The Impact of CEOs in the Public Sector: Evidence from the English NHS

Katharina  Janke; Carol  Propper; Raffaella  Sadun

Working Paper | HBS Working Paper Series | 2019

The Impact of CEOs in the Public Sector: Evidence from the English NHS

by Katharina Janke, Carol Propper and Raffaella Sadun

Abstract

We investigate whether top managers affect the performance of large and complex public sector organizations, using as a case study CEOs of English public hospitals (large, complex organizations with multi-million turnover). We study the extent to which CEOs are differentiated in terms of their pay, as well as a wide range of hospital production measures including inputs, intermediate operational outcomes and clinical outcomes. Pay differentials suggest that the market perceives CEOs to be differentiated. However, we find little evidence of CEOs’ impact on hospital production. This does not appear to be driven by endogenous sorting. The results question the effectiveness of leadership changes to improve performance in the public sector.

Keywords: Management; Performance; Public Sector; Measurement and Metrics; Health Industry;

Language: English

Format: Print

88 pages

Read Now

Citation:

Janke, Katharina, Carol Propper, and Raffaella Sadun. "The Impact of CEOs in the Public Sector: Evidence from the English NHS." Harvard Business School Working Paper, No. 18-075, March 2018. (Revised November 2019.)

We explore the critical question of how executives make strategic decisions. Utilizing a new survey of 262 CEO alumni of Harvard Business School, we gather evidence on four aspects of each executive’s business strategy: its overall structure, its formalization, its development, and its implementation. We report three key results. First, different CEOs use markedly different processes to make strategic decisions; some follow highly formalized, rigorous, and deliberate processes, while others rely heavily on instinct and intuition. Second, more structured strategy processes are associated with larger firm size and faster employment growth. Third, using a regression discontinuity centered around a change in the curriculum of Harvard Business School’s required strategy course, we trace differences in strategic decision making back to differences in managerial education.

Case | HBS Case Collection | September 2019 (Revised August 2020)

Engineering an Inclusive Bioeconomy

Tarun Khanna, Raffaella Sadun and Susie L. Ma

In 2019, entrepreneur Juan Carlos Castilla-Rubio was developing a project he hoped could generate and share wealth from the natural resources of the Amazon without destroying those resources. His idea, called Earth Bank of Codes (EBC), would create a library of the genomic codes of all known species that could be tapped for discovery and innovation, from new medical interventions to more efficient manufacturing processes. He proposed to use blockchain technology to make the data both accessible and trackable so that its use could be monitored. Castilla-Rubio envisioned a time when a company in the U.S. could access a biological asset from the Peruvian Amazon, develop and commercialize a product based on the asset, and have a fraction of the resulting sales land directly in the bank account of various beneficiaries, including the Peruvian government and indigenous communities. Now he was facing major decisions about how to structure EBC to achieve his goals. Should he start at the top and build partnerships with national governments and inter-governmental organizations as the cornerstone of EBC? Or would it be better to forge ahead with a few stakeholders in an entrepreneurial project?

Keywords: Decision Making; Development Economics; Entrepreneurship; Innovation and Invention; Intellectual Property; Emerging Markets; Market Design; Marketplace Matching; Science; Genetics; Natural Environment; Environmental Sustainability; Climate Change; Social Enterprise; Strategy; Strategic Planning; Technology; Ownership; Social Psychology; Trust; Society; Biotechnology Industry; South America; Amazon Basin;

Citation:

Khanna, Tarun, Raffaella Sadun, and Susie L. Ma. "Engineering an Inclusive Bioeconomy." Harvard Business School Case 720-356, September 2019. (Revised August 2020.) View Details

Cite View Details Educators Purchase

We explore the impact of COVID-19 on employee's digital communication patterns through an event study of lockdowns in 16 large metropolitan areas in North America, Europe and the Middle East. Using de-identified, aggregated meeting and email meta-data from 3,143,270 users, we find, compared to pre-pandemic levels, increases in the number of meetings per person (+12.9 percent) and the number of attendees per meeting (+13.5 percent), but decreases in the average length of meetings (-20.1 percent). Collectively, the net effect is that people spent less time in meetings per day (-11.5 percent) in the post-lockdown period. We also find significant and durable increases in length of the average workday (+8.2 percent, or +48.5 minutes), along with short-term increases in email activity. These findings provide insight from a novel dataset into how the nature of work has changed for a large sample of knowledge workers. We discuss these changes in light of the ongoing challenges faced by organizations and workers struggling to adapt and perform in the face of a global pandemic.

Faculty & Research

The Impact of CEOs in the Public Sector: Evidence from the English NHS

Abstract

Citation:

About the Author

More from the Author