Trade union recognition and the independent health care sector

2008

A thesis submitted for the degree of Doctor of Philosophy of the University of Bedfordshire.

Human Resource Management Journal, 2004

This article examines the role of trade unions in the health service at workplace level under the Labour government's modernisation agenda, and focuses on the shifting balance between forms of direct and indirect participation drawing on case studies of three acute hospital trusts. There has been a strong growth in forms of direct communication within the case study trusts and some increase in direct participation among professional groups. Despite this ‘dualism’ in employment relations, however, the target culture of the NHS has precluded the development of effective voice mechanisms. The policy implications for trade unions and the implications for the implementation of NHS pay modernisation are considered.

2009

Objectives: To better understand the information that is used in business cases for employee health activities. Methods: Interviews with 18 occupational health and safety professionals at major organisations in the UK were conducted to explore attitudes, motivations, behaviours and information needs about employee health investment. Results: The occupational health and safety professionals interviewed for this study have described how employee health issues are discussed in their organisations. Ethical arguments about it being the 'right thing to do' are common and are believed to have impact. Unsurprisingly legal compliance is stated to be the driver of most employee health activity. Higher-level activities and resource do require a business case. It is suggested that currently business cases for employee health are often not overly empirical, with more intuitive arguments appealing to people management issues, notions of corporate reputation and alignment with business objectives. Data on benchmarking and some kind of return-on-investment assessment are normally required. Data on cost of illness (mostly expressed via sickness absence), direct health expenditure per employee and insurance premiums are also used. These data are mostly captured by existing sources and procedural systems, although sickness absence data especially is often thought to be unreliable. Data on staff retention and productivity were considered relevant but not currently used or analysed by this sample. There was support for the notion that more robust empirical business cases may help overcome some of the barriers that were identified, for example where costs are more quantifiable than benefits. Conclusions: There is scope to make significant improvements to the business case for employee health investments in UK organisations through better measurement of impact on productivity and reputation risk and greater business-aligned communication by health professionals. More empirical business cases that meet the needs of decision-makers are more likely to attract investment into employee health activities.

2010

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The Pathways to Work (PtW) initiative has been rolled out in 49 Jobcentre Plus districts across Great Britain as the government seeks to provide services to activate claimants of incapacity benefits and help them overcome health-related barriers to work. The recent expansion of PtW has seen a heavy reliance on the contracting-out of services to the private and third sectors, with ‘Lead Providers’ paid according to job outcomes achieved for clients. However, during the initial development of PtW, the initiative was defined by a flexible, partnership-based form of governance, with a key role for the public National Health Service (NHS) in the delivery of health ‘condition management’ services. This approach has been retained in a minority of Jobcentre Plus Districts. Based upon a review of previous evaluation evidence and more than 50 in-depth interviews with NHS staff and managers, this article critically assesses this partnership-based governance model and the potential added value flowing from the involvement of the NHS and its professional clinicians in the delivery of condition management services. The article concludes by identifying lessons for the continuing development of governance and delivery mechanisms for condition management under the PtW regime and future employability/health interventions.

Research report, 2019

Healthcare systems around the world have been under immense pressure for some years now caused among other factors by shortages of trained staff, changing demographics and introduction of market-based approaches. In the UK, staff shortages in the NHS and an ageing population have combined to create a perfect storm within nursing with demand for nurses and midwives outstripping supply (NHS Improvement, 2016). In a recent study, an overwhelming majority of NHS Trusts reported that they were experiencing a severe shortage in supply of registered nurses . The unions estimate a shortage of around 40,000 nurses and 2,500 midwives. The impending likelihood of Brexit threatens to intensify NHS staffing shortages not least because of the dependence for healthcare professionals on non-UK EU nationals who are expected to become in short supply post-Brexit RCM, 2018). For patients, understaffing can lower quality of care, compromise safety and increase clinical errors. These risks came into full public view with the publication of the Francis Report in 2013 that attributed the failings of one NHS Trust in part to understaffing of qualified nurses. The long-term crisis has also had an extremely negative impact upon the work environment and working conditions of healthcare employees globally. The five most common problems nursing staff experience globally are understaffing, health and safety, mandatory overtime, privatisation, and bullying . There is plenty of evidence that the UK is experiencing these problems where the staff supply shortages that self-evidently cause understaffing in workplaces, in turn lead to additional stress and greater work/workplace pressures for nursing staff in particular, and to some extent midwifery staff. The greater research gap exists on how unions are responding to these challenges and defending and promoting nursing and midwifery.

RAND Corporation, 2018

Nonprofit and Voluntary Sector Quarterly, 2000

This article describes how the largest labor market survey in the United Kingdom has been used to compare employment in the third sector with other sectors. This is based on employees'own internal definition of their employers'sector, an approach that it is argued can usefully supplement the dominant external approach. The dimensions along which the (self-defined) third sector emerges as distinctive include its rather small absolute size, its relatively high concentration of part-time and temporary staff, the greater proportion of its workers who work unpaid overtime, the relatively high proportion of employees who are women, the tendency for its respondents to have high levels of educational qualifications, and its distinctive composition. At least some of these features seem to be shared with the third sector in other developed countries, although it is very difficult to be confident in these comparisons for the reasons discussed in the article. Note: This article has been prepared for submission to Nonprofit and Voluntary Sector Quarterly. It is based on research commissioned by the National Council for Voluntary Organisations (NCVO). We gratefully acknowledge this financial support. We would also like to thank anonymous referees and the editor of NVSQ for insightful comments on an earlier draft. This article is filed internally as Personal Social Services Research Unit Discussion Paper 1, 567.

Routledge, 2005

Acknowledgements iv List of tables vi List of figures vii Reporting conventions viii Recruitment, appraisal and training 9 Work organisation Representation, consultation and communication Reward and remuneration Addressing workplace conflict Equal opportunities policies and practices Work-life balance Employee well-being