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Even for successfully implemented programs, there is a great risk that new work practices are not sustained over time. Previous research has yielded a number of factors which influence program sustainability, but little is known about which factors are most important in different contexts or how these factors interact. This study tests a model of sustainability factors in a case where a program for structured needs assessment and documentation was implemented in the Swedish social services. In November 2020, a questionnaire was sent out to local implementing actors in the municipalities. The data include 135 municipal organizations with 1–3 respondents per organization. Descriptive statistics and multiple regression were used in the analysis. The outcome variable was routinization as one of the most central components of sustainability. The findings show that while the program was implemented at 21.5% of sites, it was both implemented and routinized at only 13.3% of sites. A key factor for successful routinization was an open project strategy, which entails coordination between the implementation process and other change initiatives, the identification of a long-term planning horizon, and development based on continuous feedback. Additional factors found to contribute to routinization were management commitment, user participation, first-line manager commitment, and available resources. Certain factors were identified as pertinent to the implementing actors themselves, such as effective project leadership and rationally planned projects. These latter factors, however, demonstrated less importance towards routinization. These findings are discussed in relation to the fragmented context of the implementation, whereby the recipient organizations were not single, unified organizations, but rather organizational clusters involving both purchaser and provider organizations. The findings have implications for the planning, management, and evaluation of social program implementation and the ability to sustain novel work practices.

Collaboration between health and social care managers – A social representations approach This small-scale study explores collaboration between managers drawing on the theory of social representations. The data were produced using visual methods: middle managers (n=25) working in the field of health and social care and education reflected on collaboration in group discussions. The data were analyzed by content analysis. The study shows that emphasizing one’s status and superiority was perceived negatively in the context of collaboration. Deconstructing hierarchies and the myth of individual strong manager seems central when promoting collaboration between managers.

Background:Although increasingly accepted in some corners of social work, critics have claimed that evidence-based practice (EBP) methodologies run contrary to local care practices and result in an EBP straitjacket and epistemic injustice. These are serious concerns, especially in relation to already marginalised clients. Aims and objectives:Against the backdrop of criticism against EBP, this study explores the ramifications of the Swedish state-governed knowledge infrastructure, ‘management-by-knowledge’, for social care practices at two care units for persons with intellectual disabilities. Methods:Data generated from ethnographic observations and interviews were analysed by applying a conceptual framework of epistemic injustice; also analysed were national, regional and local knowledge products within management-by-knowledge related to two daily activity (DA) units at a social care provider in Sweden. Findings:In this particular case of disability care, no obvious risks of epistemic injustice were discovered in key knowledge practices of management-by-knowledge. Central methodologies of national agencies did include perspectives from social workers and clients, as did regional infrastructures. Locally, there were structures in place that focused on creating a dynamic interplay between knowledge coming from various forms of evidence, including social workers’ and clients’ own knowledge and experience. Discussion and conclusions:Far from being a straitjacket, in the case studied management-by-knowledge may be understood as offering fluid support. Efforts which aim at improving care for people with disabilities might benefit from organisational support structures that enable dynamic interactions between external knowledge and local practices.

Background: Devolution and integration of health and social care have placed increasing pressure on local statutory services, with a corresponding shift of health and social care to community organisations. The voluntary and charitable sector (VCS) is expected to make the case for increased funding by providing evidence of value and impact.\ud \ud \ud Aims and objectives: This paper explores the challenges of compiling evidence on health outcomes which do not reflect the holistic nature of VCS support. We document how knowledge brokering can be used to enable the VCS to generate evidence.\ud \ud \ud Key conclusions: Knowledge brokering (KB) may be an effective approach for developing community-generated evidence. Brokering is also needed to change perspectives on what counts as good evidence\ud \ud \ud \ud \ud Key messages\ud \ud Health outcome measures are not seen to be appropriate by the voluntary sector for social prescribing services.\ud \ud \ud A new evidence base is needed that reflects the social determinants of health.\ud \ud \ud Knowledge brokering may be an effective approach for developing community-generated evidence.\ud \ud \ud Brokering is also needed to change perspectives on what counts as good evidence.

ObjectiveTo examine trends in end-of-life communication with people with cancer in general practice.MethodsMortality follow-back survey among general practitioners (GPs) in representative epidemiological surveillance networks in Belgium (BE), the Netherlands (NL) and Spain (ES) in 2009–2010 (ES: 2010–2011) and 2013–2014. Using a standardised form, GPs registered all deceased adult patients in their practice and reported for five end-of-life care topics whether they had been discussed with the patient. Non-sudden cancer deaths were included (n=2306; BE: 1233; NL: 729; ES: 344).ResultsA statistically significant increase was found between 2009/2010 and 2014 in the prevalence of communication about diagnosis (from 84% to 94%) and options for end-of-life care (from 73% to 90%) in BE, and in GPs’ awareness of patients’ preferences for medical treatment and a proxy decision-maker in BE (from 41% and 20% up to 53% and 28%) and the NL (from 62% and 32% up to 70% and 52%). Communication about options for end-of-life care and psychosocial problems decreased in the NL (from 88% and 91% down to 73%) and ES (from 76% and 77% down to 26% and 39%).ConclusionConsiderable change in GP–patient communication seems possible in a relatively short time span, but communication cannot be assumed to increase over time. Increasing specialisation of care and task differentiation may lead to new roles in communication for healthcare providers in primary and secondary care. Improved information sharing between GPs and other healthcare providers may be necessary to ensure that patients have the chance to discuss important end-of-life topics.

Faced with unprecedented challenges, the adult social care sector in England has seen increasing attention given to the potential of volunteers to contribute to service provision. This article reports the findings of a qualitative study that explored the contribution made by volunteers to social care services for older people. The article draws attention to the difficulties associated with recruiting and training volunteers to work in the sector, particularly during a period of reduced public expenditure, which is putting the sector under strain. Given the challenges faced, the article considers whether it is appropriate to involve volunteers in care work.

Šiame tyrime analizuojamas socialinio palaikymo teikimas globos namuose dirbant su senyvo amžiaus asmenimis. Analizuojamos visos socialinio palaikymo rūšys ir jų nauda senyvo amžiaus asmeniui., This study analyzes the provision of social support in care homes when working with elderly people. All types of social support and their benefits for an elderly person are analyzed.

BACKGROUND: Scotland has an ageing population, so an increasing responsibility for old age social care. Research elsewhere has demonstrated that several socio-demographic, geographical and health factors predict entry to a care home. Scotland has some key originalities, even compared to other UK countries. Thus, it was important to investigate the factors associated with using social care here. OBJECTIVES: This thesis used routinely collected administrative data to identify socio-demographic, self-rated health, geographical and household factors which were associated with institutional social care use in later life in Scotland. It aimed to investigate whether factors known to be associated with care use for older people through research elsewhere, were generalisable to Scotland. Additionally, it aimed to explore some factors which may not have been investigated elsewhere. METHODS: Linked administrative data from the Scottish Longitudinal Study (SLS), a 5.3% representative sample of the Scottish population (https://sls.lscs.ac.uk/) - provided a longitudinal dataset including people aged 65 years and older, who were still living at home. Information about socio-demographics, household members, informal care, geography and health were gathered from their census responses. Then care status – living in a nursing/care home or not – was determined from the next census. Logistic regression was used to model the associations of these factors with care outcome at follow-up. KEY FINDINGS: The analyses considered two time periods: 1991-2001 and 2001-2011. In the 1991-2001 sample, three lesser researched factors were found to be associated with care use – 1) living in a flat (1.21 (1.04, 1.41))*, 2) recent employment (0.66 (0.53, 0.80)), and 3) population density (Low density 9.71 (7.85, 12.03)); plus an interaction between population density and urban rural classification – with highest attributable risk in low-density city areas (12.83 (9.64, 17.07)). Additionally, patterns for living with different relatives originally found in a Northern Irish study were replicated, with living alone or with siblings associated with increased odds of being in care at follow-up. In the 2001-2011 sample, most associations were consistent, however, this was not the case for the area-based measures such as deprivation and measures of geography, which were no longer associated with care outcome. It was also possible to look at the association of receiving and providing informal care in this later sample, both of which were associated with care outcome (1.81(1.42, 2.29) and 0.70 (0.53, 0.91) respectively). Sex/gender differences were also evidenced for several factors. CONCLUSIONS: Administrative data were used to identify both lesser researched and known factors associated with institutional care use in Scotland, over two different time periods. The factors associated with being in a care home at follow-up in Scotland were broadly similar those evidenced by previous literature in other global-northern populations. The possible explanations for the differences between the samples, which evidence reduced spatial inequality in the later cohort, are discussed, such as the introduction of a new social care policy in 2002 and broader changes to the health and social care landscape in Scotland. Recommendations for future policy and practice are also considered. *(Odds Ratio (95% Confidence Interval)) Note: for the odds ratio the null value is 1. Source: SLS. The help provided by the staff of the Longitudinal Studies Centre – Scotland (LSCS) is acknowledged. The LSCS is supported by the ESRC/JISC, the Scottish Funding Council, the Chief Scientist’s Office, and the Scottish Government. The authors alone are responsible for the interpretation of the data. Census output is Crown copyright and is reproduced with the permission of the Controller of HMSO and the King’s Printer for Scotland.

Unexpected negative health shocks such as COVID-19 put pressure on households to provide more care to relatives and friends. This study uses data from the UK Household Longitudinal Study to investigate the impact of informal caregiving on mental health during the COVID-19 pandemic. Using a difference-in-differences analysis, we find that individuals who started providing care after the pandemic began reported more mental health issues than those who never provided care. Additionally, the gender gap in mental health widened during the pandemic, with women more likely to report mental health issues. We also find that those who began providing care during the pandemic reduced their work hours compared to those who never provided care. Our results suggest that the COVID-19 pandemic has had a negative impact on the mental health of informal caregivers, particularly for women. Horizon Europe [grant number ES/T008415/1] and from the National Institute for Health Research Applied Research Collaboration Oxford and Thames Valley at Ox ford Health NHS Foundation Trust. Consortium iNEST (Interconnected North-Est Innovation Ecosystem) funded by the European Union Next GenerationEU (Piano Nazionale di Ripresa e Resilienza (PNRR) – Mis sione 4 Componente 2, Investimento 1.5 – D.D. 1058 23/06/2022, ECS_00000043). Moscone receives funding from a project funded by Next Generation EU - ‘‘Age-It - Ageing well in an ageing society’’ project (PE0000015), National Recovery and Resilience Plan (NRRP) - PE8 - Mission 4, C2, Intervention 1.3. The views and opinions expressed are only those of the authors and do not necessarily reflect those of the NIHR or European Union or the European Commission.

The decentralization of social care in the Netherlands has had a major impact on the professionals working in this field. This dissertation examines this impact by specifically focusing on the cognitive uncertainty experiences of social care professionals. It shows that cognitive uncertainty is a multi-faceted concept that covers different domains of the work and can have multiple sources. Contrary to the frequently expressed view in the literature on bureaucracy, this dissertation shows that rules do not reduce cognitive uncertainty. Leadership of team leaders, in contrast, can reduce cognitive uncertainty experiences of professionals.Moreover, leadership plays a key role in managing cognitive uncertainty. When properly managed, cognitive uncertainty can prove highly valuable as it can spur innovation and thus contribute to achieving the goals set in the decentralization of social care in the Netherlands.

Health care organizations are increasingly incorporating social care programs into medical care delivery models. Recent studies have identified burnout as a potential unintended consequence of this expansion. Successful implementation of these programs requires investment in the health care team, although understanding the impact of this expansion on nonphysician team members remains limited. Utilizing a theory-informed model for organizational behavior change, the authors aim to characterize the perceived elements of capacity to address patients' social needs within a heterogenous group of health care workers, and to examine the association of these behavioral conditions with burnout. A cross-sectional analysis was conducted of a survey of ∼1900 health care staff from 46 organizations in a large delivery system. Exploratory factor analysis identified factors contributing to the "Perceived Capacity to Address Social Needs" domain; Motivation, Organizational Reinforcement, and 3 task-specific capacities (Identification of social needs, Providing care for patients with social needs, and Linkage to social needs resources). Logistic regression found both a lower sense of motivation (OR 0.71, 95% CI 0.59-0.86), and organizational reinforcement (OR 0.51, 95% CI 0.42-0.62) associated with a higher rate of burnout. These associations with burnout differed by organizational role, suggesting role-specific relationships between these behavioral conditions. As health care has evolved into team-based interventions, staff across the care spectrum are now tasked with addressing larger social issues that affect their patients. A systems approach, aligning organizational priorities and staff motivations, in addition to task-specific skill sets is likely necessary to prevent burnout in this setting.

Purpose People with complex health conditions must often navigate landscapes of uncoordinated public, private and voluntary health-care providers to obtain the care they need. Complex health conditions frequently transcend the scope of typical health-care service systems. The purpose of this paper is to explore and characterize such unique assemblages of actors and services as “user-defined ecosystems”. Design/methodology/approach Building on literature on customer ecosystems, this paper introduces the concept of the user-defined ecosystem (UDE). Using an abductive approach, the authors apply the concept in an interpretive, qualitative study of ten families with special needs children. Findings This study uncovers complex UDEs, where families actively combine a broad range of services. These ecosystems are unique for each family and extend beyond the scope of designed service ecosystems. Thus, the families are forced to assume an active, coordinating role. Research limitations/implications This paper shows how to identify ecosystems from the user’s point of view, based on the selected user unit (such as a family) and the focal value-creating function of the ecosystem for the user. Social implications This paper highlights how service providers can support and adapt to UDEs and, thus, contribute to user value and well-being. This can be used to understand users’ perspectives on service and systems in health and social care. Originality/value This study develops the concept of the UDE, which represents a customer-focused perspective on actor ecosystems and contrasts it with a provider-focused and a distributed perspective on ecosystems. This study demonstrates the practical usefulness of the conceptualization and provides a foundation for further research on the user’s perspective on ecosystems.

Background Evidence on the health impacts of social conditions has led US healthcare systems to consider identifying and addressing social adversity—e.g. food, housing, and transportation insecurity—in care delivery settings. Social screening is one strategy being used to gather patient information about social circumstances at the point of care. While several recent studies describe the rapid proliferation of social screening activities, little work has explored either why or how to implement social screening in clinical settings. Our study objectives were to assess diverse healthcare stakeholder perspectives on both the rationale for social screening and evidence needed to inform practice and policy-relevant implementation decisions. Methods We convened five focus groups with US experts representing different stakeholder groups: patient advocates, community-based organizations, healthcare professionals, payers, and policymakers. In total, 39 experts participated in approximately 90-minute long focus groups conducted between January-March 2021. A inductive thematic analysis approach was used to analyze discussions. Results Three themes emerged from focus groups, each reflecting the tension between the national enthusiasm for screening and existing evidence on the effectiveness and implementation of screening in clinical settings: (1) ambiguity about the rationale for social screening; (2) concerns about the relavence of screening tools and approaches, particularly for historically marginalized populations; (3) lack of clarity around the resources needed for implementation and scaling. Conclusion While participants across groups described potential benefits of social screening, they also highlighted knowledge gaps that interfered with realizing these benefits. Efforts to minimize and ideally resolve these knowledge gaps will advance future social screening practice and policy.

This paper aims to compare the long-term care systems in four Western European countries: Germany, the Netherlands, Switzerland, and France. It describes the organization, financing, and services provided in each system. In Germany and the Netherlands, long-term care systems are primarily based on public insurance, while in Switzerland and France, they are predominantly private. The article emphasizes the importance of professional training and education for healthcare and social care workers to ensure quality care for individuals in need of round-the-clock residential social services. The conclusion summarizes the findings and highlights that differences in long-term care systems can be attributed to cultural, historical, and economic characteristics of each country. The examination of long-term care systems focuses on residential social services [1]. Objective: To study the trends in the development of long-term care systems in Western European countries, in order to identify the changes occurring in these systems., {"references":["Alber, J. (1995), \"A framework for the comparative study of social services\", Journal of European Social Policy, 5(2): 131–49.","Colombo, F. (2012), \"Typology of public coverage for long-term care in OECD countries\", in CostaFont, J. and Courbage, C. (eds.), Financing long-term care in Europe: institutions, markets and models, London, S.L. UK: Palgrave Macmillan, p. 17–40.","Kraus, M., Riedel, M., Mot, E., Willemé, P. and Röhrling, G. (2010), A typology of long-term care systems in Europe, Brussels: ENEPRI.","Ranci, C. and Pavolini, E. (eds.) (2015), Reforms in Long-term Care Policies in Europe, New York: Springer.","Spasova S. and Ward T. (2019), Social protection expenditure and its financing in Europe, A study of national policies, European Social Policy Network (ESPN), Brussels: European Commission.","Gruber EM, Zeiser S, Schröder D, Büscher A. Workforce issues in home- and community-based long-term care in Germany. Health Soc Care Community. 2021 May;29(3):746-755. doi: 10.1111/hsc.13324. Epub 2021 Feb 24. PMID: 33629450.","Alders P, Schut FT. Strategic cost-shifting in long-term care. Evidence from the Netherlands. Health Policy. 2022 Jan;126(1):43-48. doi: 10.1016/j.healthpol.2021.11.008. Epub 2021 Nov 28. PMID: 34876303.","Eling M. Financing Long-term Care: Some Ideas from Switzerland Comment on \"Financing Long-term Care: Lessons From Japan\". Int J Health Policy Manag. 2020 Jan 1;9(1):39-41. doi: 10.15171/ijhpm.2019.83. PMID: 31902194; PMCID: PMC6943298.","Chevreul K, Berg Brigham K, Durand-Zaleski I, Hernandez-Quevedo C. France: Health System Review. Health Syst Transit. 2015;17(3):1-218, xvii. PMID: 26766545."]}

Kristina Popova, Closed Institutions and Social Care for Girls in Bulgaria During the First Half of the Twentieth Century Abstract This article examines the history of closed institutions for children and youth (orphanages, correctional institutions)during the first half of the twentieth century from a gender perspective and as part of a more general analysis of the attitude towardsdisadvantaged children on the Balkans, particularly in Bulgaria. The firstmodern institutions for children in the late nineteenth and early twentieth centuries replaced traditional practices of caring for orphans, that israising them in families of relatives or foster families orgiving them to a convent (monastery) or other religious institutions.The contribution presentsthe plurality of agency of children’s social care, includingthe state, municipalities, women’s societies and other civil organisations, religious institutions, military institutions and individuals.During the Balkan Wars (1912-1913) and the First World War (1914-1918), the number of children in need (orphans, refugees, neglected children, street children) grew significantly. In the post-war years, social care institutions were integrated in international networks of child protection, which contributed to the spread of international standards, practices and ideas.

BackgroundHealth and social care systems in many countries have begun to trial and adopt “integrated” approaches. Yet, the significant role care homes play within the health and social care system is often understated. A key first step to identifying the care home integration interventions that are most (cost-)effective is the ability to precisely identify and record what has been implemented, where, and when—a “policy map.”MethodsTo address gaps relating to the identification and recording of (cost-)effective integrated care home interventions, we developed a new typology tool. We conducted a policy mapping exercise in a devolved region of England—Greater Manchester (GM). Specifically, we carried out systematic policy documentary searches and extracted a range of qualitative data relating to integrated health and social care initiatives in the GM region for care homes. The data were then classified according to existing national ambitions for England as well as a generic health systems framework to illustrate gaps in existing recording tools and to iteratively develop a novel approach.ResultsA combined total of 124 policy documents were identified and screened, in which 131 specific care home integration initiatives were identified. Current initiatives emphasized monitoring quality in care homes, workforce training, and service delivery changes (such as multi-disciplinary teams). There was comparatively little emphasis on financing or other incentive changes to stimulate provider behavior for the care home setting. We present a novel typology for capturing and comparing care home integration policy initiatives, largely conceptualizing which part of the system or specific transition point the care home integration is targeting, or whether there is a broader cross-cutting system intervention being enacted, such as digital or financial interventions.ConclusionsOur typology builds on the gaps in current frameworks, including previous lack of specificity to care homes and lack of adaptability to new and evolving initiatives internationally. It could provide a useful tool for policymakers to identify gaps in the implementation of initiatives within their own areas, while also allowing researchers to evaluate what works most effectively and efficiently in future research based on a comprehensive policy map.

Social service providers work to alleviate social disadvantages, which may particularly loom during crises. These organisations have a close understanding of the needs of their clients. However, this knowledge is rarely taken into account in tailoring crisis measures, which may lead to increased vulnerability and create additional suffering. In this paper, we take a novel look at the role of care organisations as intermediaries between their clients and the authorities in representing the needs and capabilities of vulnerable people and explore the factors hindering or facilitating this representation. We focused on care organisations in Europe and collected data from 32 interviews, followed by 5 workshops and an international colloquium with 6 language-based discussion groups with participants from organisations offering care services to socially marginalised individuals. The results demonstrate the role these organisations had in advocating their clients' needs to the authorities to adapt the crisis measures accordingly (“bottom-up approach”), and communicating official information about the risks and government rules to their clients (“top-down approach”). We found effective mediation to stem from long-term, trusting client relationship to be able to reflect on clients’ needs, while the lack of collaboration protocol and tradition can be seen as the main barrier to inclusive crisis management. Networking with social care services to bring their expertise into crisis management systems is essential to promote the resilience of the diverse society.

In this article, we analyze the context of the domestic work “bed inside” carried out by foreign and indigenous women in Panama, focusing on the impacts that this context has experienced during the pandemic. To do so, we use an analysis framework that makes possible to visualize two critical scenarios in the current social care, where the employer and the employee are located. The results indicate that the conditions of domestic servitude in which these workers find themselves are not resolved exclusively with fairer labor regulations for this occupation, but rather depend on transformative measures on critical absences and unresolved inequalities in the current social care. En este artículo analizamos el contexto en el que se enmarca el trabajo doméstico “cama adentro” realizado por mujeres extranjeras e indígenas en Panamá, poniendo el foco en los impactos que dicho contexto ha experimentado durante la pandemia. Utilizamos para ello un marco de análisis que permite visibilizar dos escenarios críticos en la actual organización social de los cuidados, donde se ubican la empleadora y la empleada. Los resultados indican que las condiciones de servidumbre doméstica en las que se encuentran estas trabajadoras no se resuelven exclusivamente con normativas laborales más justas para esta ocupación, sino que dependen más bien de medidas transformadoras sobre las ausencias críticas y las desigualdades no resueltas en la actual organización social de los cuidados.

BackgroundCOVID-19 spread rapidly in UK care homes for older people in the early pandemic. National infection control recommendations included remote resident assessment. A region in North-West England introduced a digital COVID-19 symptom tracker for homes to identify early signs of resident deterioration to facilitate care responses. We examined the implementation, uptake and use of the tracker in care homes across four geographical case study localities in the first year of the pandemic.MethodsThis was a rapid, mixed-methods, multi-locality case study. Tracker uptake was calculated using the number of care homes taking up the tracker as a proportion of the total number of care homes in a locality. Mean tracker use was summarised at locality level and compared. Semi-structured interviews were conducted with professionals involved in tracker implementation and used to explore implementation factors across localities. Template Analysis with the Consolidated Framework for Implementation Research (CFIR) guided the interpretation of qualitative data.ResultsUptake varied across the four case study localities ranging between 13.8 and 77.8%.Tracker use decreased in all localities over time at different rates, with average use ranging between 18 and 58%. The implementation context differed between localities and the process of implementation deviated over time from the initially planned strategy, for stakeholder engagement and care homes’ training. Four interpretative themes reflected the most influential factors appearing to affect tracker uptake and use: (1) the process of implementation, (2) implementation readiness, (3) clarity of purpose/perceived value and (4) relative priority in the context of wider system pressures.ConclusionsOur study findings resonate with the digital solutions evidence base prior to the COVID-19 pandemic, suggesting three key factors that can inform future development and implementation of rapid digital responses in care home settings even in times of crisis: an incremental approach to implementation with testing of organisational readiness and attention to implementation climate, particularly the innovation’s fit with local contexts (i.e. systems, infrastructure, work processes and practices); involvement of end-users in innovation design and development; and enabling users’ easy access to sustained, high-quality, appropriate training and support to enable staff to adapt to digital solutions.

In this chapter, we consider social care as the provision of help, care and protection from harm to people who need additional support. This support can take a wide variety of forms and is often carried out informally by relatives, but here we primarily focus on variants of social care that occur within institutional contexts and we zoom in on situations in which the presence of an interpreter is required. These situations have thus far not been studied very extensively and in the literature, attention is mainly drawn to interpreting quality and the need for training of interpreters as well as social care providers. Next to these topics, a number of critical issues emerge, namely (1) the specific complexity and consequences of the choice to use professional interpreters or to draw on alternatives; (2) the implications of the fact that many multilingual professionals engaged in social care assume a double role; (3) the challenge of establishing rapport, which is crucial in social care contexts, but which is described as difficult when a third party is present and (4) the issue of interpreters as potential gatekeepers in social care interactions. A few concluding remarks will close this chapter.

Ethnography and cinema as meditation tools in gang research In this article, Carles Feixa and José Sánchez-García share two main results of the Special Features of the TRANSGANG project: White Paper and Documentary films which looks at mediation tools in gang research. During the last five years, the TRANSGANG Project has investigated transnational gangs as agents of mediation in twelve cities of three regions: Southern Europe (Barcelona, Madrid, Marseille, Milano), Northern Africa (Rabat-Salé, Algiers, Djendel, Tunis), and the Americas (Medellin, San Salvador, Santiago de Cuba and Chicago). Among the main outcomes of the project, two special features have used ethnography and cinema as mediation tools in gang research.

Η παρούσα μελέτη διερευνά την προσβασιμότητα στο σύστημα υγείας και κοινωνικής φροντίδας των ατόμων με εξάρτηση από ψυχοδραστικές ουσίες σε συνθήκες αστεγίας στην περιοχή της Αθήνας. Στοχεύει στην εις βάθος διερεύνηση της προσβασιμότητας μέσα από τις αντιλήψεις των ατόμων για τις παρεχόμενες υπηρεσίες του συστήματος υγείας και κοινωνικής φροντίδας, στην καταγραφή των ενδεχόμενων δυσκολιών που αντιμετωπίζουν και στη διατύπωση προτάσεων για την εφαρμογή πρακτικών και πολιτικών που αυξάνουν την πρόσβασή τους στο σύστημα υγείας και κοινωνικής φροντίδας. Διερευνώνται οι αντιλήψεις, τα κίνητρα και οι προσδοκίες των ατόμων για τις υπηρεσίες και τις κοινωνικές παροχές, καθώς και οι προγενέστερες εμπειρίες τους με το σύστημα υγείας και κοινωνικής φροντίδας. Τέλος, διατυπώνονται από τους ίδιους προτάσεις για τη βελτίωση των παρεχόμενων υπηρεσιών. Η εμπειρία της προσβασιμότητας μελετήθηκε σε πέντε ερευνητικά πεδία, τα οποία περιλαμβάνουν τις υπηρεσίες σίτισης και στέγασης, τις υπηρεσίες υγείας, τα προγράμματα απεξάρτησης, τις δυνατότητες οικονομικής και νομικής υποστήριξης καθώς και τις δυνατότητες εκπαίδευσης και επαγγελματικής αποκατάστασης. Για τη μελέτη των παραπάνω αξιοποιήθηκε η ποιοτική μεθοδολογία. Η επεξεργασία και ανάλυση του εμπειρικού υλικού έγινε σύμφωνα με την ανάλυση περιεχομένου. Πραγματοποιήθηκαν δώδεκα εις βάθος ημιδομημένες συνεντεύξεις σε άτομα με εμπειρία εξάρτησης από ψυχοδραστικές ουσίες που έχουν βρεθεί σε συνθήκες αστεγίας, εκ των οποίων οι 6 είχαν διακόψει τη χρήση τουλάχιστον τους τελευταίους έξι μήνες, ενώ οι υπόλοιποι 6 ήταν ενεργοί χρήστες ψυχοδραστικών ουσιών. Βασικά ευρήματα της έρευνας ήταν τα χαμηλά ποιοτικά χαρακτηριστικά των παρεχόμενων υπηρεσιών, συμπεριλαμβανομένων της έλλειψης συνεχούς και ολιστικής φροντίδας, των συμπεριφορών διακρίσεων και της περιορισμένης δυνατότητας διασύνδεσης των υπηρεσιών. Σημαντική έλλειψη κοινωνικής φροντίδας καταγράφηκε κυρίως στους τομείς οικονομικής στήριξης και επαγγελματικής αποκατάστασης., This study explores accessibility to the health and social care system for individuals dependent on psychoactive substances and living under conditions of homelessness in Athens. It aims at the in-depth investigation of accessibility through the perceptions of individuals regarding the offered services provided by the health and social care system, the transcription of possible difficulties they encountered and the formulation of propositions for the application of practices and policies that increase and improve their accessibility with respect to the social and health care system. A probe is conducted regarding the perceptions, motives and expectations of individuals concerning services and social provisions, as well as their previous experiences with the social and health care system. Lastly, the individuals themselves provide proposals as to how said offered services could be improved. The experience of accessibility was studied in five research sections, which include alimentation and housing services, health care services, drug rehabilitation programs, access financial and legal support and in addition the possibility of education/training and employment opportunities. To the purpose of studying all mentioned above, the qualitative research method was utilized. The processing and analysis of the empirical content was conducted according to the content analysis method. The interviews carried out were twelve, in-depth and semistructured and the interviewees were individuals with experience of dependency on psychoactive substances that have also experienced conditions of homelessness, of which 6 had seized using substances for the previous six months minimum, and the latter 6 were in active addiction to psychoactive substances. The main findings of the present research were the low-quality characteristics of the provided services, including the lack of continuous and holistic care, the discriminatory conduct and the limited ability of interconnection between services. Significant lack of social care was noted with respect to sectors of financial support and vocational rehabilitation services.

Published by Elsevier Ltd. This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/). Social service providers work to alleviate social disadvantages, which may particularly loom during crises. These organisations have a close understanding of the needs of their clients. However, this knowledge is rarely taken into account in tailoring crisis measures, which may lead to increased vulnerability and create additional suffering. In this paper, we take a novel look at the role of care organisations as intermediaries between their clients and the authorities in representing the needs and capabilities of vulnerable people and explore the factors hindering or facilitating this representation. We focused on care organisations in Europe and collected data from 32 interviews, followed by 5 workshops and an international colloquium with 6 language-based discussion groups with participants from organisations offering care services to socially marginalised individuals. The results demonstrate the role these organisations had in advocating their clients' needs to the authorities to adapt the crisis measures accordingly (“bottom-up approach”), and communicating official information about the risks and government rules to their clients (“top-down approach”). We found effective mediation to stem from long-term, trusting client relationship to be able to reflect on clients’ needs, while the lack of collaboration protocol and tradition can be seen as the main barrier to inclusive crisis management. Networking with social care services to bring their expertise into crisis management systems is essential to promote the resilience of the diverse society. Care organisations role as intermediaries between the authorities and the marginalised in crisis management

This mixed-method systematic review aimed to gather evidence on healthcare leaders’ digital competence experiences and perceptions, and factors associated to it.

The bachelor thesis focuses on satisfaction with services provided in homes for the elderly in the Příbram district. The aim of the bachelor thesis was to find out how satisfied users are with the services provided in homes for the elderly in the Příbram district. The bachelor thesis is divided into theoretical and practical parts. The theoretical part describes the concepts related to the title of this bachelor thesis - old age, ageing and the associated ageism, aspects of ageing or ageing population, senior and communication with him/her, needs of seniors or the definition of satisfaction. Last but not least, the topics of social care for the elderly, the social worker, social services for the elderly and finally I have described the actual service of the home for the elderly. In the practical part, I set one main research question, which was "How satisfied are the users of the retirement home with the services provided?", and to this six sub-questions were set. For data collection, qualitative research and interview method, semi-structured interview technique was chosen. The size of the research population was not precisely determined in advance, the questioning was conducted to theoretical saturation - only two criteria were given, namely that they must be users of one of the homes for the elderly in the district of Příbram and they must be able to communicate and understand the questions. The informants with whom the research was conducted were 16 in total. The aim of the Bachelor's thesis was fulfilled and it was found that all users of homes for the elderly in Příbram district are satisfied with the services provided. The results of the bachelor thesis can serve as feedback for the homes for the elderly where the research was carried out and as a stimulus for possible improvement of services in order to contribute to the increase of user satisfaction. Furthermore, it can help those interested in this residential service in their decision making process.

The negative health effects and mortality caused by the COVID-19 pandemic disproportionately fell upon older and disabled people. Protecting these vulnerable groups has been a key policy priority throughout the pandemic and related vaccination campaigns. Using data from the latest survey of the UK Household Longitudinal Study on COVID-19 we found that people who receive informal care have higher probability of being infected when compared to those not receiving informal care. Further, we found that care recipients who are in the lowest income groups have a higher probability of catching the virus when compared to those in the highest income groups. We also estimated the likelihood of being infected for informal carers versus those who did not provide any care during the pandemic and found no significant differences between these two groups. Our empirical findings suggest that the standard measures introduced with the aim of protecting vulnerable groups, such as closing care homes or prioritising the vaccination of their staff, were not sufficient to avoid the spread of the virus amongst disabled and older people. Informal carers play an important role in the social care sector. As such, protecting vulnerable people by investing in the informal care sector should be a priority for future health policy.

原著論文

PurposeIn the implementation of integrated care, the role of managers is important and their mutual collaboration should be addressed more visibly. The purpose of this study was to investigate how cross-boundary collaboration is constructed in the discourse of middle-level managers in health and social care.Design/methodology/approachThe study was based on a discursive approach. Group discussions with three groups of Finnish middle managers (n = 39) were analyzed using discourse analysis.FindingsFive ways of talking about cross-boundary collaboration were identified, labeled “ideal”, “structure”, “defence”, “money” and “support” discourses. In the ideal discourse, cross-boundary collaboration appeared as a “good thing” and is self-evident. Structural discourse defined managers as passive actors in self-sustaining entities. Defensive discourse highlighted the problems of cross-boundary collaboration and the hierarchy within the health and social sectors. Financial discourse constituted the ultimate obstacle to successful cross-boundary collaboration, and both strengthened and explained defensive discourse. Supportive discourse portrayed other managers as partners and as an important resource.Research limitations/implicationsCross-boundary collaboration can be experienced as a resource, helping managers cope with their workload. However, identification of and continuous attention to challenges at macro, meso and micro levels of integrated care is crucial for successful collaboration. Thus, critical discussion of collaboration needs to be given space.Originality/valueThe study design and discursive approach highlights the power of language and give voice to middle managers who are key actors when implementing integrated care.

Background Abused and neglected children are at increased risk of health problems throughout life, but negative effects may be ameliorated by nurturing family care. It is not known whether it is better to place these children permanently with substitute (foster or adoptive) families or to attempt to reform their birth families. Previously, we conducted a feasibility randomised controlled trial (RCT) of the New Orleans Intervention Model (NIM) for children aged 0–60 months coming into foster care in Glasgow. NIM is delivered by a multidisciplinary health and social care team and offers families, whose child has been taken into foster care, a structured assessment of family relationships followed by a trial of treatment aiming to improve family functioning. A recommendation is then made for the child to return home or for adoption. In the feasibility RCT, families were willing to be randomised to NIM or optimised social work services as usual and equipoise was maintained. Here we present the protocol of a substantive RCT of NIM including a new London site. Methods The study is a multi-site, pragmatic, single-blind, parallel group, cluster randomised controlled superiority trial with an allocation ratio of 1:1. We plan to recruit approximately 390 families across the sites, including those recruited in our feasibility RCT. They will be randomly allocated to NIM or optimised services as usual and followed up to 2.5 years post-randomisation. The principal outcome measure will be child mental health, and secondary outcomes will be child quality of life, the time taken for the child to be placed in permanent care (rehabilitation home or adoption) and the quality of the relationship with the primary caregiver. Discussion The study is novel in that infant mental health professionals rarely have a role in judicial decisions about children’s care placements, and RCTs are rare in the judicial context. The trial will allow us to determine whether NIM is clinically and cost-effective in the UK and findings may have important implications for the use of mental health assessment and treatment as part of the decision-making about children in the care system.

There is an international movement towards integrated care. This systema- tized literature review studied healthcare chaplaincy spiritual care interventions that support adult mental health by integrating health and social care. Seventeen relevant studies were found. One analysed individual and family care in a general hospital. Twelve described one-to-one community-based interventions, of which ten concerned general practice healthcare centres. Four involved groups supporting mental health in hospitals or community-centres. Two studies used qualitative approaches, seven quantitative and eight mixed methods. The quality of evidence for the outcomes of interventions was examined. The review found that studies demonstrated shifts in healthcare professionals’ working practices anticipated by Paterson (2014), from hospital towards community bases, from treatment of individuals towards empowering ser- vice users to self-manage their health, and in mental health contexts from treatment of individuals towards care in groups.

Numbers of older prisoners have been increasing in recent years and there is no national strategy addressing their care. Older prisoners have more physical health needs, complex social care needs and high rates of mental disorder compared with younger prisoners. These needs are often not identified or addressed. We developed the Older prisoner Health and Social Care Assessment and Plan (OHSCAP), a structured approach for identifying and managing the health and social care needs of older prisoners. It consists of an assessment, care plan and review of needs. The current study aims to establish the fidelity of implementation of the OHSCAP as part of a larger RCT. Compliance, context and competence fidelity were audited to assess compliance with training and the manual, adequacy of completion and identification of needs and quality of care planning. Results showed that the OHSCAP was not implemented as intended with needs identified not being consistently translated into care plan actions, little evidence to suggest that prisoner involvement in the care planning process and difficulties in collaborative working. Implications with respect to effectively embedding complex interventions within prisons, along with wider policy-related issues affecting the entire prison estate are discussed.

This article focuses on how length of participation in professional youth work is associated with five outcome variables: prosocial skills, self-mastery, social network, civic participation (volunteering and organizing activities) and finding support from social care services. The study was designed as a longitudinal cohort study of four waves during a 16-month period, gathering the data of 1597 youngsters aged 10–24 who participated in Dutch professional youth work. The results show that, on average, youngsters who participated longer in youth work scored significantly higher on the outcome variables. Respondents did not show individual improvements on outcome variables over the period, but the results demonstrate a cautious positive trend over time in volunteering. Referring youngsters (33%) by youth workers to care services could prevent an exacerbation of existing problems. The results provide knowledge that legitimizes the role of professional youth workers and which can be used by them to improve the support of socially vulnerable youngsters in their personal development and social participation.

This paper provides a commentary on "Vascular amputees: A study in disappointment" (Little et al. 1974) and its significance in the development of the disability rights movement, as well as the movements for values-based medicine and person-centred health and social care.

The ageing population and long-term care policies of the Organisation for Economic Co-operation and Development countries have put pressure on social care work, creating patterns of difficult ethical situations. This article contributes to contextualising such situations by applying a ‘micro-ethics’ perspective and a theoretical framework that connects micro-ethics to macro-sociological contexts, and combines the concept of ‘moral distress’ (of healthcare professionals) with feminist ethics. Based on two case studies from an ethnographic study of Norway’s long-term care, findings demonstrate how ethically difficult moments connect with structural factors, including bureaucratic, managerialist and de-professionalised models of social care work, and new relationships between older people and their families.

BACKGROUND Germany already has a high degree of urbanisation, and the share of urban population is expected to increase further. Thus, it is important to explore urban primary care from a scientific point of view. METHOD In this article, the author suggests a framework for urban primary care. RESULTS AND CONCLUSION Three core characteristics of urban areas are a high population density, a high population heterogeneity (including socioeconomic heterogeneity) and a fragmentation of health care and social care. These characteristics influence the health of urban dwelling population. Thus, these characteristics form the future challenges for urban primary care.

The purpose of this study was to compare the application of the print module and the electronic module to see the indicators of the character of social care. This type of research is quantitative research. This study involved two variables, namely learning teaching materials in class with a sample size of 47 students. Data analysis used descriptive and inferential statistics. The character of students' social care can be seen in the application of the electronic module and the print module. The result, from the two teaching materials, the social care character of SD 64/I Muara Bulian students was dominant in the good category, while the social care character of students with the application of the dominant print module was sufficient.

This policy paper bridges interdisciplinary research to analyze the effects of drug policy in Azerbaijan on the provision of social care and treatment for young people who use illicit drugs. Drawing on Carol Bacchi’s critical policy analysis method – ‘what’s the problem represented to be’ – the paper focuses on what the state’s drug policy enables and/or impedes in the implementation of better protection and care for young people aged between 14 and 17. To do this, two texts are selected for the analysis to explore representations and social construction of youth through various problematizations in policy legislations. The analysis suggests that drug policy in Azerbaijan is formulated to further cultural and political purposes to maintain a community-based immunity to drugs, rather than psycho-social and medical interventions or individual engagement with young people’s wellbeing.

The background of foster children in Kemala Puji orphanage are mostly from poor families, orphans, neglected, and homeless child. The institution have been serve, nurture, and empower by providing them a sufficient living. Hence, it still needs a better improvement. This is because these children deserve to be made for the next generation. This activity aims to rise of social care between humanity in adolescents, especially for children in the orphanage. This have been done by imparting knowledge to them about healthy internet. Moreover, its increases understanding how to use the internet more healthily, properly and to anticipate of cyber bullying against them. The outcome of training activities are the youth children have been understood how to use a healthy internet, and they have been sufficient skills how to use internet which was given during the training.

Past research has shown that routines can be a vehicle for both stability and change in organizations. It is unclear however how this relationship alters and solidifies over time. In this paper, the changing behaviours of three newly formed teams within a domiciliary care organization are tracked over a period of two years. It was seen that self-reinforcing processes shaped the emergence and persistence of action patterns within these groups. The first process achieved coordination benefits which drove the emergence of routines, as ‘action patterns’ were first negotiated and then assigned to members of the care team. The second self-reinforcing process involved sets of expectations which deepened interpersonal relationships between the care worker and client. The impact of both these processes, altered the ostensive-performative duality, as routines emerged and persisted over time. This study therefore highlights the changing dynamics of stability and change within routines, and the key role played by social relations in this process.

This article contributes to ongoing discussions about frailty and vulnerability in critical gerontology by asserting that possibilities to engage and enact influence in everyday life situations is a crucial dimension of democracy in later life. We discuss how democracy in this sense can be threatened for older persons for whom health and social care services are needed, following from the labelling practices of frailty and the non-recognition of the social processes that set capabilities in motion. We utilise three examples grounded in research with older persons in their home environment in a Swedish context. The examples show how older people use creative, emotional, practical and social resources to integrate activities in a manner that address their needs and capabilities, and influence the situations in direction towards how and when to be engaged in everyday activities. Based on a discussion of the examples, we argue that health and social care services that provide and build social infrastructures need to recognise the potential concurrency of interdependency, vulnerability and agency within older persons’ local everyday practices. This to address capabilities and enable concrete expression of democracy in everyday situations. Overall, we suggest that conceptual and methodological shifts in research, as well as policy and practice, are needed to bring democratic processes forward through the relational and situated aspects of resources, agency and influence.

A munka célja, hogy a szolidaritás és spiritualitás fogalmain keresztül bemutassa, milyen új módszerek lehetségesek a szociális ellátással kapcsolatos képzésben és gyakorlatban. Különös figyelmet kell fordítani az emberre, mint kiindulópontra, továbbá az egyházi fenntartók sajátos értékeire is.

Physical function scoring of burn ICU patients is recommended but currently validated scores are lacking.To evaluate the predictive validity of the FAB -CC for burn ICU patients' discharge outcome.All patients underwent daily exercise and FAB -CC screen if they were stable. Two FAB-CC scores were performed; FAB-CC1 on the first day the patient passed the FAB-CC screen, FAB-CC2 within 48 h before ICU discharge. Hospital discharge outcome was defined as transfer for further inpatient rehabilitation or home with social care versus home with no social care. 76 patients' data were entered into the analyses. We used multiple logistic regression analysis to identify variables that predict discharge outcome.Increasing patient age (p = 0.001), duration of ventilation (p = 0.0003), ICU Length of stay (LOS) (p = 0.0001), total hospital LOS (p0.0001), presence of cardiopulmonary disease (p = 0.008), neurological disorder (p = 0.0003) and psychiatric illness (p = 0.003) are positively associated with transfer for inpatient rehabilitation or home with social care. Increasing FAB-CC1 (p0.0001) and FAB -CC2 (p = 0.0001) are negatively associated with transfer for inpatient rehabilitation or home with social care. The most predictive model for discharge outcome combined the variables patient age, FAB-CC1, FAB-CC2 and psychiatric illness. Patient age (p = 0.01), FAB-CC1 (p = 0.02) and psychiatric illness (p = 0.009) independently predict discharge outcome.FAB-CC2 is associated with, and FAB-CC1 has predictive validity for, patient hospital discharge outcome. These findings, in conjunction with our earlier work, confirm clinical utility of the FAB-CC for burns ICU patients.

Kari Almendingen,1 Anne Kristine Bergem,2 Bente Sparboe-Nilsen,1 Lisbeth Gravdal Kvarme,1 J&umacr;rat&edot; Šaltyt&edot; Benth3,4 1Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet – Oslo Metropolitan University, Oslo, Norway; 2Centre for Next of Kin and Carers, Stavanger, Norway; 3Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway; 4Health Services Research Unit, Akershus University Hospital, Lørenskog, NorwayCorrespondence: Kari AlmendingenDepartment of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet – Oslo Metropolitan University, Oslo, NorwayEmail kalmendi@oslomet.noIntroduction: Children who are “next of kin” (ie, sick/dying/addicted/imprisoned close relatives) are at increased risk for health consequences. Health professionals in Norway are required by law to help such children, and professional educations should focus on this issue.Aim: To assess the extent to which students attending health, social care, and teacher education felt their uni-professional education and a mandatory interprofessional learning (IPL) course had taught them about children as next of kin. To explore variations in student responses according to age and educational background.Methods: This was a cross-sectional study. Students (n = 2811) completed questionnaires relating to IPL courses delivered in 2019 and 2020 (hybrid case-based learning). Students discussed issues relating to interprofessional collaboration targeting children, young people and their families in small IPL groups.Findings: The response rates ranged from 25.8% to 36.0%. All but 5.2% of the students agreed that it was important to learn about children as next of kin. Although 61.9% reported that their education had not taught about such children, 73.8% had gained increased insight from the IPL course (difference 35.7% 95% CI (29.0; 42.0), p < 0.001). The teacher and child welfare students had gained greater insight than the health and social care students. Significant pre- to post-course increases were found among the physiotherapy (p < 0.001), Mensendieck physiotherapy (p < 0.001), teacher education (p < 0.001), early childhood education (p < 0.001), and teacher education in art and design (p = 0.042) students.Conclusion: Nearly 2/3 reported that they had not been taught about children as next of kin at their own educations, but more than 2/3 had gained greater insight from the IPL course. The health and social care students reported the least gain. Although the law has existed for a decade, the topic of children as next of kin is still omitted from most educational programs.Keywords: children as next of kin, children as relatives, health, social care, teachers, collaboration, interprofessional

There is no Strategic Plan for tackling and preventing homelessness in Slovakia, which exacerbates the unsystematic process of social services for homeless people. For this reason, we point out the positives and negatives of the whole system. The research focuses on mapping the current situation of homelessness and describes the aid system under the auspices of the non-profit sector. The participants in the research were social and street workers who provide care and counseling for the homeless on an outpatient basis, on a residential basis or directly in the street where they live.

This article uses John Kelly’s mobilisation framework, with its foundational concept of injustice, to explore workers’ propensity towards unionism in England’s outsourced social care sector. Drawing on 60 interviews with union organisers and officers, care workers, support workers and care company managers, this research highlights the difficulties of union organising in the sector and explores theorisations of mobilising. The research contends that for mobilisation theory to provide insight into relationships between work and unionism, varieties of injustice and collectivism need to be contextualised. Paid care provision generates both employment-related injustices and care-related injustices, which lead to divergent collective identities and attitudes towards unions. An absence of a coherent entity for workers to attach blame to – within a context where private providers frequently remain reliant on state funding levels – affects whether injustice and collectivism progress to mobilisation and unionisation.

Purpose The purpose of this paper is to broaden the discussion on some of the barriers and solutions for co-production in positive behaviour support (PBS) planning as identified in the paper “Including people with intellectual disabilities in the development of their own Positive Behaviour Support Plans”. Design/methodology/approach Drawing on the literature associated with co-production in PBS planning, this commentary will reflect on the wider systems and culture needed to enable successful implementation of this way of working. Findings Co-production in PBS planning is recommended as part of best practice guidelines. However, there is limited research in the area of co-production with regards to PBS and use of augmentative and alternative communication methods. Collaboration among speech and language therapy and PBS practitioners is an important factor for co-production to achieve the best outcomes for people with learning disabilities who display behaviours of concern. Along with identifying a range of communication tools/strategies needed for PBS assessment/planning, it also requires a whole systems approach and culture shift to ensure the necessary foundations are in place. Originality/value Co-production in PBS planning remains an under practiced way of working. This commentary builds on the barriers and solutions identified for co-production and provides further insight into what might be needed to achieve this in health and social care settings.

This commentary offers some observations on and around aspects of the Financialisation Theme Issue Papers.

Why you should read this article:• To enhance your understanding of the networking role of the registered nurse in intellectual disability• To familiarise yourself with the requirements of the networking role during the COVID-19 pandemic• To learn more about how to access services for clients with a learning disability during COVID-19The role of the registered nurse in intellectual disability (RNID) includes networking, which is an important aspect of supporting people with an intellectual disability with their health and social care needs. Networking involves RNIDs communicating with various people in intellectual disability services, mainstream health services and local communities. The advent of coronavirus disease 2019 (COVID-19) resulted in RNIDs having to use their networking competences to support clients and their families, particularly in accessing the services they needed to maintain their health during the pandemic.This article examines this networking role and discusses the developments required for RNIDs to support people with an intellectual disability effectively during a pandemic. The article also calls for further research and clarification of the networking aspect of the RNID role. This will provide knowledge that can underpin intellectual disability nursing education and practice.