COP23: introducing a new toolkit to help support the Paris Agreement

From 6-17 November, representatives from around the world are meeting in Bonn to discuss climate change at the 23rd 'conference of the parties' (COP23) under the UN Framework Convention on Climate Change. Steven Malby introduces a new Law and Climate Change Toolkit developed as a global resource for legal policy makers responsible for climate change policies

Primary care networks: navigating new organisational forms.

National Health Service England (NHSE) instigated Primary Care Networks (PCNs) as a collaboration of general practices working together at scale to improve population health in the local community. The aim of the study was to capture general practitioner PCN leaders' perceptions of the opportunities and pitfalls of PCNs, as well as points of learning, during their inception and development, in order to guide the future development of PCN form and function. The study, carried out in primary care, took a qualitative design. Nine PCN general practitioner leaders were interviewed in depth to gather their views and experiences of PCNs. We also collated 31 free-text survey responses pertaining to how participants perceived the purpose of PCNs. The key themes were - defining purpose and managing ambiguity; bureaucracy vs. local autonomy; relational working; facilitative leadership. The need for purpose setting to remain adaptive was seen as crucial in avoiding the constraints of too rigid a structure in order to retain local ownership, whilst remaining focussed around meeting complex population needs and reducing variation. Participants reported navigating their way through striking a balance between the 'top down' mandate and recognising local need. Of importance to the success of PCNs was the necessity of effective relational working and facilitative leadership CONCLUSION: Whilst the desire to be proactive and collaborative was emphasised by the PCN leaders, the importance of distributed leadership and time given to building trust and effective working relationships within new organisational forms cannot be underestimated. [Abstract copyright: Copyright © 2021, The Authors.

AIR POLLUTION IMPACTS AND SOURCES UNDER A CHANGING CLIMATE: A CASE STUDY FOR SCUNTHORPE, UK

Climate change may affect local air quality by altering the emission, dispersion, chemical transformation and deposition of air pollutants. This study evaluates the effects of climate change in a real-life mixed land-use situation where there are adjacent urban and industrial activities and also fugitive emissions from stockpiles and unpaved roads. For this example we show how windspeed and time-of-day dependent ‘bi-polar plots’ created from ambient monitoring data can be used to learn more about the nature of sources responsible for exceedances of particulate matter air quality standards, and hence to assess how sensitive their impacts are to climate change. Unpaved roads and wind-blown fugitive sources such as stockpiles and coal handling beds in the industrial area appear to contribute substantially to raised air-quality impacts. The effect of climate change on impacts from these sources may differ from its effect on impacts from conventional combustion sources

Considérations sur les dangers du travail des tronçonneurs dans les exploitations forestières de l'Hérault

L'utilisation d'une tronçonneuse comporte des risques pour la santé des travailleurs ? En particulier en raison des vibrations et du bruit

Can Volunteering Help Create Better Health and Care. An evidence review.

This report was commission by Sir Thomas Hughes-Hallett founder of HelpForce in March 2017 to review the current evidence on the effectiveness, deployment and impact of volunteers in the NHS, to support the organisation’s work in maximizing the potential of volunteering in health and social care. This report’s remit was to pull together evidence to help answer the following questions: 1. What volunteer / lay roles are effective in health and care? 2. What do we know about the effective recruitment, management and deployment of volunteers (in any setting)? 3. What evidence is there about the impact of volunteers in health and social care, within England health and social care organisations, and from voluntary sector initiatives working into health and social care

Challenges and Insights in Inter-Organizational Collaborative Healthcare Networks: An Empirical Case Study of a Place-Based Network

Purpose Public sectors have responded to grand societal challenges by establishing Collaboratives – new inter-organisational partnerships to secure better quality health services. In the UK, a proliferation of collaboration-based healthcare networks exists that could help to both enhance the value of investments in quality improvement programmes. The nature and organisational form of such improvements is still a subject of debate within the public-sector literature. Placed-based collaboration has been proposed as a possible solution. In response, this research paper presents the results and findings of a placed-based collaborative network, highlighting challenges and insights. Design/methodology/approach This study adopted a social constructionist epistemological approach, using a qualitative methodology. A single case study was used, and data collected in three different stages over a two-year period. Findings The study finds that leadership, data-enabled learning through system-wide training and development, and the provision of an enabling environment that is facilitated by an academic partner, can go a long way in the managing of healthcare networks for improving quality. Research limitations/implications Regardless of the tensions and challenges with placed-based networks, they could still be a solution in maximising the public value required by government investments in the healthcare sector since they offer a more innovative structure that can help to address complex issues beyond the remit of hierarchical structures. This research is limited by the use of a single case study. Practical implications Across countries health systems are moving away from markets to collaborative models for health care delivery and from individual services to population based approaches. This paper provides insights to inform leaders of collaborative health models in the design and delivery of these new collaborations. Social implications As demand rises (as a result of increasing complexity and demographics) in the western world, health systems are seeking to redefine the boundaries between health service provision and community self-reliance and resilience. This paper provides insights into the new partnership between health institutions and communities, providing opportunities for more social-based and solidarity-based healthcare models which place patients and the public at the heart of change

Longitudinal Study of the Impact of the London Darzi fellowship Programmes years 1-8.

This report is based on a retrospective evaluation of the Darzi Fellows in Clinical Leadership Programme, supporting multidisciplinary clinicians and allied healthcare professionals (AHPs) in project-based attachments to NHS organisations across London. The Darzi Alumni and London South Bank University collaborated to develop a longer-term review of the impact of the Darzi programme (currently in Cohort 9). This evaluation complements the in-programme evaluations of each cohort demonstrating the immediate success of eight previous cohorts of ‘Darzi’ Fellowships in London. The fellowship combines a work-based change project and a Leadership Development Programme incorporating a Post Graduate Certificate over the course of a year. This longitudinal study demonstrates that overall there is much evidence that the Darzi programme has practically and intuitively shown Fellows how to think first and then act differently for alternative outcomes. Fellows are much more proactive than reactive because of the programme. Many responses carried a central message of empowered, enlightened and highly skilled individuals who are actively and uniquely challenging the status quo. Thus, there is clear evidence that the Darzi programme has created a plethora of systems thinkers and doers, with a greater understanding of how to use data to bring about system change. A picture emerged of often bold individuals with a determination to actively instigate change across London and beyond. There is evidence that many Fellows are emerging as leaders, acting as catalysts for sustainable change in the healthcare environment. By any reasonable measurement, the Darzi programme continues to be successful with learning and behavioural change sustained after the Fellowship year

Innovation and Sustainability in Large-Scale Healthcare Improvement Collaborative – Seven Propositions for Achieving System-wide Innovation and Sustainability

Change and reform in the Healthcare system, and policy determination to reduce costs has now necessitated a rethink and more innovation for this sector. In the healthcare sector, leadership needs to strengthen professionals who have the dual responsibility for ensuring the quality and effectiveness of healthcare and this requires new organisational forms beyond the traditional hierarchical organisational structures. Drawing upon strategic management and leadership discourse to underpin the study into sustainable and high performing systems, we then look at seven key lessons (propositions) from a mixed-methods study of a live city-wide large-scale collaborative in Leeds, UK. These seven propositions are framed in the context of leadership and strategy, however interesting and emergent findings also emerged as a result of the study. We thereby illuminate the challenges and opportunities to the collaboratives development in the context of global government calls for better healthcare management within the sector. We found that in the sustainability of such collaboratives, requires a more effective structure could be local city-wide collaborative in contrast to national or regional collaborative, however there are also several unknowns in such novel organisational structures. The shared and distributive form of leadership is underpinned with an energetic strategic leader who holds the centre whilst inspiring and empowering the collective nature of all members. This is also effectively achieved through promotion of a professional culture that is sustained through structured organisational learning. This paper adds to the small but growing body of knowledge in Improvement Collaboratives in the Health sector