Professor Ruth McDonald

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Position: Professor of Health Science Research and Policy


Ruth is a political science graduate and a former UK National Health Service hospital finance director. In 2007/8 she spent a year at UC Berkeley as a Harkness Fellow in Health Care Policy and Practice, comparing pay for performance programmes in the UK and California. She has also held posts at the Universities of Warwick, Nottingham, Manchester, Liverpool and Leeds. Ruth is a member of the executive committee of the European Sociological Association.

Programme involvement

Specialist fields




Publication summary




Working papers

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Showing 87 publication(s)

Authored book

  • Harrison SR, McDonald ER. The Politics of Healthcare in Britain. Sage, 2008. eScholarID:4d193
  • McDonald ER. Using Health Economics in Health Services, Rationing Rationally?. Open University Press. Open University Press, 2002. eScholarID:4d213

Book contribution

  • McDonald, R. and Waring, J. "Creating a Safety Culture: Learning from Theory and Practice." In Patient Safety Culture, Ashgate, 2014. eScholarID:239708
  • McDonald, R. "Financial Incentives and the Governance of Performance." In International Handbook of Healthcare Policy, Palgrave, Palgrave, 2014. eScholarID:239707
  • McDonald ER. "Creating a patient-led NHS: empowering 'consumers' or shrinking the State?." In Social Policy Review, 33-48.2006. eScholarID:3d471
  • McDonald ER, Chapman S, Bottomley J. "Disease Management." In Pharmacoeconomics Walley , T., Haycox, A. and Boland, A. (eds), 2004. eScholarID:3d821
  • McDonald ER. "Empowerment and Modernisation: Managing Change in an English Primary Care Trust." In Unmasking Health Management (Harding and Learmonth eds.), 2004. eScholarID:3d280
  • McDonald ER. "The Economics of Health Care Systems." In Pharmacoeconomics Walley, T., Haycox, A. and Boland, A. (eds), 2004. eScholarID:3d891
  • McDonald ER. "The policy context." In Pharmacoeconomics Walley, T., Haycox, A. and Boland, A. (eds), 2004. eScholarID:3d820
  • McDonald ER. "Health economics and PCGs." In A practical guide to primary care groups and trusts, 2002. eScholarID:3d656
  • McDonald ER. "Programme Budgeting and Marginal Analysis - a pragmatic approach to economic evaluation." In Getting health economics into practice, 2002. eScholarID:3d475
  • McDonald ER. "Using economic evaluation at grassroots level." In Getting health economics into practice D.Kernick ed, 2002. eScholarID:3d523
  • McDonald ER. "Using health economics to facilitate decision-making: Economic Evaluation - the basics." In Getting health economics into practice D. Kernick (ed), 2002. eScholarID:3d474

Journal article

  • McDonald, R. "Bad doctors, democracy and the public interest." Symbolic Interaction(2015) . eScholarID:262619
  • McDonald, R. "Beyond Binaries Reflections and a Suggestion on the Subject of Medical Professional Satisfaction." Professions & Professionalism 5, no. 1(2015) . eScholarID:262620
  • McDonald, R., Boaden, R., Roland, M., Kristensen, S., Meacock, R., Lau, Y., Mason, T., Turner, A. and Sutton, M. "Evaluation of the advancing quality pay for performance programme in the NHS North West." Health Services and Delivery Research n/a(2014) . eScholarID:240158
  • McDonald, R. "Leadership and leadership development in healthcare settings – a simplistic solution to complex problems?" International Journal of Health Policy and Management 3, no. 5(2014) : 227-229. eScholarID:238447
  • Kristensen S, Meacock, R., Turner, A., Boaden, R. McDonald R, Roland, M. and Sutton M. 371. "Long-Term Effect of Hospital Pay for Performance on Outcomes in England." New England Journal of Medicine(2014) . eScholarID:238264
  • McDonald, R. "Paying for Performance in healthcare organisations." International Journal of Health Policy and Management 2(2014) : 6-7. eScholarID:238445
  • McDonald, R. "‘Bourdieu’, medical elites and ‘social class’: a qualitative study of ‘desert island’ doctors." Sociology of Health and Illness 36(2014) : 902-916. eScholarID:237000
  • McDonald, R. et al. "Competing and coexisting logics in the changing field of English general medical practice." Social Science & Medicine 93(2013) : 47-54. eScholarID:238361
  • Brocklehurst P., Birch S., McDonald R., Tickle M. "Determining the optimal model for role-substitution in NHS dental services in the United Kingdom." B M C Oral Health 13(2013) . eScholarID:238449
  • Kristensen S, McDonald R, Sutton M. "Should pay-for-performance schemes be locally designed? Evidence from the Commissioning for Quality and Innovation (CQUIN) framework." Journal of Health Services Research & Policy 18(2013) : 38-49. eScholarID:238362
  • Sutton, M., Nikolova, S., Boaden, R., Lester, H., McDonald, R. and Roland, M. "Association between Mortality and Hospital Pay for Performance in England." New England Journal of Medicine 367(2012) : 1821-1828. eScholarID:238448
  • McDonald R., Cheraghi-Sohi, S., Sanders, C., Tickle, M. "Changes to financial incentives in English dentistry 2006 to 2009: a qualitative study." Community Dentistry and Oral Epidemiology (Online) 40(2012) : 468-473. eScholarID:238455
  • Martin, G, Weaver, S., Currie, G, Finn, R and McDonald, R. "Innovation sustainability in challenging healthcare contexts: embedding clinically led change in routine practice." 25, no. 4(2012) : 190-199. eScholarID:238446
  • Morriss, R…..McDonald, R et al. "Persistent frequent attenders in primary care: costs, reasons for attendance, organisation of care and potential for cognitive behavioural therapeutic intervention." B M C Family Practice 13(2012) . eScholarID:238452
  • McDonald, R. "Restratification Revisited: The Changing Landscape of Primary Medical Care in England and California." Current Sociology 60(2012) : 441-455. eScholarID:238453
  • Cheraghi-Sohi, S., McDonald, R., Sanders, C. and Harrison S. "The experience of contractual change in UK general practice: A qualitative study of salaried GPs." British Journal of General Practice 62(2012) : 282-287. eScholarID:238456
  • Tickle M., McDonald R., Franklin J., Aggarwal V, Milsom KM., Reeves D. "Paying for the wrong kind of performance? Financial incentives and behaviour changes in NHS dentistry 1992-2009." Community Dentistry and Oral Epidemiology (Online) 39, no. 5(2011) : 465-473. eScholarID:238457
  • Martin, G., Currie, G., Finn, R., McDonald, R. "The medium-term sustainability of organisational innovations in the National Health Service." Implementation Science 6, no. 19(2011) . eScholarID:238458
  • McDonald, R., Cheraghi-Sohi, S., Sanders, C. and Ashcroft, D. "Professional status in a changing world: The case of Medicines Use Reviews in English community pharmacy." Social Science & Medicine 71, no. 3(2010) : 451-458. eScholarID:238459
  • Morriss, R., Marttunnen, S., Garland, A., Nixon, N., McDonald, R. et al. "Randomised controlled trial of the clinical and cost effectiveness of a specialist team for managing refractory unipolar depressive disorder." B M C Psychiatry 10(2010) . eScholarID:238460
  • McDonald ER. "Market reforms in English primary medical care: Medicine, habitus and the public sphere." Sociology of Health and Illness(2009) . eScholarID:1d18214
  • McDonald ER, Roland M. "Pay for Performance in Primary Care in England and California: comparison of unintended consequences." Annals of Family Medicine(2009) . eScholarID:1d17663
  • McDonald ER, White J, Marmor Ted. "Paying for Performance in Primary Medical Care: Learning About and Learning From "Success" and "Failure" in England and California." Journal of Health Politics, Policy and Law(2009) . eScholarID:1d18877
  • McDonald ER, Campbell SM, Lester HE. "Practice nurses and the effects of the new General Practitioner contract in the English National Health Service: the extension of a professional project?" Social Science and Medicine(2009) . eScholarID:1d18252
  • McDonald ER, Checkland KH, Harrison SR, Coleman A. "Rethinking collegiality: Restratification in English General Medical Practice 2004-2008." Social Science and Medicine(2009) . eScholarID:1d18250
  • McDonald ER, Harrison SR, Checkland KH. "The new GP contract in English primary health care: an ethnographic study." International Journal of Public Sector Management(2009) . eScholarID:1d17859
  • Checkland KH, Harrison SR, McDonald ER, Suzanne Grant, Campbell SM, Bruce Guthrie. "Biomedicine, holism and general medical practice: responses to the 2004 General Practitioner contract." Sociology of Health and Illness 30(2008) : 788-803. eScholarID:1d17644 | DOI:10.1111/j.1467-9566.2008.01081.x
  • McDonald ER, Rogers AE, Macdonald WJ. "Dependence and identity: nurses and chronic conditions in a primary care setting." Journal of Health Organisation and Management 22(2008) : 294-308. eScholarID:1d17639 | DOI:10.1108/14777260810883558
  • McDonald ER. "Everything you wanted to know about anxiety but were afraid to ask." Journal of Health Service Research and Policy 13(2008) : 249-250. eScholarID:1d17860 | DOI:10.1258/jhsrp.2008.008067
  • McDonald ER, Harrison SR, Checkland KH. "Identity, contract and enterprise in a primary care setting: an English general practice case study." Organization 15(2008) : 355-370. eScholarID:1d17091 | DOI:10.1177/1350508408088534
  • McDonald ER, Harrison SR, Checkland KH. "Incentives and control in primary health care: findings from English Pay for Performance case studies." Journal of Health Organisation and Management 1(2008) : 48-62. eScholarID:1d17176
  • Campbell SM, McDonald ER, Lester HE. "The Experience of Pay for Performance in English Family Practice: A Qualitative Study." Annals of Family Medicine 6(2008) : 228-234. eScholarID:1d17334 | DOI:10.1370/afm.844
  • Fotaki M, Roland M, Boyd A, McDonald ER, Sheaff R, Smith L. "What benefits will choice bring to patients?Literature review and assessment of implications." Journal of Health Services Research & Policy 13(2008) . eScholarID:1d17396
  • Cheraghi-Sohi S, Hole AA, Mead NJ, McDonald ER, Whalley D, Bower PJ, Roland M. "What patients want from primary care consultations: a discrete choice experiment to identify patients' priorities." Annals of Family Medicine 6(2008) : 107 -115. eScholarID:1d17089 | DOI:10.1370/afm.816
  • Huby G, Guthrie B, Grant S, Watkins F, Checkland KH, McDonald ER, Davies H. "Whither British General Practice after the 2004 GMS contract? : Stories and realities of change in 4 UK general practices." Journal of Health Organisation and Management 1(2008) : 63-78. eScholarID:1d17178
  • Waring JJ, Harrison SR, McDonald ER. "A culture of safety or coping? ritualistic behaviours in the operating theatre." Journal of Health Services Research and Policy 12(2007) : 3-9. eScholarID:1d15622 | DOI:10.1258/135581907780318347
  • Dunckley P, McDonald ER, Dickson R, Jayram R, Quinn T, Wright C. "Acute Coronary Syndromes patients' experience of Hospital Care: A focus group study." British Journal of Cardiac Nursing 2(2007) . eScholarID:1d15888
  • McDonald ER, Harrison SR, Checkland KH, Campbell SM, Roland M. "Impact of financial incentives on clinical autonomy and internal motivation in primary care: ethnographic study." BMJ(2007) . eScholarID:1d15854
  • McDonald ER, Waring JJ. "Safety in the operating theatre: what underpins attitudes and behaviour?" Health Care Risk Report 13(2007) : 12-14. eScholarID:1d15456
  • Sibbald BS, McDonald ER, Roland M. "Shifting care from hospitals to the community: a review of the evidence on quality and efficiency." Journal of Health Service Research and Policy 12(2007) : 110-117. eScholarID:1d15463 | DOI:10.1258/135581907780279611
  • Checkland KH, McDonald ER, Harrison SR. "Ticking boxes and changing the social world: Data collection and the new UK general practice contract." Social Policy and Administration 41(2007) : 693-710. eScholarID:1d16653 | DOI:10.1111/j.1467-9515.2007.00580.x
  • M Dunckley, T Quinn, R Dickson, R Jayram, C Wright, McDonald ER. "Acute coronary syndrome nurses perceptions of other members of the health care team." Accident and Emergency Nursing 4(2006) : 204-9. eScholarID:1d15126 | DOI:10.1016/j.aaen.2006.07.005
  • McDonald ER, Waring JJ, Harrison SR. "At the cutting edge? Modernisation and nostalgia in a hospital operating theatre department." Sociology 40, no. 6(2006) : 1097-1115. eScholarID:1d11788 | DOI:10.1177/0038038506069851
  • Roland M, McDonald ER, Sibbald BS, A Boyd, M Fotaki, Gravelle H. "Outpatient services and primary care. A scoping review of research into strategies for improving outpatient effectiveness and efficiency." Manchester. National Primary Care Research and Development Centre(2006) . eScholarID:1d33166
  • McDonald ER, Waring JJ, Harrison SR. "Rules, safety and the narrativization of identity: a hospital operating theatre case study." Sociology of Health and Illness(2006) . eScholarID:1d11784 | DOI:10.1111/j.1467-9566.2006.00487.x
  • J Waring, McDonald ER, Harrison SR. "Safety and complexity. Inter-departmental relationships as a threat to patient safety in the operating department." Journal of Health Organisation and Management 3(2006) : 227-42. eScholarID:1d15251 | DOI:10.1108/14777260610662753
  • McDonald ER, J Waring. "Safety in the operating theatre: the impact of interdepartmental delays." Health Care Risk Report(2006) : 12-15. eScholarID:1d15127
  • McDonald ER, Waring JJ, Harrison SR. "Balancing risk, that is my life: the politics of risk in a hospital operating theatre department." Health, Risk and Society(2005) . eScholarID:1d11789
  • McDonald ER, Waring JJ, Harrison SR, Walshe K, Boaden R. "Rules and guidelines in clinical practice: a qualitative study in operating theatres of doctors' and nurses' views." Qual Saf Health Care(2005) . eScholarID:1d11786
  • McDonald ER. "Shifting the Balance of Power? Culture change and identity in an English health care setting. Awarded outstanding paper of 2005 in this journal." Journal of Health Organization and Management(2005) : 189-203. eScholarID:1d11787
  • McDonald R, Harrison SR. "Autonomy and Modernisation: the management of change in an English Primary Care Trust." Health and Social Care in the Community(2004) : 104-201. eScholarID:1d9789
  • McDonald ER. "Individual identity and organisational control: empowerment and modernisation in a primary care trust." Sociol Health Illn 26( 7)(2004) : 925-50. eScholarID:1d9585 | DOI:10.1111/j.0141-9889.2004.00423.x
  • McDonald ER. "Involving Patients and the Public: How to do it better." Quality and Safety in Health Care(2004) . eScholarID:1d15891
  • Coast J, McDonald ER, Baker R, McDonald ER. "Issues arising from the use of qualitative methods in health economics." J Health Serv Res Policy 9( 3)(2004) : 171-6. eScholarID:1d9587
  • McDonald ER. "Protecting Patients' Rights." International Journal of Public Sector Management 17(2004) . eScholarID:1d15892
  • Mair FS, Lloyd-Williams F, Shiels C, McDonald ER, Beaton S, Goldstein P, Roberts C, Haycox A. "The economic costs of heart failure: a community perspective." EUROPEAN HEART JOURNAL 25(2004) . eScholarID:1d11299
  • McDonald ER, Harrison SR. "The micropolitics of clinical guidelines: an empirical study." Policy and Politics(2004) : 223-239. eScholarID:1d9787
  • Saxena P, Saxena P, McDonald ER, McDonald ER, Gull S, Hyder N, Gull S, Hyder N. "Diagnostic scanning for suspected scaphoid fractures: an economic evaluation based on cost-minimisation models." Injury 34( 7)(2003) : 503-11. eScholarID:1d9783
  • Harrison SR, McDonald ER. "Science, consumerism and bureaucracy: the new legitimations of medical professionalism." International Journal of Public Sector Management(2003) : 110-121. eScholarID:1d9791
  • Lloyd-Williams, F, Mair, F, Shiels, C, Hanratty, B, Goldstein, P, Beaton, S, Capewell, S, Lye, M, McDonald, ER, Roberts, C, McDonald, ER. "Why are patients in clinical trials of heart failure not like those we see in everyday practice?" J Clin Epidemiol 56( 12)(2003) : 1157-62. eScholarID:1d9785 | DOI:10.1016/S0895-4356(03)00205-1
  • McDonald ER, McDonald ER. "Street-level bureaucrats? heart disease, health economics and policy in a primary care group." Health Soc Care Community 10( 3)(2002) : 129-35. eScholarID:1d9780
  • McDonald ER, McDonald ER, Burrill P, Walley T, Burrill P, Walley T. "Managing the entry of new medicines in the National Health Service: health authority experiences and prospects for primary care groups and trusts." Health Soc Care Community 9( 6)(2001) : 341-7. eScholarID:1d9781
  • McDonald ER, Baughan S. "Rationality and reality: attitudes of health economists working at local level in the UK National Health Service." Critical Public Health(2001) . eScholarID:1d11790
  • McDonald ER, Haycox A, Walley T, McDonald ER, Haycox A, Walley T. "The impact of health economics on healthcare delivery: the health economists' perspective." Pharmacoeconomics 19( 8)(2001) : 803-9. eScholarID:1d9779
  • Bowens A, McDonald ER, Ayres P, Robinson M. "The processes and costs of local guideline development: experiences from the Path.Finder NHS consortium." British Journal of Clinical Governance(2001) . eScholarID:1d11791
  • McDonald ER. "Just say no? Drugs Politics and the UK National Health Service." Policy and Politics 4(2000) : 563-576. eScholarID:1d15889
  • McDonald ER. "Health economics has lost its way or why David Kernick is (partly) right." Health Economics 8(1999) : 175-176. eScholarID:1d15890


  • McDonald, R. 2014 Evaluation of a BME Leadership Programme, Report to NHS Leadership Academy.
  • Martin, G., Weaver, S., Currie, G., Finn, R., McDonald, R. 2013 The medium-term sustainability of organisational innovations in the National Health Service. NIHR Report.
  • McDonald R., et al. 2013 Evaluation of the Commissioning for Quality and Innovation Framework, Report to the Department of Health.
  • McDonald R. et al. 2012 A Qualitative and Quantitative Evaluation of the Introduction of Best Practice Tariffs, Report to the Department of Health.
  • Mannion, R.; Davies, H.T.O.; Harrison, S.; Konteh, F.; Greener, I.; McDonald, R.; Dowswell, G; Walshe, K.; Fulop, N.; Walters, R; Jacobs, Rowena; Hyde, P. 2010 Changing Management Cultures and Organisational Performance in the NHS (OC2). National Co-ordinating Centre for the National Institute for Health Research Service Delivery and Organisation Programme (NCCSDO).
  • Fotaki, M., Boyd, A., McDonald, al. 2005 Patient Choice and the Organisation and Delivery of Health Services: Scoping Review. Manchester: Manchester Business School.
  • McDonald, R., Cheraghi-Sohi, S., Tickle, M. et al. 2010 The impact of incentives on the behaviour and performance of primary care professionals. Report for the National Institute for Health Research Service Delivery and Organisation programme.