Tom Forbes

Taught and enacted strategic approaches in young enterprises

The relevance of the planning approach for innovative and for young entrepreneurial firms had been subject to debate. It has been argued that planning dampens the realisation of entrepreneurial vision. This study examines the enacted strategy approaches of entrepreneurs who had studied on a Graduate Enterprise programme that aimed to help them to start a business. The approaches they used to strategy formation were compared to the planning approach that had been emphasised to them seven to 12 years earlier. Data were gathered through non‐directive interviews, and were analysed using survey and case study methods. The formation of strategy by these entrepreneurs relied more on emergent than planning approaches, but some elements of the planning approach were strongly associated with growth. Some key resources were essential for the firms and their strategy formation processes. These were key personal relationships, with whom and through whom the entrepreneurs found ways of enacting their visions – the essence of their strategy process. Implications for curriculum and course development are given.

The evaluation of partnership working in the delivery of health and social care

Recent Government policy in the UK has resulted in a rapid growth of partnership working. This has lead to a need for the evaluation of partnership performance, particularly in the area of health and social care partnerships. Methodologies were developed to evaluate progress on both ‘process’ and ‘outcome’ aspects of partnership working and this was applied to evaluating the performance of three Community Health Partnerships in Central Scotland. Results obtained demonstrate that the methodology is capable of discriminating between the performance of different partnerships and also between different aspects of partnership working.

Implementing health and social care policy – England and Scotland compared

This article explores the implementation of health and social care policy designed to improve partnership working between the health and social care sectors in the UK. Devolution has allowed Scotland to develop its own policies in several key areas. Given the potential for policy divergence, health and social care policy in England and Scotland is compared and contrasted. Using four partnership case studies, similar issues were apparent in both countries. Policy was dominated by the National Health Service at the expense of local authority partners and each partnership found the implementation of policy challenging, often due to inadequate policy guidance and difficult working relationships between the health and social care sectors. A key finding was that devolution had allowed Scotland more freedom to experiment with policy and the policy process became more readily influenced and challenged by local practitioners. Implications for policy implementation in similar devolved and decentralised contexts are considered.

Three's a Crowd: The Role of Inter‐Logic Relationships in Highly Complex Institutional Fields

Institutional complexity is increasingly seen in terms of potential schisms between logics in pluralist fields. However, research into complexity is mostly confined to binary institutional logics that oversimplify settings where more logics interact. The reorganized mental health service we studied brought a range of expert groups together in a highly complex institutional field. Three logics were seen to be continually in play: a health logic based on expert medical values, a care logic of holistic values, and a logic of integration based partly on managerial priorities but also shared more broadly. The paper identifies how the pattern of conflicting and reinforcing inter‐logic relations that underpinned this field was constituted and further explores a number of critical implications for complexity theory.

Institutional Entrepreneurship in Hostile Settings: Health and Social Care Partnerships in Scotland, 2002–05

Using institutional entrepreneurship theory, I examine the emergence of a novel partnership model in Scotland between 2002 and 2005 to deliver health and social care services. Utilising a qualitative methodology based on interviews and secondary data, I investigate how health and social care managers in a large urban city area acted as institutional entrepreneurs. By engaging in institutional work at a microlevel, mesolevel, and macrolevel, these managers overcame institutional pressure to implement a centrally mandated partnership model advocated by the then Scottish Executive. The study suggests that institutional entrepreneurship is a specific form of change management that can provide unique insights into the political and negotiative processes involved in implementing divergent change in the face of local and national resistance and offers guidance to policy makers and practitioners in framing and implementing change initiatives.

Changing Domains in the Management Process: Imaging Services Managers in the Post-1990 National Health Service

Much of the current literature on healthcare professionals developing management roles has focused almost exclusively upon hopsital doctors. This paper seeks to redress this imbalance and explores the emergence of the professions allied to medicine (PAMs) as clinical managers. A comparative study of 25 English and Scottish radiographer managers were interviewed. From the interviews, a number of themes were developed associated with moving from a clinical professional to a clinical manager and were analysed using domain theory. These themes included management, professionalism, management style, conflicts between the role of both manager and professional, and role change. Radiographer managers are forming new ‘hybrid’ managerial roles, which have been developing within a changing NHS. A definite tension was seen in this role change, and the transition has not been easy for this group of PAMs. However, they have shown resilience in undertaking both operational and strategic management decisions, while using their clinical background in their decision-making and have much to offer the management process.