Showing papers in "Journal of Health Organisation and Management in 2012"
TL;DR: A number of social values relating both to the process and content of priority-setting decisions are reviewed, finding process values are found to be closely linked, such that success in increasing, for example, transparency may depend on increasing participation or accountability.
Abstract: Purpose – It is commonly recognized that the setting of health priorities requires value judgements and that these judgements are social. Justifying social value judgements is an important element in any public justification of how priorities are set. The purpose of this paper is to review a number of social values relating both to the process and content of priority‐setting decisions.Design/methodology/approach – A set of key process and content values basic to health priority setting is outlined, and normative analysis applied to those values to identify their key features, possible interpretations in different cultural and institutional contexts, and interactions with other values.Findings – Process values are found to be closely linked, such that success in increasing, for example, transparency may depend on increasing participation or accountability, and “content” values are found often to be hidden in technical criteria. There is a complex interplay between value and technical components of priority...
126 citations
TL;DR: Key lessons include the need for co-ordination and leadership alongside the lateral influence of peers, and advantages of starting with a clear programme theory of change to offer practical lessons for those engaged in improving healthcare quality in practice.
Abstract: Purpose – Approaches to quality improvement in healthcare based on clinical communities are founded in practitioner networks, peer influence and professional values. However, evidence for the value of this approach, and how to make it effective, is spread across multiple disciplines. The purpose of this paper is to review and synthesise relevant literature to provide practical lessons on how to use community‐based approaches to improve quality.Design/methodology/approach – Diverse literatures were identified, analysed and synthesised in a manner that accounted for the heterogeneity of methods, models and contexts they covered.Findings – A number of overlapping but distinct community‐based approaches can be identified in the literature, each suitable for different problems. The evidence for the effectiveness of these is mixed, but there is some agreement on the challenges that those adopting such approaches need to address, and how these can be surmounted.Practical implications – Key lessons include: the n...
119 citations
TL;DR: The results indicate that a culture with a dominating focus on social competence decreases "routine seeking behaviour", i.e. tendencies to uphold stable routines and a reluctance to give up old habits.
Abstract: Purpose – The purpose of this paper is to explore the connection between organisational cultures and the employee's resistance to change at five hospital wards in Western Sweden. Staff had experienced extensive change during a research project implementing person‐centred care (PCC) for patients with chronic heart failure.Design/methodology/approach – Surveys were sent out to 170 nurses. The survey included two instruments – the Organisational Values Questionnaire (OVQ) and the Resistance to Change Scale (RTC).Findings – The results indicate that a culture with a dominating focus on social competence decreases “routine seeking behaviour”, i.e. tendencies to uphold stable routines and a reluctance to give up old habits. The results indicate that a culture of flexibility, cohesion and trust negatively covariate with the overall need for a stable and well‐defined framework.Practical implications – An instrument that pinpoints the conditions of a particular healthcare setting can improve the results of a chang...
97 citations
TL;DR: The findings suggest that appropriate legislations backing salary supplements, commitment-based bonus payments with a set of internal regulations and leadership with sound managerial qualities are required to pursue workforce retention in district hospitals.
Abstract: Purpose – This study seeks to undertake a systematic review to consolidate existing empirical evidence on the impact of financial and non‐financial incentives on motivation and retention of health workers in Ghana's district hospitals.Design/methodology/approach – The study employed a purely quantitative design with a sample of 285 health workers from ten district hospitals in four regions of Ghana. A stepwise regression model was used in the analysis.Findings – The study found that financial incentives significantly influence motivation and intention to remain in the district hospital. Further, of the four factor model of the non‐financial incentives, only three (leadership skill and supervision, opportunities for continuing professional development and availability of infrastructure and resources) were predictors of motivation and retention.Research limitations/implications – A major limitation of the study is that the sample of health workers was biased towards nurses (n=160; 56.1 percent). This is exp...
86 citations
TL;DR: A framework for exploring and potentially aligning multiple stakeholder perspectives of systems integration, which consists of three types of mental models, i.e. integration-task, system-role, and integration-belief, is built.
Abstract: Purpose – Health service organizations and professionals are under increasing pressure to work together to deliver integrated patient care. A common understanding of integration strategies may facilitate the delivery of integrated care across inter‐organizational and inter‐professional boundaries. This paper aims to build a framework for exploring and potentially aligning multiple stakeholder perspectives of systems integration.Design/methodology/approach – The authors draw from the literature on shared mental models, strategic management and change, framing, stakeholder management, and systems theory to develop a new construct, Mental Models of Integrated Care (MMIC), which consists of three types of mental models, i.e. integration‐task, system‐role, and integration‐belief.Findings – The MMIC construct encompasses many of the known barriers and enablers to integrating care while also providing a comprehensive, theory‐based framework of psychological factors that may influence inter‐organizational and int...
71 citations
TL;DR: The article explores the drivers increasing the importance of teamwork, reviews the current knowledge base on how to build a team and focuses on some of the barriers to effective team performance.
Abstract: Purpose – This article aims to review teamwork and the creation of effective teams within healthcare.Design/methodology/approach – By combining research material found in management, psychology and health services research the article explores the drivers increasing the importance of teamwork, reviews the current knowledge base on how to build a team and focuses on some of the barriers to effective team performance.Findings – The simultaneous inflation of healthcare costs and necessity to improve quality of care has generated a demand for novel solutions in policy, strategy, commissioning and provider organisations. A critical, but commonly undervalued means by which quality can be improved is through structured, formalised incentivisation and development of teams, and the ability of individuals to work collectively and in collaboration. Several factors appear to contribute to the development of successful teams, including effective communication, comprehensive decision making, safety awareness and the ab...
68 citations
TL;DR: The paper discusses whether hybridity needs re-theorizing to adequately account for clinician leadership, and is the first to examine the concept of hybridity in the context of Clinician leadership.
Abstract: Purpose – In many countries leadership theories and leadership development programs in healthcare have been dominated by individualistic and heroic approaches that focus on developing the skills and competencies of health professionals. Alternative approaches have been proffered but mainly in the form of post‐heroic and distributed forms of leadership. The notion of “hybridity” has emerged to challenge the assumptions of distributed leadership. The paper seeks to explore how the concept of hybridity can be used to re‐theorize leadership in healthcare as it relates to clinician managers (or hybrid‐professional managers).Design/methodology/approach – The theoretical developments are explored and empirical material is presented from research in Australian public hospitals to support the case for the existence of hybridized forms of leadership in healthcare. The paper discusses whether hybridity needs re‐theorizing to adequately account for clinician leadership. It contributes to debates surrounding the role ...
68 citations
TL;DR: The paper concludes that the era of strong general management may be replaced by one where non-clinical managers and clinicians work in partnership to optimise the different expertise, experience and values to achieve high quality, productive and patient-focused care.
Abstract: Effective clinical leadership and engagement are increasingly being recognised as important contributors to the delivery of high standards of clinical care and organisational performance. This chapter argues that it is no longer acceptable for a doctor just to be a clinical expert. Other competences, including appropriate management and leadership skills, should be integral elements of practice and thus need to be included as part of selection of medical students and doctors at all levels as well as incorporated within education and training.
61 citations
TL;DR: This study is one of the first studies to provide evidence of the moderating roles of the team leader's EI and team members' proactive personality levels on the relationship between team empowerment and team proactivity in university hospitals that formally implement work teams.
Abstract: Purpose – The purpose of this study is to investigate the relationship between team empowerment and team proactivity and the moderating roles of a team leader's emotional intelligence (EI) and a team member's proactive personality.Design/methodology/approach – To provide a rigorous test of the hypotheses, a field study from a sample of 910 certified nurses in 82 teams from 12 university hospitals in Turkey was conducted.Findings – The results reveal that proactivity is positively associated with team empowerment. In addition, team leader's EI and team members' proactive personality influence the relationship between team empowerment and team proactivity. Specifically, teams exhibit the highest proactivity when team leaders' EI and team members' proactive personality are high.Research limitations/implications – The main strength of the investigation in this study was its multilevel research design. Most research on proactivity and empowerment has been conducted within single organizations, precluding an as...
60 citations
TL;DR: This is the first empirical report comparing longitudinal and contextualised findings from a number of case studies of different organisational and management healthcare innovations, making possible explanations for success factors and useful practical recommendations for conditions needed to nurture such innovation in public healthcare.
Abstract: Purpose: The purpose of this paper is to compare the implementation of twelve different "organization and management innovations" (OMIs) in Swedish healthcare, to discover the generic and specific ...
55 citations
TL;DR: The content of radical change is examined by mapping differences between two templates for organizing delivery of healthcare; the enabling and constraining mechanisms underlying major change from one template to another; and the processes implicated in change implementation.
Abstract: Purpose – The purpose of this paper is to examine: the content of radical change by mapping differences between two templates for organizing delivery of healthcare; the enabling and constraining mechanisms underlying major change from one template to another; and the processes implicated in change implementationDesign/methodology/approach – Longitudinal, qualitative case study design allowed the tracking, over a four‐year period, of the transformation of healthcare service in a community from provider‐centered, fragmented delivery to patient‐centered, integrated delivery The authors conducted 90 interviews at three intervals, observed meetings, and analyzed internal and external documents Concepts on content, process and mechanisms were used to analyze the dataFindings – Transition from one template to another involves radical change in structures/systems and underlying values Mechanisms precipitating and enabling change include: powerful stakeholders' dissatisfaction with current template and commit
TL;DR: The context of healthcare priority-setting is outlined, and each of the other ten papers in this special edition are summarised, to introduce a new multidisciplinary research programme drawing on ethics, philosophy, health economics, political science and health technology assessment.
Abstract: Purpose – This editorial aims to outline the context of healthcare priority‐setting, and summarise each of the other ten papers in this special edition. It introduces a new multidisciplinary research programme drawing on ethics, philosophy, health economics, political science and health technology assessment, out of which the papers in this edition have arisen.Design/methodology/approach – Key normative concepts are introduced and policy and research context provided to frame subsequent papers in the edition.Findings – Common challenges of health priority‐setting are faced by many countries across the world, and a range of social value judgments is in play as resource allocation decisions are made. Although the challenges faced by different countries are in many ways similar, the way in which social values affect the processes and content of priority‐setting decisions means that those challenges are resolved very differently in a variety of social, political, cultural and institutional settings, as subseq...
TL;DR: This study is the first to demonstrate the importance of organizational culture to intersectoral collaboration in health care, and one of very few to examine organizational culture as a predictor of performance, compared with other organizational-level factors, in a multivariate analysis.
Abstract: Purpose – This study aims to investigate whether and how organizational culture moderates the influence of other organizational capacities on the uptake of new mental health care roles by non‐medical primary health and social care servicesDesign/methodology/approach – Using a cross‐sectional survey design, data were collected in 2004 from providers in 41 services in Victoria, Australia, recruited using purposeful sampling Respondents within each service worked as a group to complete a structured interview that collected quantitative and qualitative data simultaneously Five domains of organizational capacity were analyzed: leadership, moral support and participation; organizational culture; shared concepts, policies, processes and structures; access to resource support; and social model of health A principal components analysis explored the structure of data about roles and capacities, and multiple regression analysis examined relationships between them The unit of analysis was the service (n=41)Find
TL;DR: Both personality and motivation are found to significantly influence primary care managers' managerial competency and motivation tends to have a stronger influence than personality.
Abstract: Purpose – The purpose of this paper is first, to identify the critical managerial competencies of primary care managers; and second, to determine the relationship between personality and motivation, and managerial competency.Design/methodology/approach – A survey was conducted involving distribution of questionnaires to 358 rural primary care managers in Southern Thailand.Findings – The survey found six critical managerial competencies: visionary leadership; assessment, planning, and evaluation; promotion of health and prevention of disease; information management; partnership and collaboration; and communication. Both personality and motivation are found to significantly influence primary care managers' managerial competency. In particular, conscientiousness (i.e. perseveres until the task is finished, does a thorough job, full of energy, does things efficiently, and a lot of enthusiasm) is related to all managerial competencies. It is clear that extrinsic and intrinsic factors (i.e. quality of supervisi...
TL;DR: In this paper, boundary object theory and empirical data collected from a range of health and social care integration initiatives in Wales to illustrate the value of the focus on objects and to identify the potential implications of this approach for studies in other national contexts.
Abstract: Purpose
– This article aims to explore how objects function in integration efforts in health and social care contexts.
Design/methodology/approach
– The article draws on boundary object theory and empirical data collected from a range of health and social care integration initiatives in Wales to illustrate the value of the focus on objects and to identify the potential implications of this approach for studies in other national contexts.
Findings
– Attention to objects can shed light on the dynamics of integration, its potential and limits, offering insights that conventional analysis might otherwise miss.
Research limitations/implications
– The data drawn on in this paper are illustrative. Exploring the role of objects in integration requires more focused studies.
Practical implications
– The results suggest that integration designers and managers need to pay closer attention to the attachments that practitioners develop to objects.
Originality/value
– This is a highly original paper in view of its innovative use of boundary object theory in the context of integration, and its contribution to theory, research and practice.
TL;DR: The role of social values in the decision-making process in England and Wales is described, including the range of potential new approaches being developed including multiple criteria decision analysis.
Abstract: Purpose – The purpose of this paper is to provide an overview of the organisational and procedural arrangements for priority setting in England and Wales. It describes the role of social values in the decision‐making process.Design/methodology/approach – The processes and content of decisions made by the National Institute for Health and Clinical Excellence are analysed using the framework developed by Clark and Weale for identifying social values in health priority‐setting.Findings – While countries are seeking to achieve similar outcomes from their health prioritisation processes, each country has established different systems that reflect the social and legal framework underpinning their health systems. England is somewhat unique in being explicit about assessing “value for money” and using formal cost‐effectiveness in developing policy.Originality/value – Many countries are now considering the use of formal health economic methodologies to assess the value and prioritise health care interventions. How...
TL;DR: Results show that age-related attitudes (intergenerational cooperation and the perception of older employees' capabilities) are important factors influencing the perceived quality level of in-group cooperation, affecting performance in mentally and physically demanding work settings.
Abstract: Purpose – This paper aims to examine the influence of age and age‐related attitudes on relationship factors. In addition, it seeks to assess how both factors affect care service work performance.Design/methodology/approach – The paper explores the influence of age and age‐related attitudes on the relationship quality among employees, affecting performance in mentally and physically demanding work settings. The authors conducted the research in six residential homes for the elderly in Germany (152 respondents) and collected the data with questionnaires. Data are analyzed by multi‐hierarchical regression analyses.Findings – Results show that age‐related attitudes (intergenerational cooperation and the perception of older employees' capabilities) are important factors influencing the perceived quality level of in‐group cooperation. Both age‐related attitudes and relationship factors influence perceived employee performance, and job satisfaction.Research limitations/implications – The findings contribute to u...
TL;DR: An overview of current research regarding the concept of "health tourism" with a focus on Switzerland is given, to determine whether a consensus on this concept and its embedding in existing/future markets can be found.
Abstract: Purpose – This paper's purpose is to give an overview of current research regarding the concept of “health tourism” with a focus on Switzerland, and to determine whether a consensus on this concept and its embedding in existing/future markets can be found.Design/methodology/approach – The paper is an explorative study combining literature review, questionnaires and qualitative interviews. Grounded theory was employed.Findings – A service from the field of health care must have been provided prior to health tourism, allowing it to be classified under the health care system. Thus, health tourism is classified under the market for the sick and not under tourism which targets the healthy. Furthermore a new market for the healthy is emerging, which needs to be defined. As an example health(i)ness could help to clarify the terminology, to be seen as a gatekeeper of health and as a cultural paradigm change from cure to prevention.Research limitations/implications – Further research is needed, regarding the posit...
TL;DR: An empirical study based on the effects of managerialism on nurses with managerial duties in Portugal confirms that professionalism can also be conceptualised as a technology of self-control being able to discipline professionals at the micro level.
Abstract: Purpose – There have been profound changes in the Portuguese national health system (NHS), instigated under the influence of managerialism and the new public management (NPM) “philosophy”. These changes have been in line with what has happened in other developed countries. At the beginning of the new century, important reforms that emphasised the efficient use of scarce resources were implemented. The objective of this study is to understand how nurses are adapting to a more managerial environment, one in which economic rationalism and market‐driven initiatives are the key principles behind the health reforms.Design/methodology/approach – A qualitative study was developed, based on semi‐structured interviews with 83 nurses with managerial duties in ten hospitals in Portugal. All interviews were tape‐recorded and each interviewee's discourses were subjected to content analysis.Findings – Data analysis led to the conclusion that under the new logic of the market and managerialism, these professionals have t...
TL;DR: It is argued that further inspection of the assumptions associated with social enterprise reveal an organisational form that is symbolic of isomorphic processes pushing healthcare organisations toward greater levels of homogeneity, based on market-based standardisation and practices.
Abstract: Purpose – The purpose of this paper is to reflect on social enterprise as an organisational form in health organisation and management.Design/methodology/approach – The paper presents a critique of the underlying assumptions associated with social enterprise in the context of English health and social care.Findings – The rise of social enterprise models of service provision reflects increasingly hybrid organisational forms and functions entering the health and social care market. Whilst at one level this hybridity increases the diversity of service providers promoting innovative and responsive services, the paper argues that further inspection of the assumptions associated with social enterprise reveal an organisational form that is symbolic of isomorphic processes pushing healthcare organisations toward greater levels of homogeneity, based on market‐based standardisation and practices. Social enterprise forms part of isomorphic processes moving healthcare organisation and management towards market “norms...
TL;DR: Analysis of the roles of social values in the reform of coverage decisions for Thailand's Universal Health Coverage (UC) plan in 2009 and 2010 suggests that in allocating its resources to subsidise particular services, the UC authority took into account not only cost-effectiveness, but also budget impacts, equity and solidarity.
Abstract: Purpose – The purpose of this paper is to analyse the roles of social values in the reform of coverage decisions for Thailand's Universal Health Coverage (UC) plan in 2009 and 2010.Design/methodology/approach – Qualitative techniques, including document review and personal communication, were employed for data collection and triangulation. All relevant data and information regarding the reform and three case study interventions were interpreted and analysed according to the thematic elements in the conceptual framework.Findings – Social values determined changes in the UC plan in two steps: the development of coverage decision guidelines and the introduction of such guidelines in benefit package formulation. The former was guided by process values, while the latter was shaped by different content ideals of stakeholders and policymakers. Analysis of the three interventions suggests that in allocating its resources to subsidise particular services, the UC authority took into account not only cost‐effectiven...
TL;DR: The findings in this paper argue for the need to incorporate a rights-based approach to health policy as a foundation of societal efforts to achieve universal health coverage in Latin America.
Abstract: In recent years, several middle-income Latin American countries have seen a steep increase in the number of cases litigating access to curative services and inputs. A renewed judicial approach to the enforcement of the right to health, the expansion of health coverage, a more demanding public interest, an increased prevalence of non communicable diseases and a limited capacity for fair and solid benefit basket design lie at the basis of this phenomenon. Using an interdisciplinary approach and evidence from Argentina, Brazil, Chile, Colombia, Costa Rica, Peru, and Uruguay, this paper examines this complex phenomenon and outlines some of its roots and impacts. It also argues for the need to incorporate a rights-based approach to health policy as a foundation to societal efforts to achieve universal health coverage.
TL;DR: An overview of health priority setting structures in Germany is provided, and the role of the Institute for Quality and Efficiency in Health Care (IQWiG) in integrating evidence-based decision making into the German system is investigated.
Abstract: Purpose – The purpose of this paper is to provide an overview of health priority setting structures in Germany. It reflects on how and which social values may influence decision making, and in particular investigates the role of the Institute for Quality and Efficiency in Health Care (IQWiG) in integrating evidence‐based decision making into the German system.Design/methodology/approach – The paper applies Clark and Weale's framework of analysis for Social Values and Health Priority Setting to the German context. Placing German health care decision making into Clark and Weale's framework allows for an analysis of the role and content of social values in different dimensions of decision making.Findings – Germany has witnessed significant changes in its health care decision‐making procedures in recent decades. The establishment of the Institute of Quality and Efficiency in Health Care (IQWiG) represents an effort to introduce health technology assessment (HTA) as a formal element of decision making in healt...
TL;DR: An introduction to the individual contributions to the special issue of integration, designed to encourage fresh perspectives and approaches to be brought to bear on understanding, conducting and evaluating integration, is provided.
Abstract: 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 limited but possibly developing achievement. Multiple meanings and usages are themselves sources of confusion and contestability that contribute to poor performance, as does an emphasis on process over outcome. This special issue provides an opportunity for the limitations and possibilities of integration to be explored from a wide range of disciplinary perspectives and international settings. Individual papers draw on a wide and innovatory range of theoretical approaches in addressing reasons for limited progress and opportunities for taking it further. Nonetheless, how far we have a good fit between this area of study and the tools we use for its evaluation remains an issue for concern and further exploration.Research limi...
TL;DR: Three critical factors are identified that seem to be instrumental for the process and outcome of integration efforts and these are clinical management's interpretation of the mandate; design of the management constellation; and approach to integration.
Abstract: Purpose - This paper explores critical factors that may obstruct or advance integration efforts initiated by the clinical management following a hospital merger The aim is to increase our understa
TL;DR: Clinical outcomes and patient satisfaction were reported frequently in telemedicine studies, but reporting of other performance metrics was rare, and routine use led to increased reporting of all metrics, except diagnostic accuracy.
Abstract: Purpose – This innovative analysis aims to quantify the use of evaluation criteria in telemedicine and to identify current trends in metric adoption. The focus is to determine the frequency of actual performance metric reporting in telemedicine evaluation, in contrast to systematic reviews where assessment of study quality is the goal.Design/methodology/approach – Automated literature search identified telemedicine studies reporting quantitative performance metrics. Studies were classified by telemedicine class; store‐and‐forward (SAF), real‐time consultation (RTC) and telecare (TC), and study stage. Studies were scanned for evaluation metric reporting, i.e. clinical outcomes, satisfaction, patient quality and cost measures.Findings – Evaluation metric use was compared among telemedicine classes, and between pilot and routine use stages. Diagnostic accuracy was reported significantly more frequently in pilots for RTC and TC. Cost measures were more frequently reported in routine use for TC. Clinical effec...
TL;DR: It was found that multiple factors influence the decision-making process in the Korean health priority setting, and how the interpretation and use of social values has changed over recent years was extended.
Abstract: Purpose – The purpose of this paper is to present the role of social values in setting healthcare priorities in Korea.Design/methodology/approach – Using Clark and Weale's draft framework, Korean healthcare priority setting was analysed. The process values used were transparency, accountability, and participation, and the content values used were clinical effectiveness, cost effectiveness, justice/equity, solidarity and autonomy.Findings – In the Korean health priority setting, it was found that multiple factors influence the decision‐making process. Effectiveness and safety are the two most important values mentioned in the process. Cost‐effectiveness is also considered in reimbursement decisions for new drugs since 2007. Recently, health technology assessment (HTA) has begun to change the social value system traditionally used in the Korean healthcare priority setting.Originality/value – The paper extends understanding of health priority setting in Korea, and how the interpretation and use of social val...
TL;DR: It is suggested that the development of integrated practices results from an evolutional and collective process of constructing meanings that is rooted in the work activities of the professionals involved, and the capacity of managers to actually manage such a process is questioned.
Abstract: Purpose – There has been considerable effort in recent years to link and integrate professional services more closely for patients with comorbidities. However, difficulties persist, especially at the clinical level. This study aims to shed light on these difficulties by examining the process of sensemaking in professionals directly involved in this integration.Design/methodology/approach – The authors conducted an eight‐year longitudinal case study of an organization specializing in mental health and substance abuse. Different data collection methods were used, including 34 interviews conducted between 2003 and 2009, observations and document analysis. The authors performed a qualitative analysis of the data using a processual perspective.Findings – This paper provides empirical insights about the nature of the sensemaking process in which professionals collectively participate and the effects of this process on the evolution of integrated services. It suggests that the development of integrated practices...
TL;DR: It is argued that it is time for a root-and-branch inquiry into the composition, structure, processes and dynamics of healthcare boards in the interests of assuring patient safety and to move away from a tendency to faith-based and exhortative approaches to guidance, training and development of boards.
Abstract: Purpose – In the light of failings of the board highlighted by the mid Staffordshire NHS Foundation Trust public inquiry, this paper seeks to offer insights about how boards in general might develop in order to discharge their responsibilities for quality and safety in health care more consistently in the future. The paper also proposes to examine wider questions about the role, purpose, and impact of boards on organisations.Design/methodology/approach – The paper draws on literature from across the social sciences to assess the evidence for effective board working using a contingency and realist approach.Findings – The examination leads to the identification of three key issues surrounding the construction and the development of boards. First, there is no evidence or consensus about an “ideal” board form. The rationale and evidence‐base, for example for the 1991 model for NHS boards in the English NHS, has never been set out in an adequate manner. Second, the evidence about effective board working sugges...
TL;DR: In this article, the authors consider some of the philosophical and bio-ethical issues raised by the creation of the draft social values framework developed to facilitate data collection and country-specific presentations at the inaugural workshop on social values and health priority setting.
Abstract: Purpose – The purpose of this paper is to consider some of the philosophical and bioethical issues raised by the creation of the draft social values framework developed to facilitate data collection and country‐specific presentations at the inaugural workshop on “Social values and health priority setting” held in February 2011.Design/methodology/approach – Conceptual analysis is used to analyse the term “social values”, as employed in the framework, and its relationship to related ideas such as moral values. The structure of the framework (process and content values) is considered in light of current debate in philosophy and bioethics about the political and moral aims served by these kinds of values, and the extent to which they are either suited to, or sufficient for, the policy context.Findings – There is much to be gained by engaging with the arguments presented in the philosophical literature in order to further refine the framework. The framework should remain neutral in respect of the importance of...