BackgroundConventional systematic review techniques have limitations when the aim of a review is to construct a critical analysis of a complex body of literature. This article offers a reflexive account of an attempt to conduct an interpretive review of the literature on access to healthcare by vulnerable groups in the UKMethodsThis project involved the development and use of the method of Critical Interpretive Synthesis (CIS). This approach is sensitised to the processes of conventional systematic review methodology and draws on recent advances in methods for interpretive synthesis.ResultsMany analyses of equity of access have rested on measures of utilisation of health services, but these are problematic both methodologically and conceptually. A more useful means of understanding access is offered by the synthetic construct of candidacy. Candidacy describes how people's eligibility for healthcare is determined between themselves and health services. It is a continually negotiated property of individuals, subject to multiple influences arising both from people and their social contexts and from macro-level influences on allocation of resources and configuration of services. Health services are continually constituting and seeking to define the appropriate objects of medical attention and intervention, while at the same time people are engaged in constituting and defining what they understand to be the appropriate objects of medical attention and intervention. Access represents a dynamic interplay between these simultaneous, iterative and mutually reinforcing processes. By attending to how vulnerabilities arise in relation to candidacy, the phenomenon of access can be better understood, and more appropriate recommendations made for policy, practice and future research.DiscussionBy innovating with existing methods for interpretive synthesis, it was possible to produce not only new methods for conducting what we have termed critical interpretive synthesis, but also a new theoretical conceptualisation of access to healthcare. This theoretical account of access is distinct from models already extant in the literature, and is the result of combining diverse constructs and evidence into a coherent whole. Both the method and the model should be evaluated in other contexts.

The COVID-19 pandemic has confronted school leaders across the four devolved nations of the United Kingdom (UK) with a period of exceptional crisis. This responsive, small-scale, but UK-wide study focuses on headteacher perspectives on leadership and management in the initial stages of this pandemic, contributing to our understanding of this crucial period. The headteacher respondents met the multiple predicaments and situational ambiguities of the pandemic with a resilience which drew heavily upon the strengths of pre-existing structures and teams. They were required to provide effective emotional and moral leadership in uncharted and rapidly shifting territory. They spoke most eloquently of how they developed pragmatic, versatile and personally reassuring approaches to communication with parents, staff, pupils, and a range of external agencies, all of which were also facing extraordinary circumstances with varying degrees of resilience. The paper concludes by conceptualising the key elements of headteachers’ leadership and management, both inside and outside of school, at in the early stages of societal crisis.

This paper explores the determinants of performance of research groups in the context of the emergence of knowledge as a key intangible asset. It focuses specifically on how best to configure knowledge producers for optimal effectiveness in the current research environment. It explores the under-researched area of the organization and management of research groups located in and at the interface of university research and focuses on medical and medical-related research groups. The discussion is embedded within the current debate concerning modes of organization in knowledge production. Factors identified with high-achievement are: strong leadership; finding, motivating and retaining talent; strategies of related diversification; strongly linked theory and practice and, in particular, network connectedness. Such groups exhibit an increasingly complex internal environment, facilitating a flexible response to an increasingly complex external environment. It finds evidence of Mode 2 working, with increasing use of collaborative strategies and some evidence of a thematic emphasis emerging, although to a lesser extent than the literature suggests, since participants are still working from a strongly disciplinary base. Driven by the more competitive environment, both intellectual and commercial forms of entrepreneurship are present. At the hub of this complex web of inter-related factors is network connectedness, which proves to be centrally facilitative in mobilizing the other necessary resources. In an age of uncertainty and indeterminacy, performance and its measurement have become an obsession. Managerialism with its emphasis on: 'order and ratio-

This article examines the concept of distributed leadership, drawing from a systematic review of relevant literature commissioned by the National College for School Leadership (NCSL) and jointly funded by NCSL and the Open University’s Centre for Educational Policy, Leadership and Lifelong Learning (CEPoLL). The concept attracts a range of meanings and is associated with a variety of practices, with varying implications for organizational processes and values. The article highlights key variables that emerged from the literature review. It then elaborates one of the emergent themes—the distinction between structure and agency—and seeks to utilize this further as a means of illuminating the concept and practice of distributed leadership. In conclusion, areas for future research are identified.

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