The organisational and human resource challenges facing primary care trusts : protocol of a multiple case study

BACKGROUND: The study is designed to assess the organisational and human resource challenges faced by Primary Care Trusts (PCTs). Its objectives are to: specify the organisational and human resources challenges faced by PCTs in fulfilling the roles envisaged in government and local policy; examine how PCTs are addressing these challenges, in particular, to describe the organisational forms they have adopted, and the OD/HR strategies and initiatives they have planned or in place; assess how effective these structures, strategies and initiatives have been in enabling the PCTs to meet the organisational and human resources challenges they face; identify the factors, both internal to the PCT and in the wider health community, which have contributed to the success or failure of different structures, strategies and initiatives. METHODS: The study will be undertaken in three stages. In Stage 1 the key literature on public sector and NHS organisational development and human resources management will be reviewed, and discussions will be held with key researchers and policy makers working in this area. Stage 2 will focus on detailed case studies in six PCTs designed to examine the organisational and human resources challenges they face. Data will be collected using semi-structured interviews, group discussion, site visits, observation of key meetings and examination of local documentation. The findings from the case study PCTs will be cross checked with a Reference Group of up to 20 other PCG/Ts, and key officers working in organisational development or primary care at local, regional and national level. In Stage 3 analysis of findings from the preparatory work, the case studies and the feedback from the Reference Group will be used to identify practical lessons for PCTs, key messages for policy makers, and contributions to further theoretical development

Developing transferable management skills through Action Learning

There has been increasing criticism of the relevance of the Master of Business Administration (MBA) in developing skills and competencies. Action learning, devised to address problem-solving in the workplace, offers a potential response to such criticism. This paper offers an insight into one university’s attempt to integrate action learning into the curriculum. Sixty-five part-time students were questioned at two points in their final year about their action learning experience and the enhancement of relevant skills and competencies. Results showed a mixed picture. Strong confirmation of the importance of selected skills and competencies contrasted with weaker agreement about the extent to which these were developed by action learning. There was, nonetheless, a firm belief in the positive impact on the learning process. The paper concludes that action learning is not a panacea but has an important role in a repertoire of educational approaches to develop relevant skills and competencies

To Act and Learn: A Bakhtinian Exploration of Action Learning

This paper considers the work of the Russian social philosopher and cultural theorist, Mikhail Mikhailovich Bakhtin as a source of understanding for those involved in action learning. Drawing upon data gathered over two years during the evaluation of 20 action learning sets in the north of England, we will seek to work with the ideas of Bakhtin to consider their value for those involved in action learning. We consider key Bakhtin features such as Making Meaning, Participative Thinking, Theoreticism and Presence, Others and Outsideness, Voices and Carnival to highlight how Bakhtin's can enhance our understanding of the nature of action and learning

Leadership Development, Wicked Problems and Action Learning: Provocations to a Debate

"The problem is the domain of the leader; unlike the puzzle, it is charged with unanswerable questions as well as unformulatable ones" (Revans, 1982: 712) If leadership is defined by a willingness to tackle the intractable or wicked issues - rather than the technical or procedural (Revans 1982: 712-4; Grint, 2005; 2007; 2010) - then, given that action learning is commonly employed on leadership development programmes, do the participants on these programmes address the unanswerable and unformulatable questions of leadership? This rather complex question arose in a conversation between the three of us at an editorial board meeting. It then led on to a protracted discussion over several months. We had all worked on leadership development programmes but had they actually tackled those challenges that formed the essence of leadership according to Revans, Grint and others? This felt like a straightforward query, yet we found it difficult to frame as a research question. The focus on the combination of leadership development, action learning and wicked problems proved hard to formulate; depending on which was taken as the "lead" term, different, if related, inquiries might follow. The question lay in the conjunction of these notions, and in our individual and joint experiences of trying to grasp it we found echoes of Revans' descriptions of leadership work

A simple inverse method for the interpretation of pumped flowing fluid electrical conductivity logs

Pumped flowing fluid electrical conductivity (FFEC) logs, also known as pumped borehole dilution testing, is an experimentally easy‐to‐perform approach to evaluating vertical variations in the hydraulic conductivity of an aquifer. In contrast to the simplicity of the logging equipment, analysis of the data is complex and laborious. Current methods typically require repeated solution of the advection‐dispersion equation (ADE) for describing the flow in the borehole and comparison with the experimental results. In this paper, we describe a direct solution for determining borehole fluid velocity that bypasses the need for complex numerical computation and repetitive optimization. The method rests on the observation that, while solving the ADE for concentration profile in the borehole (as required for modeling and combined methods) is computationally challenging, the solution for flow distribution along the length of the borehole given concentration data is straightforward. The method can accommodate varying borehole diameters, and uses the fact that multiple profiles are taken in the standard logging approach to reduce the impact of noise. Data from both a simulated borehole and from a field test are successfully analyzed. The method is implemented in a spreadsheet, which is available as supporting information material to this paper

Do institutional arrangements make a difference to transport policy and implementation? Lessons for Britain

This paper describes local government decision-making in transport in three areas of the UK, London, West Yorkshire and Edinburgh, in which major changes in local government decision-making structures have taken place over the last decade, and between which arrangements are now very different. The research discusses whether institutional change has had a beneficial or adverse effect, and whether any of the current structures provides a more effective framework for policy development and implementation. The results show that although the sites share a broadly common set of objectives there are differences in devolved responsibilities and in the extent to which various policy options are within the control of the bodies charged with transport policy delivery. The existence of several tiers of government, coupled with the many interactions required between these public sector bodies and the predominantly private sector public transport operators appears to create extra transactional barriers and impedes the implementation of the most effective measures for cutting congestion. There is, however, a compelling argument for the presence of an overarching tier of government to organise travel over a spatial scale compatible with that of major commuter patterns. The extent to which such arrangements currently appear to work is a function of the range of powers and the funding levels afforded to the co-ordinating organisation

Fifty years of spellchecking

A short history of spellchecking from the late 1950s to the present day, describing its development through dictionary lookup, affix stripping, correction, confusion sets, and edit distance to the use of gigantic databases

Radio-Excess IRAS Galaxies: PMN/FSC Sample Selection

A sample of 178 extragalactic objects is defined by correlating the 60 micron IRAS FSC with the 5 GHz PMN catalog. Of these, 98 objects lie above the radio/far-infrared relation for radio-quiet objects. These radio-excess galaxies and quasars have a uniform distribution of radio excesses and appear to be a new population of active galaxies not present in previous radio/far-infrared samples. The radio-excess objects extend over the full range of far-infrared luminosities seen in extragalactic objects. Objects with small radio excesses are more likely to have far-infrared colors similar to starbursts, while objects with large radio excesses have far-infrared colors typical of pure AGN. Some of the most far-infrared luminous radio-excess objects have the highest far-infrared optical depths. These are good candidates to search for hidden broad line regions in polarized light or via near-infrared spectroscopy. Some low far-infrared luminosity radio-excess objects appear to derive a dominant fraction of their far-infrared emission from star formation, despite the dominance of the AGN at radio wavelengths. Many of the radio-excess objects have sizes likely to be smaller than the optical host, but show optically thin radio emission. We draw parallels between these objects and high radio luminosity Compact Steep-Spectrum (CSS) and GigaHertz Peaked-Spectrum (GPS) objects. Radio sources with these characteristics may be young AGN in which the radio activity has begun only recently. Alternatively, high central densities in the host galaxies may be confining the radio sources to compact sizes. We discuss future observations required to distinguish between these possibilities and determine the nature of radio-excess objects.Comment: Submitted to AJ. 44 pages, 11 figures. A version of the paper with higher quality figures is available from http://www.mso.anu.edu.au/~cdrake/PMNFSC/paperI

Comparison of incidence, rate and length of all-cause hospital admissions between adults with normoglycaemia, impaired fasting glucose and diabetes: a retrospective cohort study in Geelong, Australia

OBJECTIVE: To determine whether adults with normoglycaemia, impaired fasting glucose (IFG) and diabetes differed according to the incidence, rate, length and primary reasons for hospital admission.&nbsp;DESIGN: Retrospective cohort study.&nbsp;SETTING: Barwon Statistical Division, Geelong, Australia. PARTICIPANTS: Cohort included 971 men and 924 women, aged 20+ years, participating in the Geelong Osteoporosis Study. Glycaemic status was assessed at cohort entry using fasting plasma glucose, use of antihyperglycaemic medication and/or self-report. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcome measure was any admission to the major tertiary public hospital in the study region over the follow-up period. Secondary outcome measures were admission rate and length (days).&nbsp;RESULTS: Over a median follow-up of 7.4 years (IQR 5.3-9.6), participants with diabetes, compared with those with normoglycaemia, were two times as likely to be hospitalised (OR 2.07, 95%&thinsp;CI 1.42 to 3.02), had a higher admission rate (incidence rate ratio 1.61, 95%&thinsp;CI 1.17 to 2.23) and longer hospital stay (third quartile difference 7.7, 95%&thinsp;CI 1.3 to 14.1 and ninth decile difference 16.2, 95%&thinsp;CI 4.2 to 28.3). IFG group was similar to normoglycaemia for the incidence, rate and length of admission. Cardiovascular disease-related diagnoses were the most common primary reasons for hospitalisation across all glycaemic categories.&nbsp;CONCLUSIONS: Our results show increased incidence, rate and length of all-cause hospital admission in adults with diabetes as compared with normoglycaemia; however, we did not detect any associations for IFG. Interventions should focus on preventing IFG-to-diabetes progression and reducing cardiovascular risk in IFG and diabetes.</div