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The National Health Service (NHS) in England continues to experience ongoing change in order to complete the transition to the new delivery system outlined in Liberating the NHS (Department of Health, 2010a). Treating and caring for patients in a safe environment and protecting them from acquiring avoidable infections remains a high priority and a central quality improvement component within the outcome Indicator set for 2013/14 (NHS Commissioning Board, 2012a). Infection prevention and control practitioners will be required to use a range of innovative quality improvement strategies to facilitate engagement with clinicians and meet the challenges that lie ahead for the NHS. The purpose of this paper is to report on the implementation of an infection prevention and control self-audit (IPCSA) project within general practice. The aim of the project was to empower practice staff to become actively involved with an infection prevention and control (IPC) audit in order to support the development of an IPC quality improvement culture within general practice teams. The paper outlines the methodology used to implement self-audit. The findings suggest that IPCSA can be used as an effective alternative to an IPC nurse-led infection prevention and control audit. [ABSTRACT FROM PUBLISHER]

In addition to radical reduction of greenhouse gas emissions, large-scale removal of anthropogenic CO2 will be required to mitigate the impacts of global warming. However, many greenhouse gas removal (GGR) methods remain at a nascent stage of development. A case study was carried out on the application of the collective intelligence (CI) model to the UK GGR sector and the need to scale up and accelerate development in an economically, socially and environmentally sustainable way. Through systems mapping, thematic analysis, workshops and semi-structured interviews, a rich dataset was formed on the existing level of and potential for CI within the UK GGR ecosystem. It was found that implementing CI thinking could address the need for increasing the visibility of the system and its workings to participants and the public. This would contribute to the formation of coherent, shared vision for the role of GGR in the UK's net zero strategy. It is proposed that these risks could be mitigated by creating a publicly accessible 'commons' to visualise the UK GGR ecosystem process, dynamics, components, and goals, allowing innovation policy to be more responsive to innovator and net zero policy needs. Increasing ecosystem awareness could lay the foundations for sharing of information, promotion of a more collective culture, and increased transparency and accountability, all of which are critical building blocks in establishing a robust GGR sector for the future. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic generated a series of profound and unprecedented challenges for health and social care systems and those frontline clinicians responsible for delivering services including nurses. One consequence has been the rapid and widespread introduction of a range of digital tools, solutions, and initiatives. In the United Kingdom, this has required clinical leadership to drive implementation and adoption of digital innovations across the system, ranging from those in senior executive board level positions to those on the frontline. Findings: This commentary presents a framework highlighting the breadth of digital transformations which emerged as a consequence of the U.K. health and social care systems' response to the COVID-19 crisis. The framework outlines the different levels of digital transformation, ranging from what we have termed "ceremonial adoption" to isolated automation, organizational integration, and full systems integration. We reflect on the nursing leadership practices that need to be in place to support these changes. Conclusion: Whilst acknowledging the extraordinary results achieved by the COVID-19 driven tsunami of digital transformation, we reflect on the essential steps required to translate these nascent, isolated efforts into fully integrated, long-term solutions. We also offer recommendations for clinical digital leaders and suggest steps that will be crucial to translate the temporary and/or limited interventions into effective, permanent features of our health and social care systems, while also providing a platform on which to build future digital capabilities. We will inevitably continue to see an increase in the use of technology in everyday clinical practice, and nurses are well positioned to take a lead in its widespread adoption. [ABSTRACT FROM AUTHOR]

This article advances knowledge on the diversity and heterogeneity of women-led small and medium-sized enterprises (SMEs) in the United Kingdom by analysing how gender intersects with ethnicity and place to influence their engagement in innovation. We adopt an intersectional perspective, and base our analyses on the Longitudinal Small Business Survey (LSBS) data of 29,257 SMEs over the period 2015–2018. Our findings suggest that despite their limited number, as well as firm size and industry sector constraints, women-led SMEs are actively engaged in innovation activities. In addition, our results on the effects of intersecting categories of gender, ethnicity and place on innovation, further emphasise the heterogeneity of women-led SMEs, both with regard to their likelihood to engage in innovation, as well as the place where innovation is most likely to occur. Implications for policy and practice are highlighted. [ABSTRACT FROM AUTHOR]

How did the great financial crisis (GFC) of 2008–2010 impact on R&D and innovation in the United Kingdom and internationally? What can we learn about the likely innovation effects of the COVID-19 crisis on small and medium enterprises (SME) innovation? Numerous international studies suggest the strong procyclicality of R&D and innovation investments in firms: investment rises in recovery and falls sharply in times of crisis. This procyclicality is driven in firms by both internal financial resources or slack and varying market incentives for innovation. Cash constraints, in particular, may impact most strongly on R&D and innovation investments by smaller firms. In the United Kingdom, the proportion of innovating firms fell by around a third during the GFC and took around four to six years to recover. Recovery was also uneven – notably weaker in some sectors and regions. The COVID-19 crisis seems likely to leave many firms financially weaker, with the most significant impacts on the willingness or ability of SMEs to sustain R&D and innovation. Where firms are able to sustain these investments, however, the evidence from the GFC suggests that they will lead to better survival chances, stronger growth and higher profitability. Some additional financial support for innovation has been announced by the UK government. Whether this will be sufficient to sustain SME levels of innovative activity, however, remains to be seen. [ABSTRACT FROM AUTHOR]

Drawing upon data from the fifth UK Innovation Survey, this article sheds light on how management choices on the nature of appropriation relate to management choices on the degree of openness within small and medium-sized enterprises (SMEs). To this end, our findings indicate a threshold effect of both informal and formal appropriation mechanisms on the likelihood of engaging in both coupled and inbound open innovation. That is, an emphasis on appropriation appears to be important in shifting firms from a closed to an open strategy. There is, however, little evidence that either approach to appropriation increases the extent of open innovation. In this, only informal intellectual property (IP) protection mechanisms associate with an increasing extent of inbound open innovation. [ABSTRACT FROM AUTHOR]

This article uses Ordinary Least Squares estimation techniques on data from a large-scale survey to examine the effect of firms' innovation activities on their growth performance. In the article the authors use four measures of growth, namely, growth in employment, growth in turnover; growth in productivity and, change in the profit margin. These measures of growth are analyzed separately for manufacturing and service sector firms. The data that has been analyzed was collected as part of a wide-ranging survey of enterprise in Northern Great Britain.

The introduction of regional secure units into the NHS was studied as one example of the diffusion of patient care innovations. As well as the general history of secure units events in four Regions were studied in detail for the period from 1974 up to mid-1983. It is concluded that secure units became gradually more acceptable over time as (i) the need for such units was recognized, (ii) the climat, of opinion changed in psychiatric hospitals from seeing secure units as a retrograde step, following the acceptance of more open door policies, to seeing secure units as a prestige development which might safeguard the future of a particular hospital, (iii) government loosened the definitions of what secure units should be and how they should operate so that there was more room for different regions to assess their own needs. Regions which were able to move relatively fast on secure unit development were those where there-was already a 'product champion' present to promote the ideas, usually a forensic psychiatrist, and where there was also managerial support and designated responsibility for secure unit development at local and regional level. It is concluded that while public reaction was a hindrance it did not slow down secure unit development as much as might have been expected. [ABSTRACT FROM AUTHOR]