Purpose – The purpose of this paper is to evaluate the claims made for the clinical microsystems approach of healthcare improvement within an English NHS context. Design/methodology/approach – The research adopted a Realistic Evaluation approach to examine a series of pilot clinical...

In a context of ever increasing demand, the recent economic downturn has placed further pressure on decision-makers to effectively target healthcare resources. Over recent years there has been a push to develop more explicit evidence-based priority-setting processes, which aim to be transparent...

The economic downturn is placing increasing pressure on the financing of health care. For many health care providers, this means difficult decisions need to be made over what will and will not be funded. The NHS has not typically been good at decommissioning and disinvesting in services. The...

While continued interest in the application of priority-setting technologies is perhaps unsurprising in a time of austerity, they require sensitive implementation for their full potential benefits to be realized. This article looks at the role and value of leadership in addressing problems of a...

Purpose – The aims of this paper are to explore the experiences of budget holders within the English National Health Service (NHS), in their attempts to implement programmes of disinvestment, and to consider factors which influence the success (or otherwise) of this activity....

Purpose – The purpose of this paper is to set the context for this special issue and provide an introduction to the individual contributions. Design/methodology/approach – This paper uses a literature survey and analysis. Findings – Integration remains both a central goal and a field of...