LOCAL AUTHORITY E-GOVERNMENT PARTNERSHIPS IN ENGLAND: A CASE STUDY

This paper uses a case study of an e-government partnership of ten local authorities to consider how governance structures, financial arrangements and performance management systems may promote or inhibit successful collaborative working. The case is considered within the contexts of continuing new public management reforms including the balance between formal performance measurement indicators imposed by higher authorities and the scope for dialogue in the development of performance management systems. The case supports a view that collaborative working can benefit from a governance structure supporting a consistency of objectives of the partners operating within similar political and regulatory environments. Externally imposed performance indicators are significant to the partner authorities but their influence does not exclude the possibility of more dialogue-driven performance management systems being developed within the partnership. Sustainability of the partnership is never assured and tensions develop as a result of developing priorities of individual authorities, the possibility of local government reorganisation and changing national policy initiatives.     

Comparing the content of regulatory impact assessments in the UK and the EU

The need for effective leadership in the UK public sector has been a prominent discourse in recent years. One aspect of this is a growing interest in talent management. This article examines the evolution of processes used for managing talent and developing leaders in the UK's National Health Service (NHS) by applying human resource management theory to an empirical case study. Our aim was to provide a constructive, but critical, analysis of the current role of managerial talent management and to comment on the suitability of the adopted approach in the NHS. Over the past three decades the NHS has come to adopt an increasingly ‘hard’ approach to talent management, i.e. rationalistic, managerial and narrowly focused on leadership competencies and senior management roles. This parallels a more general shift in the NHS from its traditional public sector ethos and humanistic values to more business-oriented values and ways of working.     

Loose coupling in asset management systems in the NHS

This paper aims to identify whether the components of a loose-coupled system were present in the asset management systems of the National Health Service (NHS) in Wales and, if so, whether this had a negative impact. By utilising a qualitative analysis of semi-structured interviews with senior officials at two NHS Hospital Trusts together with the findings of a survey of all of the Hospital Trusts in Wales, we conclude that the asset management system of the NHS in Wales exhibits the features of a loosely coupled system with detrimental consequences. Where information on capital assets has been required below board level, lower management relies on local systems, while the information for senior managers and political leaders relies on the management accounting system and ad hoc enquiries. The result has been an impairment of the ability of lower management to reconfigure capital assets which leads to the nation's health service underperforming.     

New development: Reconnecting public service ethos and multi-agency collaboration. What are the possibilities and prospects for new local collaborative environments?

The public service ethos (PSE) is typically portrayed as the responsibility of public officers working for the public good, or described negatively as requiring intervention from the private sector. This article explores the relationship between the ethos and collaboration informed by findings from an empirical case study of public officers. It ends by identifying future avenues for research on the PSE by setting out possibilities and prospects for new local collaborative environments.     

Accounting for Public Hospitals: A Case Study of Modified GAAP

Public hospitals in the U.K. apply GAAP as modified by the Treasury, the Financial Reporting Advisory Board (FRAB) and the Department of Health. Individual National Health Service (NHS) Trusts apply their interpretation of the accounting manuals with further guidance and scrutiny from oversight bodies such as the Audit Commission. This article uses a case study approach to investigate how GAAP is modified and to outline the consequences of the constructed reality. The modifications are layered and often opaque. The accounts are constructed according to accounting requirements stipulated by Government and the account preparers adapt the requirements at Trust level. The accounting statements play a part in constructing a reality ( Hines, 1988 ) that has consequences through the NHS control regime and in how the financial position is portrayed to the public. It appears that GAAP is used to legitimate the NHS as a modern organization applying commercial accounting practice, but the accounting statements provide a distorted view of GAAP compliant statements. The accounting, while not itself real, is real in its consequences and can lead to biased decision‐making, service closures and job losses. The planned compliance of NHS Trusts with international GAAP may provide further scope for modification and manipulation in constructing NHS accounting reality.     

ACCOUNTING FOR (A) PUBLIC GOOD: PUBLIC HEALTHCARE IN ENGLAND

This paper reviews accounting technologies used over recent decades in the National Health Service: a public service (good) and the accounting for public interest (good) therein. The trends in NHS accounting are considered in the context of the defining characteristics of a modern public service. The accounting technologies, collectively known as New Public Financial Management (NPFM), are integral to wider public service reform. The overview of accounting technologies in context attempts to draw out some of the deficiencies or apparent mismatches in accounting technologies and public service reform.     

Cuts,collaboration and creativity

Massive cuts in public spending are demanding a new era of collaborative working among partners in English local governance. Partnerships have the capacity to pool assets, share scarce resources and leverage new forms of social and human capital. City-wide partnerships are also ideal vehicles for public service creativity. Action research in Sheffield reveals the potential, but also the pitfalls, of attempts to mainstream partnership principles, now they are no longer mandated by central government.     

Divergent Identities? Professions, Management and Gender

This article critically examines issues of gender in relation to the 'professionalization' of management, with particular reference to the National Health Service (NHS). It focuses on the Master of Business Administration (MBA) qualification and the role this plays in professional development of managers and clinicians. One MBA course, which has included a number of participants from the NHS and has attempted to include some recognition of gender issues, is used for illustrative purposes. The article raises important concerns about the implications of gender for NHS and other public sector professionals, and draws some conclusions about the ways in which management education might incorporate gender into the curriculum.     

DEVOLUTION, ACCRUALS ACCOUNTING AND ASSET MANAGEMENT IN NHS WALES

This paper describes how a strategy for health services has been developed for NHS Wales and examines the role of accruals accounting in asset management and development. It uses archival investigation as well as interviews and a questionnaire. The role of accruals accounting in the operation of the service, particularly as it relates to the capital asset base of the Trusts and how these are managed, is discussed in the context that Trusts are autonomous units that develop services, and hence their capital asset base, through their own internal planning structure. It is found that, on devolution, there was a lack of consistent information about the stock of capital assets and that capital charges, based on accruals accounting, were not penetrating asset management within individual Trusts. Although strategies were being developed centrally, their implementation at a Trust level can be impeded as a consequence of accruals accounting.     

Coping with austerity: innovation via collaboration or retreat to the known?

This paper explores new approaches to the management of public sector austerity through collaborative innovation. Practitioner-based insider research offers an insight into how collaborative innovation can work in the public sector, what undermines it and what impact the active management of a turbulent environment can make to outcomes. A flexible action framework—modelling collaborative innovation—offers a practical means of understanding and supporting effective innovation through collaboration.     

Creativity, Leadership and Change

The Department for Education and Employment's (DfEE) Permanent Secretary asks what needs to be done to deliver better public services. What are the priorities for modernization and how can these be achieved? He explains that the civil service has often under-valued management, skimped on management development, left project managers inadequately trained and recognized, and failed to reward effective service delivery. Improving delivery therefore requires a major cultural shift. He discusses four key issues: creativity, leadership, delivery, and community ownership.     

Dynamic web server construction on the intranet using a change management framework

As organizations increasingly emphasize effective collaborative working through networked systems, the World Wide Web (WWW) server and associated intranet technologies are gaining wider acceptance as a new enterprisewide information systems paradigm. In an intranet collaborative working environment, data used in the web server are usually modified more frequently than are those used in a traditional Internet web server. Thus, to support synchronous collaboration without causing any inconsistency among multiple concurrent users, the intranet web server must provide users with synchronized and consistent views of shared data. However, current web technologies have limitations in supporting this, largely because the existing Hypertext Transfer Protocol (HTTP) is unidirectional and does not allow web servers to send messages to their web browsers without first receiving requests from them. This paper proposes a web-based change management framework that can overcome such limitations and support synchronous collaboration in an intranet computing environment. The web-based change management framework facilitates management of dependency relationships between shared data in the web server and dependent user views in the client web browser and allows the web server to actively propagate changing details of the shared objects to all users referencing them. On the basis of the change management framework, we propose a dynamic web server that can support synchronous collaboration in various intranet-based collaborative systems including concurrent engineering design systems and electronic approval systems. The prototype system of the dynamic web server is developed on a commercial Object-oriented Database Management System (ODBMS) called OBJECTSTORE using the C++ programming language. Copyright © 1999 John Wiley & Sons, Ltd.     

Change management in government

Since the days of John F. Kennedy's New Frontier, the American public's regard for the competence of public agencies and the value of the services they perform has steadily declined. During that time, innovations in management practice and thinking have mostly originated and been tested in the private sector. But recent events, such as the attacks on the World Trade Center and the engulfment of New Orleans, have demonstrated how essential it is for public agencies to be well run, too. Unfortunately, few public administrators have a background in change management, and a variety of factors-such as civil service rules, political considerations, and the limited tenures of agency heads-have combined to make true reform a rare event. These facts of public life may never go away. But some agency leaders have figured out how to court important stakeholders, rededicate staffers to an agency's true mission, undertake reform so comprehensively that resistant elements are unable to subvert it, and lay the groundwork for next steps clearly and systematically. Consultant Frank Ostroff has studied turnarounds at the federal Occupational Safety and Health Administration, the Government Accountability Office, and Special Operations Forces-the fast-response, clandestine arm of the military. From these examples and others, he has distilled five principles that underlie successful change efforts: Improve performance against agency mission; win over external and internal stakeholders; establish a road map; recognize the connections among all the organizational elements; and be a leader, not a bureaucrat. Change programs that follow these principles are more likely to survive when leadership changes hands.     

Interorganizational cost management and relational context

Many firms today form alliances with their suppliers and customers that do not fit into the classical dichotomy of hierarchies and markets. The emergence of so-called hybrid relational forms makes the make-or-buy decision more complicated than the neo-classical economic perspective indicates. One outcome of these hybrid relational forms appears to be the development of cost management techniques that cross the organizational boundary between buyers and suppliers and whose objective is to reduce costs through collaborative efforts. This paper explores how firms enact interorganizational cost management during product design and the characteristics of the relational contexts associated with them. It also discusses the implications of such developments for the make-or-buy decision.     

Shaping strategic change ‐ The case of the NHS in the 1980s

This article explores the question of why the management of change has become an issue in the National Health Service (NHS). It reports the results of a study which explored reasons for variability in the observed rate and pace of strategic service change in the NHS. The metaphor of ‘receptive’ and ‘non‐receptive’ contexts for change is introduced and eight ‘signs and symptoms’ of receptivity outlined. Some examples are presented. These results give us a logic and language which may enable us to understand processes of change in the NHS.     

Service line reporting in a National Health Service foundation trust: an initial assessment of its relevance and applicability

Financial management and control systems are key components of effective management in NHS organizations. Systems have recently been enhanced by the introduction of service line reporting (SLR) in NHS foundation trusts (NHSFT). This article explores the extent to which SLR has been introduced into one NHSFT and what achievements have been made so far. It also considers the extent to which the SLR approach aligns with modern thinking about budgetary systems.     

医院管理中绩效考核作用的探讨

按照我国医疗体制改革的要求,坚持科学发展观,不断提高医院的服务水平,优化医院内部管理,促进医院的可持续发展,绩效考核发挥着极其重要的作用。本文通过对我国医院实行绩效考核的重要性、科学性、实用性、有效性等方面进行分析,就医院如何建立考核指标体系,医务工作者如何转变工作方式和服务模式,医院如何提高竞争力做了进一步探讨。     

Book Reviews

References to ‘customers’ have become commonplace in the policy discourses within UK government and other public sector bodies. It is a working assumption of UK public sector management that the concept of the ‘customer’ can be applied to any public sector service agency or department; and this paper analyses how the UK government's revenue department, formerly titled the Inland Revenue (IR), re-characterised firstly taxpayers and latterly tax claimants as ‘customers’, rather than ‘users’, of IR services. This paper identifies some problems, dilemmas and ambiguities associated with this reconceptualisation in the context of an organisation that is predominantly a regulating department. Far from being merely a reclassification of the taxpayer as customer, the emerging discourse and associated practices of the IR were in part embedded in organisational change, including the merger with HM Customs and Excise to form the present-day HMRC. Thus this case analysis illustrates the limits of consumerism as a strategic tool of a government revenue department and raises wider questions for public management.