Increasing diagnostic capacity is a national priority to expedite the timeliness and appropriateness of patient treatment interventions. Imaging—encompassing a range of technologies including X-ray, CT, MRI, nuclear medicine and ultrasound—is a key diagnostic service and central to decision-making in most, if not all, disease pathways. However, imaging is an expensive discipline accounting for an estimated 3–5% of the annual NHS budget. As a result, it is imperative that we maximise service efficiency while optimising patient outcomes.

Non-communicable diseases (NCDs) are currently the leading cause of death worldwide. In this paper, we examine the channels through which economic growth affects NCDs’ epidemiology. Following a production function approach, we develop a basic technique to break up the impact of economic growth on NCDs into three fundamental components: (1) a resource effect; (2) a behaviour effect; and (3) a knowledge effect. We demonstrate that each of these effects can be measured as the product of two elasticities, the output and income elasticity of the three leading factors influencing the frequency of NCDs in any population: health care, healthrelated behaviours and lifestyle, and medical knowledge.

This paper examines the feasibility of using a holistic approach to sustainability in a business context. The aim is to help organisations from a healthcare perspective increase their adaptability to volatile business environments, by aligning external and internal elements with success, based on internal validation of output. A literature review on existing sustainability theory was conducted and the results divided into versions of sustainability from an initial idea (1.0), to a situation where sustainably will become the nature of business rather than one of its objectives (4.0). In order to align business health and strengthen self-healing powers of businesses, eight pillars of relevance were identified as post conditional. The method adopted to interpret the approaches was informed by a structured process of healthcare perspectiveness healing using figurational dynamics as an analytical lens. Findings indicate that for implementation of an improvement structure based on holistic governance to be successful, acceptance of changes in economic, political and social spheres towards holistic business development need to exist. Secondly, figurational dynamics has to evolve as an overarching or inclusive system to include influences and inspiration from various specialist arenas.

Increasing diagnostic capacity is a national priority to expedite the timeliness and appropriateness of patient treatment interventions. Imaging, encompassing a range of technologies including X-ray, Computer Tomography, Magnetic Resonance Imaging and ultrasound, is a key diagnostic service and central to decision making in most, if not all, disease pathways. However, imaging is an expensive discipline accounting for an estimated 3-5% of the annual NHS budget. As a result, it is imperative that we maximize service efficiency while optimizing patient outcomes.

In October 2014, Simon Stevens, the chief executive of NHS England, committed the service to plugging £22 billion of the expected £30 billion gap in its finances by 2020 through productivity gains of 2–3% a year by 2020. Since that announcement, the Government promised to provide £8 billion by 2020. This may notionally have been received, but it has not alleviated the severity of these financial constraints (Barnes and Dunhill, 2015). With austerity measures biting even deeper into the budgets of NHS organisations, all staff are under pressure to make cost efficiencies and at the same time improve operational standards and patient outcomes. In this pressured change environment, there are hospitals and departments that have embraced the demand for change, creating innovative skills mix platforms from which to deliver services. But there are also those who have remained entrenched in operational protocols. In both scenarios, the overarching driver for service re-design has been operational efficiency guided by government targets.

Purpose: There has been considerable interest in implementing practices imported from manufacturing into healthcare as a solution to rising healthcare spending and disappointing patient safety indicators. One approach attracting particular interest is Lean management, which is explored in this article. Design/methodology/approach: The exploratory research focuses on Lean management in the health sector. It is based on extensive secondary data and it is a practical in implication. Data provided both background and context. Findings: Despite widespread enthusiasm about Lean management’s potential, evidence about its contribution to higher performance is inconsistent. Research limitations/implications: Major Lean operations management and human resource management concepts, including just-in-time (JIT), total quality management (TQM) and total productive maintenance (TPM) are explored. Practical implications: This article contributes to the healthcare organizational management literature by showing that although Lean management seems to have the potential to improve organizational performance; it is far from a panacea for underperforming hospitals. The article informs policy-making by suggesting that a progressive managerial philosophy has a stronger impact on healthcare performance than adopting practices from any particular managerial approach. Originality/value: A critical evaluation on Lean’s impact on informing healthcare policy is presented, which contributes to healthcare organisational management literature by showing that even though Lean management in healthcare appears to have the potential to improve performance; there remain problems with its application.

Purpose - Within nursing, there appear to be two enduring sets of assumptions: firstly, that woman with children should prioritise the care of children; and secondly, that nursing standards require nurses to put their profession above other priorities. Commitment is linked to full-time working this contrasts sharply with the reality for many women with children who need to work part-time and are not able to change or extend working hours. Design/methodology/approach - This qualitative research involved the use of 32 in-depth interviews with thirty-two female registered nurses with children and without children. They were employed in ‘acute’ nursing where aged between 25 to 60 years old and employed in registered grades ‘D’ to ‘senior nurse manager’. They worked or had worked on a variety of employment conditions, some, but not all, had taken career breaks. The rationale for exclusively selecting women was based on the need to identify and describe organisational, situational, and individual factors related to women and the associations and barriers which affect their careers. Findings - In a female dominated profession, we find the profession resisting attempts to make the profession more accessible to women with young children. The career progression of women with children is inhibited and this is driven in part by a determination to maintain ‘traditional’ employment practices. Originality/value – This paper develops Heilman's argument that the restructuring of employment has lead to work intensification which stokes gender tensions. These findings are relevant across many areas of employment and they are significant in relation to broadening the debate around equal opportunities for women.

In England, social choice in education faces trade-offs between equity and efficiency. The scope of these trade-offs ranges from the introduction of choice to correcting 'market failures' to reduce inequalities and restrict social injustices. The article analyses the English school education system and its relationship with social preferences. The authors argue that the moral and legal need for non-discriminatory education supersedes perceptions of cost-effectiveness and utilitarianism. They consider that the current system has failed owing to inappropriate processes within social and public choice and that a reformed system based on a social democratic imperative will allow closer social integration on the basis of ability rather than privilege.

After heart disease, cancer is the most common cause of death in many developed countries. In this paper, we discuss the relationship between economic growth and cancer incidence. The purposes of the paper are to describe and measure the influence of an increasing real per capita income on the overall incidence of cancer. Using cross-sectional data for 162 countries, regression results with crude and age-standardised rates allow us to measure the elasticity of cancer incidence with respect to per capita income, and to decompose the elasticity coefficient into two components: age-effect and lifestyle-effect.