Understanding the supply chain integration - supply chain sustainability relationship: a study of the pharmaceutical industry in the UK and Ghana

Purpose- The purpose of this thesis is to identify, propose, and test a framework that provides insights into the internal and external factors which enhance or hinder supply chain sustainability through supply chain integration (SCI).

Design/methodology/approach- The conceptual framework was noted/developed after the review on the main constructs SCI, supply chain sustainability, and external uncertainty (EU). From the conceptual framework, it was noted that this thesis can explore the direct impact of SCI on supply chain sustainability, and also how the aforementioned impact is moderated by EU. Based on this assertion first, empirical data were obtained through interviews with managers in 18 leading pharmaceutical companies and national pharmaceutical institutions and regulators in Ghana and the UK. Observations and secondary data were also used. The conceptual framework was then reformed to include the additional moderators' product innovation, resource, and leadership style, and the mediator patient satisfaction. Second, survey data were collected from 231 pharmaceutical companies in both the UK and Ghana which were used to test the reformed proposed framework.

Findings- All three dimensions of supply chain sustainability can be positively impacted through SCI. The SCI-supply chain sustainability relationship is moderated by different levels of EU, the amount of resources available to firms, the type of leadership style adopted by firms, and the rate at which a firm engages in product innovation. The extent to which a firm satisfies its customers, through its products and services mediates the SCI-supply chain sustainability relationship. Hence, the proposed framework shows that the internal and external contextual factors (IECF's): EU, patient satisfaction, leadership style, product innovation, and resource constraint, must be collectively considered as they enhance or hinder supply chain sustainability through SCI.

Practical implications- To achieve supply chain sustainability through SCI, practitioners should first operationalise and strengthen the collaboration of activities and flow of adequate and timely information among internal functions before investing in external integration. This thesis provides practitioners with guidance on how to achieve supply chain sustainability whilst increasing patient satisfaction and managing the effect different levels of EU, autocratic and non-autocratic leadership style, high and low product innovation, and resource constraint and availability have on supply chain activities.

Originality/value- This thesis, to the best of the author's knowledge, is the first to propose a framework that adds to the literature on how SCI can be used to simultaneously impact the three dimensions of supply chain sustainability given different EU's. The proposed framework considers the IECF's: patient satisfaction, leadership style, product innovation, and resource constraint as factors that need to be collectively considered to achieve supply chain sustainability.