Professor Ruth McDonald

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Profile photo of: Professor Ruth McDonald Email: Show Email Address
Position: Professor of Health Science Research and Policy


Ruth is 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.

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Showing 97 publication(s)


  • Mcdonald, E., & Spence, C. (2016). Professions and Financial Incentives. In M. Dent, I. L. Bourgeault, J-L. Denis, & E. Kuhlmann (Eds.), Routledge Companion to the Professions and Professionalism. Oxford: Routledge. . Publication link: d6d3ba55-4a5a-4884-92d6-957a88892451
  • Turner, S., Goulding, L., Denis, J-L., Mcdonald, E., & Fulop, N. (2016). Major system change: A management and organisational research perspective. Health Services and Delivery Research, 4(16), 85–104. . Publication link: b2b610b7-e5bf-4643-88fc-cd666bd530c9
  • Brocklehurst, P., Birch, S., Mcdonald, E., Hill, J., O'Malley, L., Macey, R., & Tickle, M. (2016). Determining the optimal model for role substitution in NHS dental services in the UK: a mixed-methods study. Health Services Delivery Research, 4(22). DOI: 10.3310/hsdr04220. Publication link: bfd2e76c-a563-4676-a766-07baf2fd7202
  • Martin, G., Currie, G., Weaver, S., Finn, R., & Mcdonald, E. (2016). Institutional complexity and individual responses: delineating the boundaries of partial autonomy. Organization Studies. . Publication link: 7a43b409-be84-40ff-a495-6e5e37adc9fb
  • Bienkowska-Gibbs, T., Exley, J., Saunders, C., Marjanovic, S., Chataway, J., MacLure, C., ... Ling, T. (2016). Evaluating the role and contribution of innovation to health and wealth in the UK: A review of Innovation, Health and Wealth: Phase 1 Final Report. RAND Corporation.. Publication link: 4b1e9964-f9ec-4aed-ae05-49a64686ed8f
  • Mcdonald, E. (2016). Research and innovation in healthcare. In W. Kieran, & S. Judith (Eds.), Healthcare Management. (3 ed.). London: Open University Press. . Publication link: 0273be38-c2ab-483a-8eda-754777437ba9


  • Mcdonald, R. (2015). Beyond Binaries Reflections and a Suggestion on the Subject of Medical Professional Satisfaction. Professions & Professionalism, 5(1). . Publication link: e7361115-f303-4b4b-8a01-313f8825b422
  • McDonald, R., Boaden, R., Roland, M., Kristensen, S. R., Meacock, R., Lau, Y-S., ... Sutton, M. (2015). A qualitative and quantitative evaluation of the Advancing Quality pay-for-performance programme in the NHS North West. Health Services Delivery Research, 3(23). DOI: 10.3310/hsdr03230. Publication link: 9e27254b-4f5f-49cf-87f0-4449582edd11


  • Mcdonald, R. (2014). Leadership and leadership development in healthcare settings – a simplistic solution to complex problems?International Journal of Health Policy and Management, 3(5), 227-229. . Publication link: a3f882ab-3611-4673-9cb7-05adcf65cc16
  • Mcdonald, R., & Waring, J. (2014). Creating a Safety Culture: Learning from Theory and Practice. In Patient Safety Culture. Ashgate. . Publication link: 28928745-dc5d-4693-8a2b-37d200e7f03a
  • Kristensen, S. R., Meacock, R., Turner, A., Boaden, R., McDonald, R., Roland, M., & Sutton, M. (2014). Long-Term Effect of Hospital Pay for Performance on Mortality in England. New England Journal of Medicine, 371(6), 540-548. DOI: 10.1056/NEJMoa1400962. Publication link: 286cac0e-a3b2-425a-947e-9cb97d1dbd52
  • Mcdonald, R., Boaden, R., Roland, M., Kristensen, S., Meacock, R., Lau, Y., ... Sutton, M. (2014). Evaluation of the advancing quality pay for performance programme in the NHS North West. Health Services and Delivery Research, n/a. . Publication link: 51f650ca-8a30-4b16-9fa7-4d16febaa4de
  • Mcdonald, R. (2014). Financial Incentives and the Governance of Performance. In International Handbook of Healthcare Policy, Palgrave. Palgrave. . Publication link: 4979ef6d-a448-418f-94a7-4dd65af94592
  • Mcdonald, R. (2014). Paying for Performance in healthcare organisations. International Journal of Health Policy and Management, 2, 6-7. . Publication link: c96441b6-1774-4a83-b26a-67973a99a2d0


  • Kristensen, S. R., McDonald, R., & Sutton, M. (2013). Should pay-for-performance schemes be locally designed?: Evidence from the Commissioning for Quality and Innovation (CQUIN) Framework. Journal of Health Services Research and Policy, 18(2 Suppl), 38-49. DOI: 10.1177/1355819613490148. Publication link: bc7b22fd-b0bf-4ea3-91f8-abfc542e327c | PubMed:24121835
  • Kristensen, S. R., McDonald, R., & Sutton, M. (2013). Should pay-for-performance schemes be locally-designed? Evidence from the Commissioning for Quality and innovation (CQUIN) Framework in England.Journal of Health Services Research & Policy, (Oct; 18 (2 Suppl)), 38-49. . Publication link: 60fa9af4-d9c7-4b92-94d4-f23c6338a5ca


  • Cheraghi-Sohi, S., Mcdonald, R., Sanders, C., & Harrison, S. (2012). The experience of contractual change in UK general practice: A qualitative study of salaried GPs.British Journal of General Practice, 62, 282-287. . Publication link: 14bc0f3d-6603-4578-81cf-0454737f6e57
  • Cheraghi-Sohi, S., McDonald, R., Harrison, S., & Sanders, C. (2012). Experience of contractual change in UK general practice: A qualitative study of salaried GPs. British Journal of General Practice, 62(597), e282-e287. DOI: 10.3399/bjgp12X636128. Publication link: 7b7a93a3-53c8-4760-a908-86a881af06e6
  • Sutton, M., Nikolova, S., Boaden, R., Lester, H., McDonald, R., & Roland, M. (2012). Association between Mortality and Hospital Pay for Performance in England.New England Journal of Medicine, 367, 1821-1828. . Publication link: 7a70b4c8-7dd4-496b-b730-870e6c790680
  • Martin, G., Weaver, S., Currie, G., Finn, R., & Mcdonald, R. (2012). Innovation sustainability in challenging healthcare contexts: embedding clinically led change in routine practice. Health Services Management Research, 25(4), 190-199. . Publication link: 9014a08d-4d5a-4418-a285-7c6c88b29e6c
  • McDonald, R. (2012). Restratification revisited: The changing landscape of primary medical care in England and California. Current Sociology, 60(4), 441-455. . Publication link: fab1c741-13ea-45da-a26e-f8ddb85a3acb
  • Morriss, R., Kai, J., Atha, C., Avery, A., Bayes, S., Franklin, M., ... Yang, M. (2012). Persistent frequent attenders in primary care: Costs, reasons for attendance, organisation of care and potential for cognitive behavioural therapeutic intervention. BMC family practice, 13, [39]. DOI: 10.1186/1471-2296-13-39. Publication link: ece930a8-78c8-46c5-a3b8-0b0c4c547fe1


  • Tickle, M., McDonald, R., Franklin, J., Aggarwal, V. R., Milsom, K., & Reeves, D. (2011). Paying for the wrong kind of performance? Financial incentives and behaviour changes in National Health Service dentistry 1992-2009. Community dentistry and oral epidemiology, 39(5), 465-473. DOI: 10.1111/j.1600-0528.2011.00622.x. Publication link: 239a724f-4b8a-48bc-a288-f63d7586e17f | PubMed:21668463
  • Tickle, M., McDonald, R., Franklin, J., Aggarwal, V., Milsom, K. M., & Reeves, D. (2011). Paying for the wrong kind of performance? Financial incentives and behaviour changes in NHS dentistry 1992-2009.Community Dentistry and Oral Epidemiology (Online), 39(5), 465-473. . Publication link: cc4a18ee-c062-49e6-8d2d-56a41ad952e2
  • Martin, G. P., Currie, G., Finn, R., & McDonald, R. (2011). The medium-term sustainability of organisational innovations in the national health service. Implementation Science, 6(1), [19]. . Publication link: b213c0a4-44a7-44e7-9ce9-7d31d7a761cb


  • Morriss, R., Marttunnen, S., Garland, A., Nixon, N., McDonald, R., Sweeney, T., ... Yang, M. (2010). Randomised controlled trial of the clinical and cost effectiveness of a specialist team for managing refractory unipolar depressive disorder. BMC Psychiatry, 10, [100]. . Publication link: 3d91a319-64ce-4be5-bc55-017ff0fee716


  • Grant, S., Huby, G., Watkins, F., Checkland, K., McDonald, R., Davies, H., & Guthrie, B. (2009). The impact of pay-for-performance on professional boundaries in UK general practice: An ethnographic study. Sociology of Health and Illness, 31(2), 229-245. DOI: 10.1111/j.1467-9566.2008.01129.x. Publication link: 0c42a305-8457-4cd3-8605-620ebc202dee
  • McDonald, R., Campbell, S., & Lester, H. (2009). 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, 68(7), 1206-1212. DOI: 10.1016/j.socscimed.2009.01.039. Publication link: 56a03837-f370-472e-9d5c-6a7cc4428751
  • McDonald, R., White, J., & Marmor, T. R. (2009). 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, 34(5), 747-776. DOI: 10.1215/03616878-2009-024. Publication link: 5ac6a15c-1c94-42f8-a1a6-a55fe19453ec
  • Beaver, K., Hollingworth, W., McDonald, R., Dunn, G., Tysver-Robinson, D., Thomson, L., ... Luker, K. (2009). Economic evaluation of a randomized clinical trial of hospital versus telephone follow-up after treatment for breast cancer. British Journal of Surgery, 96(12), 1406-1415. DOI: 10.1002/bjs.6753. Publication link: 62a6c3c5-f5f4-411e-9f36-cfcdea30671c
  • McDonald, R. (2009). Market reforms in English primary medical care: Medicine, habitus and the public sphere. Sociology of Health and Illness, 31(5), 659-672. . Publication link: 690def51-852c-430b-9f4c-2718317dad23


  • Fotaki, M., Roland, M., Boyd, A., McDonald, R., Scheaff, R., & Smith, L. (2008). What benefits will choice bring to patients? Literature review and assessment of implications. Journal of Health Services Research and Policy, 13(3), 178-184. DOI: 10.1258/jhsrp.2008.007163. Publication link: 3f5af68e-1009-4a58-9d18-fe218b6dc91c
  • Campbell, S. M., McDonald, R., & Lester, H. (2008). The experience of pay for performance in english family practice: A qualitative study. Annals of Family Medicine, 6(3), 228-234. DOI: 10.1370/afm.844. Publication link: 0e1ca232-2ed9-4b3d-9844-b94e1087dadd


  • Cheraghi-Sohi, S., Bower, P., Mead, N., McDonald, R., Whalley, D., & Roland, M. (2007). Making sense of patient priorities: Applying discrete choice methods in primary care using 'think aloud' technique. Family Practice, 24(3), 276-282. DOI: 10.1093/fampra/cmm007. Publication link: 573401ce-76fd-4a6c-b75e-7c277f296658
  • Mcdonald, R., & Waring, J. J. (2007). Safety in the operating theatre: what underpins attitudes and behaviour?Health Care Risk Report, 13. . Publication link: f8cddb75-62ba-49a9-8344-fdefbe08e19d


  • Waring, J., McDonald, R., & Harrison, S. (2006). Safety and complexity: Inter-departmental relationships as a threat to patient safety in the operating department. Journal of Health, Organisation and Management, 20(3), 227-242. DOI: 10.1108/14777260610662753. Publication link: e251f2b5-c4ae-42f6-811f-f7af3f1754c6
  • Mcdonald, R., & McDonald, E. R. (2006). Creating a patient-led NHS: empowering 'consumers' or shrinking the State? In Social Policy Review. (Vol. 18). Publication link: f6122477-4eba-491a-a0ba-6fd0530df6ec
  • Mcdonald, R., & Waring, J. (2006). Safety in the operating theatre: the impact of interdepartmental delays.Health Care Risk Report. . Publication link: fef262d3-eaa3-42bc-91ae-2f3219c1d2f6


  • Mcdonald, R. (2005). 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. . Publication link: feba6083-54bd-440a-9d1c-2c706c71e38c
  • McDonald, R., Waring, J., Harrison, S., Walshe, K., & Boaden, R. (2005). Rules and guidelines in clinical practice: A qualitative study in operating theatres of doctors' and nurses' views. Quality and Safety in Health Care, 14(4), 290-294. DOI: 10.1136/qshc.2005.013912. Publication link: 483fa745-a075-4874-926a-c943648e80a8


  • Mcdonald, R., McDonald, E. R., Chapman, S., & Bottomley, J. (2004). Disease Management. In Pharmacoeconomics Walley , T., Haycox, A. and Boland, A. (eds).. Publication link: 1543f09d-0390-4483-9d3d-cf1f6da6c66a
  • Mcdonald, R., & McDonald, E. R. (2004). The Economics of Health Care Systems. In Pharmacoeconomics Walley, T., Haycox, A. and Boland, A. (eds).. Publication link: 486be8ad-1a7b-47e1-8e9d-7ddd89a32d5f
  • Mair, F. S., Lloyd-Williams, F., Shiels, C., Mcdonald, R., Beaton, S., Goldstein, P., ... Haycox, A. (2004). The economic costs of heart failure: a community perspective. European Heart Journal, 25. . Publication link: 4176547d-c20e-4d15-a2b3-8480ad134c4b
  • McDonald, R., & Harrison, S. (2004). The micropolitics of clinical guidelines: An empirical study. Policy & Politics, 32(2), 223-239. . Publication link: aa0c0981-37da-46db-989c-0a2bf004c759
  • Mcdonald, R., & McDonald, E. R. (2004). Empowerment and Modernisation: Managing Change in an English Primary Care Trust. In Unmasking Health Management (Harding and Learmonth eds.).. Publication link: 8e7b7fc6-e51a-40f4-a456-f087c5206ddd
  • Mcdonald, R., & McDonald, E. R. (2004). The policy context. In Pharmacoeconomics Walley, T., Haycox, A. and Boland, A. (eds).. Publication link: d243be3b-3e25-4569-8c2e-c0461608613f


  • Harrison, S. R., & Mcdonald, R. (2003). Science, consumerism and bureaucracy: the new legitimations of medical professionalism. International Journal of Public Sector Management. . Publication link: cecd2fd4-850a-4657-b77a-6246586b9558


  • McDonald, R. (2002). Street-level bureaucrats? Heart disease, health economics and policy in a primary care group. Health and Social Care in the Community, 10(3), 129-135. . Publication link: f9c5673d-030f-4fe8-b0e3-82a52d5e69fc
  • Mcdonald, R., & McDonald, E. R. (2002). Programme Budgeting and Marginal Analysis - a pragmatic approach to economic evaluation. In Getting health economics into practice.. Publication link: bae1638e-ccab-43f4-8c57-3df95de6ee7c
  • Mcdonald, R., & McDonald, E. R. (2002). Using economic evaluation at grassroots level. In Getting health economics into practice D.Kernick ed... Publication link: 4d9c66f2-434c-40b5-ae8e-77e1de204e55
  • Mcdonald, R., & McDonald, E. R. (2002). Using health economics to facilitate decision-making: Economic Evaluation - the basics. In Getting health economics into practice D. Kernick (ed).. Publication link: 10671ddf-4109-42cd-bb8d-fdd003654987
  • Mcdonald, R., & McDonald, E. R. (2002). Using Health Economics in Health Services, Rationing Rationally? (Open University Press). Open University Press.. Publication link: 7d7dd328-da67-4f89-8e42-ec0d3c8f623e


  • McDonald, R., Burrill, P., & Walley, T. (2001). Managing the entry of new medicines in the National Health Service: Health authority experiences and prospects for primary care groups and trusts. Health and Social Care in the Community, 9(6), 341-347. . Publication link: 967c50a8-2cb1-4dcb-9914-296b7d78491e
  • McDonald, R., Haycox, A., & Walley, T. (2001). The impact of health economics on healthcare delivery: The health economists' perspective. Pharmacoeconomics, 19(8), 803-809. . Publication link: 3135e8b9-9d21-486e-b7f9-510ef787aa7b
  • Bowens, A., Robinson, M., Mcdonald, R., & Ayres, P. (2001). The processes and costs of local guideline development: Experiences from the Path.Finder NHS consortium. British Journal of Clinical Governance, 6(3), 159-165. DOI: 10.1108/14664100110400688. Publication link: b1d8c185-1749-4647-8abc-9087247d5fb3
  • McDonald, R., & Baughan, S. (2001). Rationality and reality: Attitudes of health economists working at local level in the UK National Health Service. Critical Public Health, 11(4), 329-330. . Publication link: e755fef0-1837-44f4-9fb8-059725dd80cd



  • McDonald, R. (1999). Health economics has lost its way - Or why David Kernick is (partly) right [1]. Health Economics , 8(2), 175-176. . Publication link: 7ab81f97-d57b-4460-9c64-cb2be586eb41