A Balanced Judgement?: Performance Indicators, Quality and the English Ambulance Service; some issues, developments and a research agenda.

A significant feature of the 'New Public Management' has been the particular emphasis it placed on public sector organisations measuring their performance. However, in practice, this has often been carried out in ways which proved dysfunctional: for example, by concentrating on a single dimension of performance, perverse incentives and unintended consequences arise. The previous performance measurement regime for the English ambulance service was regarded as a classic example of this since it concentrated on response times at the expense of other aspects of performance, such as the outcomes of treatment at the scene. However, that regime has been replaced by a 'dashboard', containing a wider range of performance indicators. At the same time, NHS organisations (including ambulance services) have to produce annual Quality Accounts. Thus English ambulance services are now faced with two new performance measurement regimes. Both of these seem, in principle, an improvement on the old regime; but also seem somewhat contradictory in their 'philosophies'. These developments are worthy of further exploration and, in this paper, we set out a research agenda, whilst placing the issues in the context of debates concerning multi-dimensional approaches to performance evaluation, such as the Balanced scorecard and Tableau de Bord, and, more generally, the 'paradox of performance' in public services

Exploring the Wellbeing of Ambulance staff using the ‘Public Value’ perspective: Opportunities and Challenges for Research

This paper explores and integrates three over-lapping topics: concerns about the wellbeing of ambulance staff; the revival of interest in the Public Value conceptual framework in Public Sec-tor Management research; and current calls for interdisciplinary research between public sector accounting academics and public administration scholars in the 'post-NPM' context

The DNA sequence of the human X chromosome

The human X chromosome has a unique biology that was shaped by its evolution as the sex chromosome shared by males and females. We have determined 99.3% of the euchromatic sequence of the X chromosome. Our analysis illustrates the autosomal origin of the mammalian sex chromosomes, the stepwise process that led to the progressive loss of recombination between X and Y, and the extent of subsequent degradation of the Y chromosome. LINE1 repeat elements cover one-third of the X chromosome, with a distribution that is consistent with their proposed role as way stations in the process of X-chromosome inactivation. We found 1,098 genes in the sequence, of which 99 encode proteins expressed in testis and in various tumour types. A disproportionately high number of mendelian diseases are documented for the X chromosome. Of this number, 168 have been explained by mutations in 113 X-linked genes, which in many cases were characterized with the aid of the DNA sequence