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2014 - American Sociological Association Annual Meeting Pages: unavailable || Words: 8147 words || 
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1. Petrakaki, Dimitra. and Klecun, Ela. "Customisation of Health Technology as a Condition of Hybridity: The Case of the English NHS" Paper presented at the annual meeting of the American Sociological Association Annual Meeting, Hilton San Francisco Union Square and Parc 55 Wyndham San Francisco, San Francisco, CA, Aug 15, 2014 Online <PDF>. 2019-04-24 <http://citation.allacademic.com/meta/p723000_index.html>
Publication Type: Conference Paper/Unpublished Manuscript
Review Method: Peer Reviewed
Abstract: This paper presents findings from our research into the implementation of a national Electronic Patient Record (EPR) in the NHS in England. It aims to discuss the relation between phenomenally contradictory processes namely software customisation and standardisation. It focuses on the way in which a hospital customised an EPR as it collaborated with stakeholders such as software developers, local service providers, healthcare professionals and a governmental authority that oversaw the process. The paper argues that customization of EPR is a distributed process that involves cycles of translation, which span across geographical, cultural and professional boundaries. Translation conditions the emergence of hybrid technology in which the politics of boundaries play a prominent role. Finally, it proposes that hybrid technology opens up space for innovation, and specifically for standardization of healthcare.

2016 - American Political Science Association Annual Meeting Pages: unavailable || Words: unavailable || 
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2. Greer, Scott. and Jarman, Holly. "The Palace Politics of NHS Reform: Ministers, Mandarins, and Managers" Paper presented at the annual meeting of the American Political Science Association Annual Meeting, TBA, Philadelphia, PA, Aug 31, 2016 <Not Available>. 2019-04-24 <http://citation.allacademic.com/meta/p1127597_index.html>
Publication Type: 30-minute Paper Presentation
Review Method: Peer Reviewed
Abstract: The interplay of central and local in English public administration is perhaps more fraught and fascinating than in most countries because the historical centralization of England makes central ambitions more plausible than elsewhere and focuses attention on both the political stakes and policy instruments used by the center. This paper examines the central management of the English National Health Service, focusing on the central management structures as a way to understand the interaction between Westminster politics, the state in Whitehall, the orrery of regulators, executive agencies that surround them, and the public services that they aspire to manage.

The stylised plot is a common one in English policy since 1980. Ministers at the centre, charged with responsibility for a health or other system that they cannot control, are willing consumers for organisational designs that promise them good outcomes, legibility to the centre, and a set of automatic incentives that harness competition through carefully constructed mimic markets. In practice, this means, first of all, the creation of a powerful management infrastructure that responds to ministerial policy designs, and second, intricate legislation setting up markets and a set of more or less autonomous regulatory agencies charged with enforcing those rules. The result is usually a market that, if it functions, does not do what ministers want, and a reversion over time to more direct use of the management structure to tell the system.

2013 - SASE Annual Conference Words: 536 words || 
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3. Findlay, Patricia., Commander, Johanna. and Lindsay, Colin. "New Distribution Technologies and the Restructuring of Public Sector Work: Evidence from the NHS in Scotland" Paper presented at the annual meeting of the SASE Annual Conference, University of Milan, Milan, Italy, Jun 27, 2013 <Not Available>. 2019-04-24 <http://citation.allacademic.com/meta/p657595_index.html>
Publication Type: Conference Paper/Unpublished Manuscript
Review Method: Peer Reviewed
Abstract: Significant restructuring of public services predated the 2008 financial crisis in a number of countries across Europe. Three major influences have shaped this restructuring. First, since the 1980s, the policies of new public management have re-shaped many parts of the public sector aimed at improving efficiencies in service delivery through externalisation, the introduction of market mechanisms and a range or labour process and employee relations interventions. Second, over much the same time period, ideas of lean production have also become influential in the delivery of public services, increasing the use of a range of continuous improvement and problem solving techniques and the focus on more explicit monitoring of performance metrics. Third, policy makers and public sector management have become increasingly interested in the potential of automation and ICT to radically re-shape service delivery and improve process efficiencies. Following the 2008 crisis, the austerity measures adopted by many governments has resulted not only in a reduction in public sector employment but also a renewed zeal for reforming public sector workplaces with consequent implications for public sector workforces.

Our research focuses on a major automation process within a health service setting and its implications for job quality and for the work experience of a range of different public sector employees working within NHS Pharmacy services in the context of public sector resource constraints. In our study area, NHS pharmacy distribution services have been subject to substantial redesign based around the introduction of robotics technologies. New technologies, and accompanying work redesign processes, were advocated by management as a means of achieving efficiencies, but also as an opportunity to empower employees to carry out more ‘high value added’ activities with the ultimate aim of improving patient care. The research focuses on both the process of technology implementation and on the outcomes in terms of service delivery and for health service workers. Our research involved in-depth, qualitative interviews with 46 employees and managers across 5 different sites who had experienced job change as a result of the redesign and automation of pharmacy distribution services as well as with relevant trade union representatives.

Our findings suggest that significant organisational efficiencies have been achieved through the robotics implementation. In addition, the nature of employee relations within the NHS, and in particular collective agreements to protect employees from job loss due to organisational change, have both supported the successful implementation of robotics technology and protected workers who otherwise would have been displaced by automation. However, there remain concerns that the introduction of such technologies can in fact de-skill workers, and impact negatively on job quality. While some workers reported benefits in relation to opportunities for progression and skills utilisation, others (especially those in some lower-skilled jobs) had experienced deskilling and other negative changes in job quality as internal career progression routes were dislocated as a result of the redesign of work organisation. Moreover, increasing resource constraints appear to have mitigated some of the benefits that might otherwise have been achieved through technological change. We conclude by identifying both the opportunities and also the threats that technological and organisational change pose for public sector workers and the lessons for public sector management in undertaking technology-driven organisational change.

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