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Whether charitable fundraising might play a part in funding Britain's ostensibly tax‐funded NHS has been a longstanding dilemma, which until recently has received only occasional scholarly attention. In 1946, Aneurin Bevan argued that one of the main goals of the reformed health care system was to liberate health care from the 'caprice of private charity'. Seven decades later, NHS Charities Together's Urgent Covid‐19 Appeal became a powerful societal rallying cry in the health emergency of the pandemic and raised £150 million in the process. This paper draws together findings from new archival research, a witness seminar with key actors in the NHS charity sector, and qualitative research based on interviews with NHS charity staff and trustees (N = 13), all conducted between 2021 and 2023. We investigate the way in which national appeals have been proposed, debated and implemented at different times in the NHS's history. We trace the recurrence of conflicting ideas about the acceptability of national fundraising for the NHS, about whether public loyalties are to their local services or the national 'brand' and about the introduction of national appeals into a complex ecology of local NHS charities. The history of charitable fundraising for the NHS is, we argue, neither a simple story of spontaneous public generosity, nor often of formal policy reform, but is an artefact of more complex dynamics between a changing cast of local and national actors over the last 75 years. [ABSTRACT FROM AUTHOR]

The boundaries between state and charitable activities within the NHS are set out in regulations but are also enacted, blurred, and contested through local practices. This article reports research on NHS Charities– charitable funds set up within NHS organizations to enhance statutory provision – in Scotland. We analysed financial accounts and conducted qualitative interviews with staff in 12 of the 14 NHS Charities in Scotland, where they are generally known as endowments. Our findings suggest that Scotland's endowments are relatively wealthy in charitable terms, but that this wealth is unevenly distributed when population size and socio-economic deprivation are considered. We also identify two diverging organisational approaches to decisions, including those about appropriate and inappropriate fundraising. We argue that these approaches cohere with contrasting 'state' and 'charitable' institutional logics, which in turn imply different attitudes to potential inequalities, and to relationships with local publics. [ABSTRACT FROM AUTHOR]

Questions of legitimacy loom large in debates about the funding and regulation of complementary and alternative medicine (CAM) in contemporary health systems. CAM's growth in popularity is often portrayed as a potential clash between clinical, state and scientific legitimacies and legitimacy derived from the broader public. CAM's 'publics', however, are often backgrounded in studies of the legitimacy of CAM and present only as a barometer of the legitimating efforts of others. This article foregrounds the epistemic work of one public's effort to legitimate CAM within the UK's National Health Service: the campaign to 'save' Glasgow's Centre for Integrative Care (CIC). Campaigners skilfully intertwined 'experiential' knowledge of the value of CIC care with 'credentialed' knowledge regarding best clinical and managerial practice. They did so in ways that were pragmatic as well as purist, reformist as well as oppositional. We argue for legitimation as negotiated practice over legitimacy as a stable state, and as labour borne by various publics as they insert themselves into matrices of knowledge production and decision-making within wider health care governance. [ABSTRACT FROM AUTHOR]

Objectives: This study sought to understand the different approaches taken to involving the public in service reconfiguration in the four United Kingdom health systems. Methods: This was a multi-method study involving policy document analysis and qualitative semi-structured interviews in England, Northern Ireland, Scotland and Wales. Results: Despite the diversity of local situations, interview participants tended to use three frames within which they understood the politics of service reconfigurations: an adversarial approach which assumed conflict over scarce resources (change against the public); a communications approach which defined the problem as educating the public on the desirability of change (change for the public); and a collaborative approach which attempted to integrate the public early into discussions about the shape and nature of desirable services (change with the public). These three framings involved different levels of managerial time, energy, and resources and called on different skill sets, most notably marketing and communications for the communications approach and community engagement for the collaborative approach. Conclusions: We argue that these framings of public involvement co-exist within organisations. Health system leaders, in framing service reconfiguration as adversarial, communicative or collaborative, are deciding between conceptions of the relationship between health care organisations and their publics in ways that shape the nature of the debates that follow. Understanding the reasons why organisations adopt these frames would be a fruitful way to advance both theory and practice. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses articles in the issue on topics including relationships between power, space and dominant discourses; importance of structural dimensions of power between professionals and patients; and role of environment in healthcare services.

The "problem" of public resistance to hospital closure is a recurring trope in health policy debates around the world. Recent papers have argued that when it comes to major change to hospitals, "the public" cannot be persuaded by clinical evidence, and that mechanisms of public involvement are ill‐equipped to reconcile opposition with management desire for radical change. This paper presents data from in‐depth qualitative case studies of three hospital change processes in Scotland's National Health Service, including interviews with 44 members of the public. Informed by sociological accounts of both hospitals and publics as heterogeneous, shifting entities, I explore how hospitals play meaningful roles within their communities. I identify community responses to change proposals which go beyond simple opposition, including evading, engaging with and acquiescing to changes. Explicating both hospitals and the publics they serve as complex social phenomena strengthens the case for policy and practice to prioritise dialogic processes of engagement. It also demonstrates the continuing value of careful, empirical research into public perspectives on contentious healthcare issues in the context of everyday life. [ABSTRACT FROM AUTHOR]

Students in higher education face a variety of learning hindrances while studying at university. These hindrances may negatively impact on learning by distracting from study, or may enhance learning by encouraging students to address challenges as they arise. In the current study students were asked to describe their learning hindrances at a single point early in semester, and to outline the strategies for overcoming these hindrances in future. Five hindrance clusters were determined and differences between student academic subgroups were identified. Hindrances associated with difficulties understanding were reported most frequently by improving students, who had demonstrated resilience by passing second year biomedical science courses after failing in first year. Improving students were also most likely to report learning strategies that promote understanding. These results suggest that early interventions to encourage students to critically evaluate their understanding may benefit struggling students. [ABSTRACT FROM AUTHOR]

Of all the social sciences, social policy is one of the most obviously policy-orientated. One might, therefore, expect a research and funding agenda which prioritises and rewards policy relevance to garner an enthusiastic response among social policy scholars. Yet, the social policy response to the way in which major funders and the Research Excellence Framework (REF) are now prioritising ‘impact’ has been remarkably muted. Elsewhere in the social sciences, ‘research impact’ is being widely debated and a wealth of concerns about the way in which this agenda is being pursued are being articulated. Here, we argue there is an urgent need for social policy academics to join this debate. First, we employ interviews with academics involved in health inequalities research, undertaken between 2004 and 2015, to explore perceptions, and experiences, of the ‘impact agenda’ (an analysis which is informed by a review of guidelines for assessing ‘impact’ and relevant academic literature). Next, we analyse high- and low-scoring REF2014 impact case studies to assess whether these concerns appear justified. We conclude by outlining how social policy expertise might usefully contribute to efforts to encourage, measure and reward research ‘impact’. [ABSTRACT FROM AUTHOR]

The expanding phenomenon of crowdfunding for healthcare creates novel potential roles for members of the public as fundraisers and donors of particular forms of provision. While sometimes interpreted as an empowering phenomenon (Gonzales et al., 2018), or a potentially useful communication of unmet needs (Saleh et al., 2021), scholars have predominantly been critical of the way in which crowdfunding for healthcare normalises unmet needs and exacerbates entrenched inequalities (Berliner and Kenworthy, 2017; Igra et al., 2021; Paulus and Roberts, 2018). We report a thematic analysis of the text of 945 fundraising appeals created on JustGiving and GoFundMe in the first months of the COVID-19 pandemic, where the recipient was NHS Charities Together's dramatically successful COVID-19 Urgent Appeal. Unlike in existing accounts of individual healthcare crowdfunding, we identify the relative absence of both coherent problem definition and of a fundable solution within the pages. Instead, appeals are dominated by themes of solidarity and duty during the UK's 'hard' lockdown of 2020. A national appeal reduces the risks of crowdfunding exacerbating existing health inequalities, but we argue that two kinds of non-financial consequences of collective crowdfunding require further exploration. Specifically, we need to better understand how expanded practices of fundraising co-exist with commitment to dutiful, means-based funding of healthcare via taxation. We must also attend to how celebration of the NHS as a national achievement, might squeeze spaces for critique and challenge. Analyses of crowdfunding need to explore both financial and non-financial aspects of practices within different health system and historical contexts. • NHS Charities Together raised £150 million in charitable donations during the COVID-19 pandemic. • Fundraising pages were impersonal, without detailed plans for spending money raised. • Fundraisers expressed solidarity and duty, mobilising nationalistic narratives. • Healthcare crowdfunding should be understood in historic and health system context. • Both financial and non-financial consequences need to be explored. [ABSTRACT FROM AUTHOR]

Abstract: This paper presents findings from a multimethod study of pilot elections held to choose members of health boards in the National Health Service in Scotland. We begin by proposing that much current public involvement practice is dominated by a volunteerist model, in which members of the public with time and skills to offer play essentially supportive and non-challenging roles within health care organizations. This model contrasts sharply with the adversarial, political model of electoral democracy. Nonetheless, drawing on a postal survey of voters, non-participant observation of Boards, and semi-structured interviews with candidates, elected Board members and other stakeholders, we demonstrate that the introduction of elections did not overcome the volunteerist slant of current public involvement with health care organizations. Far from offering a ‘quick fix’ for policymakers seeking to ensure accountability of health care organizations, elections may produce remarkably similar outcomes to existing mechanisms of public involvement. [Copyright &y& Elsevier]

Does citizen participation in health care planning and provision have a clear purpose? Can it reasonably be considered a unified phenomenon? Current conceptual accounts – including a range of typologies descended from Arnstein's ubiquitous but misunderstood ‘ladder of participation’ – are inadequate. The popularity of citizen participation belies fundamental uncertainties about what it entails and its associated benefits. A more pragmatic and less normative usage of the term is vital for the future. [ABSTRACT FROM PUBLISHER]

Forms of large‐scale change, such as the regiona l re‐distribution of clinical services, are an enduring reform orthodoxy in health systems of high‐income countries. The topic is of relevance and importance to medical sociology because of the way that large‐scale change significantly disrupts and transforms therapeutic landscapes, relationships and practices. In this paper we review the literature on large‐scale change. We find that the literature is dominated by competing forms of knowledge, such as health services research, and show how sociology can contribute new and critical perspectives and insights on what is for many people a troubling issue. [ABSTRACT FROM AUTHOR]

Purpose: Achieving greater health and social care integration is a policy priority in many countries, but challenges remain. We focused on governance and accountability for integrated care and explored arrangements that shape more integrated delivery models or systems in Italy, the Netherlands and Scotland. We also examined how the COVID-19 pandemic affected existing governance arrangements. Design/methodology/approach: A case study approach involving document review and semi-structured interviews with 35 stakeholders in 10 study sites between February 2021 and April 2022. We used the Transparency, Accountability, Participation, Integrity and Capability (TAPIC) framework to guide our analytical enquiry. Findings: Study sites ranged from bottom-up voluntary agreements in the Netherlands to top-down mandated integration in Scotland. Interviews identified seven themes that were seen to have helped or hindered integration efforts locally. Participants described a disconnect between what national or regional governments aspire to achieve and their own efforts to implement this vision. This resulted in blurred, and sometimes contradictory, lines of accountability between the centre and local sites. Flexibility and time to allow for national policies to be adapted to local contexts, and engaged local leaders, were seen to be key to delivering the integration agenda. Health care, and in particular acute hospital care, was reported to dominate social care in terms of policies, resource allocation and national monitoring systems, thereby undermining better collaboration locally. The pandemic highlighted and exacerbated existing strengths and weaknesses but was not seen as a major disruptor to the overall vision for the health and social care system. Research limitations: We included a relatively small number of interviews per study site, limiting our ability to explore complexities within sites. Originality: This study highlights that governance is relatively neglected as a focus of attention in this context but addressing governance challenges is key for successful collaboration. [ABSTRACT FROM AUTHOR]

The article discusses the installation of fall protection systems. It mentions that this protection program should include various types of procedures to be follow as a guide for the workers for them to read and review before engaging in the work. It also emphasizes that the program cannot certainly answer the fall issues in the U.S. Army Corps of Engineers wherein they need the High Hazard Working Group to continue develop and maintain its fall protection program.

Background: Many policymakers, researchers and commentators argue that hospital closures are necessary as health systems adapt to new technological and financial contexts, and as population health needs in developed countries shift. However closures are often unpopular with local communities. Previous research has characterised public opposition as an obstacle to change. Public opposition to the siting of wind farms, often described as NIMBYism (Not In My Back Yard), is a useful comparator issue to the perceived NOOMBYism (Not Out Of My Back Yard) of hospital closure protestors.Discussion: The analysis of public attitudes to wind farms has moved from a fairly crude characterisation of the 'attitude-behaviour gap' between publics who support the idea of wind energy, but oppose local wind farms, to empirical, often qualitative, studies of public perspectives. These have emphasised the complexity of public attitudes, and revealed some of the 'rational' concerns which lie beneath protests. Research has also explored processes of community engagement within the wind farm decision-making process, and the crucial role of trust between communities, authorities, and developers. Drawing on what has been learnt from studies of opposition to wind farms, we suggest a range of questions and approaches to explore public perspectives on hospital closure more thoroughly. Understanding the range of public responses to service change is an important first step in resolving the practical dilemma of effecting health system transformation in a democratic fashion. [ABSTRACT FROM AUTHOR]

Primary healthcare managers are required to include citizens in service co-design and co-production. Health policy guidance appears deceptively simple and largely outlines how people could participate in a range of health services activities. Policy tends to neglect outcomes assessment, and a multidisciplinary academic literature corpus is large and complex to navigate for practical, time-poor managers. In this paper, we set out to provide a summary 'map' of key concepts in participation to assist managers in aligning participants, activities, expected outcomes and outcome indicators, and to consider contextual factors that could affect participation processes and outcomes. The intention is a practical tool for planning and evaluation of participation. The map is built drawing on policy guidance, literature and authors' experiences of implementing and researching health services participation. [ABSTRACT FROM AUTHOR]

British public services have traditionally been overseen by appointees. The idea that many of these posts should be filled by direct election, as a means of increasing engagement with local communities and accountability to them, appears to be gaining traction. In Health Board election pilots in 2010, the Scottish government replaced appointees to regional Health Boards (serving six-figure populations) with popularly elected members. The government attempted to maintain the insulation of Health Boards from party politics by restricting the use of partisan labels. Voters were deprived of a heuristic that usually helps them to decide how to cast their votes. Many electors did not vote, while others sought alternative heuristics. Interviewees simultaneously decried partisan politics, lack of information and low turnout by the rest of the population. These dislikes seem to conflict with each other. Moreover, the experience shows how the heuristics available to voters can shape democratic governance. [ABSTRACT FROM AUTHOR]