• Waste not, want not. What are the drivers of sustainable medicines recycling in National Health Service hospital pharmacies (UK)?

      Breen, Liz; Xie, Y. (2015)
      Medicines management is only one part of NHS (UK) procurement and management, but essentially a very expensive part. In December 2012 the Department of Health issued an action plan to improve the use of medicines and reduce waste. There is an onus therefore on the NHS to ensure that they are as efficient in the medicines management as possible in all aspects of the supply chain in order to ensure sustainability (economically and operationally). To do this consideration must be given to medicines optimization, from procurement, through to storage, dispensing, compliance and finally waste prevention and reduction and waste retrieval. As part of the larger National Health Service (UK), hospital pharmacy places strong emphasis on contributing to the efficiency targets through reductions in waste and drug spending, and best practice. The purpose of this study is to examine medicines reverse logistics practice within the NHS hospital pharmacies, and the operational strategy which drives such practices. The overarching aim is to explore through qualitative analysis the variance and commonality in strategy and practice in what is a standard logistical activity. The outputs offer transparency of medicines RL as practiced by NHS professionals and contribute to ongoing discussions within the Department of Health (NHS UK) on best practice governing waste medicines recycling processes. A qualitative approach was adopted in undertaking this research study, utilizing a purposive study sample. The survey examined practice in 45 hospitals as individual cases across all stages in the medicines reverse logistics system. The findings indicated there is some commonality in the strategy employed in conducting medicines recycling, and all 3 drivers are prevalent in undertaking recycling and encouraging a more sustainable approach, i.e., economic, corporate citizenship, and legislation. However, the means by which the same objective was achieved differed, such as resource utilisation, training etc.
    • Waves of Professionalization Before, During and After Management Buyouts and Buy-ins of Private Family Firms

      Howorth, Carole; Wright, M.; Westhead, P.; Allcock, D. (Enterprise Research Centre, 2015-11)
      We explore the process of professionalization pre- and post- buyout (MBO) or buyin (MBI) of former private family firms using longitudinal evidence from six UK family firms undergoing an MBO/I in 1998. Professionalization behaviour was monitored up to 2014. Previous studies have conceptualized professionalization as a threshold to be attained. We demonstrate that professionalization is a complex process occurring in waves, triggered by changes in firm ownership and management. Waves of professionalization converge during the MBO/I process. Buyouts provide a funnelling mechanism enabling diverse control systems to be standardized. Post-MBO/I, divergence in the professionalization process reoccurs contingent on firm-specific contexts. Professionalization focuses on operations when stewardship relationships predominate, but on agency control mechanisms when there is increased potential for agency costs. Buyout organizational form is an important transitory phase facilitating the professionalization process. Professionalization is not a once for all development stage.
    • A way forward: Process mapping and the delivery of mental health services

      McIntosh, Bryan; Breen, Liz; West, Sue (2016-12)
      Introduction: This paper demonstrates the practical application of process mapping principles as a model for evaluating NHS improvement. The NHS improvement in question was the merger of three crisis resolution teams within an NHS trust in 2012. The aims were to improve overall operational efficiency and enhance multidisciplinary working to meet operational targets. This paper examined changes following the merger to capture the effects of service improvement and the reality of the patient journey. Methods: A pooled cross-sectional approach, using six years of aggregated hospital data, was taken. To achieve operational efficiency, a process map of referrals, readmissions, length of stay and waiting times for crisis resolution team assessments was examined. Prevalence of clinical referral rates and disease classification before and after the merger were compared. Conclusion: Between 1 April 2009 and 30 March 2015, length of stay and readmissions for patients to crisis resolution team rates reduced. Operational sustainability and capacity was enhanced through the redistribution of clinical human resources. Multidisciplinary skill mix (e.g. through improved team composition) also improved.
    • We Are Not a Commercial Firm

      McQuillan, Deirdre (2018)
    • "We Don’t Have the Key to the Executive Washroom”: Women’s Perceptions and Experiences of Promotion in Academia

      Guth, Jessica; Wright, Fran (2010-05)
      This chapter reports on a pilot study looking at the progression of academic women at one UK University. The chapter focuses on the promotions process and criteria as one important issue emerging from that research. Earlier research has shown that women are less likely to break into institutional networks which allow them to access information not only on formal and objective promotion criteria but also on hidden criteria and the way the ‘academic game’ is played. One result of this is that some academic women may have an inaccurate view of promotion criteria and processes. At the university studied by the authors, the Human Resources department has sought to make the promotion process more transparent and, officially at least, it no longer depends purely upon research achievements. However, these changes will not necessarily result in easier progression for women academics. The authors’ study confirms that there is still a mismatch between what women think the criteria for promotion are, what the formal criteria are and how those criteria actually operate. Reliance on incomplete or inaccurate information about promotion criteria, coupled other factors, such as women’s reluctance to promote themselves actively and traditional barriers to promotion such as caring responsibilities, puts women at a disadvantage when they attempt to progress into more senior positions within universities. Reform of promotions procedures needs to look beyond re-writing the substantive criteria for promotion and look to improving understanding of what is involved.
    • We went looking for an organisation and could find only the metaphysics of its presence

      Ford, Jackie M.; Harding, Nancy H. (2004)
      This article explores the `lifeworld theories¿ of organizations held by organizational actors, gathered from staff and managers of two `organizations¿ as they went through a process of merger. Using Henri Lefebvre¿s theories of place and space read through a postmodernist lens to interrogate the data, we discovered amongst staff theories of the organization as place, arising out of the material territory in which they worked. Amongst managers and those whom we call directors/chief executives there was a contrasting theory of organization as space, based upon a sense of an immaterial space occupied by a metaphysical organization. Rather than finding a dualistic distinction between organization and agents, we found the organization and organizational members collapsed in upon each other, with managerial identities fused with and inseparable from that of `the organization¿; chief executives requiring the existence of an impossible organization that could exist only in their minds; and non-managerial employees refusing to identify anything called `an organization¿.
    • What do we mean by performativity in organization and management studies? The uses and abuses of performativity

      Gond, J-P.; Cabantous, L.; Harding, Nancy H.; Learmonth, M. (2016-10)
      John Austin introduced the formulation “performative utterance” in his 1962 book How to do things with words. This term and the related concept of performativity have subsequently been interpreted in numerous ways by social scientists and philosophers such as Lyotard, Butler, Callon, or Barad, leading to the co-existence of several foundational perspectives on performativity. In this paper we review and evaluate critically how organization and management theory (OMT) scholars have used these perspectives, and how the power of performativity has, or has not, stimulated new theory-building. In performing a historical and critical review of performativity in OMT, our analysis reveals the uses, abuses and under-uses of the concept by OMT scholars. It also reveals the lack of both organizational conceptualizations of performativity and analysis of how performativity is organized. Ultimately our aim is to provoke a ‘performative turn’ in OMT by unleashing the power of the performativity concept to generate new and stronger organizational theories.
    • What does Big Data has in-store for organisations: An Executive Management Perspective

      Hussain, Zahid I.; Asad, M.; Alketbi, R. (2017)
      With a cornucopia of literature on Big Data and Data Analytics it has become a recent buzzword. The literature is full of hymns of praise for big data, and its potential applications. However, some of the latest published material exposes the challenges involved in implementing Big Data (BD) approach, where the uncertainty surrounding its applications is rendering it ineffective. The paper looks at the mind-sets and perspective of executives and their plans for using Big Data for decision making. Our data collection involved interviewing senior executives from a number of world class organisations in order to determine their understanding of big data, its limitations and applications. By using the information gathered by this is used to analyse how well executives understand big data and how well organisations are ready to use it effectively for decision making. The aim is to provide a realistic outlook on the usefulness of this technology and help organisations to make suitable and realistic decisions on its investment. Professionals and academics are becoming increasingly interested in the field of big data (BD) and data analytics. Companies invest heavily into acquiring data, and analysing it. More recently the focus has switched towards data available through the internet which appears to have brought about new data collection opportunities. As the smartphone market developed further, data sources extended to include those from mobile and sensor networks. Consequently, organisations started using the data and analysing it. Thus, the field of business intelligence emerged, which deals with gathering data, and analysing it to gain insights and use them to make decisions (Chen, et al., 2012). BD is seem to have a huge immense potential to provide powerful information businesses. Accenture claims (2015) that organisations are extremely satisfied with their BD projects concerned with enhancing their customer reach. Davenport (2006) has presented applications in which companies are using the power of data analytics to consistently predict behaviours and develop applications that enable them to unearth important yet difficult to see customer preferences, and evolve rapidly to generate revenues.
    • What drives mandatory and voluntary risk reporting variations across Germany, UK and US?

      Elshandidy, Tamer; Fraser, I.; Hussainey, K. (2015-12)
      This paper utilises computerised textual analysis to explore the extent to which both firm and country characteristics influence mandatory and voluntary risk reporting (MRR and VRR) variations both within and between non-financial firms across Germany, the UK and the US, over the period from 2005 to 2010. We find significant variations in MRR and VRR between firms across the three countries. Further, we find, on average, that German firms tend to disclose significantly higher (lower) levels of risk information mandatorily than UK (US) firms. German firms, on average, tend to reveal considerably higher (lower) levels of VRR than US (UK) firms. Our results document that MRR and VRR variations are significantly influenced by systematic risk, the legal system and cultural values. We also find that country and firm characteristics have higher explanatory power over the observed variations in MRR than over those in VRR.
    • What if you are not Bayesian? The consequences for decisions involving risk

      Goodwin, P.; Onkal, Dilek; Stekler, H.O. (2018-04)
      Many studies have examined the extent to which individuals’ probability judgments depart from Bayes’ theorem when revising probability estimates in the light of new information. Generally, these studies have not considered the implications of such departures for decisions involving risk. We identify when such departures will occur in two common types of decisions. We then report on two experiments where people were asked to revise their own prior probabilities of a forthcoming economic recession in the light of new information. When the reliability of the new information was independent of the state of nature, people tended to overreact to it if their prior probability was low and underreact if it was high. When it was not independent, they tended to display conservatism. We identify the circumstances where discrepancies in decisions arising from a failure to use Bayes’ theorem were most likely to occur in the decision context we examined. We found that these discrepancies were relatively rare and, typically, were not serious.
    • Whatever Happened to Skill?

      Grugulis, C. Irena; Keep, E.; Warhurst, C. (2004)
    • When is a Partner not a Partner? Conceptualisations of ‘Family’ in EU free movement Law

      Guth, Jessica (2011-10-14)
      This paper considers the definitions of spouse, civil partner and partner in European Union free movement of persons law in order to question the EU’s heterocentric approach to defining ‘family’ in this context. It argues that the terms ‘spouse’ should include same sex married partners to ensure there is no discrimination on the grounds of sexual orientation. It further highlights the problems created by basing free movement rights of civil partners on host state recognition of such partnerships. This approach allows Member States to discriminate on the grounds of sexual orientation and is therefore not compatible with EU equality law in others areas. The position of unmarried or unregistered partners is also considered. In particular the paper examines the requirement of a duly attested durable relationship and its impact on same-sex partners wishing to move from one Member State to another. The paper argues that it is time to reconsider the law in this area and bring it in line with the EU’s commitment to eliminate discrimination on several grounds including sexual orientation.
    • Where are you? A preliminary examination of the track and trace mechanisms in place to facilitate effective closed-loop medical equipment retrieval in the National Health Service (NHS) (UK)

      Breen, Liz; Xie, Y.; Cherrett, T. (2016-09)
      The National Health Service (UK) is wholly accountable and heavily scrutinised for its strategy, activity, performance and spending (Appleby, 2016; NHS Confederation, 2016; Parliament UK, 2010), and much research has been undertaken as to its effectiveness at managing its operations and its competency in doing so (Gov.Uk, 2016; National Audit Office, 1999)). The impact of not performing adequately combined with threats such as funding cuts (King’s Fund, 2016), government intervention and private sector competition; has led to uncertainty and disillusion with the sustainability of the service (Hunter, 2016). Based on current economic concerns, this paper chooses to focus on the area of Medical Equipment Loans Services where products are released to patients to aid therapeutic rehabilitation and physical mobility. The aim of this study is to examine the process of product retrieval in a multi-case study analysis and consider how value-added technologies can be used to improve retrieval success rates.
    • Where do they go? Destination Unknown: An exploratory study of the disposal of transdermal drug patches in the private healthcare sector (UK)

      Breen, Liz; Zaman, Hadar; Mahmood, A.; Nabib, W.; Mansoorali, F.; Patel, Z.; Amin, M.; Nasim, A. (2015-04)
      The effective disposal of medication and more specifically accidental exposure to fentanyl via transdermal patches has recently been highlighted in two key documents [1, 2]. Whilst the volume of unused medicines cost the NHS over £300 million every year [1], the volume of transdermal patch waste is unknown. There is a need for greater pharmacy intervention in the effective disposal of medicines to resolve issues such as hospital (re)-admissions, stockpiling leading to patient self–prescribing/dosing, and land and water pollution. The aim of this study was to examine transdermal patch disposal systems and practice amongst private sector care providers in the UK. This was part of a larger study focusing on transdermal patch application.
    • Where’s the Beef? McDonald’s and its European Works Council

      Royle, Tony (1999)
      This article analyses the establishment and subsequent meetings of the McDonald's European Works Council and raises a number of questions. Who is an `employee representative' for the purposes of the EU Directive? How are such representatives elected in practice and what roles do existing national sub-structures play? Can employee representatives adequately coordinate their roles in the absence of significant unionisation? The experience of the McDonald's EWC suggests that where workforces have low levels of unionisation and employers are opposed in principle to the prescribed arrangements, a non-union firm can frustrate even the limited aims of the Directive. Furthermore, legally underpinned national-level sub-structures, which are often assumed to make such European-level bodies accountable, may fail to do so in practice.
    • Whistle while you Work? Disney Animation, Organizational Readiness and Gendered Subjugation.

      Griffin, M.; Harding, Nancy H.; Learmonth, M. (2016)
      This paper introduces the concept of ‘organizational readiness’: socio-cultural expectations about working selves that prepare young people (albeit indirectly and in complex and multi-faceted ways) for their future life in organizations. This concept emerges from an analysis of Disney animations and how they constitute expectations about working life that may influence children through their representations of work and gendered workplace roles. The paper’s exploration of Disney’s earlier animations suggests they circulated norms of gender that girls should be weak and avoid work. In contrast, its contemporary productions circulate gender norms that suggest girls should be strong and engage in paid work. In this reading, the continued circulation of earlier alongside contemporary animations may convey to young viewers a paradox: girls must and must not work; they must be both weak and strong. We thus offer new insights into the puzzle of the continued relegation of women to the side-lines in organizations; although, more optimistically, we also point to ways in which future generations of employees may forge ways of constituting forms of gendered selves as yet hardly imaginable.
    • Who cares wins? A comparative analysis of household waste medicines and batteries reverse logistics systems

      Xie, Y.; Breen, Liz (2014)
      The purpose of this paper is to determine how best to reduce, reuse and dispose of household waste medicines in the National Health Service (NHS) (UK). Through a combination of literature review and empirical work, this research investigates the existing household waste medicines reverse logistics (RL) system and makes recommendations for improvement by benchmarking it against household waste batteries RL. The viability and feasibility of these recommendations are evaluated through in-depth interviews with healthcare professionals and end user surveys. The batteries RL system appears to be a more structured and effective system with more active engagement from actors/stakeholders in instigating RL practices and for this very reason is an excellent comparator for waste medicines RL practices. Appropriate best practices are recommended to be incorporated into the waste medicines RL system, including recapturing product value, revised processing approaches, system cooperation and enforcement, drivers and motivations and system design and facilitation. This study offers academics and professionals an improved insight into the current household waste medicines RL system and provides a step towards reducing an existing gap in this under-researched area. A limitation is that only a small sample of healthcare professionals were involved in subjectively evaluating the feasibility of the recommendations, so the applicability of the recommendations needs to be tested in a wider context and the cost effectiveness of implementing the recommendations needs to be analysed. Reducing, reusing and properly disposing of waste medicines contribute to economic sustainability, environmental protection and personal and community safety. The information retrieved from analysing returned medicines can be used to inform prescribing practice so as to reduce unnecessary medicine waste and meet the medicine optimisation agenda. This paper advocates learning from best practices in batteries RL to improve the waste medicines RL design and execution and supports the current NHS agenda on medicine waste reduction (DoH, 2012). The recommendations made in the paper not only aim to reduce medicine waste but also to use medicines effectively, placing the emphasis on improving health outcomes.
    • Who is 'the middle manager'?

      Harding, Nancy H.; Lee, Hugh; Ford, Jackie M. (2014-10)
      Middle managers occupy a central position in organizational hierarchies, where they are responsible for implementing senior management plans by ensuring junior staff fulfil their roles. However, explorations of the identity of the middle manager offer contradictory insights. This article develops a theory of the identity of the middle manager using a theoretical framework offered by the philosopher Judith Butler and empirical material from focus groups of middle managers discussing their work. We use personal pronoun analysis to analyse the identity work they undertake while talking between themselves. We suggest that middle managers move between contradictory subject positions that both conform with and resist normative managerial identities, and we also illuminate how those moves are invoked. The theory we offer is that middle managers are both controlled and controllers, and resisted and resisters. We conclude that rather than being slotted into organizational hierarchies, middle managers constitute those hierarchies.
    • Who is it That Would Make Business Schools More Critical? Critical Reflections on Critical Management Studies

      Ford, Jackie M.; Harding, Nancy H.; Learmonth, M. (2010)
      We suggest in this paper that whilst exploring how to make business schools more critical we must also turn a critical and reflexive lens upon ourselves, critical management thinkers. Our endeavour is outlined here as a ‘reflexive journey’ in which we turn upon ourselves, academics who identify as ‘critical’ thinkers, the theories we use to analyse others. Our focus is upon critical management education. We use three vignettes drawn from our previous research. One is of graduands from the postgraduate programmes on which two of us teach, the second an analysis of knowledge transfer programmes in which we have participated, and the third a study of the construction of academic identities. The first study shows the academic teacher may become an internalized, judgemental gaze, the second that what we see as a critical approach may be construed by our students as another ‘truth’ that fails to encompass the complexities of organizations and management, and the third encourages us to ask some questions about our own positions. This causes us to ask some uncomfortable questions about our own positions as critical management scholars and the ways in which we conceptualize business schools and our colleagues who work in them.