Social enterprise in health organisation and management: hybridity or homogeneity?

The purpose of this paper is to reflect on social enterprise as an organisational form in health organisation and management.\ud \ud The paper presents a critique of the underlying assumptions associated with social enterprise in the context of English health and social care.\ud \ud The rise of social enterprise models of service provision reflects increasingly hybrid organisational forms and functions entering the health and social care market. Whilst at one level this hybridity increases the diversity of service providers promoting innovative and responsive services, the paper argues that further inspection of the assumptions associated with social enterprise reveal an organisational form that is symbolic of isomorphic processes pushing healthcare organisations toward greater levels of homogeneity, based on market-based standardisation and practices. Social enterprise forms part of isomorphic processes moving healthcare organisation and management towards market “norms”.\ud \ud In line with the aim of the “New Perspectives section”, the paper aims to present a provocative perspective about developments in health and social care, as a spur to further debate and research in this area.\ud \u

Framing quality improvement tools and techniques in healthcare: the case of Improvement Leaders' Guides

The paper presents a study of how quality improvement tools are framed within healthcare settings.\ud \ud The paper employs an interpretive approach to understand how quality improvement tools and techniques are mobilised and legitimated using a case study of the NHS Modernisation Agency Improvement Leaders’ Guides.\ud \ud Improvement Leaders’ Guides were framed within a service improvement approach encouraging the use of quality improvement tools and techniques within healthcare settings. Their use formed part of enacting tools and techniques across different contexts. Whilst this enactment was believed to support the mobililsation of tools and techniques, the experience also illustrated the challenges in distributing such approaches.\ud \ud The paper provides a contribution to our understanding of framing the 'social act' of quality improvement. Given the ongoing emphasis on quality improvement and the persistent challenges involved, it also provides information for healthcare leaders globally in seeking to develop, implement or modify similar tools and distribute leadership within health and social care settings.\ud \ud \u

Jumped or pushed: what motivates NHS staff to set up a social enterprise?

Purpose – The purpose of this paper is to examine the motivations behind public sector spin outs, focusing on the Right to Request policy, which enabled NHS staff to set up their own social enterprises to deliver healthcare services.\ud \ud Design/methodology/approach – The paper draws on empirical data gathered from 16 in-depth interviews with individuals who had led a Right to Request proposal.\ud \ud Findings – Motivations to spin out of the NHS into a social enterprise were often “empathetic” in nature, built around the good of the service for staff and users. Alongside this, some felt “pushed” out of the NHS as a result of government restructuring policy, with social enterprise offering the only hope to survive as an organisation.\ud \ud Research limitations/implications – The study captures a particular point in time and there may be other perspectives that have not been included.\ud \ud Social implications – The paper is of use to academics, policy makers and practitioners. It provides an important contribution in thinking about how to motivate public sector staff, especially those from a health profession, to consider spinning out into social enterprises.\ud \ud Originality/value – The paper is the first to look at the motivations of healthcare spin outs through the Right to Request programme. The findings are related to previous literature on social entrepreneurship within public sector settings.\u

What was the programme theory of New Labour’s health system reforms?

To examine whether the Health System Reforms delivered the promise of being a coherent and mutually supporting reform programme; to identify the underlying programme theory of the reform programme; to reflect on whether lessons have been learned. \ud \ud Documentary analysis mapping the implicit and explicit programme theories about how the reforms intended to achieve its goals and outcomes. Semi-structured interviews with policy-makers to further understand the programme theory. \ud \ud The Health System Reforms assumed a ‘one size fits all’ approach to policy implementation with little recognition that some contexts can be more receptive than others. There was evidence of some policy evolution and rebalancing between the reform streams as policy-makers became aware of some perverse incentives and unforeseen consequences. Later elements aimed to restore balance to the system. \ud \ud The Health System Reforms do not appear to comprise a coherent and mutually supportive set of levers and incentives. They appear unbalanced with the centre of gravity favouring suppliers over commissioners. However, recent reform changes have sought to redress this imbalance to some extent, suggesting that lessons have been learned and policies have been adapted over time

Studies of ylides

The preparation and attempted preparation of diaminomethylene-sulphuranes (thiouronium ylides) by various routes is described. The principal route chosen was by proton abstraction from the conjugate acid (thiouronium salt) using a suitable non-hydroxylic base, usually phenyl lithium or triethylamine. In the range of compounds examined where the carbanionic substituents contained electron withdrawing groups such as carbonyl, sulphonyl, nitrile and nitro groups, considerable difficulty was encountered in the preparation of the precursor salts. Of the few salts in this category that were obtainable, only one (disulphonyl substituted) gave rise to a stable ylide. On the other hand, many salts containing the cyclopentadiene ring gave rise to ylides. Some of these, notably the fluorenylides, could be isolated and characterised, while the properties of others could only be observed in solution and they decomposed or rearranged on attempted isolation. A second preparative route was briefly investigated, namely the thermal decomposition of 9-diazofluorene in the presence of arylthioureas, but in several cases this led to unexpected products. Comparative studies of the reactivities of the fluorenylides towards carbonyl compounds and hydrolysis have been made, and some other reactions of these ylides are also described. The 2,3,4-triphenylcyclopentadienylides have been found to undergo novel cyclisation reactions with aldehydes and nitrosobenzene. A product from the former reaction was dehydrogenated to give a stable heterocycle with a 14Π electron periphery. An attempt to prepare a selenium analogue of one of the thiouronium fluorenylides is described. The attempted preparation of guanidinium fluorenylides by various methods is described, principally the 'salt' and 'diazo' methods. The former method was more suitable for alkyl substituted guanidines, whereas the latter method was of benefit with aryl substituents. Proton abstraction from ono of the alkylguanidinium salts gave rise to a product which showed some evidence for ylide character. On the other hand, the aryl substituted products appeared to show no ylide-like properties, A further point of interest arose in the diazo reaction, whore the fluorene nucleus was shown to have substituted on the more sterically hindered position, which was verified later by synthesis

Strain engineering of Ge/GeSn photonic structures

Silicon compatible light sources have been referred to as the \holy grail" for Si photonics. Such devices would give the potential for a range of applications; from optical interconnects on integrated circuits, to cheap optical gas sensing and spectroscopic devices on a Si platform. Whilst numerous heterogeneous integration schemes for integrating III-V lasers with Si wafers are being pursued, it would be far easier and cheaper to use the epitaxial tools already in complementary-metal-oxide-semiconductor (CMOS) lines, where Ge and SiGe chemical vapour deposition is used in a number of advanced technology nodes. Germanium is an efficient absorber, but a poor emitter due to a band-structure which is narrowly indirect, but by only 140 meV. Through the application of strain, or by alloying with Sn, the Ge bandstructure can be engineered to become direct bandgap, making it an effcient light emitter. In this work, silicon nitride stressor technologies, and CMOS compatible processes are used to produce levels of tensile strain in Ge optical micro-cavities where a transition to direct bandgap is predicted. The strain distribution, and the optical emission of a range of Ge optical cavities are analyzed, with an emphasis on the effect of strain distribution on the material band-structure. Peak levels of strain are reported which are higher than that reported in the literature using comparable techniques. Furthermore, these techniques are applied to GeSn epi-layers and demonstrate that highly compressive GeSn alloys grown pseudomorphically on Ge virtual substrates, can be transformed to direct bandgap materials, with emission >3 m wavelength { the longest wavelength emission demonstrated from GeSn alloys. Such emission is modeled to have a good overlap with methane absorption lines, indicating that there is huge potential for the such technologies to be used for low cost, Si compatible gas sensing in the mid-infrared

Ultra Broadband Mid-Infrared Ge-on-Si Polarization Rotator

The design and modelling of an ultra broadband Ge-on-Si waveguide polarization rotator is presented. The polarization rotator demonstrates high extinction ratio (≥ 18.5 dB) and low insertion loss (≤ 1 dB) over the full operating range of 8 to 11 μm wavelength

Germanium-on-silicon Waveguides for Mid-infrared Photonic Sensing Chips

Germanium-on-silicon rib waveguides are modelled, fabricated and characterized with a novel near-field infrared spectroscopy technique that allows on-chip investigation of the waveguide losses at 5.8 μm wavelength