Sandra Dawson

Safety at work : the limits of self-regulation

An attempt to provide a theoretical and practical analysis of the Health and Safety at Work Act of 1974 in the UK, and its central ideas of self-regulation and workforce involvement. The development and impact of the legislation and its practice in industry is examined.

Knowledge and practice in multidisciplinary teams: Struggle, accommodation and privilege

The importance of translating knowledge across occupational boundaries is frequently identified as a means of generating innovation and improving performance. The creation of the multidisciplinary team is an institutional response to enable such translation and synergy, yet few studies examine the processes of knowledge generation and translation in such teams. This article offers a case study that analyses these processes in decisions about the diagnosis and treatment of patients. Polanyi’s concept of tacit integration is used to reveal how meaning is developed and manifest in team decisions and to examine how the discursive resources embedded in tacit knowledge shape clinical practice. We highlight the foundations and dynamics that privilege the knowledge of some team members to be reconstituted as multidisciplinary group practice. Privileged knowledge then becomes embedded in the practices of the group. We conclude that the creation of a multidisciplinary structure may support rather than challenge existing power hierarchies.

The State of the Field in UK Management Research: Reflections of the Research Assessment Exercise (RAE) Panel

This paper reviews the state of the field of the sub-disciplines within UK management research, based upon the submissions of 94 UK higher education institutions to the Business and Management Studies Panel in the UKs 2001 Research Assessment Exercise (RAE). It offers observations on the UK model of the assessment of quality in, and funding of, research conducted in publicly funded higher education institutions.

New Public Management

The paper presents an assessment and evaluation of what is termed ‘new public management’ at the end of the 1990s. In order to provide this assessment, new public management is defined in several ways: as a movement, as an academic commentary, and as reformed organizational practice in the public sector. The paper uses the UK health sector to examine some of the assumed relationships between ideology, actions and consequences implied within a broad understanding of new public management. Developments in the UK health sector are used to address assumptions focusing on different aspects of the ideology (private sector practices and markets can increase efficiency in the public sector), actions (introduction of market mechanisms and business-like, practices) and consequences (operational performance, strategic direction, governance and values). Drawing on developments in the UK health sector, an assessment of new public management at the end of the 1990s sees it much diversified and expanded from original co...

Distributed Leadership in Policy Formulation: A Sociomaterial Perspective

Leadership in public policy making is challenging. There is tension in gaining commitment from competing stakeholder groups, in sustaining public engagement in technically complex areas and securing broad-based support. Our paper illuminates these challenges through a case study of health policy development in the UK. We go beyond individual roles and leader–follower exchange relationships to develop the concept of distributed leadership using a sociomaterial approach to reveal how and why leadership is distributed across sociomaterial practices which together (re)configure policy coalitions and context. In so doing we also show how legitimacy and trust are sociomaterially enacted and shape leadership in public policy.

When the pieces don't fit: A stakeholder power matrix to analyse public sector restructuring

This article provides a broad overview of the changes taking place in public service organization and presents a model for investigating these changes. The analysis focuses on the concept of stakeholder power. The approach described provides insights which will increase understanding of these changes, and will help in identifying and resolving problems in practice.

Influences on clinical practice: the case of glue ear.

A case study of clinical practice in children with glue ear is presented. The case is part of a larger project, funded by the North Thames Research and Development Programme, that sought to explore the part played by clinicians in the implementation of research and development into practice in two areas: adult asthma and glue ear in children. What is striking about this case is the differences found in every area of the analysis. That is, diversity was found in views about diagnosis and treatment of glue ear; the organisation of related services; and in the reported practice of our interviewees, both between particular groupings of clinical staff and within these groupings. The challenge inherent in the case is to go beyond describing the complexity and differences that were found, and look for patterns in the accounts of practice and tease out why such patterns may occur.

How to secure an effective health and safety programme at work

The Health and Safety at Work Act 1974 established self regulation, albeit within specific substantive statutory requirements laid out in previous legislation, as the basis for further developments in company policies and practices designed to improve standards of health and safety at work. Drawing on eight case studies of sites in chemical and related industries, this paper focusses on the management role in achieving effective self regulation. Self regulation is discussed in terms of the development of strategies to control the particular hazards which characterise any selected work site. When such hazards are unacceptable, positive interventions need to be made, either in anticipation of hazard realisation or in reaction to the harm or loss which has actually occurred. Three main options for anticipative control are discussed: elimination, containment and mitigation. The combination selected is shown to reflect specific legal requirements and judgements about the nature of the hazard, the probability of realisation, likely consequences, possible solutions and availability of resources. The effects of the political organisational context on these judgements are considered. Concepts of control are central to this framework of self regulation and are considered in terms of both technical and motivational control. Technical controls are directed towards the identification and control of specific hazards and involve four stages: the identification of the need for control measures, the determination and prescription of control standards and processes which are going to be applied, their implementation, maintenance and adaptation. Motivational controls have a more diffuse purpose and are concerned with the development and maintenance of general safety awareness and commitment to technical controls. Three principal elements of motivational control are discussed: the general objectives, culture and atmosphere of the organisation, definitions of responsibility and authority, and mechanisms of accountability and performance measurement. The paper concludes with an account of three companies which displayed an increasing emphasis on the importance of establishing accountability for health and safety.

Strategies for controlling hazards at work

Abstract This paper presents an heuristic framework for analyzing hazards (potential for loss or harm) and strategies that may be developed to control their realization. Two basic forms of intervention for hazard control (anticipation and reaction) are identified. Three broad anticipative strategies are discussed: (1) elimination of the source of the hazard, (2) containment of the risk of its realization, and (3) mitigation of likely consequences. The communication and judgmental processes involved in decisions about strategies are shown to be embedded in the organizational “political” context, in which a variety of interests backed by varying sources of power and influence are represented. The development, implementation, and monitoring of any strategies that are decided upon are then discussed, including the fact that such actions and events may not produce the intended results. Comments are also made on the need for data provided by monitoring to be evaluated and appropriate adaptations made. Finally, a brief section of the paper discusses reactive strategies.

Transforming the National Health Service

Claims that, for the 1990s, images of careers are multidimensional and individualistic. Notes that employees are encouraged to take responsibility for their own self‐development, incorporate horizontal as well as vertical moves, and forge careers based on “employability”, i.e. learning, networking and reputation. Bases its arguments on the findings of a study into senior executives in the NHS, and explores the consequences of organizational restructuring for the careers of clinical, general and functional managers. Suggests that organizational and professional barriers exist to undermine the notion of the multidimensional career. Argues that prescriptive approaches to career self‐development need to take account of organizational context and that, to meet the challenges of careers in the 1990s, both the organization and the individual need to become more willing to take risks.