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Terrorist attacks can be seen as the ultimate wicked problem. After 9/11, terrorists moved from so-called ‘spectacular’ events to relatively low-intensity attacks against individuals and groups. The emergence of what has become known as the ‘home-grown’ terrorist has added a further dimension to the ‘wicked’ nature of the problem. This paper considers the UK’s CONTEST and PREVENT strategies as a policy response to the threats from terrorism and the impact that the policies themselves can have on the radicalization of individuals. The author highlights some of the limitations of the PREVENT strand of the overall strategy and the constraints that are imposed on government policies by failing to take a holistic perspective on the nature of the problem. [ABSTRACT FROM AUTHOR]

This article considers the challenges for hospitals in the United Kingdom that arise from the threats of mass-casualty terrorism. Whilst much has been written about the role of health care as a rescuer in terrorist attacks and other mass-casualty crises, little has been written about health care as a victim within a mass-emergency setting. Yet, health care is a key component of any nation's contingency planning and an erosion of its capabilities would have a significant impact on the generation of a wider crisis following a mass-casualty event. This article seeks to highlight the nature of the challenges facing elements of UK health care, with a focus on hospitals both as essential contingency responders under the United Kingdom's civil contingencies legislation and as potential victims of terrorism. It seeks to explore the potential gaps that exist between the task demands facing hospitals and the vulnerabilities that exist within them. [ABSTRACT FROM PUBLISHER]

Objectives Wristbands are recommended in the UK as a means of verifying patient identity but have been little studied. We aimed to document how wristbands are used in practice. Design and participants Task analysis of wristband application and use, drawing on qualitative analysis of workplace observation of, and interviews with, clinical and non-clinical staff. Setting Two acute district general hospitals in northern England. Results Our findings indicate high levels of awareness amongst clinical staff of local and national policies on wristband use, but some ambiguity about the details therein. In contrast, non-clinical staff such as ward clerks and porters were less aware of policy, although their actions also expose patients to risks resulting from misidentification. Of seven subtasks identified by the task analysis of wristband application and use, three appeared to offer particular opportunity for error. Making the decision to apply, especially in emergency patients, is important because delay in application can delay correct identification. Advance preparation of wristbands for elective admission without the patient being present can risk erroneous data or misapplication. Lastly, utilization of wristbands to verify patient identity was greater in some clinical circumstances (blood transfusion and medication administration) than in others (before transferring patients around the hospital and during handovers of care). Conclusions Wristbands for patient identification are not being used to their full potential. Attention to detail in application and use, especially during handover and transfer, and an appreciation of the role played by ‘non-clinical’ staff, may offer further gains in patient safety. [ABSTRACT FROM PUBLISHER]

The spate of terrorist attacks in New York, London and Madrid has raised some significant issues for the public management of critical infrastructures. In many countries, privatizations in the 1980s and 1990s have transferred key elements of the critical infrastructure to private companies. Because these infrastructures are of major significance to our societies and economies, they must be protected against prolonged periods of breakdown. The ‘new’ terrorism has the potential to do just that. The management of this new threat is a complex task, which invariably will be undertaken by both public and private actors. They must deal with the core challenges of the prevention of attacks, effective communication of information across organizational boundaries and the ‘ownership’ of crisis decision-making. This article considers these issues within the context of the broader research areas of public management and crisis management. [ABSTRACT FROM AUTHOR]

Challenging Turner's (1976, 1978) implicit assumption that cultural readjustment typically follows a crisis, this paper examines the evolution of the regulation of safety management within the UK soccer industry since 1946. Employing a longitudinal case study approach, the industry's response to four crises is examined. This study explores the industry's response to changes in the regulatory framework, through the lens of Gouldner's (1954) patterns of industrial bureaucracy and institutional theory. The persistence of indulgent and mock patterns of behaviour, following a series of disasters, challenges Turner's implicit assumption. Although a move towards a punitive approach to regulatory behaviour effected some changes, there was limited evidence of cultural readjustment due in part to a 'mindset of invulnerability' (Wicks, 2001). This included the fixed belief that hooligan behaviour was the primary problem facing the industry. Our findings suggest that more participative forms of regulation encourage more effective learning from crisis because they challenge core organizational and individual assumptions. [ABSTRACT FROM AUTHOR]

The article discusses the extent to which industrial archaeology has become accepted in English literature. The subject provides writers with a rich source of characters, plot situations, and both fictional and real industrial landscapes. British, and foreign travelers in Great Britain have kept meticulous diaries recording industrial architecture, landscape and technical processes. These provide a fascinating source of material for both social and engineering historians.

The role of organizational factors in the generation of adverse events, and the manner in which such factors can also inhibit an organization's abilities to learn, have become important agenda items within health care. The government report 'An organization with a memory' highlighted many of the problems facing health care and suggested changes that need to be made if the sector is to learn effective lessons and prevent adverse events from occurring. This paper seeks to examine some of these organizational factors in more detail and suggests issues that managers need to consider as part of their wider strategies for the prevention and management of risk. The paper sets out five core elements that are held to be of importance in shaping the manner in which the potential for risk is incubated within organizations. Although the paper focuses its attention on health care, the points made have validity across the public sector and into private sector organizations. [ABSTRACT FROM AUTHOR]

Editorial. Comments on issues surrounding cultural change in healthcare in Great Britain. Change process within the National Health Service; Introduction of contracts and leadership; Potential impact of local factors on the implementation of government policies; Separation of cause and effect in terms of both space and time; Central component in developing the capability of managers.

This issue of "Clinician in Management" deals with the issues of reform process and concern the discussion of capacity and staff satisfaction within healthcare. Principal role of this article within this journal is twofold. Firstly, it is to try and weave some links between the papers that have been selected for the issue in question. Secondly, to try and set out a broader topography of issues that may be worthy of consideration by others. One of the issue in this article concerns the manner in which the working lives of staff within healthcare are affected by reforms around appraisal and mentoring. The final paper in this volume deals with the process of change in practice and details the setting up of a children's learning disciplinary team. It is hoped that papers presented in this volume will stimulate responses from readership and encourage healthy debate around a range of issues that are fundamental for future success of the NHS.

After highlighting some of the key issues and positions in the debate around appropriate preventive regulation, the paper presents a number of observations directed at the proponents of greater self-regulation. These observations confront directly a number of familiar, but often unchallenged, arguments for self-regulation. More centrally we address claims concerning, the extent to which the chemicals industries have a good and improving 'safety' record; and whether the sector consists of companies both motivated and capable in the context of effective crisis and disaster management. Lastly, the paper sets out some 'new directions' for the nature and role of regulation in the effective prevention of crises. Thus the paper indicates a number of regulatory developments which are distinct from any shift towards greater self-regulation, but which would result in more effective crisis and disaster prevention in the UK chemicals industries and, indeed, beyond that specific sector. [ABSTRACT FROM AUTHOR]