Am I doing it right? Facilitating action learning for service improvement

UK doctors' anger over NHS cash crisis

A NICE adaptation

BackgroundObesity care services are often faced with the need to adapt their resources to rising levels of demand. The main focus of this study was to help prioritise planned investments...

This empirical study contributes to critical action learning research by theorizing the role of an action learning facilitator from a cultural perspective. Our article adds to critical action learning by conceptualizing the dynamics of facilitation in managing interpersonal politics within action learning sets. Employing Bourdieu’s notion of habitus as a theoretical lens, we explore both participant and facilitator accounts of action learning at three Pakistani business schools, shedding light on the culturally influenced social practices that shape their learning interactions. Through a critical interpretation of our data, we illuminate the challenges of facilitation by revealing how deeply ingrained power relations, within the context of gender and asymmetric relationships, influence participants’ ability to organize reflection. We contribute to critical action learning by theorizing the critical role of facilitator mediation in managing interpersonal and intra-group relations within the Pakistani MBA context, outlining the implications for the dynamics and facilitation of action learning.

This paper describes how an innovation in the practice of action learning, self-managed action learning (SMAL), was developed and then applied in practice on a number of management development programmes for a Health Board in Ireland. The nature of action learning set facilitation is discussed. The paper describes how the term set facilitator was replaced by set manager, since it provided a more accurate description of the role needed to sustain action learning sets. The skills necessary for effective action learning set membership and facilitation are considered and are found to be the key skills for facilitative management and the ‘soft skills’ for managing change. A new SMAL set process and its support structures are outlined. Details are given of how SMAL has been used on management development programmes involving more than 380 managers. The key beliefs and values that underpin SMAL are also explained.

Over the past few decades, the UK's National Health Service (NHS) has progressively moved away from a tethered domain thereby becoming diffused into an environment rich with remote and digital information systems components. In such an environment, the population need for healthcare information, at the point-of-care, is a prime factor in managing the NHS efficiently. However, information integrity is sometime derelict. To facilitate such tasks various strategic models have been implemented - the latest being primary service provision (PSP), a subset of the application service provision (ASP) business model. It is clear that strategic change approaches in the NHS are always going to involve internet (web services) technology, thus, there is a need to investigate certain pertinent issues regarding healthcare data quality and integrity. In this paper, the authors show how security presents serious challenges to the PSP initiative. It also explains, using the NHS case study, that the quality of health information could be affected by streamlining complex, multistage medical information processes and emphasising on cost/benefit analysis for implementation of a web services model. This paper is based mostly on secondary data from measures being taken, in this public - private collaboration initiative, involving the supporting of every aspect of patient care. The overall concern was ensuring strong attention is paid to the aspects of web services that can disengage the NHS's effort to maintain information quality and integrity, and that the traditional goal of the NHS - free for all at the point of delivery - is kept intact.

Characteristics of patients seeking national health service (NHS) care for Achilles tendinopathy: A service evaluation of 573 patients

While austerity is commonly presented as a necessary, although undesirable, reduction in public expenditure, this framing may disguise a re‐imagining of the state whereby governments seize the opportunity of economic difficulties to shrink the state. This paper offers a critical examination of the nature of austerity by exploring the case of the UK's National Health Service (NHS), which according to political rhetoric is protected from austerity cuts. However, in the context of eight years of historically low funding growth coupled with increasing demand pressures from a growing and ageing population, the NHS has for several consecutive years faced substantial overspending by NHS provider organizations. With the Government intent on continuing its deficit and debt reduction path within a framework of ‘austerity’ focused almost exclusively on the expenditure side, NHS organizations have begun to explore radical solutions for reducing their costs. Following reported savings obtained by the early termination of a PPP contract at the Hexham General Hospital, politicians and some NHS managers have considered whether this experience might be repeated elsewhere. Our aims in this paper are to examine the financial feasibility of responding to the pressures created by austerity in this particular way, and to challenge the notion that the NHS has been protected from austerity. We extend the evidence base on PPP contract termination and analyze statistical information and financial statements in the public domain to highlight the legal and financial realities of early PPP termination.

The aim of the chapter is to examine the role of a coach in supporting reflection, learning and taking action in a team or a group. The chapter will begin by exploring the role of a coach or adviser in learning groups such as action learning sets where the role of the coach is to ask questions to encourage the team to consider and reflect on their current situation. (Marquardt et al., 2009). This is compared and contrasted to the role of a team coach working with a team to achieve common team outcomes in a way that combines performance and processes (Hackman & Wageman, 2005). The concept of learning as a social process in both interventions and the role of the coach in supporting the process of reflection and dialogue for the purpose of gaining new insights are explored. Hence, one of the purposes of the chapter is to develop a sharper understanding of what distinguishes action learning from team coaching, as well as some of the overlaps between them. It must be noted that as the action learning facilitator is commonly referred to as the ‘coach’ this term has been used here interchangeably with group coaching. The distinction between the two interventions are addressed later in the chapter.

ObjectiveTo estimate the prevalence of wounds managed by the UK's National Health Service (NHS) in 2012/2013 and the annual levels of healthcare resource use attributable to their management and corresponding...

ABSTRACTObjective: To estimate the cost effectiveness of cilostazol (Pletal) compared to naftidrofuryl and pentoxifylline (Trental) in the treatment of intermittent claudication in the UK.* Pletal is a registered trade name of Otsuka America Pharmaceutical, Inc. and marketed in the UK by Otsuka Pharmaceuticals UK, Ltd, London, UK† Trental is a registered trade name of Aventis Phrmaceuticals Inc and marketed in the UK by Aventis Pharma Ltd, Kent, UKDesign and setting: This was a modelling study on the management of patients with intermittent claudication who are 40 years of age or above and have at least six months history of symptomatic intermittent claudication, secondary to lower extremity arterial occlusive disease. The study was performed from the perspective of the UK's National Health Service (NHS).Methods: Clinical outcomes attributable to managing intermittent claudication were obtained from the published literature and resource utilisation estimates were derived from a panel of vascular surgeons. Using decision analytical techniques, a decision model was constructed depicting the management of intermittent claudication with cilostazol, naftidrofuryl and pentoxifylline over 24 weeks in the UK. The model was used to estimate the cost effectiveness (at 2002/2003 prices) of cilostazol relative to the other treatments.Main outcome measures and results: Starting treatment with cilostazol instead of naftidrofuryl is expected to increase the percentage improvement in maximal walking distance by 32% (from 57% to 75%) for a 12% increase in NHS costs (from £801 to £895). Treatment with cilostazol instead of pentoxifylline is expected to increase the percentage improvement in maximal walking distance by 67% (from 45% to 75%) and reduce NHS costs by 2% (from £917 to £895). Treatment with naftidrofuryl instead of pentoxifylline is expected to increase the percentage improvement in maximal walking distance by 27% (from 45% to 57%) and decrease NHS costs by 14% (from £917 to £801).Conclusion: Within the limitations of our model, starting treatment with cilostazol is expected to be a clinically more effective strategy for improving maximal walking distance at 24 weeks than starting treatment with naftidrofuryl or pentoxifylline and potentially the most cost effective strategy. Moreover, the acquisition cost of a drug should not be used as an indication of the cost effectiveness of a given method of care.

Julie Moore: NHS leader who walks the wards

Being an addict is frustratingly hard work, finding substances, food, shelter, care, treatment are complicated formations that require knowledge situated in the actions and reactions of being addicted; yet, this knowledge never enters into the machinery of governance that purportedly cares for them. This situated knowledge has much to tell us about forms of reticulated discipline that governs addicts and workers in the care system. In 2015 YoHa took an ecological and aesthetic approach working with the UK's National Health Service, addiction clinics to investigate how databases produce an abstraction of the clinical modalities. Database Addiction explored the methods by which the materiality of the care-centres work can be managed and governed at multiple scales from within computation and how such processes transform work based cultures and the lives of addicts. The project close read the structure of the the UK's National Drug Treatment Monitoring Service which unlocked what is articulated about addiction from an idealogical, technical, political, bureaucratic or governmental viewpoint that is used, amongst other things, for monetising addiction services. This paper will explore the materiality of database algorithms, from urine and blood samples to entities and relations. This formation can be seen as pointers to a fluid formation of power that is not only a strategy in action for government but holds itself as an emergent ambiguous diagram, a sketch of relations and a technical machine for reticulate discipline. A theatre for the performance of power with a capability to insight, provoke, to compare and combine what ideology can articulate about addiction that is coextensive with creating new knowledge. A kind of abstract R&D that points to the kinds of control governance might find ideal but has not mastered yet.

ABSTRACTIn completing an action learning facilitation qualification in 2012, I documented an account of practice during the first year of my experience as a facilitator. The main areas of my learning related to four themes: fear of rejection, using and abusing power, content versus process and critical action learning. These learnings are linked to descriptions of five facilitation episodes during that formative first year, each surfacing a significant new challenge, question or realisation. Looking back seven years later, most of my early learnings about action learning facilitation (and myself) still resonate. With seven years’ more experience, it is now the less visible aspects of the facilitator's role that seem more important and hold the most need for my continued learning.

The COVID-19 response for vulnerable people in places affected by conflict and humanitarian crises