This paper investigates the managerial life and experiences of a group of service leaders in one region of the New Zealand health service. Through a complexity map methodology, creative interviewing, participant storytelling and presentation of their experiential narratives, the paper seeks to...

This paper describes managed care, competition and high health care costs and reductions in funding as the major market forces that affect US academic health centers. As academic health centers continue to preserve their missions of providing patient care, educating and training health...

Explores the implications for continuity of care of the wide range of policy initiatives currently affecting the management and use of human resources in the UK National Health Service. Draws on the findings of a short study undertaken in 2001 comprising a policy document analysis and a series...

This paper examines research that has been undertaken to investigate management in health care and argues that there is no firm “evidence base” to demonstrate its effectiveness. However there is an emerging tradition of qualitative work, which has developed in response to the pace of...

Ethnic minority people are frequently under‐represented in clinical trials. This potentially affects the generalisability/external validity of the trial findings. This not only has important repercussions regarding the safety and the efficacy of new drug use in ethnic minority groups, but also...

Palliative care is a complex environment in which teams of healthcare professionals are constantly challenged to match the configuration of care delivery to suit the dynamics of the patient's bio‐medical, social and spiritual situations as they change during the end‐of‐life process. In...

This paper describes the development and implementation of care pathways in two orthopaedic units in Scotland. Although originally developed as a tool of project management, care pathways have been promoted internationally as a response to concerns for patient safety, variability in care and...

Personal medical services pilots were introduced in England in 1998 to provide increased flexibility to general practitioners practising in deprived areas, to improve service provision and reduce inequalities. The aim of this study was to identify health authority perspectives of the...

This paper aims to explore the early experiences of a new primary care organisation in the NHS. It reports the findings of a longitudinal qualitative case study of one primary care group in its first year of operation. It concludes and makes recommendations in four key areas relevant to the...

The publication of performance ratings for NHS Trusts (star ratings) is an important part of NHS policy. There are significant benefits to a Trust in being awarded the top rating of three stars. The methodology for awarding stars to acute hospitals is explained. The most significant areas of...