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Project

Health and Social Care

Unit(s) of assessment: Business and Management Studies

Research theme: Health and Wellbeing

School: Nottingham Business School

Overview

Health and wellbeing is an interdisciplinary strategic research theme across the whole of NTU and various aspects of Health and Social Care are a focus for research in the business school. The particular interests within the public policy and management group are high-level systemic issues and changes within the NHS and the Social Care System. The team have previously looked at the impact of the 2012 Health and Social Care Act and are currently investigating the introduction of Integrated Care Systems. The team also attempt to research some of the biggest operational challenges facing the NHS, such overcrowding in Accident and & Emergency (A&E) and delayed discharges from hospitals back into residential or domiciliary care.

Workstreams

Workstream 1. Accident and Emergency

A&E delays are one of the key performance issues in the Acute Hospital Sector in the UK (Emergency admissions to hospital: managing the demand NAO 2013). Per capita, they are the most expensive part of the NHS. Nottingham University Hospitals Trust (NUHT) is the 4th largest acute hospital in the UK and the largest outside London. The team werecommissioned by Nottingham Clinical Commissioning Group to investigate the use of A&E by young people at NUHT’s Queens Medical Centre.  People between the ages of 19-29 are the least efficient users of NHS services, but represent over 17% of A&E attendances at NUHT. We attempted to identify why they attended and recommended a series of strategies and techniques to avoid unwarranted presentations thus allowing improved capacity and greater flows of patients’ genuinely needing A&E care.

Workstream 2. Hospital Discharges

The health and social care system for discharging patients from hospital accounts for significant costs but does represent value for money according to the NAO. Gross annual cost to the NHS of treating patients in hospital who no longer need to receive acute hospital care is approaching £900m per annum.

NBS advice and research informed the development and redesign of the discharge service; improved the arrangements for reducing discharge delays and evaluated the impact of the changes at the Field Mill hospital in Mansfield Nottinghamshire.

The annual multi-agency return on investment improved significantly each year and by the third stage (excluding patient benefits - which were significant but unmeasurable in the resources available) was over 300%. This project won the NICE Shared Learning Award at the 2017 annual conference and inspired similar schemes throughout the UK (as well as at NUHT).

Workstream 3. Integrated Healthcare Systems

Nottingham City was already the site of an NHS Vanguard project when in 2015 Sustainability and Transformation Plans (STPs) were announced to bring NHS organisations and local authorities together to produce ‘Place-based plans’ for the future of health and social care services. Originally intended to produce ‘Accountable Care Systems’ in July 2017 the NHS announced 8 areas which were to become Accountable Care Organisations later rebranded as local Integrated Care Systems by NHS England in 2018.

In an innovative relationship with the STP/ICS programme team the business schools team  have been acting as critical friends have acted as peer-reviewers, advisers and evaluators to the programme, reflecting earlier research on place-base public health and social care provision in the area.

Journal Articles

Murphy, P., Wankheda, P. and Lakoma, K., 2019. The strategic and operational landscape of emergency services in the UK. International Journal of Emergency Services. ISSN 2047-0894

Hewitt, M., Molthan-Hill, P., Lomax, R. and Baddeley, J., 2018. Supporting the UN's Sustainable Development Goals: reconceptualising a 'sustainable development assessment tool' for the health and care system in England. Perspectives in Public Health. ISSN 1757-9139

Whysall, Z., Bowden, J. and Hewitt, M., 2018. Sickness presenteeism: measurement and management challenges. Ergonomics, 61 (3), pp. 341-354. ISSN 0014-0139

Murphy, P., Considine, P. and Buchanan, D., 2016. Something wicked this way comes: the main barrier to transformation. Health Service Journal. ISSN 0952-2271

Greenhalgh, K. & Harradine, D. (2014) Civil society commissioning: the accounting contribution to strategy. Public Money & Management, Vol. 34, No. 1, pp. 19-26.

Hall, C.L., Moldavsky, M., Taylor, J., Sayal, K., Marriott, M., Batty, M.J., Pass, S. and Hollis, C., 2014. Implementation of routine outcome measurement in child and adolescent mental health services in the United Kingdom: a critical perspective. European Child & Adolescent Psychiatry, 23 (4), pp. 239-242. ISSN 1018-8827

Hall, C.L., Taylor, J., Moldavsky, M., Marriott, M., Pass, S., Newell, K., Goodman, R., Sayal, K. and Hollis, C., 2014. A qualitative process evaluation of electronic session-by-session outcome measurement in child and adolescent mental health services. BMC Psychiatry, 14 (1), p. 113. ISSN 1471-244X

Harradine, D. & Prowle, M. (2014) Austerity and financial governance: a UK case study of the National Health Service. International Journal of Public Sector Management. Vol. 27, No 3, pp.4-11.

Moldavsky, M., Pass, S. and Sayal, K., 2014. Primary school teachers’ attitudes about children with attention deficit/hyperactivity disorder and the role of pharmacological treatment. Clinical Child Psychology and Psychiatry, 19 (2), pp. 202-216. ISSN 1359-1045Murphy, P., 2014. Sport, physical activity and the establishment of Health and Wellbeing Boards in Nottingham and Nottinghamshire. Managing Leisure, 19 (2), pp. 92-104.

Pontones, C, R., Morote, R, P., and Prowle, M.,2014 Developing performance audit in Spanish local government: an empirical study of a way forward, Journal of Public Money and Management 34(3) 2014

Prowle, M., 2014 2014 Rebalancing the roles of the public and private health sectors in Wales, International Journal of Public and Private Health Care Management and Economics, Volume 4, 2014.

Prowle, M., and Harradine, D., 2014 Austerity and financial governance: a UK case study of the National Health Service, International Journal of Public Sector Management, 27(3), 2014

Prowle, A., Murphy, P. and Prowle M., 2014. Managing escalating demand for public services in a time of financial austerity: a case study of family interventions. The Journal of Finance and Management in Public Services 12 (1).

Batty, M.J., Moldavsky, M., Foroushani, P.S., Pass, S., Marriott, M., Sayal, K. and Hollis, C., 2013. Implementing routine outcome measures in child and adolescent mental health services: from present to future practice. Child and Adolescent Mental Health, 18 (2), pp. 82-87.

Harradine, D. & Prowle, M. (2013) The Thatcher Legacy: the long shadow over public sector reform, Public Services, April.

Murphy, P., 2013 Public Health and Health and Wellbeing Boards: Antecedents, Theory and Development. Perspectives in Public Health. 133 (5), pp. 248-253.

Prowle, M.J. and Harradine, D., 2013. Statutory financial accounting in the UK: relevance and cost? Journal of Finance and Management in the Public Services.

Harradine, D. (2012) The roles of accounting in third sector delivery of services: the case of LinkAge Plus, Public Money and Management. Vol. 22: 2; pp. 111-118.

Harradine, D. & Greenhalgh, K. (2012) Third sector commissioning: lessons from a LinkAge Plus pilot, International Journal of Public Sector Management, Vol. 25, No. 5, pp. 391-403.

Harradine, D & Prowle, M, J. (2012) Service-Line-Reporting in a NHS foundation trust: An initial assessment of its relevance and applicability, Public Money and Management. Vol. 32: 3, pp. 217-224.

Prowle, M.J., Harradine, D. & Latham, R. (2012) Statutory Financial Accounting in the UK Public Sector: Relevance and Cost? Journal of Finance and Management in the Public Services, Vol. 10, No. 2, pp. 26-39.

Prowle, M. & Harradine, D. (2012) Financial Governance ? The system is not looking healthy. Public Services, 08/11.

Harradine, D., Prowle, P., & Lowth G. (2011) A method for assessing the effectiveness of NHS budgeting: its application to a NHS Foundation Trust. CIMA Insights, Sept 2011.

Harradine, D., Prowle, M., Lowth, G. (2011) The financial malaise of the NHS: “physician, heal thyself”, Financial Management. October 2011, pp. 54-55.

Harradine, D., Prowle, P., & Lowth G. (2011) A method for assessing the effectiveness of NHS budgeting: its application to a NHS Foundation Trust, London, CIMA (RES), Vol. 7; 12, July.l

Reports

Chalmers-Page, S., Browes, S., Hewitt, M. and Quinn, J., 2018. Integrated urgent care / NHS 111 workforce blueprint: workforce governance guide. London: NHS England.

Murphy, P., Harradine, D. and Hewitt, M., 2018. Evaluation of Phase 3 of the Kings Mill Hospital discharge project of the 'ASSIST' team at Mansfield District Council. Nottingham: Nottingham Trent University

Ferry, L., Gebreitner, F. and Murphy, P., 2017. Written evidence submitted to the Public Accounts Committee on Financial Sustainability of the NHS. Research report for external body. London: House of Commons.

Harradine, D., Murphy, P., Valero-Silva, N. and Prowle, M., 2016. An examination of the reasons that result in Emergency Department attendances, in contrast to alternative care and diagnostic options, for a defined Millennials/Generation Y population in Nottingham. Nottingham: Nottingham Trent University

Murphy, P., 2016. Ambulance services: submission to National Audit Office. London: National Audit Office.

Murphy, P., Harradine, D. and Cope, R., 2016. Evaluation of Phase 2 of the early discharge project of the ‘ASSIST’ team at Mansfield District Council. Nottingham: Nottingham Trent University.

Murphy, P. and Harradine, D., 2015. Evaluation of the early discharge project of the 'ASSIST' team at Mansfield District Council. Nottingham: Nottingham Trent University.

Ferry, L. and Murphy, P., 2015. Financial sustainability, accountability and transparency across local public service bodies in England under austerity. Briefing note to Centre for Public Scrutiny (CfPS) Advisory Board.

Ferry, L. and Murphy, P., 2015. Financial sustainability, accountability and transparency across local public service bodies in England under austerity. Report to National Audit Office (NAO).

Prowle, M., Harradine, D., Latham, R., Lowth, G., Murphy, P. and Orford, K., 2013. The importance of strategic financial leadership in the UK public sector in a time of financial austerity. London: Association of Chartered Accountants (ACCA).

Conference Papers and Presentations

Wankhada, P., Swetketu, P., Murphy, P., Weir, D. and Nelson, S., 2019. Critical understanding of interoperability and governance issues in blue-light services: the need for a joined-up approach. In: British Academy of Management (BAM2019) Conference, Aston University, Birmingham, 3-5 September 2019.

Glennon, R. and Murphy, P., 2018. Accountability Provocation Workshop. In: IRSPM Audit, Accounting and Accountability SIG Meeting, University of Glasgow, Glasgow, Scotland, 6-7 November 2018.

Ferry, L., Gebreitner, F. and Murphy, P., 2017. Mirror images! - Accountability and blame avoidance in England's NHS. In: Public Services and Charities: Accounting, Accountability and Governance at a Time of Change, Queen's Management School, Queen's University, Belfast, 18-19 January 2017.

Harradine, D., Prowle, M., Murphy, P. and Valero-Silva, N., 2017. An examination of the reasons for ED attendances by a prescribed Millennials/Generation Y cohort in Nottingham. In: PAC Annual Conference 2017, Nottingham Conference Centre Nottingham Trent University, 12-14 September 2017.

Murphy, P., 2017. Health and social care rationing - who decides what is funded? In: 11th International Conference of the Society for Acute Medicine, International Convention Centre (ICC), Birmingham, 11th -12th September 2017.

Murphy, P. and Harradine, D., 2017. Better Together: the ASSIST hospital discharge scheme. In: National Institute for Health and Care Excellence (NICE) Conference, Liverpool Arena, Liverpool, 18th -19th May 2017.

Caven, V., Nachmias, S. and Pass, S., 2016. Being coeliac: hidden inequalities in the workplace. In: 9th Equality, Diversity and Inclusion International Conference (EDI): Equality, Diversity, Inclusion and Human Rights in Times of Austerity, University of Cyprus, Nicosia, Cyprus, 22 - 24 June 2016

Harradine, D., Murphy, P., Valero-Silva, N. and Prowle, M., 2016. An examination of the reasons that result in Emergency Department attendances, in contrast to alternative care and diagnostic options, for a defined Millennials/Generation Y population in Nottingham. Research report for Nottingham City CCG. Nottingham: Nottingham Trent University.

Murphy, P. 2016 Ambulance services - a submission to the National Audit Office from the Joint Universities Emergency Research Group. Nottingham: Nottingham Trent University.

Murphy, P., Harradine, D. and Cope, R., 2016. Evaluation of Phase 2 of the early discharge project of the ‘ASSIST’ team at Mansfield District Council. Research report for Mansfield and Ashfield CCG. Nottingham: Nottingham Trent University.

Ferry, L. and Murphy, P., 2015.  Financial sustainability, accountability and transparency across local public service bodies in England under austerity. Briefing note to Centre for Public Scrutiny (CfPS) Advisory Board.

Ferry, L. and Murphy, P., 2015.  Financial sustainability, accountability and transparency across local public service bodies in England under austerity. Report to National Audit Office (NAO).

Greenhalgh, K. and Murphy, P.,   2015. Towards a strategic needs assessment for the service and the review of the IRMP: a report for the Nottinghamshire Fire and Rescue Service.  Research report for external body.  Nottingham: Nottingham Trent University.

Harradine, D., Prowle, M. and Murphy, P.,   2015. Interim report: an examination of the pre-admission decision-making factors resulting in pressure on A&E at NUHNHST.

Murphy, P., 2015.  Public Management and Governance Research Group annual report 2014. Nottingham: Public Management and Governance Research Group, Nottingham Trent University.

Murphy, P. and Harradine, D.,   2015. Evaluation of the early discharge project of the 'ASSIST' team at Mansfield District Council.  Research report for external body.  Nottingham: Nottingham Trent University.      Prowle, M, J., and Harradine, D., 2014 Sustainable Healthcare Systems: An international Study. ACCA

Prowle, M., Harradine, D., Latham, R., Lowth, G., Murphy, P. and Orford, K., 2013. Importance of strategic financial leadership in the UK public sector, in a time of financial austerity: a research study. ACCA.

Harradine, D., Prowle, M.J. and Lowth, G., 2011. A method for assessing the effectiveness of NHS budgeting: its application to a National Health Service Foundation Trust. London: CIMA.

Collaboration

The programme maintains close working relationships with associate members from both academia and the NHS, who regularly participate and contribute to the programme's activities.

These include:

  • Professor David Buchanan, Visiting Professor
  • Simone Jordan, Visiting Fellow
  • Dr Phil DaSilva, Visiting Fellow
  • Rebecca Larder, Visiting Fellow
  • Dr Phil Considine University of Strathclyde
  • Professor Laurence Ferry Durham University
  • Professor Malcolm Prowle of Gloucestershire University
  • Roger Latham, Visiting Fellow and Past President of CIPFA
  • Glyn Lowth, Visiting Fellow and Past President of CIMA

Related staff

The programme is keen to include colleagues (distinguished and new) who are interested in the programme's scholarly activity policy and practitioner dialogue either to enhance their teaching and learning or to promote and strengthen relations with practice as well as to participate in theoretical and applied research.