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This paper discusses how we have improved patient handover by implementing an electronic system for weekend handover. We discuss the process of changing handover methods and the results of an audit comparing our old paper based book versus our new 'e-handover' system. [ABSTRACT FROM AUTHOR]

This paper considers the origins and traces the history of the Social Fund, an ideologically-motivated social policy departure of the Thatcher era. It identifies the controversy, in research communities amongst others, which surrounded the establishment of the Fund, and considers the evidence of recurring difficulties in its practical operation over a thirty-year period. It then turns to the Coalition administration in Westminster’s decision to divest itself of responsibility for key parts of the Fund, devolving such obligations to local authorities in England, the Parliament in Scotland and the Assembly in Wales. The paper sets out a comparison of the approaches being developed to discharge the Fund’s prior responsibilities in the three nations. It concludes that the essential policy thrust lies in a determination to roll back central state obligations in poverty relief and income maintenance which had hitherto been accepted by all post-war administrations. [ABSTRACT FROM PUBLISHER]

Despite the term 'never events' these events continue to happen in the NHS. This paper considers the findings from a review of the causes of nine surgical 'never events'; looking at the learning from the investigations to provide 'a window on the system' and considering the multiple issues that need to be addressed to reduce future risk. The paper discusses why many of the causes described in investigation reports cannot be adequately addressed by the action plans that target each individual cause - things are never that simple - instead the causes should be seen as a reflection of the current state of safety within an organization, showing the underlying cultural and systems issues that need to be addressed at a wider level than that of the incident itself. [ABSTRACT FROM AUTHOR]

Empirical evidence suggests that planning policies significantly impact on investment property market performance in the UK. It is less clear, however, how information about the planning policy environment feeds into investment decision-making. This paper seeks to explore this issue. It reports on interviews with the property investment community and focuses on the decision to invest in the retail sector. The paper uses a six-stage model of the investment decision-making process as a framework for analysing the way in which concerns about policy impact on behaviour. The results suggest that an understanding of the policy environment and the development of a relationship with local planning authorities are most important in the post-acquisition asset management stage of the investment process. The research also reveals variations in access to policy intelligence and that approaches to analysis of the likely effects of planning regimes vary with fund type and strategy. [ABSTRACT FROM PUBLISHER]

The concept of a knowledge-based approach to policy making (also referred to as 'evidence-based policy making' or 'science meets policy') has been around for 10 years, and is widely 'signed up to' by Governments. This paper examines the theory and the practice at national government (using the UK as a case study) and European levels, looking at how the knowledge-based approach has been applied in waste and resources management. There is general agreement that a knowledge(or evidence-) based approach to policy making is a 'good thing'; however putting the concept into practice has proven challenging and is still evolving. The linkages between researchers and policy makers need to be further strengthened, as does the 'demand' for evidence from policy; requiring policy specialists to articulate their requirements for evidence sufficiently well in advance, and to do so routinely, is still an area of weakness. Using a model developed by the UK's Department for Environment, Food and Rural Affairs (Defra), we examine in detail some of the implications of changing the question from 'is this good research on waste and resources issues?' to 'is this good evidence for waste and resources policy?'. The paper also provides recommendations for further work required to achieve this at a European level, and for priority areas where international co-ordination of waste and resources research could add most value to policy. [ABSTRACT FROM AUTHOR]

This chapter explores employer perspectives on the extension of behavioural conditionality to working social security claimants ('in-work conditionality'). As policymakers across Europe and other developed nations have pursued increasingly interventionist approaches to activating the unemployed through conditional welfare policies, the UK has gone a significant and 'unprecedented' step further by requiring those in receipt of in-work benefits to demonstrate their efforts to increase their working hours and/or pay. As the actors ultimately in control over the jobs people can access and progress in, understanding employer perspectives on this new policy development is critical, which, however, has so far been overlooked by policymakers and researchers. We address this omission through presenting original analysis of 84 semi-structured interviews conducted with a diverse group of employers. We find that while the UK's Work First approach to activation has seemingly encountered little resistance from employers to date, this new Work First, Work More approach may be a step too far. We contribute theoretically by identifying a potential role for employers as latent path disruptors in policy development, and challenge the commonly-held assumption that employers are typically supportive of extensions of behavioural conditionality to social security claimants. [ABSTRACT FROM AUTHOR]

While trust is seen as central to most social relations, most writers, including sociologists of science, assume that modern trust relations – especially those in regulatory relationships – tend towards the impersonal. Drawing on ethnographic material from one kind of scientific oversight body – research ethics committees based in the UK NHS – this paper argues that interpersonal trust is crucial to regulatory decision-making and intimately bound up with the way in which these oversight bodies work, and that as such they build on, rather than challenge, the trust-based nature of the scientific community. [ABSTRACT FROM PUBLISHER]

As subjects of the parental right to choose (DES, 1988), parents are called upon to fulfil certain duties and responsibilities when choosing a secondary school for their child, with the expectation that they might navigate the school system ‘successfully’ and become ‘better informed consumers’ (DCSF, 2008). To comply with these rules of citizenship parents are encouraged to make use of a variety of information on schools as part of a realistic and informed choice, one that is consummate with their role as consumer-citizens. Such ‘cognitive mapping’ is evident in school brochures and websites where choice is assembled on the basis of visual iconography and narrative terrains. This leads to a consideration of how choice is visually mediated and communicated through the circulation of symbols and the structure of narratives. To explain these phenomena, I analyse and compare the ways in which two all-girls faith secondary schools attempt to (further) define themselves, culturally, historically and pedagogically, in a crowded field of choice. I conclude the paper with a discussion of the benefits and insights generated through a visually orientated approach to the study of school choice. [ABSTRACT FROM PUBLISHER]

Recent years have seen an expansion in the work on the attitudes, beliefs and preferences of those middle-class groups that have accompanied the return of capital to many North American and western European city centres and their surrounding urban suburbs. Yet despite this, it is argued that there is little research linking gentrification to wider processes of social transformation, particularly debates over housing market decision-making, the balancing of work and life, and the gender division of labour within the household. It is to examining the interaction of these aspects of everyday life in a gentrifying area that this paper turns, using the example of Chorlton, a southern urban suburb of Manchester. [ABSTRACT FROM AUTHOR]

This paper argues that it is time for public understanding of science to develop a critical inventory of the forms, formats and methods of public participation and their respective implications and ambiguities. It highlights the need for analysing not only the limitations and deficiencies of participatory arrangements but also their constructive dimension, in particular the construction of the subject of participation. Looking into participatory governance arrangements in the issue area of genetic testing in Germany and the UK the paper presents a typology of formats according to the way the respective public is constructed and identifies four major constructions of publics: the general public, the pure public, the affected public and the partisan public. Each of these enables certain speaking positions while foreclosing others. The study shows that the main purposes of participatory arrangements in this issue area are knowledge production and education rather than political deliberation and decision-making. [ABSTRACT FROM AUTHOR]

This paper analyses a corpus of articles on GM crops and food which appeared in six UK newspapers in the first three months of 2004, the year following the GM Nation? debate (2003). Using the methods of critical discourse analysis we focus on how specific and pervasive representations of the major stakeholders in the national debate on GM--the British public, the British government, the science of GM, and biotechnology companies--served significant rhetorical functions in the controversy. Of particular significance was the pervasive representation of the British public as uniformly opposed to GM crops and food which served rhetorically to position the British government as undemocratic and as being beholden to powerful political and economic interests. Of significance also in our analysis, is how the science of GM farming itself became a highly contested arena. In short, our analysis demonstrates how the GM debate was represented in the newsprint media as a "battleground" of competing interests. We conclude by considering the possible implications of this representation given the increasing emphasis placed on the importance of deliberative and inclusive forms of science policy decision-making. [ABSTRACT FROM AUTHOR]

The use of area-based deprivation indices is now a firmly established means of assessing which areas ought to be the focus of government policy, with separate indices of deprivation established for each constituent part of the UK. In England, the Index of Multiple Deprivation 2004 has been widely used to support decision-making for key urban policies and in more local assessments of deprivation. Implicit in the development and use of these indicators is the notion that area matters and that it can be an important influence on a whole range of different activities. However, there is also a sense in which contemporary measures of deprivation are spatially short-sighted since they are not able to account formally for the spatial context of individual locations. This paper therefore offers an alternative approach to the measurement of local conditions by combining spatial statistical approaches with a much-used deprivation index. [ABSTRACT FROM AUTHOR]

Despite recent UK Government commitments' to encourage public participation in environmental decision making, those exercises conducted to date have been largely confined to 'traditional' modes of participation such as the dissemination of information and in encouraging feedback on proposals through, for example, questionnaires or surveys. It is the premise of this paper that participative approaches that use IT-based methods, based on combined geographical information systems (GIS) and multi-criteria evaluation techniques that could involve the public in the decision-making process, have the potential to build consensus and reduce disputes and conflicts such as those arising from the siting of different types of waste facilities. The potential of these techniques are documented through a review of the existing literature in order to highlight the opportunities and challenges facing decision makers in increasing the involvement of the public at different stages of the waste facility management process. It is concluded that there are important lessons to be learned by researchers, consultants, managers and decision makers if barriers hindering the wider use of such techniques are to be overcome. [ABSTRACT FROM AUTHOR]

In the United Kingdom, individuals requiring inpatient care for mental health purposes can be admitted to hospital with their consent as informal patients, or formally through procedure(s) prescribed by law. There are, however, instances where individuals otherwise referred to as informal patients are on admission without their consent or in circumstances that amount to deprivation of their liberty as defined by the United Kingdom Supreme Court and without recourse to lawful procedures by their clinical team as stipulated by the European Convention on Human Rights. Such instances might be without the awareness of the individuals or their clinical teams or the clinical teams might be unclear as to which statute applies to patient care. This paper has been written to help clinicians define the legal status of patients at the point of admission, during their stay on the inpatient unit and the statute(s) that apply to different in-patient situations. [ABSTRACT FROM AUTHOR]

The aim of the paper is to assess open disclosure in Ireland following clinical adverse events in healthcare. A number of areas were examined from the patient's and healthcare team's perspectives. The barriers/constraints to open disclosure, the extent of policies, procedures or guidelines that are available for staff to consult with, inclusive of how they are implemented, harvested valuable insight. The supports available for healthcare staff following an adverse event and patients' expectations after such an event are also encompassed to include the relationship open disclosure has on concerns regarding litigious intent. The questionnaire was disseminated to a multidisciplinary healthcare group. The questions were numbered 1-9, with a mixture of open and closed questions. A five-point Likert format was used with three questions in attitudinal/ opinion statements, regarding supports available for staff following an adverse event. A Statistical Package for Social Sciences was used to assist with the interpretation of data. This study was directed at the multidisciplinary healthcare team and senior management within the Health Service Executive (HSE) and Voluntary sectors. The oldest hospitals in Ireland are voluntary public hospitals some of them originating from the 18th century, having been established by charities and religious orders. Voluntary hospitals are partly funded by the HSE, specifically having their own governance structure. There was a response rate of 67% (n ¼ 192). A total 56.5% of respondents stated their organization did not have an open disclosure policy, procedure or guideline in place however, 16% of the attendees stated there was one in place. A total of 54.4% (104) acknowledged barriers/concerns surrounding open disclosure, with fear of litigious intent noted by 24% of respondents. A total of 52.3% (101) identified support availability to staff following an adverse event, 38.9% (10) felt there was little/no follow-up support, with 11.1.% (2) stating they were made to feel guilty, and associated it with being "on trial". Findings demonstrate an unstructured approach to disclosure of adverse events in Ireland, with fear of litigation a major concern for healthcare professionals. Error awareness among the general public, the introduction of protective legislation and implementation of a national standard on open disclosure in conjunction with practical training and education will all positively and practically influence open disclosure of adverse events in Ireland. [ABSTRACT FROM AUTHOR]

Healthcare is a highly regulated environment. This has driven what could be characterized as a papersafe approach, whereby organizations are required to demonstrate to a multiplicity of regulators, inspectorates and accrediting bodies that they are paper safe. However, for many organizations, this has not produced a system which is actually patient safe; rather it has in practice operated as a parallel system that does not reflect the true state of safety. This project looks at a quality improvement and patient safety programme and critically asks the question of whether it is flawed because of failure to address issues surrounding Doctors and cultural change. We used Johnson & Schole's cultural web framework to explore the attitudes of junior doctors towards a patient safety and quality improvement programme. Data collection was through the use of focus groups backed up with quantitative data from a web based questionnaire survey. It has been demonstrated that Doctors represent a dominant sub-culture within the NHS and their beliefs, attitudes and value are often at odds or unrecognized by senior healthcare managers. Unless the cultural differences are adequately addressed then transformational change projects such as 'Best and Safest Care' are unlikely to succeed. A better understanding of the organizational context allows for more appropriate change interventions to be developed. [ABSTRACT FROM AUTHOR]

This paper discusses the early implementation of the Mental Capacity Act 2005 in health and social care in England. The author examines the research evidence to date, particularly monitoring data from the Department of Health, in order to review the progress made in implementation. The extent to which the Act is achieving its overall aim of facilitating decision-making by people lacking capacity is discussed, focusing on people with dementia. The author concludes that the initial implementation of the Act (and the related Deprivation of Liberty Safeguards) has had only limited effectiveness in facilitating decision-making by people lacking capacity, promoting their best interests and protecting their liberty. Future implementation needs to ensure that the rights of people lacking capacity, particularly people with dementia, are taken more seriously in health and social care and are better protected. [ABSTRACT FROM PUBLISHER]

This paper discusses the role of gender dynamics in the experiences of credit and debt in low income families in the UK, drawing on a qualitative longitudinal study funded by the Joseph Rowntree Foundation. It builds on earlier work on: the household economy; the gendered distribution of income specifically within low income families in receipt of benefits; and the extent of credit and debt in the UK currently. Following critiques of traditional sociological and social psychological analyses of the household economy, it takes a more discursive approach, which enables identification of gender dynamics as one of the mechanisms through which decision-making in relation to this area of practice is accomplished. [ABSTRACT FROM AUTHOR]

Using discourse analysis, this study examines the representation of prescription medicines in the UK newsprint media and, specifically, how the meaning and function of medicines are constructed. At the same time, it examines the extent to which the newsprint media represents a resource for health information, and considers how it may encourage or challenge faith in modern medicine and medical authority. As such, it extends analysis around concepts such as the informed patient and examines the representation of patients and doctors and the extent to which patient-doctor identities promoted in the newsprint media reflect a shift away from paternalism to negotiated encounters. Findings show the media constructs a discrete, contradictory, and frequently oversimplified set of characterizations about medicine. Moreover, it discursively constructs realities that justify and sustain medial dominance. Ideological paradigms in discourse assign patients as passive and disempowered while simultaneously privileging "expert" knowledge. This constructs a reality that marginalizes patients' participation in decision-making. [ABSTRACT FROM AUTHOR]

Particular decisions about nuclear weapons are made by individuals on the basis of a set of assumptions. These assumptions are rarely revealed in official publications which explain or support those decisions. But wit bout knowing what these assumptions are it is impossible to test the validity of the decision-makers' arguments, or to know what kind of debate with them is likely to be fruitful or effective. This paper describes the assumptions made by a small group of influential British nuclear weapons decision-makers. The research on which it was based was carried out in four stages. First each decision-maker was interviewed at length. Next, the statements made in the interview were assembled into a cognitive map in order to find those assumptions which were not articulated or which were hidden in chains of reasoning, the use of analogies or the structure of the whole system of thought. Next the maps were compared to find the commonalities shared by all decision-makers and to isolate the critical assumptions. Finally, the identification of these assumptions as critical was tested by interviews with knowledgeable critics of nuclear defence policy. The most important assumptions are as follows. Nuclear weapons are not qualitatively different from conventional weapons. Decision-makers in all the nuclear nations are rational and in control of the weapons. Because they are rational it is assumed that the system of deterrence as a whole works rationally and is stable. Indeed, it is so stable that any change is dangerous and it should remain unaffected, in particular, by any reduction in the perceived threat. The paper does not discuss the validity of these assumptions, but considers their implications for change. [ABSTRACT FROM AUTHOR]

This article explores what role lawyers can play in contributing to learning from those incidents that result in a litigation claim. Specifically the authors consider what role the NHSLA has played and should be playing in improving patient safety. [ABSTRACT FROM AUTHOR]

Erasmus student mobility is the most recognised element of Erasmus+ and clearly popular with an increase in student uptake from 3,000 in 1987 to over 300,000 today. Recent studies show that students from lower socio-economic backgrounds are less likely to study abroad than better-off students, thereby benefitting less from improved employment opportunities and language competences often associated with mobility. Unequal uptake is generally explained by students' choices: disadvantaged students hold lower social capital which leads them to decide against mobility. However, not much is known about the importance of students' selection into universities and fields of study. Using multilevel logistic regressions, this article examines whether social segregation in universities and field of study matters beyond individual characteristics for explaining unequal Erasmus mobility uptake. The study exploits rich population data of around 200,000 UK first-degree graduates of the year 2014/2015 deriving from the Higher Education Statistics Agency (HESA) data. Results show that while student characteristics like ability and social status are important predictors of Erasmus mobility, they only explain one part of unequal uptake. In addition, social segregation of universities and fields of study contribute to the unequal mobility pattern found. Student mobility is less common for students enrolled in fields of study and universities attended by disadvantaged students conditional on student characteristics. This implies that student mobility could become more inclusive if grant funding and incentives targeted universities attended by a high proportion of disadvantaged students. [ABSTRACT FROM AUTHOR]

Recent technological and market changes in the television industry appear to have transformed the corporate configurations which conduce to economic success in the production industry. As a result, many leading independent television production companies in the United Kingdom and elsewhere across Europe have become prime targets for corporate activity and many have been subject to takeover, often by the US media groups. Does this matter? Does the concept of 'national' television content still have any relevance in the digital era? Drawing on a multiple-case-study-based analysis of several UK-based television production companies over recent years, this article examines how corporate takeovers in the production sector may affect creative decision-making and impact on the nature and quality of television content. Against a background of increased investment interest from multinationals in indigenous players in the United Kingdom and across Europe, the analysis presented makes a timely and policy-relevant contribution to knowledge. [ABSTRACT FROM AUTHOR]

Gender differences in the accumulation of pension savings are well documented. Work in this field has concluded that while differing lifetime work profiles (and family history) explained much of the difference, other factors such as pension knowledge and confidence in decision-making, may also be significant. This research, commissioned by the Fawcett Society and funded by Scottish Widows, explores some of these factors through the use of 30 semi-structured interviews and a focus group with women (aged 24–39) about their attitudes and motivations towards pension saving. It concentrates on discussions around pension knowledge, advice and decision-making, and identifies challenges in relation to women’s pension knowledge and the use of male ‘role models’ in making decisions. The article then explores potential policy mechanisms to enhance women’s pension saving for retirement, including the manner in which information and advice is provided and strategies to improve confidence in pension decision-making. [ABSTRACT FROM AUTHOR]

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This article provides an empirical assessment of the relationship between unionization and the adoption of equal opportunities (EO) policies and practices in British workplaces, using data from the 2004 Workplace Employment Relations Survey. The results demonstrate an association between union recognition and the adoption of a range of EO practices. However, this association largely only holds where unions are able to influence EO decision-making via negotiation or consultation. There is little evidence that the equality practices adopted in unionized workplaces where negotiation and consultation does not occur are any different from those adopted in non-unionized workplaces. [ABSTRACT FROM AUTHOR]

Drawing on interviews, this article investigates change and continuity induced by greater diversity among pension trustees in terms of trustees’ involvement in boardroom activities in the UK. Utilizing Bourdieu’s theory of habitus, the authors demonstrate the agency of trustees, and how greater diversity among trustees changes the boardroom decision-making process. However, the authors also reveal forms of continuity by reproduction of educational, corporate and social values within a boardroom context. The findings challenge the assumption that greater diversity may radically transform organizations. [ABSTRACT FROM PUBLISHER]

Medical authorities have historically either been silent or circumspect about the role of candour in clinical relationships. Hippocrates told doctors to abstain from doing harm, not entertaining the possibility that they might be negligent, while in 1847 the American Medical Association declared that doctors have: ‘a sacred duty … to avoid all things which have a tendency to discourage the patient and depress his spirits’. Being candid about an injurious mistake in the course of treatment would no doubt discourage even the worldliest of 19th century patients. However, in recent years, the focus has shifted: doctors in 21st century have an obligation to disclose even the most depressing of mistakes. This modern ‘duty of candour’ is found in a mish-mash of moral principles, regulatory guidelines and contractual agreements but following the Francis Report it will be buttressed by statute. [ABSTRACT FROM AUTHOR]

This longitudinal study tracks US and UK participants’ shifts in their motivations and forms of engagement with technology and information as they transition between four educational stages. The quantitative and qualitative methods, including ethnographic methods that devote individual attention to the subjects, yield a very rich data set enabling multiple methods of analysis. Instead of reporting general information-seeking habits and technology use, this study explores how the subjects get their information based on the context and situation of their needs during an extended period of time, identifying if and how their behaviors change. [ABSTRACT FROM PUBLISHER]

The article presents several case studies related to maternity claims. It states that in one of the cases a sonographer wasn't able to identify fetal bladder and later the baby was born with bladder exstrophy. It mentions that in another case a woman claimed disabling fecal incontinence due to a third-degree tear during delivery. It highlights that in another case a woman claimed that she was not advised properly by a hospital about uterine rupture due to labor induction.

"Failure to rescue" is the inadequate or delayed response to clinical deterioration in hospitalized patients. Rapid response systems are a set of hospital-wide interventions that attempt to reduce failure to rescue by improving patient monitoring on general wards (the afferent component) and the reliability of the response to deterioration by a dedicated Critical Care Outreach Team, Rapid Response Team or Medical Emergency Team (the efferent component). The reliability of such systems depends on the faultless functioning of a "chain of survival" consisting of: (1) high-quality recording of vital signs; (2) the education and mind-set of staff at the bedside to recognize pathological patterns; (3) the reporting of abnormality to the efferent team; (4) a timely and appropriate response by the latter. Repeated feedback loops are crucial for an effective functioning of the chain. [ABSTRACT FROM AUTHOR]

Consultants have considerable freedom and power to improve the quality and safety of clinical care within their services. Whatever happens to healthcare in the future, patients acutely unwell with critical illnesses will be taken to hospital. The priority work of acute hospitals will always be to treat these patients with high-quality effective clinical care to swiftly and safely restore their health so that they can resume living outside hospital. For a small proportion of patients the work is to anticipate and provide for a calm end of life. Integral to this work is also the training of the next generation of healthcare professionals. Over the last five years I have been working to improve quality and safety at the point of care in acute general medicine. I discuss some of the successes and hope to open the reader's eyes to the potential for improvement in acute care processes, if clinicians and managers work together to optimize working at the point of care. [ABSTRACT FROM AUTHOR]

Arguments for public involvement in science and technology are often based on ideas of developing a more capable public and the assumed effects this may have for science. However, such a relationship is yet to be sufficiently explored and recent work indicates that a more involved public may have counterintuitive effects. Using nationally representative survey data for the UK and Northern Ireland, the effects of the public's own beliefs about involvement are explored. Developing the concept of "belief in public efficacy," findings suggest those who believe that the public might be able to affect the course of decision making have less approving attitudes towards future applications of genetic science; however, an individual's political efficacy does not significantly influence these attitudes. Furthermore, political efficacy and belief in public efficacy have some distinct and opposing relationships with the principles of governance people prefer. Overall, findings provide support for suggestions that it is simplistic to consider increasing public involvement as a way of increasing the approval of risky new technologies. [ABSTRACT FROM AUTHOR]

The question is posed: why were two pesticides, Aldrin and Dieldrin, judged to be carcinogenic in the US but not in Britain when the same evidence was available to the public authorities in both countries? No single cause is identified; rather, a variety of mutually reinforcing factors account for the decisions by the two public authorities: the uncertainty of the scientific evidence; the application of different standards of carcinogenicity associated with different social and scientific commitments; the government agencies with primary responsibility for the decisions; the way in which pesticides are regulated; and several cultural and economic considerations. The case study illustrates the analytical inadequacy of the fact-value distinction, and the tendency of decision-makers to justify their decisions by recourse to science. It also supports the view that the traditional relationship between science and public policy is being redefined in complex, technical areas of decision-making like risk assessment. [ABSTRACT FROM AUTHOR]