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Since February 2020 the COVID-19 pandemic has strained health systems worldwide. Despite several measures adopted, including the deployment of emergency funds to sustain health service transformations and investment in vaccine development, the crisis has taken over a year to be controlled. The consequences are still affecting the capacity and capabilities of health systems. In light of the ongoing pandemic, this book explores the factors determining the ability of health systems to cope with and recover from a crisis, and therefore their level of resilience. The term resilience has gained momentum in health systems research, with several scholars contributing to the definition of the concept. Providing a comprehensive health system resilience agenda, policy-makers, public health specialists, health managers, scholars and practitioners will find in this work both a grounded framework for the assessment of the level of resilience of healthcare systems and organizations, and specific actionable changes that should be pursued to consolidate and improve that level of resilience. Ultimately, this work identifies desirable paths of action through the investigation of real-world cases to improve health systems and organizations capacity and capability to face any future dramatic crisis.

From precision medicine to pandemics, from value-based healthcare to stakeholder engagement, European health systems are facing unprecedented change. How can health managers cope with these challenges and what skills and competencies will they need to deliver transformational change in the 'new normality'? This original volume presents a blueprint for Health Management 2.0 and helps set a path for long-term health system sustainability. Along with a comparative European framework to illustrate current developments in health management, the authors also highlight five key change drivers: integration; personalization; empowerment; digitalization; and life sciences, and examine how each is enabling the development of health systems that are fundamentally different from those of today. With fresh insights for managers, educators, researchers and policy makers, Health Management 2.0 promotes a modern interdisciplinary and dynamic approach to health leadership and management - one that focuses on skills and competencies - and outlines international best practice for future teaching and training.

Background Since the early 1980s all European countries have given priority to reforming the management of health services. A distinctive feature of these reforms has also been the drive to co-opt professionals themselves into the management of services, taking on full time or part time (hybrid) management or leadership roles. However, although these trends are well documented in the literature, our understanding of the nature and impact of reforms and how they are re-shaping the relationship between medicine and management remains limited. Most studies have tended to be nationally specific, located within a single discipline and focused primarily on describing new management practices. This article serves as an Introduction to a special issue of BMC Health Services Research which seeks to address these concerns. It builds on the work of a European Union funded COST Action (ISO903) which ran between 2009 and 2013, focusing specifically on the changing relationship between medicine and management in a European context.

Background: Since the early 1980s all European countries have given priority to reforming the management of health services. A distinctive feature of these reforms has also been the drive to co-opt professionals themselves into the management of services, taking on full time or part time (hybrid) management or leadership roles. However, although these trends are well documented in the literature, our understanding of the nature and impact of reforms and how they are re-shaping the relationship between medicine and management remains limited. Most studies have tended to be nationally specific, located within a single discipline and focused primarily on describing new management practices. This article serves as an Introduction to a special issue of BMC Health Services Research which seeks to address these concerns. It builds on the work of a European Union funded COST Action (ISO903) which ran between 2009 and 2013, focusing specifically on the changing relationship between medicine and management in a European context. Main text: Prior to describing the contributions to the special issue, this Introduction sets the scene by exploring four main questions which have characterised much of the recent literature on medicine and management. First is the question of what we understand by the changing relationship between medicine and management and in particular which this means for the emergence of so called 'hybrid' clinical leader roles? A second question concerns the forces that have driven change, in particular those relating to the wider project of management reforms. Third, we raise questions of how medical professionals have responded to these changes and what factors have shaped their responses. Lastly we consider what some of the outcomes of greater medical involvement in management and leadership might be, both in terms of intended and unintended outcomes. Conclusions: The paper concludes by summarising the contributions to the special issue and highlighting the need to extend research in this area by ...

Purpose
– As a consequence of new public management reforms, leading professionals in public service organizations have increasingly been involved in management roles. The phenomenon of clinical directors in the healthcare sector is particularly representative of this, as this medical manager role has been adopted in many countries around the world. However, professionals' managerial role taking still falls quite short of expectations. While most research has searched for the causes of this gap at the individual level by exploring the clash between management and professionalism, the purpose of the paper is to argue that a contextualized understanding of the antecedents at the organizational level, and particularly the existing medical management roles, provides a more thorough picture of the reality.


Design/methodology/approach
– The paper adopts an institutional perspective to study the development of existing medical management roles and the rise of new ones (clinical directors). The analysis focuses on the case of Italy, a country with a tradition in medical management where, following the example of other countries, clinical director roles were introduced by law; yet they were not incisive. The paper is based on a review of the existing literature and extensive field research on Italian clinical directorates.


Findings
– The paper shows how in contexts in which doctors in management roles exist and are provided with legitimacy deriving from legal norms, historical settlements between professions and taken for granted arrangements, medical management becomes institutionalized, stability prevails and change towards new doctor-in-management roles is seriously hampered.


Originality/value
– The paper contributes to existing knowledge on professionals' managerial role taking, underlining the relevance of contextual and nation-specific factors on this process. It provides implications for research and for policy making in healthcare and other professional public services.