Stepping into the kitchen: lay clients as co-producers of a professional service

This study examines the implications for service organizations and their staff of clients’ involvement as co-producers of a professional service. Two female infertility clinics were analysed, one using micro-surgery (MS) and the other in-vitro fertilization (IVF) techniques. These differed on the dimension of patients’ involvement in the delivery of treatment. In the MS clinic patients were ‘passive’ recipients of treatment, whereas in the IVF clinic patients were required to partake as co-producers in the delivery of the medical service. Thus, reflected here are two different forms of client–provider interface, which the results show to have different implications. Bringing the clients, as co-producers, ‘into the kitchen’ where service is prepared (IVF) was found to involve issues associated with the lay client–professional provider work interactions, like perceptions of performance, functional work behaviour (conflicts, poor co-ordination, etc.), lower work/service satisfaction of staff and clients, and coping with service uncertainty. These and other implications for front-line service are examined and discussed.     

A Simple Matter of Control? NHS Hospital Nurses and New Management*

ABSTRACT Over the past two decades the National Health Hospital Service has been subjected to considerable changes in is organization. ‘New’ public sector management (NPM) has been given the task of changing hospital culture and making service provision more efficient. Nurses, as the largest occupational group within the National Health Service (NHS), have attracted considerable management attention and there are two distinct accounts concerning how NPM has supposedly gained control of the nursing labour process. Firstly, it is proposed that the physical division of labour of health care professionals is now firmly in the hands of hospital management through the use of Tayloristic techniques. Secondly, alternative accounts suggest that public sector organization cultures have been successfully orientated toward a customer service ethos, and that the convincing discourse of ‘quality’ is achieving some success as a normative control device. This paper investigates the responses of nurses to NPM, whichever form this may take, and presents data collected as part of a longitudinal study carried out in an NHS Trust hospital. It charts the changes which have occurred in the nursing labour process over a six year period, but especially draws upon more recent data to show how nurses, over a period of time, develop their own ways of reinterpreting management's desires. It argues that management is more likely to continue to rely on nurses’ traditional autonomy in the delivery of health care in recognition that nurses may resist some but accommodate many of the demands made of them.     

The influence of authentic leadership behaviors on trust and work outcomes of health care staff

A key element of a healthy work environment is trust: trust between staff and their leaders. Authentic leadership is proposed as the core of effective leadership needed to build trust because of its clear focus on the positive role modeling of honesty, integrity, and high ethical standards in the development of leader‐follower relationships. A model linking authentic leadership behaviors with trust in management, perceptions of supportive groups and work outcomes (including voice or speaking‐up behavior, self‐rated job performance, and burnout) using secondary analysis procedures was examined. The hypothesized model was tested using structural equation modeling in two samples of health care employees from a western Canadian cancer care agency: clinical care providers including nurses, pharmacists, physicians, and other professionals (N = 147) and nonclinical employees including administrative, support, and research staff (N = 188). Findings suggest that supportive leader behavior and trust in management are necessary for staff to be willing to voice concerns and offer suggestions to improve the workplace and patient care.     

Implementing the third way

This article examines the transfer of NPM strategies by comparing Service Charter initiatives in the United Kingdom, United States and Australia. These three countries, together with Canada and New Zealand,are partofwhathas beendescribedas the ‘core’ new public management (NPM) policy community (Common 1998). Service Charters are an NPM strategy intended to change the culture of public service delivery to focus on the needs of the users, identified as ‘clients’ or ‘customers’. The objectives are to make service providers more responsive to users by guaranteeing specific standards for service delivery, providing a substitute for competition and a benchmark for measuring service quality. The first section examines the historical and political context of the development of the Citizen's Charter and Service First programmes in the UK, customer service plans in the USA and Government Service Charters in Australia. The second section explores the similarities and differences between these charter initiatives based on analysis of public documents. There is evidence of convergence at the ideological level as managerial values underpin the service charter frameworks in all three jurisdictions (Walsh 1994; Pollitt 1995; Kettl 1997). Despite drawing from a similar toolkit influenced by private sector techniques, significant differences between the country contextshaveresultedindivergent strategies. Timing in the three countries examined suggests that national politics rather than global policy convergence is more significant in explaining the development of service charters. This case study provides evidence of policy transfer rather than policy convergence (Common 1998). The final section considers the limitations of the customer service model. Monitoring quality iscentral to theprogrammes in all three countries. Performance monitoring is essentially a quantitative methodology that requires criteria and indicators for measuring the quality of service delivery and programme outcomes. Two problems are considered. The first is the difficulty of specifying and measuring service quality. The second is that quality indicators derived from services marketing and management research do not take into account the characteristics of public services.     

NPM Can Work: An optimistic review of the impact of New Public Management reforms in central and eastern Europe

Abstract

This article reviews the New Public Management (NPM) literature in central and eastern Europe (CEE) with the aim of assessing whether reforms have ‘worked’. Increasingly, academics have tended to argue against the suitability of NPM instruments in this region. To understand the impact of this much-debated policy, we first propose a classification of the impacts of NPM geared to the realities of central and eastern European states. Then, we use this classification to carefully review empirical studies across the region over the past 10 years. Unlike much of the recent academic literature, we suggest that NPM can work. NPM policy has not always been successful to the extent expected and promoted, but there is enough evidence to show that some of the central ideas in NPM have led to improvements in public service organization or provision across different organizational settings. An adequate degree of administrative capacity, sustained reform over time and a ‘fitting context’ are the main factors that can tip the scale for the success of these management instruments. The article provides a fresh and transparent assessment of a major administrative development in a growing region with implications for other parts of the world that experience similar challenges and opportunities.     

Defining,achieving, and evaluating collaborative outcomes: a theory of change approach

Governments have repeatedly claimed that collaboration improves public service outcomes. However, defining, achieving, and evaluating collaborative outcomes is often problematic. Analysis of multi-sectoral projects in Wales, which were supported by the European Social Fund, exemplifies these challenges. Shifts in policy discourses and the interplay between national and local agendas produced complex and contested understandings of outcomes which made difficult to evaluate the projects’ achievements. We argue that the pursuit of collaboration needs to be understood not simply as an attempt to improve public service effectiveness but also ‘cultural efficacy’. The conclusions offer reflections relevant for theory and practice.     

Citizens’ Entrepreneurial Role in Public Service Provision

Abstract

In public service provision, citizens are conventionally reactive, portrayed as ‘users’, ‘customers’, ‘co-producers’, or ‘participators.’ Occasionally, following dissatisfaction, citizens themselves proactively create alternative services, namely, entrepreneurial exit (EE). Laymen then become providers of previously governmental professional services. Drawing upon six EE manifestations, findings suggest that if the newly-introduced service gains social acceptance, existing provision may change in one of the three modes: (a) First-order incremental change, legitimization of EE as an alternative service provision; (b) Second-order participative change, increased public participation in service provision fostered by EE; and (c) Third-order reformative change, existing service provision is reformed to satisfy citizens’ demands.     

Job autonomy, trust in leadership, and continuous improvement: An empirical study in health care

This research examines the influence of autonomy in day-to-day work on commitment of frontline employees to continuous improvement. Our hypothesized model links the job characteristics theory of work design that associates job autonomy with responsibility for outcomes, and the total quality management perspective that advocates empowering employees in order to generate commitment to continuous improvement. Further, as leadership is known to have a role in shaping job behaviors, and is considered important for the success of total quality management, the influence of trust in leadership on the relationship between job autonomy and commitment to continuous improvement is also examined. We test our hypotheses on data collected from individual employees working for an outpatient health care organization that is applying lean principles for managing and improving work processes. Based on our results, we present implications for organizations implementing continuous improvement initiatives such as lean, particularly in service environments such as health care.     

Role redesign in a modernised NHS: the case of health care assistants

This article examines role redesign in the National Health Service (NHS), which has been central to the Labour government's modernisation agenda, focusing on the role of health care assistants (HCAs). Drawing on data from two acute hospital trusts, this article focuses on variation in HCA roles between trusts, indicating that there may not have been a uniform expansion of the HCA role as the government's HR agenda and most commentators suggest. Although the modernisation agenda has curtailed registered nurses' role in direct care, there are significant variations in the degree to which HCAs undertake a ‘relief’, ‘substitute’ or ‘apprentice’ role at trust level. These variations in HCA role stem from distinctive models of the nursing workforce with differing assumptions about the respective roles of registered and non‐registered nurses. The variations in HCA role have important consequences for the prospects for role redesign and HR policy in the NHS.     

Gendering and Gender in Public Service Organizations: Changing Professional Identities Under New Public Management

This article examines the enactment of new public management (NPM) in public service professional organizations, the nature of professional/managerial subjectivities promoted within the NPM discourse, and the implications for male and female professionals/managers. The article has two aims. First, taking a gender ing organization perspective, it explores the gendered meanings of NPM and the promotion of new professional/managerial subjectivities. Second, focusing on gender in organizations, the article then considers the implications of the enactment of NPM for male and female professionals/managers. The article illustrates the complex, manifold and fluid nature of both the meanings ascribed to NPM and individual responses. It is argued that a gender lens offers a more nuanced and sophisticated understanding of NPM enactment and the implications of this for public service professionals/managers are considered.     

The non‐professionally affiliated (NPA) worker as co‐producer of public services: how is the role experienced in UK mental health services?

Recent workforce reforms have led to the widespread expansion of non‐professionally affiliated (NPA) support and assistant roles within UK public services. Research into these roles has been confined to a limited range of settings, with a focus on the consequence of change for professional workers. This article explores the emergence of ‘co‐production’, whereby NPA workers contribute alongside the professional in a distinct, complementary way. Findings are drawn from semi‐structured interviews with frontline workers and managers within the context of mental health workforce reform. The results build a picture of NPA working life characterised in part by autonomy and responsibility. At the same time, NPA workers rely on colleagues for support and are subject to being used indirectly by professionals. Contextual influences are considered. The conceptual implications of the analysis are brought out, both for the NPA role itself and for the broader issues involved in front line service work.     

Anchoring the mission: A framework for understanding mission maintenance in professional service firms

Mission maintenance in professional service firms must balance the commercial and professional logics and prevent mission drift. Based on a case study of ‘auditing in action’ in a German professional service firm we argue that mission maintenance results from interactions between the practice and field level. We find that anchors on the field level target individuals’ discretionary choices by balancing competing demands from the commercial and professional logics on the practice level. Therefore, we identify anchoring as a central cross-level mechanism for maintaining the balance between routinizing for professional quality and ‘flexibilizing’ for efficiency on the practice level. With these findings we make two contributions to the literature: an analysis of how the field level can contribute to maintaining organisations’ missions in fields that have competing logics, and the identification of anchoring as a central mechanism to balance competing demands with the expectations of referent audiences on the field level.     

A comparative study of the effects of ‘best practice’ HRM on worker outcomes in Malaysia and England local government

This paper presents the findings of a cross-cultural comparison of the effects of ‘best practice’ HRM using employees from a matched sample of local government service departments in England and Malaysia (England n = 569, Malaysian n = 453). The paper tests the universal ‘best practice’ thesis, and also assesses the perceived level of up-take of HR practices in the two samples. The research also considers the effects of the psychological climate and employees' perceptions of trust on five work-related outcomes, namely job satisfaction, motivation, organizational citizenship behaviour, stress and quit intentions. The findings reveal that the Malaysian workers perceived the up-take of HR practices to be higher in comparison to their counterparts in England. A less consistent pattern emerged with regards to perceptions of climate. OLS regression revealed that consistent with the universal thesis, a bundle of HR practices significantly predicted employee outcomes in the hypothesized directions in both samples. Therefore, these findings provide strong support for the universal thesis.     

The new public management and the UK Police Service

This article explores the impact of the introduction of the New Public Management (NPM) within the UK Police Service since the mid-1990s. A specific focus upon individual performance management (one of the central features of NPM) is examined from the perspective of the police sergeant who has primary responsibility for managing performance and ultimately the delivery of policing services within one of the UK's ‘essential’ public services. After a discussion of the literature on individual performance management within the context of the NPM, the article identifies four major research questions relating to: the job role demands of performance management; access to valid and reliable performance management information; the capacity to provide follow-up development and support; and the wider integration of performance management with organization strategy and service objectives. After reporting on interview data collected from role sets in which the sergeant is a focal member, the article concludes with a discussion of the constraints upon effective performance management within the NPM.     

Managing the hollow state Collaboration and contracting

This article presents what the authors have learned about managing networks of public, private and nonprofit service providers in the context of decentralized and devolved governmental regimes - what the authors have termed the hollow state. The characteristics of the hollow state are discussed along with two strategies for managing networks of organizations that jointly produce a public service - collaboration and contracting. The article revisits the authors' preliminary theory of network effectiveness, based on a four-city study of mental health in light of an evolutionary study conducted on one city's mental health system over four years.     

The spirit of management reforms

Abstract

The article reports on a comparative case study of the administrative cultures of the Australian (Queensland) and the Hungarian governmental administration. The basic finding of the study is that the culture profiles of the two administrative (sub-)systems are surprisingly similar. This finding is used to conclude that the organizational level of administrative culture is unlikely to play a significant role in shaping New Public Management (NPM) reforms. Moreover, this conclusion sheds a cloud of doubt onto the claim frequently found in NPM literature that NPM reforms involve a replacement of ‘outmoded, bureaucratic thinking’ with a ‘culture of efficiency and entrepreneurship’.     

The relationship between ‘high-performance work practices’ and employee attitudes: an investigation of additive and interaction effects

In order to improve our understanding of mediating variables inside the ‘black box’ of the firm's labour management, this paper examines the relationship between high-performance work system (HPWS) practices and employee attitudes. Using a randomly selected, national population sample, clear evidence was found for a positive relationship between HPWS practices and the attitudinal variables of job satisfaction, trust in management, and organizational commitment, implying that HPWS can provide win-win outcomes for employees and employers. However, the study also tests – from an employee perspective – the ‘complementarities thesis’ and finds negative interaction effects among HPWS practices. This strengthens the argument that there are likely to be limits to the positive outcomes of HPWSs for employees. Evidence of sequencing in the employee attitudinal responses to HPWSs was also found, with job satisfaction as the key mediating variable.     

Public–Private Partnerships in Health Services Delivery

Abstract

In this article, we conceptualize public–private partnerships (PPPs) from a network organizations perspective, and apply interorganizational relations (IOR) to study fifteen PPPs in a district health system in the state of Rajasthan in India. We find that the Government occupies a dominant position in the network because of the centrality of its functions, authority and control over resources and information. There is greater reliance on formal mechanisms of co-ordination. For effective network governance, it is imperative to reduce the power asymmetry, develop horizontal co-ordination, trust and social capital, and enhance public managers’ capacity for effectively managing interorganizational relationships.     

Multinationals and human resource practices in Ireland: a rejection of the 'new conformance thesis': a reply

This paper reports on a study of 398 people employed in two UK service organizations: a hospital and two divisions of a high street bank. The main purpose of the study was to determine the degree to which dispositional factors (predisposition to trust and trait anxiety) and situational factors (seven aspects of the job environment) predicted a person's reported trust in their managers. Two types of managers were investigated: a person's immediate line manager and ‘senior managers in their industry’. It was hypothesized that the dispositional factors would have a greater influence on trust in managers in the industry and that situational factors would have a greater influence on trust in one's immediate line manager. The first hypothesis was supported, but the second was not. It was found that trust in both types of managers was best predicted by a combination of general disposition to trust (not trait anxiety) and situational factors: five of the seven situational factors had a role in predicting intention to trust. This reflects the complexity involved in predicting trust at work and the managerial challenge of creating a trusting culture.     

A New Strategy Against Hostile Takeovers: A Model of Defense in Participations

This article examines the efficacy of a ‘defense in participations’ policy consisting of competitors acquiring cross‐equity participations within the same industry to prevent hostile takeovers. This defense in participations strategy provides disincentive for raiders as partial ownerships increase market power of competitors and then reinforce the ‘outsider effect’. Also, we find conditions for a general result, which state that takeovers are less profitable in an industry with participations rather than in an industry without any capital links. We provide information to regulators about the positive social impact of cross participations in the context of mergers and expose an economic dilemma between a ‘laissez‐faire’ and an interventionist approach. Copyright © 2016 John Wiley & Sons, Ltd.