Human resource management in recession: Restructuring and alternatives to downsizing in times of crisis

In just over a decade two global crises have created significant instability across the world and plunged many national economies into recession. While studies of HRM during economic downturns are limited, the global impact of COVID-19 on employment adds impetus to the debate. Though downsizing and mass layoffs attract most attention, redundancies are just one potential response to challenging economic conditions, and various other employment adjustments might be viewed as complements or alternatives to workforce reductions. However, little is known about the implementation of HR practices or enactment of HR strategies during recession. Drawing upon 56 in-depth interviews, this article presents three case studies of recessionary restructuring in British manufacturing firms. The cases share a concern with mitigating redundancies and highlight the importance of actor agency as well as institutional and organisational context in shaping restructuring outcomes. The article contributes to HR theory regarding HRM in recession and employment restructuring.

Has the impact of the COVID-19 pandemic on uptake andusage of indwelling pleural catheters reduced its cost-effectiveness?

During the COVID pandemic, the British Thoracic Society recommended first-line indwelling pleural catheter (IPC)insertion or therapeutic aspiration for malignant pleural effusion (MPE) instead of admission for chest drain and talcpleurodesis to minimise hospital visits. This study aimed to review the uptake and usage of IPCs during and followingthe pandemic and its potential cost-effectiveness.Retrospective data analysis of IPCs between 2020-2021 was performed. Data collection included patient sex, age,WHO performance status (PS), indication and duration of IPC.187 IPCs were inserted;91% for MPE. 75% elected for IPC as first-line. 57% patients were PS 0-1 and 77% werePS 0-2. In 2020, 30% patients were self-draining compared to 12% in 2021. Mean duration IPC in-situ was 87 days(median 68 days). The pandemic saw increased use of first-line IPCs (75% 2020 vs 52% 2019) particularly in patients with good PS. This reduced initial hospitalisation (4.08 bed days) with an estimated cost saving of 1200 (300/day) per patient. Self-drainage rates also increased from 13% (2019) to 30% (2020) but have returned to pre-pandemic levels of selfdrainage at 12% in 2021 with need for district nurse visits for up to 3 months. Current practice of widespread first-line IPC use in the COVID endemic era may not be cost-effective and needs to be reviewed alongside the pre-existing evidence base.

Has COVID-19 affected complication rate ofIPC placements?

The COVID pandemic increased uptake of indwelling pleural catheters (IPC) as first-line management of malignant and non-malignant pleural effusions. This study reviewed the complication rate in view of this and its associated impact. Retrospective data analysis of IPCs between 2020-2021 was performed. Data collection included patient demographics, indication, treatment, and complication rate. 187 IPCs were inserted in 180 patients. Pneumothorax rate was low (1%). Common complications were incomplete drainage at point of IPC removal, IPC-related infection, and chronic pain. Despite incomplete drainage in 54 (29%) patients, only 8 required further procedures (1 IPC, 7 therapeutic aspirations). 80 patients received chemotherapy or immunotherapy. 11% developed IPC-related infection: 7% pleural infection and 4% cellulitis. 100 patients did not receive immunosuppressive treatment: 2% had pleural infection. Pleural infection occurred 8 weeks post-insertion (median 63 days) requiring 19 bed days per patient and 1 IPC removal. 2 IPCs were removed due to intractable chronic pain. Overall, complications associated with IPC in our practice were lower than recently published data. IPC-related infection is a problem;however, our study was underpowered, and the effect of immunosuppressive treatment could not be analysed. Despite this, most patients required conservative treatment only and did not require IPC removal, allowing ongoing usage of the IPC.

Comparative impacts of the COVID-19 pandemic on work and employment—Why industrial relations institutions matter

This introduction assesses the international impacts of the COVID-19 pandemic on work and employment. It outlines conceptually why industrial relations institutions matter for shaping policy choices across different countries. This includes countries in the Global South that are not covered by conventional varieties of capitalism theories. An important focus is what IR institutions and policies played a protective role in the decommodification of labor during the pandemic, notably short-time working (furlough) schemes, tripartite cooperative pacts, works councils, collective bargaining, and active labor market policies. IR institutions continue to matter, and the contributions in this Special Issue can inform future research. © 2023 Regents of the University of California (RUC).

Never 'one-size-fits-all': Mick Marchington's unique voice on voice, from micro-level informality to macro-level turbulence

Mick Marchington's contributions to employee voice, participation, and involvement are broad and deep. This scholarship is consistently distinguished by a rejection of 'one-size-fits-all' approaches in favour of complex, multi-layered understandings. We reflect on some of Marchington's key contributions to employee voice, participation, and involvement, with an emphasis on the importance of internal actors who are conditioned by diverse internal and external influences. We also illustrate the lasting importance of this approach by applying it to the COVID-19 health crisis currently unfolding.

'Pleural triage' facilitates effective Management of a pleural service in the covid-19 era

Aims The COVID-19 pandemic has created new challenges for management of pleural diseases. Pleural patients can be highly vulnerable to infection and often have conditions for which treatment cannot be safely delayed. We reviewed our pleural service to implement changes that allowed maintenance of a service whilst maximising patient and staff safety. Method Establishment of a Pleural Triage MDT meeting 48 hrs prior to pleural clinic to review all referrals and stream patients to i) telephone consultation only, ii) remote CXR (24 hrs pre-clinic) plus telephone consultation iii) face-to-face (F2F) review or iv) direct to a procedure. We reviewed case numbers post lockdown for March-August 2020 and compared to 2019. Results During the COVID pandemic outpatient pleural management was implemented where possible, including adaptation of our ambulatory pneumothorax pathway to comply with COVID-19 recommendations. March-August 2019 there were 293 F2F pleural consultations. March-August 2020 there were 408 consultations [103 telephone only, 168 remote CXR + telephone consult (11 declined) and 123 F2F (3 declined)]. The 14 declines had telephone consults only. Previously all these patients would have been F2F. COVID-19 symptom screening occurred if attending for CXR/F2F. F2F consults were held in designated outpatient areas with access to CXR and procedure rooms, with timings to maintain social distancing. Where required, definitive pleural intervention was undertaken on the same visit. Direct-to-procedure pathways for thoracoscopy or IPC were implemented with COVID-testing 48 hrs prior. Patients with malignant effusions were counselled on management options and uptake of day-case IPC increased [March-August 2020 vs 2019 IPC = 44 vs 35] compared to elective admission for drain and talc pleurodesis. During the April 2020 COVID peak there were 12 admissions for chest drain vs 50 in April 2019. The pleural/cancer themed ward was designated a COVID-negative area for inpatients. Conclusion In the ever-changing situation of a global pandemic it is possible to successfully implement changes to maintain and enhance the safety and efficiency of pleural services, with selected changes likely to remain post-pandemic. Further evaluation of these changes over time could help to shape the future of pleural medicine.

P26 ‘Pleural Triage’ facilitates effective management of a pleural service in the COVID-19 era

P26 Figure 1ConclusionIn the ever-changing situation of a global pandemic it is possible to successfully implement changes to maintain and enhance the safety and efficiency of pleural services, with selected changes likely to remain post-pandemic. Further evaluation of these changes over time could help to shape the future of pleural medicine.ReferenceGuidance on pleural services during the COVID-19 pandemic;https://www.brit-thoracic.org.uk/document-library/quality-improvement/covid-19/