Cardiff Health Organisation and Policy Studies

Cardiff Health Organisation and Policy Studies (CHOPs) is a multi-disciplinary research group that aims to foster collaboration and innovation to produce healthcare research relating to service organisation, delivery and improvement, in health and social care contexts.

Key research themes include:

• service improvement and innovation, including starting, embedding and scaling up initiatives
• quality and safety
• people management
• process mapping and management
• purchasing, procurement and supply chain management

CHOPs disseminates its findings to national and international academic and practitioner audiences.

The group's mission is to explore dynamic healthcare system change through academic research that is rigorous, independent and relevant to advance societal knowledge and further inform leading edge health care practice.

Meet the team

Co-ordinators

Academic staff

Upcoming events

Healthcare Planning in Action: Roles, Relationships, and Support

with Samta Marwaha, Cardiff Business School

Wednesday 22 May 15:00-16:00, Executive Education Suite, 3rd floor, Postgraduate Teaching Centre, Cardiff Business School, Colum Drive, Cardiff, CF10 3EU

Register here

Abstract

The research project focuses on developing a systemic and role-oriented description of healthcare planning within the context of the Welsh NHS, and with a specific focus on the management-led roles of healthcare planners. Underpinned by the legislative guidelines of the NHS Finance (Wales) Act and the Future Generations Act, healthcare planning is led by a composite set of professionals termed as healthcare planners. Within this context of the Welsh NHS, the study investigates the roles, responsibilities, and interactional dynamics of healthcare planners. The research employs a qualitative embedded case study approach, wherein semi-structured interviews undertaken with policy stakeholders are compared to interviews with healthcare planners at different levels of seniority across NHS health boards.

Now in the analysis phase, the research focuses on the differing policy and practice perspectives on the roles and responsibilities of healthcare planners. Firstly, it finds an expectation gap between the perspectives of policy and practice. Leading from this, it also uncovers challenges and conflicts linked to the recognition and importance of healthcare planning as a profession; tensions between the local and national priorities; the policy-practice expectation gap; multiple stakeholder interactions; and capacity, resource, and time constraints. Finally, the research unravels the varied, complex, and at times contradictory professional competencies and role identities of healthcare planners.

Speaker Bio

Samta Marwaha is a third year PhD student in the Management, Employment, and Organisation Section at Cardiff Business School, Cardiff University. She is currently researching the management roles of Healthcare Planners within the Welsh NHS. Being a public value-based project, her research is funded by the Hodge Foundation. Also, as a former postgraduate in Human Resource Management from the University of Westminster, London, and a former MBA from India, over the years, she has research experience in other areas relevant to the NHS including medical leadership and competencies, and leadership-as-practice. Alongside research, Samta is also employed as a Graduate Tutor at the Business School, for teaching second- and third-year undergraduate students, subjects relevant to Human Resource Management and Organisational Behaviour.

Past events

The politics of essentiality: Praise for dirty work in healthcare organizations during the COVID-19 pandemic

with Nancy Côté, Université Laval, Québec.

Wednesday 20 March 15:00-16:00, Executive Education Suite, 3rd floor, Postgraduate Teaching Centre, Cardiff Business School, Colum Drive, Cardiff, CF10 3EU

Abstract

The study focuses on the COVID-19 pandemic's impact on the recognition, through discourses of essentiality, of low-status workers and more specifically of care aides as an occupational group that performs society's "dirty work". The pandemic appears as a privileged moment to challenge the normative hegemony of how work is valued within society. However, public recognition through political discourse is a necessary but insufficient element in producing social change. Based on the theory of performativity, the study empirically probes conditions and mechanisms that enable a transition from discourse of essentiality to substantive recognition of the work performed by care aides in healthcare organizations. We rely on three main sources of data: scientific-scholarly works, documents from government, various associations and unions, and popular media reports published between February 2020 and July 1, 2022. While discourse of essentiality at the highest level of politics is associated with rapid policy response to value the work of care aides, it is embedded in a system structure and culture that restrains the establishment of substantive policy that recognizes the nature, complexity and societal importance of care aide work. The study shows the importance of the institutionalization of competing logics in contemporary health and social care systems and how it limits the effectivity of discourse in promulgating new values and norms and engineering social change.

Speaker bio:

Nancy Côté is an Associate Professor in the Department of Sociology at Université Laval in Québec, Canada. She holds the Canada Research Chair in the Sociology of Work and Healthcare Organizations. Her research focuses on the transformations of healthcare organizations and their effects on the work of professionals and managers in this sector. She is also interested in innovations in primary care and social services, such as governance and leadership, new modes of collaboration and redefinition of professional roles. She has developed an expertise in research conducted in partnership with healthcare and social organizations. Her work has been published in French and English in health, sociology and management journals.

She leads several research projects including:

• Innovative management of human resources in health and social services: a better understanding of the modes and conditions of commitment at work
• Evolution of work among family doctors in Quebec: Analysis of new forms of professionalism, cooperation and commitment at work
• Learning from experience during a pandemic. Analysis of the conditions for sustaining primary care and social care innovations to better serve vulnerable clienteles.

If you were unable to attend, watch this recording of the event.

Trading Capital – A Bourdieusian exploration of the job interviews for Health Care Support Workers in a NHS Organisation

with Donna McLaughlin, Northern Care Alliance NHS Trust

Wednesday 21 February 15:00-16:00, Executive Education Suite, 3rd floor, Postgraduate Teaching Centre, Cardiff Business School, Colum Drive, Cardiff, CF10 3EU

Speaker Bio

Donna McLaughlin is Director of Social Value Creation at Northern Care Alliance NHS Trust which provides a range of specialist, acute, community and integrated health and social care services across Bury, Rochdale, Oldham, and Salford in Greater Manchester.  She participated in the NHS Graduate Management Training Scheme and has worked in the NHS for nearly 30 years including serving Trust Boards in Merseyside and Greater Manchester as Director of Operations/ Chief Officer.

She is a trained executive coach, caring passionately about empowering people and communities to create a more inclusive society.  She is a Non Exec Director of The Health Creation Alliance https://thehealthcreationalliance.org/.   
As a “pracademic” her PhD explores the role of the NHS as an inclusive employer focusing specifically on recruitment of Health Care Support Workers (HCSWs).  The aim of the presentation is to share background and rationale for the topic, theoretical framework (using Bourdieu’s Theory of Practice) and share preliminary findings.

If you were unable to attend, watch this recording of the event.

Does professional leadership increase staff satisfaction? Evidence from a panel study of hospital board

With Professor Gianluca Veronesi, University of Bristol

Wednesday 29 November 15:00-16:00, Executive Education Suite, 3rd floor, Postgraduate Teaching Centre, Cardiff Business School, Colum Drive, Cardiff, CF10 3EU

Abstract

The influence of professional-turned-leaders in public sector organizations has been a subject of ongoing debate. Previous studies suggest positive implications for organizational performance, but little is still known about the effect of professional leadership, particularly its implications for staff satisfaction.

Drawing from the notion of organizing professionalism, this study investigates whether a greater representation of individuals with a professional background on governing boards of public sector organizations can have a positive influence on staff satisfaction. Furthermore, it examines whether the human and social capital of professional leaders function as boundary conditions of this relationship.

Focusing on the acute care hospital sector in the English NHS, the analysis is based on 8 years of a composite database for a total of 1,081 observations. Against expectations, the findings do not show any statistically significant, direct effect of professional leadership on staff satisfaction. Nevertheless, they reveal a positive, moderating effect of management experience and the degree of connectedness on the board on this relationship. Thus, the study contributes to the literature on professional leadership by highlighting the role of individual board human and social capital as boundary conditions for staff satisfaction.

If you were unable to attend, watch this recording of the event.

Speaker Bio

Gianluca Veronesi has been a Professor of Public Management and Accounting at the University of Bristol Business School since 2017. Before that, he worked for 10 years at Leeds University Business School, where he earned a PhD in Governance in 2011. Gianluca is a visiting scholar at the Crown Prince Frederick Center for Public Leadership at Aarhus University. His main research interests are in the areas of governance, organisational performance, and leadership and management in public services.

Gianluca has published in several reputable academic outlets such as Public Administration Review, Journal of Public Administration Research and Theory, Organization Studies, Public Administration, and Public Management Review. He is currently serving as the Head of the Operations, Management Science, Healthcare and Innovation Academic Group at Bristol Business School.

Baking the Cake': Ingredients for 'meaningful' social care innovation to support care leavers

Professor Graeme Currie, Warwick Business School

Wednesday 23 May 15:00-16:30, Postgraduate Teaching Centre, Cardiff Business School, Colum Drive, Cardiff, CF10 3EU

The seminar presentation derives from the ESRC-funded EXIT study (2019-2023) led by Graeme Currie. Its title captures its content; to identify the ingredients for 'meaningful' (it works for care leavers) social care innovation to support care leavers' transition into adulthood.

Within the study, we conceived innovation as a journey, examining ingredients across ideation, implementation, sustaining, and scale-up of innovation. As such it represents a study of process, but it does identify how outcomes are measured influence the innovation journey. Other ingredients identified are receptiveness of setting for innovation (invokes culture and leadership), co-production, the discrete identity of innovation, and the scope for translation of innovation as it scales up.

Graeme Currie is a Professor of Public Management at Warwick Business School and Senior Editor at Organization Studies. He currently leads three large-scale research programmes:

• ESRC EXIT Study focused upon innovation for care leavers
• Department for Education What Works for SEND Service Improvement
• NIHR Applied Research Centre West Midlands Implementation Research (focused upon driving evidence into practice to improve care for those with long-term conditions)

His work has been published in high-impact journals across various disciplines, ranging from the Academy of Management Journal, Human Resource Management and Journal of Management Studies, the Journal of Public Administration and Theory, to the British Medical Journal. His gaining of research income and multidisciplinary publications are above all linked to his desire to carry out research that impacts health and social care delivery to vulnerable populations.

If you were unable to attend, watch this recording of the event.

Lost in transition? Unravelling career advancement in emergent hybrid roles

Professor Julie Davies, University College London, and Dr Karen Shawhan, University of Manchester

Thursday 26 January 14:30-16:00, Aberconway Suite (Room T23), Cardiff Business School, Aberconway Building, Colum Drive, Cardiff, CF10 3EU

Transitions between jobs are common experiences with important consequences for people’s lives. The impact of creating new types of hybrid roles in the public sector which span multiple professions is not well understood.

In this three-year study using focus groups, we analysed the experiences of 36 trainee advanced clinical practitioners (ACPs) to examine the effects of public policies which are intended to address nursing and medical workforce shortages by creating new kinds of roles for non-medical prescribing clinicians.

We investigated change trajectories during the transitions of trainee ACPs. We found that several ACPs felt highly valued as intermediaries between different occupational groups and those towards the end of their careers who had wished to retire in palliative care settings felt liberated in their new roles. Some individuals, however, in acute settings tended to feel trapped as substitutes for junior doctors and misunderstood while ACPs in primary care felt most vulnerable in practising beyond their licence.

We found that older and more experienced secondary care nurses had higher levels of confidence and satisfaction in hybrid roles than individuals who were less used to working in multi-disciplinary teams and hospital settings. Our findings illustrate the phenomenon of permanent liminality as ACPs act as go-betweens and never fully transition from one traditional professional identity to another emergent hybrid identity.

These findings point to dynamic relationships between public sector workforce policies, inter-occupational transitions, and career satisfaction. They raise important questions about creating enhanced roles to integrate professional services in the context of public sector pay restrictions and chronic essential workforce retention and recruitment challenges.

If you were unable to attend, watch this recording of the event.

CHOPS Early Career Network launch event

The new CHOPS Early Career Network was launched on Friday 30 April 2021. This initiative aims to provide early career researchers with a space to find and talk to people at a similar stage of their research journey, with a mutual interest in research relating to organisation, delivery and improvement in health and social care contexts.

This first event brought us together to hear about one another’s research and to talk about major challenges early career researchers are currently facing. We set in motion an ongoing ‘buddying’ activity, called ‘walk and talk’. The idea is to have the opportunity to get to know one another, and each other’s research, better than may be possible within a restricted amount of time in a breakout room.

Thanks go to Professor Martin Kitchener (Cardiff Business School) and Professor Donald Forrester (School of Social Sciences) for leading the discussion session, and to all the early career and PhD researchers who joined us from across different schools and universities.

Future events will be announced via the main CHOPS mailing list and the Early Career Teams group page. If you or your organisation would like to get involved, please email Tracey Rosell at rosellta@cardiff.ac.uk or carbs-meo@cardiff.ac.uk.

Employment Relations in the Healthcare Setting: Lessons COVID-19 Taught Us that we Already Knew

Dr Ariel Avgar, ILR School, Cornell University

Wednesday 28 April 2021, 15:30-16:30

Abstract

The COVID-19 pandemic has brought into clear focus the importance of frontline healthcare providers, including low-wage workers. Celebrated as essential workers, the pandemic has demonstrated the centrality of a workforce far too often invisible to policymakers and practitioners. As such, this crisis provides an opportunity to amplify existing employment relations research regarding the link between conditions in which frontline workers are employed and the delivery of high-quality patient care.

This presentation will provide an overview of research conducted on the role that employment relations play in the healthcare industry. In particular, I will discuss findings from several studies that document the relationship between different workplace practices and outcomes for patients, workers, and healthcare organizations. Thus, for example, the presentation will focus on the implications associated with specific work practices for the adoption of health information technology (HIT).

In addition, I will present findings from a study that examines the consequences associated with outsourcing of hospital cleaners. Taken together, the presentation will offer an overarching argument regarding the need to include employment relations factors in any effort to address longstanding challenges within the healthcare industry.

Why do some healthcare collaborations work when others do not?

Dr Justin Aunger and Dr Ross Millar, University of Birmingham

Wednesday 25 November 2020, 14:00-15:00

Abstract

Improving the quality, efficiency, and sustainability of NHS provider organisations continues to be high on the agenda for policymakers and practitioners. In response to these challenges, particular interest and emphasis have been given to partnering and collaboration with a proliferation of inter-organisational forms including mergers, groups, networks, and buddying.

Research continues to document these developments, however, there have been limited attempts to understand how and why such partnerships might work, in what contexts, and to whom they might benefit. Drawing on literature and interview evidence our realist synthesis examines how trust, conflict, leadership, and faith, along with other factors shape the development and outcomes of different partnering arrangements.

By exploring these areas, the seminar will also encourage discussion about the difficulties and benefits of inter-organisational collaboration for current and future healthcare agendas as the landscape moves towards greater service integration and response to COVID-19.

If you were unable to attend, watch this recording of the event.

Advancing the study of virtuality: A leadership-as-practice research framework and illustration

Tracey Rosell, Cardiff University

Wednesday 4 November 2020, 14:00-15:00

Abstract

While analysts of ‘virtuality’ in leadership have conceived a spectrum - ranging from traditional face-to-face arrangements at one end, to fully virtual relations at the other - its implications for leadership practice remain underexplored. Because the COVID-19 pandemic has produced a sudden push to reduce or stop teams working together in the same physical space, there is a pressing need to develop a more comprehensive understanding of the ‘virtual context’ of leadership.

This paper advances the study of the virtuality in leadership in two main ways. First, we extend the Leadership-As-Practice (L-A-P) literature to present a conceptual model that focuses on the relational aspects of virtual leadership. Second, drawing on recent interviews with surgeons from five hospitals, we apply our framework to examine their movement along the virtuality spectrum, a transition we term ‘virtualizing’.

Our analysis reveals two key dimensions: distancing and disruption. The conceptual and empirical outputs of this paper present a promising basis for investigating emerging virtual leadership practices across diverse contexts.

If you were unable to attend, watch this recording of the event.

The role of professional elites in healthcare governance: Exploring the work of the medical director

Lorelei Jones, Bangor University

Wednesday 14 October 2020, 14:00-15:00

Abstract

Medical leaders occupy a prominent position in healthcare policy in many countries, both in terms of the governance of quality and safety within healthcare organisations and in broader system-wide governance. There is evidence that having doctors on hospital boards is associated with higher-quality services, what is not known is how they have this effect.

Analysing data collected from observations, interviews and documents from 15 healthcare providers in England (2014 -2019), we elaborate on the role of medical directors in healthcare governance as ‘translation work’, ‘diplomatic work’, and ‘repair work’.

Our study highlights the often enduring emotional effects of repeated structural changes to clinical services. It also contributes to theories of professional restratification, showing the work of medical directors in regional healthcare politics, and as ‘corporate elites’ in publicly-funded healthcare systems.

If you were unable to attend, watch this recording of the event.

Related groups

Cardiff Health Organisation and Policy Studies has a core focus on selected research themes. However, a broader range of work relating to healthcare is conducted across Cardiff University.

Cardiff Unit for Research and Evaluation in Medical and Dental Education (CUREMeDE)

Led by Professor Alison Bullock, CUREMeDE conducts multidisciplinary research and evaluation of the education and training of health professionals. Our future healthcare professionals rely on excellent training led by the best educators. What makes the educational experience excellent needs further research.

DECIPHer

DECIPHer is the Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement. DECIPHer brings together leading experts from a range of disciplines to tackle public health issues such as diet and nutrition, physical activity, tobacco, alcohol and drugs, with a particular focus on developing and evaluating multi-level interventions that will have an impact on the health and wellbeing of children and young people.

Responsible Innovation Network

The Responsible Innovation Network (RIN) is a multi-stakeholder and interdisciplinary network designed to encourage collaborative research between Cardiff University’s academics and external constituents. RIN aims to promote the understanding, practice, and diffusion of responsible innovation in a variety of areas, including healthcare.

Wales Public Services 2025

The Wales Public Services 2025 programme is investigating the long-term financial, demographic and demand pressures confronting public services in Wales and possible responses. Hosted by Cardiff Business School and independent, the programme is a unique partnership between Cardiff University and five national bodies in Wales: the Welsh Local Government Association, SOLACE Wales, the Welsh NHS Confederation, the Wales Council for Voluntary Action and Community Housing Cymru.

Y Lab

Y lab is a team of social science and innovation experts working together to support innovation in Welsh public services. Established in 2015 Y Lab (Welsh for ‘The Lab’) is the Public Services Innovation Lab for Wales, a partnership between Cardiff University and Nesta.