Handbook of Systems Analysis," which will appear in three volumes: Volume 1, "Overview," is aimed at a widely varied audience of producers and users of systems analysis; Volume 2, "Methods," is aimed at systems analysts who need basic knowledge of methods in which they are not expert; the volume contains introductory overviews of such methods; Volume 3, "Cases," contains descriptions of actual systems analyses that illustrate the methods and diversity of systems analysis. Volume 1 will have ten chapters: 1) The context, nature, and use of systems analysis; 2) Applied systems analysis: a genetic approach; 3) Examples of systems analysis; 4) The method of applied systems analysis: finding a solution; 5) Formulating problems for systems analysis; 6) Generating alternatives for systems analysis; 7) Estimating and predicting consequences; 8) Guidance for decision; 9) Implementation; 10) Principles of good practice. To these ten chapters will be added a glossary of systems analysis terms and a bibliography of basic books in the field. This Working Paper is the current draft of Chapter 5. A word about the format of this Working Paper. In order to make the text of each chapter easily amended, it has been entered into the IIASA computer, from which the current version can be reproduced in a few minute's time whenever needed. This Working Paper was produced from the version current on the date shown on each page

Governing in the Anthropocene: What Future Systems Thinking in Practice?

The revealing and concealing features of the metaphor ‘earth as Anthropocene’ are explored in an inquiry that asks: In the Anthropocene what possible futures emerge for systems thinking in practice? Framing choice, so important yet so poorly realised, is the starting point of the inquiry. Three extant conceptual pathway-dependencies are unpacked: governance or governing; practice or practising and ‘system’. New data on the organisational complexity within the field of cybersystemics is presented; new ‘imaginaries’ including systemic co-inquiry and institutional recovery are proposed as novel institutions and practices to facilitate systemic transformations within an Anthropocene setting. The arguments of the paper are illustrated through a research case study based on attempts to transform water and/or river situations towards systemic water governance. It is concluded that future systems research can be understood as the search for effective ‘imaginaries’ that offer fresh possibilities within an Anthropocene framing

The Iwakura Mission in Britain, 1872

In London, at the Suntory and Toyota International Centres for Economics and Related Disciplines (LSE), a symposium was held on 6 December 1997 - the anniversary of the day when the members of Iwakura's delegation were received by Queen Victoria. Comprising four lectures the symposium was attended by a packed audience of some 75 people including the Joint Chairman and many members of the Japan Society, several senior representatives of the Japanese Embassy, as well as staff and students. Each lecturer focused sharply on a particular aspect of the Mission's work in Britain that fell within his or her special field and each prompted numerous questions and much discussion. It is some measure of the great range of subjects that the Mission was attempting to cover that there was no real overlap between any of the four papers. They are now included in their entirety in this volume.Iwakura misson, Victorian London, Kume Kunitake, Iwakura Tomomi, Ito Hirobumi, education, industry, exports, religion, Kairan Jikki chronicle, Meiji government, unequal treaties, embassy, 1872, Britain, Japan, America.

The limits of market-based reforms in the NHS: the case of alternative providers in primary care

BACKGROUND: Historically, primary medical care in the UK has been delivered by general practitioners who are independent contractors, operating under a contract, which until 2004 was subject to little performance management. In keeping with the wider political impetus to introduce markets and competition into the NHS, reforms were introduced to allow new providers to bid for contracts to provide primary care services in England. These contracts known as ‘Alternative Provider Medical Services’, were encouraged by two centrally-driven rounds of procurement (2007/8 and 2008/9). This research investigated the commissioning and operation of such Alternative Providers of Primary Care (APPCs). METHODS: Two qualitative case studies were undertaken in purposively sampled English Primary Care Trusts (PCTs) and their associated APPCs over 14 months (2009-10). We observed 65 hours of meetings, conducted 23 interviews with PCT and practice staff, and gathered relevant associated documentation. RESULTS AND CONCLUSIONS: We found that the procurement and contracting process was costly and time-consuming. Extensive local consultation was undertaken, and there was considerable opposition in some areas. Many APPCs struggled to build up their patient list sizes, whilst over-performing on walk-in contracts. Contracting for APPCs was ‘transactional’, in marked contrast to the ‘relational’ contracting usually found in the NHS, with APPCs subject to tight performance management. These complicated and costly processes contrast to those experienced by traditionally owned GP partnerships. However, managers reported that the perception of competition had led existing practices to improve their services. The Coalition Government elected in 2010 is committed to ‘Any Qualified Provider’ of secondary care, and some commentators argue that this should also be applied to primary care. Our research suggests that, if this is to happen, a debate is needed about the operation of a market in primary care provision, including the trade-offs between transparent processes, fair procurement, performance assurance and cost

Views of NHS commissioners on commissioning support provision. Evidence from a qualitative study examining the early development of clinical commissioning groups in England

Objective: The 2010 healthcare reform in England introduced primary care-led commissioning in the National Health Service (NHS) by establishing clinical commissioning groups (CCGs). A key factor for the success of the reform is the provision of excellent commissioning support services to CCGs. The Government's aim is to create a vibrant market of competing providers of such services (from both for-profit and not-for-profit sectors). Until this market develops, however, commissioning support units (CSUs) have been created from which CCGs are buying commissioning support functions. This study explored the attitudes of CCGs towards outsourcing commissioning support functions during the initial stage of the reform. Design: The research took place between September 2011 and June 2012. We used a case study research design in eight CCGs, conducting in-depth interviews, observation of meetings and analysis of policy documents. Setting/participants: We conducted 96 interviews and observed 146 meetings (a total of approximately 439 h). Results: Many CCGs were reluctant to outsource core commissioning support functions (such as contracting) for fear of losing local knowledge and trusted relationships. Others were disappointed by the absence of choice and saw CSUs as monopolies and a recreation of the abolished PCTs. Many expressed doubts about the expectation that outsourcing of commissioning support functions will result in lower administrative costs. Conclusions: Given the nature of healthcare commissioning, outsourcing vital commissioning support functions may not be the preferred option of CCGs. Considerations of high transaction costs, and the risk of fragmentation of services and loss of trusted relationships involved in short-term contracting, may lead most CCGs to decide to form long-term partnerships with commissioning support suppliers in the future. This option, however, limits competition by creating ‘network closure’ and calls into question the Government's intention to create a vibrant market of commissioning support provision

Bringing genetics into primary care: findings from a national evaluation of pilots in England

Objectives: Developments in genetic knowledge and clinical applications are seen as rendering traditional modes of organizing genetics provision increasingly inappropriate. In common with a number of developed world countries the UK has sought to increase the role of primary care in delivering such services. However, efforts to reconfigure service delivery face multiple challenges associated with divergent policy objectives, organizational boundaries and professional cultures. This paper presents findings from an evaluation of an English initiative to integrate genetics into 'mainstream' clinical provision in the National Health Service. Methods: Qualitative research in 11 case-study sites focusing on attempts by pilots funded by the initiative to embed knowledge and provision within primary care illustrating barriers faced and the ways in which these were surmounted. Results: Lack of intrinsic interest in clinical genetics among primary care staff was compounded by national targets that focused their attention elsewhere and by service structures that rendered genetics a peripheral concern demanding minimal engagement. Established divisions between the commissioning of mainstream and specialist services, along with the pressures of shorter-term targets, impeded ongoing funding. Conclusions: More wide-ranging policy and organizational support is required if the aim of entrenching genetics knowledge and practice across the Health Service is to be realized

Secondary user relations in emerging mobile computing environments

Mobile technologies are enabling access to information in diverse environ.ments, and are exposing a wider group of individuals to said technology. Therefore, this paper proposes that a wider view of user relations than is usually considered in information systems research is required. Specifically, we examine the potential effects of emerging mobile technologies on end-­‐user relations with a focus on the ‘secondary user’, those who are not intended to interact directly with the technology but are intended consumers of the technology’s output. For illustration, we draw on a study of a U.K. regional Fire and Rescue Service and deconstruct mobile technology use at Fire Service incidents. Our findings provide insights, which suggest that, because of the nature of mobile technologies and their context of use, secondary user relations in such emerging mobile environments are important and need further exploration