Purpose: The aim of this research therefore is to explore the causes of drug shortages within the pharmaceutical supply chain and assess the adopted mitigation strategies. Research Approach: The study is carried out from an inductive perspective where we seek to understand the phenomenon by a detailed review of extant literature followed by a series of semi-structured interviews with first tier consumers within a case study framework. The respondents were chosen using purposive sampling as those best to comment on the phenomenon under scrutiny. Data was analysed using thematic analysis, where a dual focus was adopted; 1) the preliminary focus was on the identification of system themes (where the system was impacted and the responds e.g. complexity, disruptions and product alternatives) and 2) the secondary focus was the impact on the patient as system recipient and product user (where themes such as stress, anxiety, and adverse drug reactions emerged). Findings and Originality: The analysis show that drug shortages within the pharmaceutical supply chain in the UK occur as a result of stringent regulatory frameworks, faults in the manufacturing processes, lack of Active Pharmaceutical Ingredients, monopolistic wholesaler markets; lack of information dissemination, offshore trading and price manipulations for profit. The impact on the consumers is reported to be extensive and can endure long after the disruptive event occurs. The findings indicate that existing recovery strategies are however cumbersome, add complexity to the supply chain and in extreme cases facilitate the infiltration of counterfeits. The study is innovative as it explores disruptive events and associated recovery strategies which have not been adequately addressed in supply chain management studies to date. Research Impact: This research contributes to existing literature by extending discussions on supply chain disruptions within a dynamic supply chain whilst focusing on product service supply chain recovery strategies and mechanisms. Practical Impact: This study provides Operations/Supply Chain Managers and Pharmaceutical companies and professionals with strategies that can be adopted can adopt in reducing and recovering in a more resilient manner to disruptive events. This thus presents the bedrock for resilient practice and systems design and development, thus reducing system vulnerability and ultimately leading to improved product availability and patient care.

The National Health Service (NHS) Five Year Forward View in 2014 issued a grave warning that if healthcare demand in the UK continued to grow as its current rate, and efficiency or funding changes were not instigated there could be a mismatch between the service (in terms of resource provision) and patients of up to £30 billion a year by 2020/21. The report asserted that in order to “sustain a comprehensive high-quality NHS; action will be needed on all three fronts – demand, efficiency and funding” (2014:5). Based on this escalating issue, and with a focus on the expanded and value-added role of Community Pharmacists, this study chooses to focus on this service operation in light of the pressures as highlighted above by examining what Sustainability means and how it is applied in Community Pharmacy as a service provider in the NHS (UK).

Operations management theory suggests that professional services firms (PSFs) have some distinct operational challenges. The purpose of this paper is to trace the emergence of professional service operations management (PSOM) thinking within a legal partnership. With the impact of deregulation there is an emerging consensus that legal services is changing, due to the socio-economic and political climates in which they operate. The purpose of this paper is to trace the value-add through the legal profession and examine how PSOM practice can be applied within a legal practice in order to create a leaner thinking. The case study analysis suggests a potential methodological mismatch between the core theoretical frameworks, exploring features of effectiveness and efficiency across legal disciplines. This paper makes a contribution through a reflection of PSOM thinking in law.

The chapter interrogates the teaching and application of management consultancy as part of an MBA and examines its relevance in management education. Mature and experienced students, many with impressive CVs recording multiple career successes, demand that the core experience of their MBA programmes provide opportunities apply theoretical knowledge in real-life situations. The further opportunity to work with blue-chip clients on projects of strategic importance to the client offers further opportunities to test management thinking and consultancy practise in a robust and challenging manner. Students often have experience of working with consultants previously, but most have little experience of managing and delivering projects for clients within a consultancy framework. The pedagogical challenge is to teach students the true value proposition in consultancy beyond the transactional relationship inherent in answering a question set by the client. The basic process approach moves students from considering consultancy as a phenomenon that ‘happens’ to a client with a solution magically appearing upon project conclusion, to a position where students recognise consultants as a true ‘change agent’, unfreezing clients from previous positions and realising new capabilities (Lewin, 1951). There is an examination of ensuring the relevance of the management consultancy approach to students as part of their MBA journey as well as relevance to the client companies in engaging with the University. There is discussion on how teaching the right approach to management consultancy project management and research-orientated methodology retains the focus on the performance of the client organisation (Applebaum and Steed, 2005). There is consideration of how true impact on client companies is achieved by ensuring legacy forms part of expectation management (Kirk, 2000) with client companies keen to reengage with future MBA student teams. The chapter concludes with a reflection on future development of consultancy within management education, including syllabus co-design with consultancy clients.

Purpose: The aim of this research is to evaluate if the Complex Adaptive Systems theory can be used to explain resilience strategies within the pharmaceutical supply chain Research Approach: An in depth review of literature surrounding resilience in the pharmaceutical supply chain. In order to pursue this study agenda, data was collected from Scopus, the largest peer review journal as well as EBSCOhost. The PRISMA guideline was adopted in the systematic review process where 34 peer reviewed papers in the field of CAS, supply chain and supply chain resilience were identified with respect to methodologies employed, location of the study and approaches. Findings and Originality: The systematic review of literature shows that there are inherent similarities between the concept of resilience and the CAS theory. The CAS theory explains that PSC’s are dynamic, have emergent behaviours complex, adaptive, interconnected as well as possess schemas that regulate their operations. Hence if resilience strategies are to be employed to mitigate disruptive events they need to be harnessed in a manner to fit this particular supply chain. This work is innovative as it provides a new insight into the contemporary discourse on resilience strategy creation and deployment, examining the use of this theory in the PSC, and thus provides original contribution. Research Impact: This study contributes to the existing literature base, by providing theoretical underpinnings in the area of resilience and the pharmaceutical supply chain. This furthers the CAS agenda, SCR agenda and also presents an innovative output which warrants more detailed analysis and feasibility testing. Practical Impact: Complexity principles are multi-scaled and multi-domain and as such the suggestions put forward in this theoretical framework can be adopted in various supply chain networks as well as disruptive events. It provides new insights with regards to structures for managers seeking to design and improve resilience supply chains, a key element of which is the adoption of a holistic analysis by SC managers when developing resilience strategies. This is critical if disruptions are to be identified and mitigated before their impact is felt.

The chapter explores the current landscape in the public sector, considering complications and constraints inherent in delivering service and performance improvement. Cost challenges are key factors for all departments, as are wider societal changes, and have led to changes to delivery models. UK government cuts have already been the biggest in the G7 group of major developed economies, and more are planned. Departmental structure, culture and behaviour as well as the scale of service delivery, present operational challenges not just internally but also to the consultants engaged to help. Consideration is also given to commercial constraints which govern the contracting process and how that in turn affects consultant:client interaction and outcomes. Taking into account the salient features which must be overcome, the chapter concludes by suggesting how the constraints and complications can be minimised or mitigated by adopting alternative approaches more attuned to operating within a public service environment.

After reading this chapter you will be able to: Examine the role of Performance Management in ensuring effective business performance; Consider how a culture of suitable measurement can be established and how sustainable performance can be embedded; Demonstrate a systematic understanding of the processes involved in the development and implementation of Performance Management systems; Devise and use performance measures to inform the performance management system; Assess the benefits and drawbacks inherent in the implementation of Performance Management Systems; Analyse and evaluate different Performance Management methodologies; and Synthesise and analyse data and information and evaluate its relevance and validity in the context of any given organisation.