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139-740: The Defence and Security Public Contracts Regulations 2011, also derived from EU law, apply to defence procurement. Health commissioners in England are exempt from the Lord Young Rules when procuring clinical services and these rules do not apply in Wales (i.e. to wholly or mainly devolved functions). Before the United Kingdom joined the European Communities in 1973 there was no significant legislation governing public procurement. New legislation,

278-667: A comparative advantage in the production of tradable goods. The Roman Empire used collaboration through ruling with visible control, which lasted from 31BC until (in the east ) 1453CE, across around fifty countries. The growth of trade was supported by the stable administration of the Romans. Evidence shows that the Roman Empire and Julius Caesar were influenced by the Greek writer Xenophon 's The Education of Cyrus on leadership. This says that 'social bonds, not command and control, were to be

417-505: A specialist , or watchful observation. A follow-up may be advised. Depending upon the health insurance plan and the managed care system, various forms of " utilization review ", such as prior authorization of tests, may place barriers on accessing expensive services. The medical decision-making (MDM) process includes the analysis and synthesis of all the above data to come up with a list of possible diagnoses (the differential diagnoses), along with an idea of what needs to be done to obtain

556-634: A "commitment to promote small business procurement", in particular by aiming to award 25% of government contracts (by value) to small and medium sized enterprises . At the same time a policy presumption was made that individual ICT contracts and projects "should be less than £100m lifetime costs". The government promoted and welcomed reform during the period from 2010 onwards, especially the development and implementation of European Commission 's proposals to modernise procurement legislation published in 2011. A "strategic supplier summit" held in February 2011 promoted

695-449: A 2010 review of the use of framework agreements and other forms of collaboration, they noted that there was a "wide variation" among public bodies in the extent to which they were being used. The Public Contracts (Amendment) Regulations 2009 came into effect on 20 December 2009, implementing the EU's Remedies Directive published on 20 December 2007. These regulations introduced the possibility of

834-502: A 2012 Action Note that "it is not against EU procurement law to talk to potential suppliers before starting the formal procurement process", and confirming in 2016 that "pre-procurement engagement ... is now expressly permitted". Since 2011 the UK Government has operated a policy regarding the choice of procurement routes (for example, using the Open or Restricted procedures) and for recording

973-655: A central steering group charged with developing and sharing best practice, but the Public Accounts Committee recommended additional central controls, fearing that the controls then in place were not adequate "to prevent and deter inappropriate use". Of particular concern was the extensive use of cards by staff of the Ministry of Defence , who accounted for just under 75% of all card expenditure but where controls were felt to be weaker than those in place in other departments. The Committee also suggested that lodge cards offered

1112-527: A change which was expected to be "particularly advantageous to SMEs in managing their cash flow ". This was a reversal of previous government contracting practice in model contract documents, where assignment of debts was allowed only with the prior consent of the relevant public body. Government suppliers who act as prime contractors for major contracts should also engage with SME's in their supply chains to ensure opportunities are available and fairly awarded. The government noted in 2013 that it did not yet have

1251-404: A close and symbiotic relationship among a nation's armed forces , its private industry , and associated political interests. In such a system, the military is dependent on industry to supply material and other support, while the defence industry depends on government for revenue. Skunk Works is a term used in engineering and technical fields to describe a group within an organization given

1390-628: A collaborative food group to review this area of procurement, leading to the launch of the Public Sector Food Procurement Initiative (PSFPI) in August 2003. The PSFPI set out to "encourage public bodies to procure food in a manner that considers the principles of sustainable development ". Its initial aims were to: A more extensive set of objectives was adopted in 2017 to reflect initial learning and revised government priorities. A Select Committee report published in 2021 noted that

1529-407: A combination of all three. Most tribal societies provide no guarantee of healthcare for the population as a whole. In such societies, healthcare is available to those who can afford to pay for it, have self-insured it (either directly or as part of an employment contract), or may be covered by care financed directly by the government or tribe. Transparency of information is another factor defining

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1668-429: A combination of art and science (both basic and applied , under the umbrella of medical science ). For example, while stitching technique for sutures is an art learned through practice, knowledge of what happens at the cellular and molecular level in the tissues being stitched arises through science. Prescientific forms of medicine, now known as traditional medicine or folk medicine , remain commonly used in

1807-568: A commitment to become "more transparent" about its procurement activity. Tender opportunities advertised by public sector bodies in the UK are legally required to be published to the following sites: Medicine#Clinical practice This is an accepted version of this page Medicine is the science and practice of caring for patients, managing the diagnosis , prognosis , prevention , treatment , palliation of their injury or disease , and promoting their health . Medicine encompasses

1946-404: A common social , political or spiritual vision. They share responsibilities and resources. Intentional communities include cohousing , residential land trusts , ecovillages , communes , kibbutzim , ashrams , and housing cooperatives . Typically, new members of an intentional community are selected by the community's existing membership, rather than by real estate agents or land owners (if

2085-458: A competitive dialogue request if further pre-market engagement would better support the process of defining the nature or function of the goods or services required. The 2014 Directive and 2015 Regulations introduced some minor variations to the wording on how a CD must be conducted, for example provision for tenders to be "optimised" after they had been submitted was changed so that they could be "fine-tuned", while restriction on changes being made to

2224-607: A constant feature of electroacoustic music , due to the technology's complexity. Embedding technological tools into the process stimulated the emergence of new agents with new expertise: the musical assistant, the technician, the computer music designer, the music mediator (a profession that has been described and defined in different ways over the years) – aiding with writing, creating new instruments, recording and/or performance. The musical assistant explains developments in musical research and translates artistic ideas into programming languages. Finally, he or she transforms those ideas into

2363-662: A contract being declared "ineffective" if it has been awarded by a contracting authority "in serious breach of the procurement rules", along with civil financial penalties and contract shortening, two alternative remedies available to the courts. In August 2010, David Cameron , then recently elected as prime minister, invited businessman Sir Philip Green to carry out a review of UK government spending and procurement. Green's summary report, Efficiency Review by Sir Philip Green , published in October 2010, alleged significant failings in government procurement processes. The government published

2502-421: A contractor has failed to comply with such laws in its contract performance, confirming that a contract clause to this effect would be compliant with the requirement in law for "appropriate measures to ensure that in the performance of public contracts economic operators comply with applicable obligations in the fields of environmental, social and labour law" (Directive 2014/24/EU, Article 18(2). The OGC introduced

2641-500: A decade after medical school. Furthermore, surgical training can be very difficult and time-consuming. Surgical subspecialties include those a physician may specialize in after undergoing general surgery residency training as well as several surgical fields with separate residency training. Surgical subspecialties that one may pursue following general surgery residency training: Other surgical specialties within medicine with their own individual residency training: Internal medicine

2780-553: A definitive diagnosis that would explain the patient's problem. On subsequent visits, the process may be repeated in an abbreviated manner to obtain any new history, symptoms, physical findings, lab or imaging results, or specialist consultations . Contemporary medicine is, in general, conducted within health care systems . Legal, credentialing , and financing frameworks are established by individual governments, augmented on occasion by international organizations, such as churches. The characteristics of any given health care system have

2919-491: A delivery system. Access to information on conditions, treatments, quality, and pricing greatly affects the choice of patients/consumers and, therefore, the incentives of medical professionals. While the US healthcare system has come under fire for its lack of openness, new legislation may encourage greater openness. There is a perceived tension between the need for transparency on the one hand and such issues as patient confidentiality and

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3058-513: A few minutes or a few weeks, depending on the complexity of the issue. The components of the medical interview and encounter are: The physical examination is the examination of the patient for medical signs of disease that are objective and observable, in contrast to symptoms that are volunteered by the patient and are not necessarily objectively observable. The healthcare provider uses sight, hearing, touch, and sometimes smell (e.g., in infection, uremia , diabetic ketoacidosis ). Four actions are

3197-797: A few selected firms has been shown to positively impact firm performance and innovation outcomes. Technology has provided the internet, wireless connectivity and collaboration tools such as blogs and wikis, and has as such created the possibility of " mass collaboration ". People are able to rapidly communicate and share ideas, crossing longstanding geographical and cultural boundaries. Social networks permeate business culture where collaborative uses include file sharing and knowledge transfer . According to author Evan Rosen command-and-control organizational structures inhibit collaboration and replacing such structures allows collaboration to flourish. Studies have found that collaboration can increase achievement and productivity. However, Bill Huber, former chair of

3336-491: A framework for controlling how they spent public funds. The Office of Government Commerce (OGC) set up a "Collaborative Procurement Programme" in 2007, managing over £18 billion of expenditure falling within eight categories of goods and services frequently purchased across the public sector, namely energy, vehicle fleet, travel, office solutions, information and communications technology, professional services, food and construction. A further category, facilities management ,

3475-513: A full understanding of the role played by SMEs in the supply chains for their purchasing, especially their contribution to supplying the Ministry of Defence and the Department for Work and Pensions . The UK public sector relies heavily on the use of framework agreements : the NAO found that 93% of the public bodies they surveyed had used a framework agreement during the financial year 2008–09. However, in

3614-456: A high degree of autonomy unhampered by bureaucracy, tasked with advanced or secret projects. One such group was created at Lockheed in 1943. The team developed highly innovative aircraft in short time frames, notably beating its first deadline by 37 days. As a discipline, project management developed from different fields including construction, engineering and defense. In the United States,

3753-498: A key aspect of the economic, social and environmental well-being supported by public sector contracting. CCS operated a Mystery Shopper scheme from February 2011 to November 2018, whose remit was to provide a route for suppliers to raise concerns about public procurement practice in England, The service was rebranded as the "Public Procurement Review Service" in November 2018, responding to feedback from suppliers and public bodies that

3892-505: A lower-risk alternative to the standard card. Lodge cards can be used for purchasing travel but not for other use, and allow for one centrally-held card to be used in conjunction with a centralised booking system. Publication of a "procurement pipeline" provides notice of current and planned procurement activity to be undertaken by a purchasing organisation so that prospective suppliers can be made aware of business opportunities for which they may bid . The 2011 Autumn Statement incorporated

4031-426: A market economy, leading to trading within the Roman Empire and taxes. In Hutterite communities housing units are built and assigned to individual families, but belong to the colony with little personal property. Meals are taken by the entire colony in a common long room. The Oneida Community practiced Communalism (in the sense of communal property and possessions) and Mutual Criticism , where every member of

4170-421: A means of achieving financial savings and operational efficiency in the acquisition of common goods and services in the public sector, and producing mutually beneficial results in the private sector. Collaboration allows for better communication within organizations and along supply chains . It is a way of coordinating different ideas from numerous people to generate a wide variety of knowledge. Collaboration with

4309-473: A one-time or long-term basis. It can be as simple as dual-authorship or as complex as commons-based peer production . Tools include Usenet , e-mail lists , blogs and Wikis while ' brick and mortar ' examples include monographs (books) and periodicals such as newspapers, journals and magazines. One approach is for an author to publish early drafts/chapters of a work on the Internet and solicit suggestions from

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4448-448: A patient to investigate or treat a pathological condition such as disease or injury , to help improve bodily function or appearance or to repair unwanted ruptured areas (for example, a perforated ear drum ). Surgeons must also manage pre-operative, post-operative, and potential surgical candidates on the hospital wards. In some centers, anesthesiology is part of the division of surgery (for historical and logistical reasons), although it

4587-434: A perception that the buyer was in a win-win situation, it soon became apparent that it was either close to a lose-win or at best a partial win-win situation favouring the supplier. A four-year study of interorganizational collaboration in a mental health setting found that successful collaboration can be rapidly derailed through external policy steering, particularly where it undermines relations built on trust. Collaboration

4726-417: A period of supervised practice or internship , or residency . This can be followed by postgraduate vocational training. A variety of teaching methods have been employed in medical education, still itself a focus of active research. In Canada and the United States of America, a Doctor of Medicine degree, often abbreviated M.D., or a Doctor of Osteopathic Medicine degree, often abbreviated as D.O. and unique to

4865-494: A recommendation to central government departments and non-departmental public bodies in March 2010 suggesting inclusion within contracts of a clause under which the public body concerned could require the supplier to submit detailed management information . Government policy as announced in the March 2013 budget is to use the procurement process to promote tax compliance . Regulation 57 of

5004-446: A relatively isolated rural location with little budget, Black Mountain fostered an informal and collaborative spirit. Innovations, relationships and unexpected connections formed at Black Mountain had a lasting influence on the postwar American art scene, high culture and eventually pop culture . Buckminster Fuller met student Kenneth Snelson at Black Mountain, and the result was the first geodesic dome (improvised out of slats in

5143-403: A score or a computer program and often performs the musical piece during the concerts. Examples of collaboration include Pierre Boulez and Andrew Gerzso, Alvise Vidolin and Luigi Nono , Jonathan Harvey and Gilbert Nouno. Although relatively rare compared with collaboration in popular music, there have been some notable examples of music written collaboratively by classical composers. Perhaps

5282-587: A secondary care setting. Tertiary care medical services are provided by specialist hospitals or regional centers equipped with diagnostic and treatment facilities not generally available at local hospitals. These include trauma centers , burn treatment centers, advanced neonatology unit services, organ transplants , high-risk pregnancy, radiation oncology , etc. Modern medical care also depends on information – still delivered in many health care settings on paper records, but increasingly nowadays by electronic means . In low-income countries, modern healthcare

5421-584: A series of supply-side measures which the government was undertaking "to rebalance and strengthen the economy in the medium term", which included extension of the existing pipelines in the construction and ICT fields to cover the publication of plans setting out the procurement needs for other categories by April 2012, "to give suppliers the confidence to invest for the future and compete on a level playing field". Other more specialist procurement pipelines include: Northern Ireland's procurement pipeline arrangements are supported by an industry liaison group, chaired by

5560-547: A significant impact on the way medical care is provided. From ancient times, Christian emphasis on practical charity gave rise to the development of systematic nursing and hospitals, and the Catholic Church today remains the largest non-government provider of medical services in the world. Advanced industrial countries (with the exception of the United States ) and many developing countries provide medical services through

5699-460: A study of Mayan fathers and children with traditional Indigenous ways of learning worked together in collaboration more frequently when building a 3D model puzzle than Mayan fathers with western schooling. Also, Chillihuani people of the Andes value work and create work parties in which members of each household in the community participate. Children from indigenous-heritage communities want to help around

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5838-479: A survey stated that the 2006 directives had led to more efficient and effective procurement practice, but 54% felt that "the simplicity of the procurement process" had deteriorated. The 2006 directives had created greater legal uncertainty within the local government procurement community. Several responses highlighted the need for better guidance and support from the EU and from the Office of Government Commerce (OGC), which

5977-410: A system of universal health care that aims to guarantee care for all through a single-payer health care system or compulsory private or cooperative health insurance. This is intended to ensure that the entire population has access to medical care on the basis of need rather than ability to pay. Delivery may be via private medical practices, state-owned hospitals and clinics, or charities, most commonly

6116-594: A variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness . Contemporary medicine applies biomedical sciences , biomedical research , genetics , and medical technology to diagnose , treat, and prevent injury and disease, typically through pharmaceuticals or surgery , but also through therapies as diverse as psychotherapy , external splints and traction , medical devices , biologics , and ionizing radiation , amongst others. Medicine has been practiced since prehistoric times , and for most of this time it

6255-528: A venue, lighting, etc. Hypothetically, one person could control all of this, but most often every work of ballet is the by-product of collaboration. From the earliest formal works of ballet, to the great 19th century masterpieces of Pyotr Tchaikovsky and Marius Petipa , to the 20th century masterworks of George Balanchine and Igor Stravinsky , to today's ballet companies, feature strong collaborative connections between choreographers, composers and costume designers are essential. Within dance as an art form, there

6394-435: Is a form of collaboration between two societies which produce and exchange different portfolios of goods. Trade began in prehistoric times and continues because it benefits all of its participants. Prehistoric peoples bartered goods and services with each other without a modern currency. Peter Watson dates the history of long-distance commerce from circa 150,000 years ago. Trade exists because different communities have

6533-495: Is a presumption in favour of contractual information being made publicly available (except in matters of commercial confidentiality such as pricing, intellectual property and business plans). The 2015 guidance made provision for a "safety valve" allowing suppliers to raise concerns if they felt that contractual information was being requested which did not add value, represented poor contract management practice or otherwise seemed unreasonable. The Scottish Government has also referred to

6672-538: Is also the collaboration between choreographer and dancer. The choreographer creates a movement in her/his head and then physically demonstrates the movement to the dancer, which the dancer sees and attempts to either mimic or interpret. Musical collaboration occurs when musicians in different places or groups work on the piece. Typically, multiple parties are involved (singers, songwriters, lyricists, composers, and producers) and come together to create one work. For example, one specific collaboration from recent times (2015)

6811-782: Is also threatened by opportunism from the business partners and the possibility of coordination failures that can derail the efforts of even well-intentioned parties. Margarita Leib, a professor at Tilburg University in the Netherlands, wrote about how individuals working together sometimes promote dishonest behavior that prioritizes profit, like what Volkswagen did to fake vehicle emission levels . This often begins with one person lying, which incentivizes or pressures everyone else to escalate in response. In recent years, co-teaching has become more common, found in US classrooms across all grade levels and content areas. Once regarded as connecting special education and general education teachers, it

6950-450: Is classified into primary, secondary, and tertiary care categories. Primary care medical services are provided by physicians , physician assistants , nurse practitioners , or other health professionals who have first contact with a patient seeking medical treatment or care. These occur in physician offices, clinics , nursing homes , schools, home visits, and other places close to patients. About 90% of medical visits can be treated by

7089-525: Is derived from Latin medicus , meaning "a physician". Medical availability and clinical practice vary across the world due to regional differences in culture and technology . Modern scientific medicine is highly developed in the Western world , while in developing countries such as parts of Africa or Asia, the population may rely more heavily on traditional medicine with limited evidence and efficacy and no required formal training for practitioners. In

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7228-670: Is in a letter written by James Waldegrave, 1st Earl Waldegrave in 1713. Antoine Augustin Cournot 's Researches into the Mathematical Principles of the Theory of Wealth in 1838 provided the first general theory. In 1928 it became a recognized field when John von Neumann published a series of papers. Von Neumann's work in game theory culminated in the 1944 book The Theory of Games and Economic Behavior by von Neumann and Oskar Morgenstern . The term military-industrial complex refers to

7367-595: Is not a surgical discipline. Other medical specialties may employ surgical procedures, such as ophthalmology and dermatology , but are not considered surgical sub-specialties per se. Surgical training in the U.S. requires a minimum of five years of residency after medical school. Sub-specialties of surgery often require seven or more years. In addition, fellowships can last an additional one to three years. Because post-residency fellowships can be competitive, many trainees devote two additional years to research. Thus in some cases surgical training will not finish until more than

7506-502: Is now more generally defined as "…two professionals delivering substantive instruction to a diverse group of students in a single physical space." As American classrooms have become increasingly diverse, so have the challenges for educators. Due to the diverse needs of students with designated special needs, English language learners (ELL), and students of varied academic levels, teachers have developed new approaches that provide additional student support. In practice, students remain in

7645-400: Is often too expensive for the average person. International healthcare policy researchers have advocated that "user fees" be removed in these areas to ensure access, although even after removal, significant costs and barriers remain. Separation of prescribing and dispensing is a practice in medicine and pharmacy in which the physician who provides a medical prescription is independent from

7784-456: Is the medical specialty dealing with the prevention, diagnosis, and treatment of adult diseases. According to some sources, an emphasis on internal structures is implied. In North America, specialists in internal medicine are commonly called "internists". Elsewhere, especially in Commonwealth nations, such specialists are often called physicians . These terms, internist or physician (in

7923-512: Is the process of two or more people, entities or organizations working together to complete a task or achieve a goal. Collaboration is similar to cooperation . The form of leadership can be social within a decentralized and egalitarian group. Teams that work collaboratively often access greater resources, recognition and rewards when facing competition for finite resources. Structured methods of collaboration encourage introspection of behavior and communication. Such methods aim to increase

8062-552: The Government Procurement Card (GPC), was introduced in 1997 and can be used by central government departments, local government and other public bodies. Cards are issued by Barclays Bank , HSBC , Lloyds and National Westminster Bank . The House of Commons Committee of Public Accounts noted in a report issued in 2012 that at that time, all seventeen central government departments were operating their own procurement card programmes. The Cabinet Office has established

8201-603: The House of Commons , Clarke observed that With the development of the Government's policies for private finance , market testing, contracting out and internal markets, Departments are doing more of their business than ever before through procurement as against in-house provision. The annual spend is now about £40 billion a year and, in addition, purchasing authorities in the national health service internal market spend more than £20 billion. These policies have brought immense benefits to

8340-985: The Internet . Screenwriter organizations bring together professional and amateur writers and filmmakers. Collaboration in business can be found both within and across organizations, and examples range from formalised partnerships , use of coworking spaces where freelancers can work with others in a collaborative environment and crowd funding , to the complexity of a multinational corporation . Inter-organizational collaboration brings participating parties to invest resources, mutually achieve goals, share information, resources, rewards and responsibilities, as well as make joint decisions and solve problems. Collaboration between public, private and voluntary sectors can be effective in tackling complex policy problems, but may be handled more effectively by boundary-spanning teams and networks than by formal organizational structures. In turn, business and management scholars have paid much attention to

8479-667: The Local Government, Planning and Land Act 1980 . CCT was then extended to "blue-collar" services such as refuse collection by the Local Government Act 1988, sports and leisure management in 1989, and to "white-collar" services such as housing management in 1994/95. Kenneth Clarke , then Chancellor of the Exchequer , published a Government procurement strategy White Paper in 1995 called Setting New Standards: A Strategy for Government Procurement (Cm 2840). In his statement to

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8618-536: The Lockheed Corporation ) Polaris missile submarine program; and (2) the " Critical Path Method " (CPM) developed in a joint venture by both DuPont Corporation and Remington Rand Corporation for managing plant maintenance projects. These mathematical techniques quickly spread into many private enterprises. In 1969, the Project Management Institute (PMI) was formed to serve the interest of

8757-463: The Procurement Act 2023 , received royal assent on 26 October 2023, with implementation planned for 24 February 2025. In 2021, the government estimated the value of public sector expenditure on goods and services at around £290 billion per year, an increase of around £70 billion from a National Audit Office estimate for 2008–09. Both estimates suggest that one third of all public sector spending

8896-562: The University of Victoria assert that until the early 1990s the individual was the 'unit of instruction' and the focus of research. The two observed that researchers and practitioners switched to the idea that "knowing" is better thought of as a cultural practice. Roth and Lee also claim that this led to changes in learning and teaching design in which students were encouraged to share their ways of doing mathematics, history, science, with each other. In other words, that children take part in

9035-517: The developed world , evidence-based medicine is not universally used in clinical practice; for example, a 2007 survey of literature reviews found that about 49% of the interventions lacked sufficient evidence to support either benefit or harm. In modern clinical practice, physicians and physician assistants personally assess patients to diagnose , prognose, treat, and prevent disease using clinical judgment. The doctor-patient relationship typically begins with an interaction with an examination of

9174-913: The pharmacist who provides the prescription drug . In the Western world there are centuries of tradition for separating pharmacists from physicians. In Asian countries, it is traditional for physicians to also provide drugs. Working together as an interdisciplinary team , many highly trained health professionals besides medical practitioners are involved in the delivery of modern health care. Examples include: nurses , emergency medical technicians and paramedics , laboratory scientists, pharmacists , podiatrists , physiotherapists , respiratory therapists , speech therapists , occupational therapists , radiographers, dietitians , and bioengineers , medical physicists , surgeons , surgeon's assistant , surgical technologist . The scope and sciences underpinning human medicine overlap many other fields. A patient admitted to

9313-474: The "basic features" of a tender was changed to a reference to its "essential features". Noting that the public sector spent over £2 billion per year on the purchase of food and catering services (England and Wales) and that more than 30,000 public sector organisations were involved in food procurement, including schools and social services providers, the OGC and the Department for Children, Schools and Families launched

9452-423: The "best example" of where different government departments had separate contracts in place with different suppliers, so that overall government scale could not be levered effectively. Green suggested that an "urgent review" could lead to savings of 30-40% in this category of expenditure. "Poor negotiation " was further identified as a cause of inflexibility in contracts. The coalition government of 2010 also made

9591-422: The "mystery shopper" title did not properly reflect the role of the service. The Public Contracts Regulations 2015 provide that public sector buyers must pay prime contractors within 30 days and must ensure that any subcontracts through the supply chain include a similar provision. In 2014–15 at least 33 NHS trusts paid fewer than half of their trade invoices on time, up from 23 in 2015–16 and 11 in 2014–15. Under

9730-490: The "particularly complex" threshold, where pre-market engagement with suppliers would be more appropriate. The government therefore adopted a presumption against competitive dialogue, implemented from May 2012 through a requirement that within central government, departments wishing to use this procedure required approval from their Accounting Officer, or a Commercial Director in cases where the authority has been delegated. Guidance states that Accounting Officers should not sign off

9869-462: The 2019-2020 coronavirus pandemic were published in March 2020 and remained in effect until 31 October 2020, allowing public bodies to make advance payments and retention payments for contracts which have been interrupted by the measures taken to reduce the spread of the coronavirus. Since 1 January 2021, the social value model in use among central government public bodies has included COVID-19 recovery, employment and social and community support as

10008-598: The Better Payment Practice Code, they should pay at least 95% of non-NHS invoices within 30 days. Within the context of local government , many local authorities have adopted the National Procurement Concordat for Small and Medium-Sized Enterprises to encourage SMEs to engage in procurement and supply for local public services. Examples include the City of Wakefield 's Concordat agreed in 2005, and

10147-590: The Cabinet Office is the minister with overall responsibility for procurement policy, which is delivered through the Crown Commercial Service , an executive agency sponsored by the Cabinet Office. The Crown Commercial Service (CCS) publishes Procurement Policy Notes from time to time, which advise procurement staff in the public sector of government policy developments and best practice in relation to procurement. Procurement Policy Notes on responding to

10286-664: The Concordat agreed by East Suffolk Council in 2019. The UK government requires all government departments and their related organisations to ensure that they meet the minimum mandatory Government Buying Standards (GBS) when buying goods and services. Organisations in the wider public sector are also encouraged to specify the minimum mandatory standards in their tenders. As of 2023, many aspects of government policy pertaining to procurement have been brought together in The Sourcing Playbook . The competitive dialogue (CD) procedure

10425-467: The Department of Finance and Personnel's Central Procurement Directorate (CPD). Guidance issued in 2015 and 2016 confirmed that rules and good practice provisions intended to ensure that business opportunities were available for small and medium sized enterprises were not intended to offer small businesses any preferential treatment. In November 2016 an advisory panel of 24 entrepreneurs and business figures

10564-623: The European Union, the profession of doctor of medicine is regulated. A profession is said to be regulated when access and exercise is subject to the possession of a specific professional qualification. The regulated professions database contains a list of regulated professions for doctor of medicine in the EU member states, EEA countries and Switzerland. This list is covered by the Directive 2005/36/EC . Collaboration Collaboration (from Latin com- "with" + laborare "to labor", "to work")

10703-528: The International Association for Contract and Commercial Management (IACCM, now World Commerce & Contracting ), notes that not all companies have what he calls "collaborative DNA". Huber argues that often when companies fail to implement or sustain successful collaborative relationships, the causes can be traced to insufficient leadership support or to underdeveloped collaboration skills. Andrew Cox, formerly of Birmingham Business School and

10842-564: The Public Contract Regulations provides for contracting authorities to exclude a supplier if they are aware that it is in breach of its obligations relating to the payment of taxes or social security contributions, and where the breach has been established by a judicial or administrative decision having final and binding effect. Suppliers bidding for contracts over £5,000,000 in expected value are required to self-certify their status regarding tax compliance. A revised policy statement

10981-443: The UK Government. This policy is intended to prevent public sector organisations, including local councils, from adopting their own boycotts, including boycotting Israeli suppliers in particular. Then- Labour Party leader Jeremy Corbyn criticsed the introduction of the policy as "an attack on local democracy". The government encourages departments to consult with potential suppliers before commencing formal procurement, noting in

11120-422: The UK where all doctors are now required by law to work less than 48 hours per week on average. The following are some major medical specialties that do not directly fit into any of the above-mentioned groups: Some interdisciplinary sub-specialties of medicine include: Medical education and training varies around the world. It typically involves entry level education at a university medical school , followed by

11259-456: The US demonstrates that these advances have not been able to overcome the challenges of such projects. Founded in 1933 by John Andrew Rice , Theodore Dreier and other former faculty of Rollins College , Black Mountain College was experimental by nature and committed to an interdisciplinary approach, attracting a faculty which included leading visual artists, poets and designers. Operating in

11398-480: The United States, can be searched at http://data.medobjectives.marian.edu/ Archived 4 October 2018 at the Wayback Machine . In most countries, it is a legal requirement for a medical doctor to be licensed or registered. In general, this entails a medical degree from a university and accreditation by a medical board or an equivalent national organization, which may ask the applicant to pass exams. This restricts

11537-473: The United States, must be completed in and delivered from a recognized university. Since knowledge, techniques, and medical technology continue to evolve at a rapid rate, many regulatory authorities require continuing medical education . Medical practitioners upgrade their knowledge in various ways, including medical journals , seminars, conferences, and online programs. A database of objectives covering medical knowledge, as suggested by national societies across

11676-446: The absence of scientific medicine and are thus called alternative medicine . Alternative treatments outside of scientific medicine with ethical, safety and efficacy concerns are termed quackery . Medicine ( UK : / ˈ m ɛ d s ɪ n / , US : / ˈ m ɛ d ɪ s ɪ n / ) is the science and practice of the diagnosis , prognosis , treatment , and prevention of disease . The word "medicine"

11815-589: The basis of physical examination: inspection , palpation (feel), percussion (tap to determine resonance characteristics), and auscultation (listen), generally in that order, although auscultation occurs prior to percussion and palpation for abdominal assessments. The clinical examination involves the study of: It is to likely focus on areas of interest highlighted in the medical history and may not include everything listed above. The treatment plan may include ordering additional medical laboratory tests and medical imaging studies, starting therapy, referral to

11954-470: The beginning of the modern project management era. Again, in the United States, prior to the 1950s, projects were managed on an ad hoc basis using mostly Gantt charts , and informal techniques and tools. At that time, two mathematical project scheduling models were developed: (1) the " Program Evaluation and Review Technique " or PERT, developed as part of the United States Navy 's (in conjunction with

12093-486: The best-known examples are: Collaboration in entertainment dates from the origin of theatrical productions, millennia ago. It takes the form of writers, directors, actors, producers and other individuals or groups working on the same production. In the twenty-first century, new technology has enhanced collaboration. A system developed by Will Wright for the TV series title Bar Karma on CurrentTV facilitates plot collaboration over

12232-502: The broadest meaning of "medicine", there are many different specialties. In the UK, most specialities have their own body or college, which has its own entrance examination. These are collectively known as the Royal Colleges, although not all currently use the term "Royal". The development of a speciality is often driven by new technology (such as the development of effective anaesthetics) or ways of working (such as emergency departments);

12371-609: The classroom and receive instruction by both their general teacher and special education teachers. In the 1996 report "What Matters Most: Teaching for America's Future" economic success could be enhanced if students developed the capacity to learn how to "manage teams… and…work together successfully in teams". Teachers increasingly use collaborative software to establish virtual learning environments (VLEs). This allows them to share learning materials and feedback with both students and in some cases, parents. Approaches include: Writers, both in fiction and non-fiction, may cooperate on

12510-546: The college established The Washington Center for Improving the Quality of Undergraduate Education, which focuses on collaborative education approaches, including learning communities as one of its centerpieces. The school later became notorious for less-successful collaborations. The romanticized notion of a lone, genius artist has existed since the time of Giorgio Vasari 's Lives of the Artists , published in 1568. Vasari promulgated

12649-568: The community was subject to criticism by committee or the community as a whole, during a general meeting. The goal was to remove bad character traits. A kibbutz is an Israeli collective community. The movement combines socialism and Zionism seeking a form of practical Labor Zionism . Choosing communal life, and inspired by their own ideology, kibbutz members developed a communal mode of living. The kibbutzim lasted for several generations as utopian communities, although most became capitalist enterprises and regular towns. The Manhattan Project

12788-405: The companies they work for, resulting in technical documents that are more comprehensive and accurate than documents produced by individuals. Technical communication collaboration typically occurs on shared document work-spaces (such as Google Docs), through social media sites, videoconferencing, SMS and IM, and on cloud-based authoring platforms. Scientific collaboration rapidly advanced throughout

12927-459: The considerable legal authority of the medical profession to physicians that are trained and qualified by national standards. It is also intended as an assurance to patients and as a safeguard against charlatans that practice inadequate medicine for personal gain. While the laws generally require medical doctors to be trained in "evidence based", Western, or Hippocratic Medicine, they are not intended to discourage different paradigms of health. In

13066-455: The construction of consensual domains, and 'participate in the negotiation and institutionalization of ... meaning'. In effect, they are participating in learning communities . This analysis does not consider the appearance of Learning communities in the United States in the early 1980s. For example, The Evergreen State College , which is widely considered a pioneer in this area, established an intercollegiate learning community in 1984. In 1985,

13205-735: The country. Their full potential has still to be realised. The more procurement there is, the more important it becomes that Government Departments should make a first-class job of it. Peter Gershon , in his 1999 Review of Civil Procurement in Central Government , referred to and followed the White Paper's definition of procurement as inclusive of "conventionally funded projects" and also those supported by "more innovative types" of funding such as PFI. Gershon noted in his findings that previous governments had decentralised procurement and delegated expenditure decisions to Departments without creating

13344-763: The examination for the Membership of the Royal College of Physicians (MRCP) or the equivalent college in Scotland or Ireland. "Surgery" refers to the practice of operative medicine, and most subspecialties in this area require preliminary training in General Surgery, which in the UK leads to membership of the Royal College of Surgeons of England (MRCS). At present, some specialties of medicine do not fit easily into either of these categories, such as radiology, pathology, or anesthesia. Most of these have branched from one or other of

13483-417: The expertise or procedures performed by specialists. These include both ambulatory care and inpatient services, emergency departments , intensive care medicine , surgery services, physical therapy , labor and delivery , endoscopy units, diagnostic laboratory and medical imaging services, hospice centers, etc. Some primary care providers may also take care of hospitalized patients and deliver babies in

13622-439: The forefather of project management is Henry Gantt , who is known for his use of the "bar" chart as a project management tool, for being an associate of Frederick Winslow Taylor 's theories of scientific management , and for his study of the management of Navy ship building. His work is the forerunner to many modern project management tools including the work breakdown structure (WBS) and resource allocation. The 1950s marked

13761-697: The founder of the International Institute for Advanced Purchasing and Supply (IIAPS), has highlighted the dangers in thinking that collaborative relationships always produce mutually advantageous " win-win " outcomes for both buyers and sellers in commercial relationships. Cox uses case studies which show where competent buyers have used collaboration successful to secure value for money , and other examples where "incompetent buyers" utilizing "what initially appear to be win-win outcomes" subsequently lose out to "more commercially competent suppliers". In relation to one of his examples, Cox concludes that From

13900-542: The government announced that it wanted to see small and medium-sized enterprises (SMEs) "compete more effectively for public sector contracts". A review of progress with this initiative published in 2013 found that "against a backdrop of falling procurement spend", there had been a slight increase in direct expenditure with SMEs between 2011/12 (£4.4bn) and 2012/13 (£4.5bn). The 2008 budget statement also announced that businesses supplying services to Government would be able to sell their public sector invoices to debt specialists,

14039-466: The government continued to expect that "food procurement should provide value for money while also ensuring 'high standards of production, animal welfare , traceability and sustainability to support our agricultural industry '. The government argues that Public procurement should never be used as a tool to boycott tenders from suppliers based in other countries, except where formal legal sanctions, embargoes and restrictions have been put in place by

14178-547: The government's intention to introduce more openness in relation to "the contracts it signs, the goods and services it purchases and the way it purchases them". The Cabinet Office was responsible for leading on UK engagement with the EU. In research undertaken by the Local Government Association (LGA) in 2010 to inform the LGA's views on the proposed modernisation legislation, 36% of local government officers responding to

14317-640: The gut and the kidneys. In the Commonwealth of Nations and some other countries, specialist pediatricians and geriatricians are also described as specialist physicians (or internists) who have subspecialized by age of patient rather than by organ system. Elsewhere, especially in North America, general pediatrics is often a form of primary care . There are many subspecialities (or subdisciplines) of internal medicine : Training in internal medicine (as opposed to surgical training), varies considerably across

14456-553: The hospital is usually under the care of a specific team based on their main presenting problem, e.g., the cardiology team, who then may interact with other specialties, e.g., surgical, radiology, to help diagnose or treat the main problem or any subsequent complications/developments. Physicians have many specializations and subspecializations into certain branches of medicine, which are listed below. There are variations from country to country regarding which specialties certain subspecialties are in. The main branches of medicine are: In

14595-472: The house voluntarily. In the Mazahua Indigenous community of Mexico, school children show initiative and autonomy by contributing in their classroom, completing activities as a whole, assisting and correcting their teacher during lectures when a mistake is made. Fifth and sixth graders in the community work with the teacher installing a classroom window; the installation becomes a class project in which

14734-446: The idea that artistic skill was endowed upon chosen individuals by gods, which created an enduring and largely false popular misunderstanding of many artistic processes. Artists have used collaboration to complete large scale works for centuries, but the myth of the lone artist was not widely questioned until the 1960s and 1970s. Collaborative art groups include: Ballet is a collaborative art form. It entails music, dancers, costumes,

14873-464: The importance of both formal and informal mechanisms to support inter-organizational collaboration. They especially point to the role of contractual and relational mechanisms and the inherent tensions between the two. Global manufacturer Unilever offers to collaborate with innovating start-up businesses, and its "Unilever Foundry" refers to over 400 examples of "strategic collaboration" in this field. Collaborative procurement has been commended as

15012-434: The information provided. During the encounter, properly informing the patient of all relevant facts is an important part of the relationship and the development of trust. The medical encounter is then documented in the medical record, which is a legal document in many jurisdictions. Follow-ups may be shorter but follow the same general procedure, and specialists follow a similar process. The diagnosis and treatment may take only

15151-569: The land is not owned by the community). Collaboration in indigenous communities, particularly in the Americas, often involves the entire community working toward a common goal in a horizontal structure with flexible leadership . Children in some indigenous American communities collaborate with the adults. Children can be contributors in the process of meeting objectives by taking on tasks that suit their skills. Indigenous learning techniques comprise Learning by Observing and Pitching In . For example,

15290-430: The light of the economic downturn of 2008 onwards, sometimes referred to as the " Great Recession ", the UK government adopted a series of ten "procurement for growth" principles, intended to ensure that UK government procurement would "take account of supply chain opportunities for UK companies in policy and delivery planning" and "analyse markets to assess where growth is achievable". In the March 2008 budget statement ,

15429-773: The narrow sense, common outside North America), generally exclude practitioners of gynecology and obstetrics, pathology, psychiatry, and especially surgery and its subspecialities. Because their patients are often seriously ill or require complex investigations, internists do much of their work in hospitals. Formerly, many internists were not subspecialized; such general physicians would see any complex nonsurgical problem; this style of practice has become much less common. In modern urban practice, most internists are subspecialists: that is, they generally limit their medical practice to problems of one organ system or to one particular area of medical knowledge. For example, gastroenterologists and nephrologists specialize respectively in diseases of

15568-496: The new specialty leads to the formation of a unifying body of doctors and the prestige of administering their own examination. Within medical circles, specialities usually fit into one of two broad categories: "Medicine" and "Surgery". "Medicine" refers to the practice of non-operative medicine, and most of its subspecialties require preliminary training in Internal Medicine. In the UK, this was traditionally evidenced by passing

15707-403: The other watches intently and all are allowed to attempt tasks with the more experienced stepping in to complete more complex parts, while others pay close attention. Game theory is a branch of applied mathematics, computer science, and economics that looks at situations where multiple players make decisions in an attempt to maximize their returns. The first documented discussion of game theory

15846-477: The patient's medical history and medical record , followed by a medical interview and a physical examination . Basic diagnostic medical devices (e.g., stethoscope , tongue depressor ) are typically used. After examining for signs and interviewing for symptoms , the doctor may order medical tests (e.g., blood tests ), take a biopsy , or prescribe pharmaceutical drugs or other therapies. Differential diagnosis methods help to rule out conditions based on

15985-440: The possible exploitation of information for commercial gain on the other. The health professionals who provide care in medicine comprise multiple professions , such as medics , nurses , physiotherapists , and psychologists . These professions will have their own ethical standards , professional education, and bodies. The medical profession has been conceptualized from a sociological perspective . Provision of medical care

16124-432: The primary care provider. These include treatment of acute and chronic illnesses, preventive care and health education for all ages and both sexes. Secondary care medical services are provided by medical specialists in their offices or clinics or at local community hospitals for a patient referred by a primary care provider who first diagnosed or treated the patient. Referrals are made for those patients who required

16263-413: The primary mechanisms of governance'. Classics professor Emma Dench notes that the Roman Empire extended its citizenship "to enemies, former enemies of state, to people who'd helped them. The Romans were incredibly good at co-opting people and ideas." The Romans created a stable empire that benefitted both ruled and allied countries. Gold and silver were currencies created by the Romans which supported

16402-536: The profession. The International Project Management Association (IPMA), founded in Europe in 1967, has undergone a similar development and instituted the IPMA Project Baseline. Both organizations are now participating in the development of a global project management standard. However, the exorbitant cost overruns and missed deadlines of large-scale infrastructure, military R&D/procurement and utility projects in

16541-560: The project management industry. The premise of PMI is that the tools and techniques of project management are common even among the widespread application of projects from the software industry to the construction industry. In 1981, the PMI Board of Directors authorized the development of what has become A Guide to the Project Management Body of Knowledge (PMBOK), standards and guidelines of practice that are widely used throughout

16680-520: The rationale supporting such choices. A "Procurement Route Decision Tree" was put in place to support this policy. The decision tree was updated on 30 July 2015 to accommodate the revision to procurement routes available under the Public Contracts Regulations 2015. Government departments use procurement cards to support prompt payment objectives; these can be used to pay for goods and services of any value. A dedicated form of payment card,

16819-450: The review identifying its main finding as "the Government is failing to leverage both its credit rating and its scale". Green argued that the report gave "a fair reflection" of government waste and inefficiency in practice, for which "very poor data and process" were seen as the main causes. Cameron welcomed the report, saying "I think it's a good report, it will save a lot of money and it's important we do it." Landline telephones offered

16958-501: The school's back yard); Merce Cunningham formed his dance company; and John Cage staged his first happening . Black Mountain College was a consciously directed liberal arts school that grew out of the progressive education movement . In its day it was a unique educational experiment for the artists and writers who conducted it, and as such an important incubator for the American avant garde . Dr. Wolff-Michael Roth and Stuart Lee of

17097-546: The scientific power of the United States for greater success. The project succeeded in developing and detonating three nuclear weapons in 1945: a test detonation of a plutonium implosion bomb on July 16 (the Trinity test ) near Alamogordo, New Mexico ; an enriched uranium bomb code-named " Little Boy " on August 6 over Hiroshima , Japan; and a second plutonium bomb, code-named " Fat Man " on August 9 over Nagasaki, Japan. The members of an intentional community typically hold

17236-452: The students participate in the process alongside the teacher. They all work together without needing leadership, and their movements are all in sync and flowing. It is not a process of instruction, but rather a hands-on experience in which students work together as a synchronous group with the teacher, switching roles and sharing tasks. In these communities, collaboration is emphasized, and learners are trusted to take initiative. While one works,

17375-403: The success of teams as they engage in collaborative problem-solving . Collaboration is present in opposing goals exhibiting the notion of adversarial collaboration , though this is not a common use of the term. In its applied sense, "[a] collaboration is a purposeful relationship in which all parties strategically choose to cooperate in order to accomplish a shared outcome". Trade between nations

17514-654: The suppliers available to public sector purchasers via their commercial agreements were micro -, small and medium sized enterprises. UK procurement policy in line with its EU background allows for social and environmental considerations to be taken into account in procurement decision-making. Government guidance on this topic has noted that tenders which are "abnormally low" may hide practices of " social dumping " and must be rejected if it has been proved that low costs reflect non-compliance with environmental, social or labour laws. The government has also recommended that public bodies make provision in contracts for later termination if

17653-486: The twentieth century as measured by the increasing numbers of coauthors on published papers. Wagner and Leydesdorff found international collaborations to have doubled from 1990 to 2005. While collaborative authorships within nations has also risen, this has done so at a slower rate and is not cited as frequently. Notable examples of scientific collaboration include CERN , the International Space Station ,

17792-555: The two camps above; for example anaesthesia developed first as a faculty of the Royal College of Surgeons (for which MRCS/FRCS would have been required) before becoming the Royal College of Anaesthetists and membership of the college is attained by sitting for the examination of the Fellowship of the Royal College of Anesthetists (FRCA). Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on

17931-765: The world at large. This approach helped ensure that the technical aspects of the novel The Martian were as accurate as possible. The science fiction author Frederik Pohl was noted for his longtime collaborations with Cyril Kornbluth and Jack Williamson . Collaboration in technical communication (also commonly referred to as technical writing) has become increasingly important in the creation and dissemination of technical documents in multiple technical and occupational fields, including: computer hardware and software, medicine, engineering, robotics, aeronautics, biotechnology, information technology, and finance. Collaboration in technical communication allows for greater flexibility, productivity and innovation for technical writers and

18070-418: The world: see the articles on medical education for more details. In North America, it requires at least three years of residency training after medical school, which can then be followed by a one- to three-year fellowship in the subspecialties listed above. In general, resident work hours in medicine are less than those in surgery, averaging about 60 hours per week in the US. This difference does not apply in

18209-739: Was a collaborative project during World War II among the Allies that developed the first atomic bomb . It was a collaborative effort by the United States , the United Kingdom and Canada . The value of this project as an influence on organized collaboration is attributed to Vannevar Bush . In early 1940, Bush lobbied for the creation of the National Defense Research Committee . Frustrated by previous bureaucratic failures in implementing technology in World War I, Bush sought to organize

18348-535: Was added at a later date. The National Audit Office (NAO) argues that collaborative procurement begins with standardising specifications , which allows public bodies to aggregate demand and compare unit costs . Lower prices should result either from economies of scale , or from using pricing information to challenge suppliers. Collaboration should result in fewer tendering exercises, leading to lower administrative costs, and allow public bodies to concentrate on more specialised purchases that are unique to them. In

18487-419: Was an art (an area of creativity and skill), frequently having connections to the religious and philosophical beliefs of local culture. For example, a medicine man would apply herbs and say prayers for healing, or an ancient philosopher and physician would apply bloodletting according to the theories of humorism . In recent centuries, since the advent of modern science , most medicine has become

18626-440: Was devoted to the acquisition of goods and services. Central government expenditure on third party goods and services was estimated at £54 billion in 2009-10 and £45 billion in 2011–12. The UK Government's first major statement on procurement strategy was published in 1984. In local government, a policy of compulsory competitive tendering (CCT) was first applied to construction, maintenance and highways work under Part III of

18765-399: Was formed to advise the government on purchasing goods and services from SMEs, and a campaign was launched to demonstrate that "government is open for business", with a target of increasing government spending with SMEs to 33% of all third-party public expenditure by 2020. As of May 2023 the advisory panel includes 20 business leaders. In 2024, Crown Commercial Services stated that 72% of

18904-441: Was introduced into EU procurement law by the 2004 Directive "on the coordination of procedures for the award of public works contracts, public supply contracts and public service contracts" as a procedure available to Member States "in the case of particularly complex contracts". In 2011, Francis Maude , then Minister for the Cabinet Office , raised concerns that public procurers were using this procedure in cases which did not meet

19043-731: Was issued in February 2014 in order to clarify certain definitions. A case raised by Turning Point Ltd. against Norfolk County Council in 2012 confirmed that it is legitimate and fair to include a requirement in a tender barring caveats and qualified bids. A short form of terms and conditions for the acquisition of low value goods and services was published by the Cabinet Office in April 2014, allowing government departments to adopt consistent, appropriate and proportionate terms which did not over-burden suppliers. General transparency principles applicable to government procurement were published in March 2015, and updated in February 2017, stating that there

19182-449: Was the song " FourFiveSeconds ". This single represents a type of collaboration because it was developed by pop idol Rihanna , Paul McCartney (former bassist, composer and vocalist for The Beatles ), and rapper/composer Kanye West . Websites and software facilitate musical collaboration over the Internet , resulting in the emergence of online bands . Several awards exist specifically for collaboration in music: Collaboration has been

19321-576: Was then responsible for procurement policy. In February 2011 the UK Government stated its view that "the public procurement regime needs to be radically simplified to reduce red tape and improve value for money ". Part 3 of the Small Business, Enterprise and Employment Act 2015 allows the Minister for the Cabinet Office or relevant Secretary of State to impose further regulations on public bodies regarding how they undertake procurement. The Minister for

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