188 research outputs found
Continuity or change in business representation in Britain? An assessment of the Heseltine initiatives of the 1990s
Britain has a fragmented, overlapping, and underresourced system of business representation. Attempts at reform, however, have proved difficult and largely unsuccessful. A coherent and logical system is relevant, in terms of both an effective dialogue between government and business, and the promotion of competitiveness and productivity. Through interviews and archival evidence, I look at how government has attempted to reform business associations. The main focus is the Heseltine initiatives of the 1990s: I outline the various initiatives taken, reveal the extent to which policy represented continuity or change, and consider whether the initiatives were effective. I show that they had a degree of success but that they would have made greater impact if they had been sustained over a longer period of time. A consideration of the historical context, moreover, suggests there may be limits to the role of government intervention in business association reform
A prospective study of consecutive emergency medical admissions to compare a novel automated computer-aided mortality risk score and clinical judgement of patient mortality risk
YesObjectives: To compare the performance of a validated automatic computer-aided risk of mortality (CARM) score versus medical judgement in predicting the risk of in-hospital mortality for patients following emergency medical admission. Design: A prospective study. Setting: Consecutive emergency medical admissions in York hospital. Participants: Elderly medical admissions in one ward were assigned a risk of death at the first post-take ward round by consultant staff over a 2-week period. The consultant medical staff used the same variables to assign a risk of death to the patient as the CARM (age, sex, National Early Warning Score and blood test results) but also had access to the clinical history, examination findings and any immediately available investigations such as ECGs. The performance of the CARM versus consultant medical judgement was compared using the c-statistic and the positive predictive value (PPV). Results: The in-hospital mortality was 31.8% (130/409). For patients with complete blood test results, the c-statistic for CARM was 0.75 (95% CI: 0.69 to 0.81) versus 0.72 (95% CI: 0.66 to 0.78) for medical judgements (p=0.28). For patients with at least one missing blood test result, the c-statistics were similar (medical judgements 0.70 (95% CI: 0.60 to 0.81) vs CARM 0.70 (95% CI: 0.59 to 0.80)). At a 10% mortality risk, the PPV for CARM was higher than medical judgements in patients with complete blood test results, 62.0% (95% CI: 51.2 to 71.9) versus 49.2% (95% CI: 39.8 to 58.5) but not when blood test results were missing, 50.0% (95% CI: 24.7 to 75.3) versus 53.3% (95% CI: 34.3 to 71.7). Conclusions: CARM is comparable with medical judgements in discriminating in-hospital mortality following emergency admission to an elderly care ward. CARM may have a promising role in supporting medical judgements in determining the patient's risk of death in hospital. Further evaluation of CARM in routine practice is required.Supported by the Health Foundation, National Institute for Health Research (NIHR) Yorkshire and Humberside Patient Safety Translational Research Centre (NIHR YHPSTRC)
Personalised service? Changing the role of the government librarian
Investigates the feasibility of personalised information service in a government department. A qualitative methodology explored stakeholder opinions on the remit, marketing, resourcing and measurement of the service. A questionnaire and interviews gathered experiences of personalised provision across the government sector. Potential users were similarly surveyed to discuss how the service could meet their needs. Data were analysed using coding techniques to identify emerging theory. Lessons learned from government librarians centred on clarifying requirements, balancing workloads and selective marketing. The user survey showed low usage and awareness of existing specialist services, but high levels of need and interest in services repackaged as a tailored offering. Fieldwork confirmed findings from the literature on the scope for adding value through information management advice, information skills training and substantive research assistance and the need to understand business processes and develop effective partnerships. Concluding recommendations focus on service definition, strategic marketing, resource utilisation and performance measurement
Responding to COVID-19 in the Liverpool City Region: Coordinating Public Procurement: Drawing Closer in a Time of Distancing
Local industrial strategy and skills policy in England: Assessing the linkages and limitations â a case study of the Sheffield City Deal
This paper examines changes in local economic development policy which occurred between 2010 and 2015, with a focus on the relationship between industrial strategy and skills policy. Under the Coalition Government, Local Enterprise Partnerships were established and tasked with facilitating local growth, and to do so many identified a set of (potential) growth sectors for industrial strategy to support. These sectors tended to be drawn from a relatively narrow range of industries which therefore often excluded a large proportion of the local economy. An important focus of the support for growth sectors for many has been through an ambition to influence the local skills system. Skills policy more broadly has been an important dimension of devolution, and a number of City Deals have included elements of skills policy. Echoing previous national policy however, the focus of local concerns with skills under devolution has been framed largely with reference to skills gaps and shortages. While specific skills gaps and shortages can be identified, this paper questions whether this default position is reflected widely, and as such, if a narrow focus on skills supply is a sufficient approach. It is argued that to support local growth across a broad base, greater attention needs to be paid to stimulating employer demand for skills through better integrating industrial and innovation policy with skills policymaking across a wider section of the local economy. To support these arguments we present a case study of the Sheffield City Deal
Association between objectively measured physical activity and opioid, hypnotic, or anticholinergic medication use in older people â data from the Physical Activity Cohort Scotland study
Territory, power and statecraft: understanding English devolution
In recent decades, the devolution of power to subnational regional authorities has formed a key element of what has been termed the âunravellingâ or âunbundlingâ of the state in many parts of the world. Even in the United Kingdom, with its distinctive global reputation as a power-hoarding majoritarian democracy, the devolution of powers to Scotland, Wales and Northern Ireland since 1998 can be located within this broader devolutionary dynamic. In recent years, this process has focused on âthe English questionâ and a reform agenda that claimed to offer a âdevolution revolutionâ. This paper offers the first research-led analysis of the scope, scale and implications of these post-2015 reforms to English governance. It utilizes Jim Bulpittâs statecraft approach to explore the changing nature of centreâperiphery relationships within England. The main conclusion has been that a ârhetoricâreality gapâ currently exists and a âdevolution revolutionâ has not occurred
Elected Mayors: Leading Locally?
The directly elected executive mayor was introduced to England a decade ago. Drawing inspiration from European and American experience, the elected mayor appealed to both New Labour and Conservative commentators in offering a solution to perceived problems of local leadership. There was a shared view that governance of local areas was failing and that elected mayors were the answer. The first local referendums were held in 2001. Most have continued to reject the idea of the elected mayor. During 2012, the coalition government initiated 10 further mayoral referendums in England's largest cities but only one, Bristol, opted for an elected mayor. Overall, there is no evidence of widespread public support, yet the prospect of more mayors - with enhanced powers - remains firmly on the policy agenda. Drawing from a decade of research, this paper considers reasons for the persistence of the mayoral experiment, the importance of local factors in the few areas where mayors hold office and the link to current policy debates. Using the authors' analytical leadership grid, this paper links the governmental, governance and allegiance roles of mayors to the problematic nature of local leadership. It then draws tentative conclusions about the strange case of the elected mayor in England
Assessing the format and content of journal published and non-journal published rapid review reports : A comparative study
BACKGROUND: As production of rapid reviews (RRs) increases in healthcare, knowing how to efficiently convey RR evidence to various end-users is important given they are often intended to directly inform decision-making. Little is known about how often RRs are produced in the published or unpublished domains, and what and how information is structured. OBJECTIVES: To compare and contrast report format and content features of journal-published (JP) and non-journal published (NJP) RRs. METHODS: JP RRs were identified from key databases, and NJP RRs were identified from a grey literature search of 148 RR producing organizations and were sampled proportionate to cluster size by organization and product type to match the JP RR group. We extracted and formally compared 'how' (i.e., visual arrangement) and 'what' information was presented. RESULTS: We identified 103 RRs (52 JP and 51 NJP) from 2016. A higher percentage of certain features were observed in JP RRs compared to NJP RRs (e.g., reporting authors; use of a traditional journal article structure; section headers including abstract, methods, discussion, conclusions, acknowledgments, conflict of interests, and author contributions; and use of figures (e.g., Study Flow Diagram) in the main document). For NJP RRs, a higher percentage of features were observed (e.g., use non-traditional report structures; bannering of executive summary sections and appendices; use of typographic cues; and including outcome tables). NJP RRs were more than double in length versus JP RRs. Including key messages was uncommon in both groups. CONCLUSIONS: This comparative study highlights differences between JP and NJP RRs. Both groups may benefit from better use of plain language, and more clear and concise design. Alternative innovative formats and end-user preferences for content and layout should be studied further with thought given to other considerations to ensure better packaging of RR results to facilitate uptake into policy and practice. STUDY REGISTRATION: The full protocol is available at: https://osf.io/29xvk/
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