Page, A.

Plume, R.

English

Middlesex University Research Repository

‘Evolving models of environmental health service delivery: a real-time experiment? Ruth Plume and Alan Page  115th CIEH National Conference  © Middlesex University Content of presentation • Authors: Ruth Plume,  Dr Alan Page, Professor Hemda Garelick • Local authority regulatory services- changing and complex • Research question? • Research design • Interim Results • Your turn! • Next steps – further participants?  Local Authority regulatory services Its complex  Legislation to enforce Govt legislation EU  Approaches  to regulation  Better/Smart regulation Kellett 2008 Govt Reviews Hampton, Macrory, Philips, Gerson, Anderson, Lofested, Young Street level bureaucracy Practice climate  Perceptions of govt, media and business  Over-regulation Under regulation Focusing on low risk, stifling business growth Over-enforcement leading to economic disadvantage against competitors, closure of firms, impact of closure on perception of locale, employment, empty buildings Perceived value of control/intervention. Financial imperatives/competition viewed more critical than safety or trading risks (Quinlan et al 2010 and Cagno et al 2013). Less risk of being visited ie Tompa et al (2007) point to evidence of regulatory citation having deterrent effect.  Risks to most vulnerable ie informal and temporary workers, unemployed, and precariat  Critiques of light touch regulation (Vickers 2008, Tombs and Whyte 2012 and O’Neill 2013) Hidden cost to the state Shalin 2009. ‘Porter hypothesis’ (Porter &van der Linde, 1995) – greater regulatory stringency stimulates innovation, thereby enhancing productivity Economics and regulation  Link between regulation and developing public health (WHO 2006) resources New management approaches Grant Thornton 2014 2 tier inspections Regulatory officer “eyes and ears” x-training  Skill set  Lipsky, Hutter, Fineman, Crool and Ayee, Evans and Harris  Localism/Devolution *resource, need, economics, politics,  Sandford 2015 Models for change Budget reductions Gainsbury and Neville 2005 New roles Priorities Perception in govt and media of regulatory crisis (Hutter 2005). Critiques of command and control (Baldwin and Black 2008, Young 2010) and anti-competiveness (Global competitiveness reports 2005-7 in Sala-i-Martin 2011) Inconsistency with other regulators, particularly for national companies Potential high risk premises/activities not acted upon, leading to loss (accidents, impact on locale and public health © Middlesex University Research question? • “What are the lessons to learn from the implementation process for differing and evolving service delivery models for environmental health?”  • Important to document the process and the experience so that we learn the lessons in real time to enhance service delivery.  • Create an evidence base. © Middlesex University Research Design Research question Design data collection – open reflective interviews Selection of cases  Conduct case study interviews, transcribe and examine data Identify emerging themes, Explore themes, Draw conclusions, Modify Theory, Suggest lessons learned, Make recommendations © Middlesex University Case studies: types of organisations   • Entire environmental health service outsourced to a large private sector organisation • Regional shared public protection service,  • Proposed mutualisation, • Shared services (management only) • Shared services (field officers and management). © Middlesex University Participants • To date, there have been 11 participants from 8 organisations.  • The participants and their place of employment are not identified by name.  • The interviews have been carried out over a 14 month period from July 2014 to September 2015. •  One of the participants has been interviewed several times over a twelve month period as the new service delivery evolved.  © Middlesex University Research Design Research question Design data collection Selection of cases  Conduct case study interviews, transcribe and examine data Identify emerging themes, Explore themes, Draw conclusions, Modify Theory, Suggest lessons learned, Make recommendations © Middlesex University Data analysis Familiarisation Initial Coding Organisation Theme development:  Theme concept model Refinement Argument © Middlesex University Emergent Themes Emergent Themes Managing changes effectively Understanding the reasons for change Understanding the nature of environmental health Meaningful consultation Viability of the proposal Planning and timeliness Understanding the reasons for change Understanding the reasons for change Politics Value Shake up needed Cost Devolution Alternatives Protection Opportunity Resilience Your turn – a real time experiment! • Posters of each emerging theme on the wall(s) • Please choose one theme that you have most interest in  • Make any comments on the “post-it” note provided e.g. – Do you recognise these sub-themes  in the outer circle? – Do you agree or disagree that the sub-theme links to the central theme? – Would you like to add a sub-theme? – Can you give us something of your experience in a sentence or two? • Stick your “post it” note next to the outer sub theme that is most appropriate.  • You need to be sat back down by 16.40 ready for the next presenter. I will be around afterwards for questions if we run short of time.   • Are you interested in taking part in a regional focus group to refine these themes? Forms for contact details at the door or email Ruth Plume – R.Plume@mdx.ac.uk  Viability of the proposal Viability of the proposal Legality Cost Commercial viability Getting it right Alternative models Emerging service demands Flexibility Workforce skills Resilience Risk Logistics Meaningful consultation  Meaningful consultation Questions Answers Honesty Appeasing staff Flexibility Engagement Trust Solutions Problems Managing changes effectively Managing changes effectively Fear Anxiety Impact of changes Difficult Process Trust Conflict Customer satisfaction Emerging service demands Skills development Understanding the nature of environmental health Understanding the  nature of environmental health Problem solving Priority Awareness Breadth Knowledge of environmental health Improving public health Statutory Regulatory Emerging service demands Planning and timeliness  Planning and timeliness Planning Pressure Detail Getting it right Specification Outcomes Expected levels of service delivery Risk Challenges Opportunities Timescale 

Evolving models of environmental health service delivery: a real-time experiment?

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Evolving models of environmental health service delivery: a real-time experiment?

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