“…Similarly, a Senior Associate at the NHS Institute for Innovation and Improvement, (Manning, 2011) promotes the Productive Community Services, referring to improvements such as a 48% reduction in stock held for a school nursing team. Productive Ward has also been associated with increased quality of patient observations and patient satisfaction (Lipley, 2009), increased staff satisfaction (Dean, 2014;Wright et al, 2012), increased Direct Care Time with patients (Blakemore, 2009), the reduction of hospital-acquired infections (Foster et al, 2009;Smith and Rudd, 2010) staff sickness (Smith and Rudd, 2010), and falls (Wilson, 2009), and more efficient admission and discharge processes (Lennard, 2014). Few of these articles provide much detail regarding the negative aspects of the programme's implementation, although for an exception see Wright et al (2012), who notes that implementing just the first module cost £236 per meeting in staff time before accounting for the time taken to prepare data and carry out the module work.…”