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NHS England’s Five Year Forward View outlines new care models and the need for a workforce that has the skills, values, and competencies to deliver this vision. This is a position paper detailing the context, method, and intentions of a Health Education England funded project led by Manchester Metropolitan University in the North West of England, which the authors see as making a key contribution to addressing issues of illness, crisis, and loss in the changing landscape of health and social care provision in England. Using an action research methodology and drawing together key stakeholders from the sector, the project aims to explore the potential for creating a professional health and social care graduate workforce which meets the needs of an integrated service delivery landscape by identifying key issues to be addressed when redeveloping the undergraduate curriculum. [ABSTRACT FROM AUTHOR]

School systems across the country are transitioning from paper-based testing (PBT) to computer-based testing (CBT). As this technological shift occurs, more research is necessary to understand the practical and performance implications of administering CBTs. Currently, there is a paucity of research using CBTs to examine working memory (WM) performance, even though CBTs may negatively influence performance. The present study compared a WM CBT and PBT and found enhanced WM performance on the PBT across several verbal and visuospatial WM tests. This pattern was evident even after age was controlled, indicating that test mode effects were persistent across ages (4-11 years). CBTs on WM performance may yield lower scores due to developmental WM differences, increased cognitive workload, test mode effects stemming from individual access to technology, and participant characteristics, such as developmental, biological, or gender differences. The presence of divergent WM in CBT and PBT indicates the need for additional options for children at risk of academic failure because of testing modality. [ABSTRACT FROM AUTHOR]

John Davies Thomas (1844-1893) described a two-ounce drop-bottle for chloroform in 1872 while he was a resident medical officer at University College Hospital, London. After working as a ship's surgeon, he settled in Australia. In May 1875, Thomas presented a paper on the mortality from ether and chloroform at a meeting of the Medical Society of Victoria in Melbourne, Victoria. Surveys conducted in Europe and North America had established that the mortality from chloroform was eight to ten times higher than that from ether. At that time, chloroform was the most widely administered anaesthetic in Australia. Thomas' paper was published in The Australian Medical Journal and reprinted by the Medical Society of Victoria for distribution to hospitals in the Colony of Victoria. Later that year, Thomas moved to Adelaide, South Australia, where he may have been influential at the Adelaide Hospital in ensuring that ether was administered more often than chloroform. It does not appear that Thomas' papers on anaesthesia had a significant effect on the conduct of anaesthesia in Victoria or New South Wales. [ABSTRACT FROM AUTHOR]

Background: Festivals play an important role in improving death and grief literacy, enabling members of the public to engage with these often-sensitive topics. Good Grief Weston festival was co-designed and delivered with the community in Weston-super-Mare, a coastal town in South-West England with high levels of socioeconomic disadvantage but rich community assets. It was held in person over 8 days in May 2023. Objectives: To evaluate the reach and impact of Good Grief Weston festival and gather data to inform future festivals. Design: Mixed methods evaluation (survey and focus groups). Methods: Online and paper surveys assessing participants' characteristics and experiences were administrated during and after the festival. Survey participants who indicated their willingness to participate were invited to attend a focus group. Focus groups were recorded, transcribed and analysed using thematic analysis. Data were collected by trained community co-researchers. Results: Approximately 3000 people attended the festival. Of 204 completed surveys, 64.5% were from women, age range ⩽15 to ⩾75 years; 88.2% identified as White; 14.9% deaf, disabled/with a chronic condition; 18.9% neurodivergent; 9.0% gay, bisexual or queer. Festival participants were entertained (70.9%), inspired (68.5%), felt part of a like-minded community (54.3%), talked to someone new (49.2%), learnt about grief/bereavement (34.3%), shared or expressed experiences (30.3%) and found out about local support (19.7%). 71.3% reported that they felt more confident talking about grief after attending. Median experience rating was 5 (IQR 0; possible range 1 = poor to 5 = excellent). In free-text comments, participants expressed appreciation for the festival and described benefits in attending. Two focus groups were conducted (n = 8 participants, all women), lasting c.1.5 h. Focus groups added rich descriptions of the festival's value, and data to inform the next festival. Conclusion: Findings suggest festivals of this nature can play a central role in a public health approach. Plain language summary: What was the impact of Good Grief Weston festival? Why was the study done? Previous studies have shown that many people feel unsupported by their community after the death of a loved one. We designed a festival to improve knowledge and support for bereaved people. We did this study to assess how the festival affected the people who attended. What did the researchers do? The team included researchers and people and organisations from the local community. Together, we designed and ran a festival on the topic of death, grief and bereavement in Weston-super-Mare, a coastal town with areas of high deprivation. The festival took place over an eight-day period in May 2023 and included creative, interactive and educational events. The team collected feedback on attendees' experiences of the festival. We did this using online and paper feedback forms, postcards, and focus groups to collect as many opinions as possible. What did the researchers find? We found that a wide range of people attended the festival. Most people who took part in the research rated the festival as 'excellent'. They told us they learnt about grief and bereavement and found out about local support services. Attendees met new people, shared their experiences, and felt that the festival built community spirit. They also made suggestions to improve any future festivals. What do the findings mean? The findings show that in-person festivals can effectively engage the public on the topic of death, grief and bereavement. They can also help develop connections between people and organisations in communities. These connections and learning opportunities may help communities to support their members through bereavement. [ABSTRACT FROM AUTHOR]

Examining the entanglement of democracy and social justice in education and the relationship to social mobility, this paper critiques the individualising nature of social mobility in policy discourse as inimical to human flourishing and education as a public good. The rhetoric of social mobility which responsibilises individuals for their success, without due regard to the systemic changes needed to enable this and the societal barriers to social mobility experienced disproportionately by some groups in society, is detrimental to social justice. A conception of education as a pathway to social mobility must be located in a wider vision of civic engagement in a more inclusive and fairer society. Yet civic engagement in education at the local level has been eroded, as illustrated in this paper by the example of an evolving model of school governance in England. As a corporatist, market driven reform, this model exemplifies how local democratic ties between schools and engagement with their communities can be undermined. Social mobility to enable opportunities, access and participation in democratic civic society becomes a fantasy when society is riven with systemic inequalities, lacks the necessary conditions to enable human flourishing and links to community engagement in education for democratic renewal are downplayed. [ABSTRACT FROM AUTHOR]

Livestock markets are pathological sites in which contrasting biopolitical regimes compete to reconfigure agricultural practices and identities. Whilst the circulation of cattle is central to agricultural geographies, little is known about the practices of cattle trading or the role of livestock markets in cattle purchasing. Drawing on recent attempts to conceptualise the process of marketisation, this paper seeks to invigorate research into livestock markets. Specifically, the paper conceptualises cattle purchasing as a market encounter in which socio-technical arrangements, devices and bodily performances entangle cattle and farmers, enabling markets to work. Using data collected from interviews, focus groups and participant observation at livestock markets in England, the paper makes two contributions. Firstly, the paper shows how farmers' cattle purchasing practices are organised by practices of 'fluid engineering' that seek to maintain the 'farm system'. Secondly, the paper shows how at livestock markets, these strategies are mediated by front and backstage 'market displays' by farmers and auctioneers which produce market price through a series of performances that are carefully spatially and temporally ordered. Specifically, these displays perform specific rural and agricultural identities, such as the 'genuine' or 'good' farmer. In creating these spatial frames, frontstage displays diminish the relevance of backstage displays that rely on abstract calculations by distant others. The paper therefore reveals the intense entanglements and socio-technical work that is required to make cattle markets function and their wider relevance for the management of livestock diseases. [ABSTRACT FROM AUTHOR]

During COVID and lockdown, many prisoners have not only been affected by infection transmission in crowded and ill-equipped institutions, they have also been separated from a range of supports, including loss of family and professional supports and support for prisoners with addiction and/or mental health problems has been disrupted. This paper reports on evidence of how peer-based recovery organizations have attempted to mitigate these adverse effects, based on a case study of one prison in the North-West of England, using a range of routine reporting data and original research data. The paper shows how prison-based peer recovery support has not only continued through lockdown but grown both in the prison and in continuing care on release. The key conclusion is that Lived Experience Recovery Organizations (LEROs) have a vital role to play in offering continuing care to prison populations both to support early recovery and to sustain change around release back into the community, in COVID but also more generally. [ABSTRACT FROM AUTHOR]

Population Health Management – often abbreviated to PHM – is a relatively new approach for healthcare planning, requiring the application of analytical techniques to linked patient level data. Despite expectations for greater uptake of PHM, there is a deficit of available solutions to help health services embed it into routine use. This paper concerns the development, application and use of an interactive tool which can be linked to a healthcare system's data warehouse and employed to readily perform key PHM tasks such as population segmentation, risk stratification, and deriving various performance metrics and descriptive summaries. Developed through open-source code in a large healthcare system in South West England, and used by others around the country, this paper demonstrates the importance of a scalable, purpose-built solution for improving the uptake of PHM in health services. [ABSTRACT FROM AUTHOR]

Policies for biodiversity no net loss and net gain underwrite narratives for green growth through advancing reparative logics to ongoing habitat impacts. By enabling offsetting practices that risk accommodating rather than averting land change developments, net principles are said to resemble modes of 'accumulation by environmental restoration'. Biodiversity net principles are frequently depicted visually as a diagram of the mitigation hierarchy for communicational ease and have proliferated over recent decades despite little evidence for their ecological effectiveness. This paper combines economic sociology, visual media analysis of the net diagram and political ecology to account for the stabilisation of net principles in policy frameworks. It highlights the upstream imaginative work that this visual tool and its wider assemblages perform to support offsetting and habitat banking practices on the ground. The paper positions the NNL diagram as a conceptual and ideational technology. It traces the practices through which biodiversity is rationalised by the Cartesian coordinates of an XY schematic, and en-framed as a measure of numerical value on a vertical scale. The effect is to engender coherence to the idea of netting out differences in aggregate sums of biodiversity unit value, making nature conceptually offset-able. I develop this account through a history of the diagram as well as the broader processes that have shaped the policy and its arrival in English planning frameworks. Observers increasingly question how biodiversity offsetting and no net loss/ net gain have become so popular when their empirical foundations are so weak. This paper proposes that within the wider assemblages of actors, one answer is located in the potency and mobility of conceptual technologies such as diagrams of no net loss or net gain of biodiversity and the logic of balance-sheet accounting that is imbricated within the visual design. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has highlighted the benefits which digital technology offers to all aspects of dental practice and education. This paper provides an overview of how digital technology has enhanced clinical and administrative procedures within dental practice, including computer-aided design/computer-aided manufacture (CAD/CAM), digital radiography, 3D printing, patient records, electronic patient referrals and electronic communications from dental practices. It then considers the development of teledentistry (mHealth) and its benefits in enabling distant consultations with patients, who for one reason or another are unable to visit dental practices easily. It then goes on to consider how and why digital dental distance learning materials were provided to general dental practitioners in England by the Department of Health (DoH) (England) and how they evolved. Finally, this paper considers the use of digital technology in dental education by dental schools. [ABSTRACT FROM AUTHOR]

This paper presents a new methodological model that was developed whilst carrying out an Institutional Ethnography to explore school food working practices. The model brings together two complementary approaches; Institutional Ethnography and Systems Thinking, to offer a novel approach to the analysis and visualisation of ethnographic data as systems maps that show how power shapes practices. This novel contribution allows for the mapping of complex working practices to show interdependencies and flows, and addresses limitations in the applicability of Institutional Ethnography to policy research. This approach will be useful for researchers and practitioners who want to utilise findings from Institutional Ethnography to design effective interventions, change outcomes of working practices, or tackle policy problems. [ABSTRACT FROM AUTHOR]

Background: Palliative care is insufficiently integrated in the continuum of care for older people. It is unclear to what extent healthcare policy for older people includes elements of palliative care and thus supports its integration. Aim: (1) To develop a reference framework for identifying palliative care contents in policy documents; (2) to determine inclusion of palliative care in public policy documents on healthcare for older people in 13 rapidly ageing countries. Design: Directed documentary analysis of public policy documents (legislation, policies/strategies, guidelines, white papers) on healthcare for older people. Using existing literature, we developed a reference framework and data extraction form assessing 10 criteria of palliative care inclusion. Country experts identified documents and extracted data. Setting: Austria, Belgium, Canada, Czech Republic, England, Japan, Mexico, Netherlands, New Zealand, Singapore, Slovenia, South Korea, Spain. Results: Of 139 identified documents, 50 met inclusion criteria. The most frequently addressed palliative care elements were coordination and continuity of care (12 countries), communication and care planning, care for family, and ethical and legal aspects (11 countries). Documents in 10 countries explicitly mentioned palliative care, nine addressed symptom management, eight mentioned end-of-life care, and five referred to existing palliative care strategies (out of nine that had them). Conclusions: Health care policies for older people need revising to include reference to end-of-life care and dying and ensure linkage to existing national or regional palliative care strategies. The strong policy focus on care coordination and continuity in policies for older people is an opportunity window for palliative care advocacy. [ABSTRACT FROM AUTHOR]

The 21st century has seen the rise of a new phenomenon – the creation of statues and monuments celebrating the lives of entertainers. Drawing on debates about popular culture, placemaking and heritage, and in the context of recent controversies about the politics of statues and memorials, this paper examines a manifestation of this phenomenon as represented by statues of comedians erected in the towns of Northern England. The paper begins by sketching the characteristics of the statues and their subjects. It proceeds by reflecting on their emergence in the context of debates about the contested place of nostalgia in social and cultural theory. The paper uses a strategically selected sub-set of the statues to reflect on the emerging cultural and political imaginary of towns as sites of contemporary political struggles. It concludes by asserting that the significant affective investment into statues projects and the progressive potential of popular cultural nostalgia offer an important corrective to crude assumptions about the cultural lives of towns. [ABSTRACT FROM AUTHOR]

Background: In recent years, a significant proportion of inpatient facilities for people with intellectual disabilities and/or autism has been de-commissioned in England, This has resulted in individuals with intellectual disabilities being sent to distant hospitals far away from their families and carers leading to challenges in follow-up, community care and interventions. The impact of de-institutionalisation, has often caused patient trauma, family distress and subsequent discharge difficulties. Not every individual with intellectual disabilities and/or autism requires inpatient care but inpatient care when needed has to be local, adequate and appropriate. Aims: To evaluate current evidence of utility of inpatient models for people with intellectual disabilities and outline best clinical practice. Method: PubMed, CINAHL, EMBASE, Cochrane Library, Scopus, Web of Science were searched with key search terms. The search was conducted by the information specialist and identified abstracts screened further for inclusion criteria, methodological issues, and other appropriate characteristics. Twenty-three papers were included in the rapid review. Papers shortlisted had the inclusion criteria applied against the full text version independently by two reviewers. Disagreements regarding eligibility of studies was resolved by discussion and consensus within the project team. Key data related to in-patient models of care was extracted from the included papers, which included year of study, design, study objectives, target population, method/s tested, outcomes reported, country of study/studies, and results. Data extraction was performed by two reviewers and reviewed by the project team. Results: From the review of services for people with intellectual disabilities, we came across four broad models/frameworks/approaches. Evidence on what worked for inpatient service provision tended to be based on models developed and implemented locally. Conclusions: We make recommendations for the best clinical practice and standards. Both clinical service providers and policymakers need to be aware of specific needs of individuals with intellectual disability and/or autism. [ABSTRACT FROM AUTHOR]

Extra care housing (ECH) is a type of housing with care and support designed to enable older people to age in place. Approximately one fifth of residents living in ECH are living with dementia and yet, there remains gaps as to how best to support people to live well with dementia in the context. ECH stock across the United Kingdom (UK) includes a diverse range of options that can be grouped into integrated, specialist and separated accommodation. Integrated models involve residents with dementia living alongside residents without dementia. Specialist ECH offer accommodation exclusively for people living with dementia. Separated models offer a separate area for residents with dementia within a larger, integrated site. How these different models work for residents living with dementia is little known and has remained a significant gap in knowledge that impairs both professionals and people living with dementia when choosing housing and care. This paper reports on findings from a large study of residents living with dementia in ECH. The focus is on the potential benefits and challenges of different models of provision. Data were generated from interviews with 100 participants (residents, family members, staff, and adult social care professionals) at eight case study sites across England. Findings demonstrated that there are potential benefits and challenges within each model, but the limited diversity of stock limits choice. Multiple variables beyond the model of provision affect the lived experience, meaning that there is no universal model of optimal support. Rather, the approach and resources of each site is more important than the model of provision. Suggestions for future research directions are considered. [ABSTRACT FROM AUTHOR]

Understanding the factors that influence domestic violence and abuse (DVA) victims to withdraw from the Criminal Justice System globally continues to be a key focus for professionals and academics working within this area. There is a dearth of extant literature examining the motivations behind victim withdrawal, particularly retraction occurring post provision of an initial statement. This paper examines the phenomenon of retraction, by thematically analysing N = 60 police retraction statements (PRS) collected by police officers in a large suburban police force in the North West of England. In examining these statements, insight can also be garnered from those victims still in an active relationship with their abusers. Findings highlight female victims' motivations for retraction and are framed around victim problem solving including: a) accepting the relationship which resulted in a discordance in proceeding with the prosecution of the abuser b) rejecting the relationship thereby rendering the prosecution as redundant c) engaging in procedural problem solving where alternative measures such as civil actions were sought to substitute a CJS prosecution and d) the effect of children where motivations were split between retracting to return to the complete family unit including the victim as the mother and retracting due to recognising the importance of the father's role without involvement from the mother. Notwithstanding limitations, this paper demonstrates that there is significant value in conducting an analysis of PRSs in furthering the understanding of why victims choose to retract at this point in their prosecution journey. The extracts from this dataset add insight and understanding into DVA female victim motivations to retract post-initial statement provision and highlight the differences within victim populations who retract their original statement. [ABSTRACT FROM AUTHOR]

Engaging in 'reflexive practice' throughout the research process (Benson and O'Reilly, 2022) and a 'reflexivity of discomfort' (Hamdan, 2009) through an intersectional lens, this article presents a reflective account of accessing and conducting observations and interviews at a South Asian women's organisation, in North England, to explore Pakistani and Bangladeshi Muslim (PBM) lone motherhood. It critically explores how researchers' own subjectivities and intersecting identities – in this case, my intersecting identities and positionalities as a young British Pakistani Muslim women, researcher and volunteer – impact interactions in different circumstances with different groups of participants and the importance of having continuous critical self-awareness. Moving beyond simplistic insider–outsider debates, the paper contributes towards further developing reflexivity debates taking an 'intersectional reflexivity' approach. It argues for thinking about the research process and engagements in the field as socially constructed, changing, adapting and negotiated overtime and to utilise intersectionality to unpick broader categories. Finally, it encourages researchers to adopt reflexivity in their research practices. [ABSTRACT FROM AUTHOR]

Aim: This paper aims to assess the complexity, quality and outcome of endodontic treatment provided in Managed Clinical Networks (MCNs) in England to understand if we are "getting it right first time" (GIRFT). Methods: In a convenient sample of endodontic treatments provided between May 2011 and April 2017, the complexity of teeth treated, the quality of treatment procedure, the radiographic appearance of root fillings, as well as clinical and radiographic healing were retrospectively assessed using records taken as part of treatment. Trained, calibrated examiners independently scored radiographs using previously published scoring systems. Results: 646 teeth were followed up for 24.7 months (standard deviation [SD] 17.08). The average age of those patients treated was 46.7 years (SD 15.38) with 48.3% being male. Of teeth treated, 70.4% were of complexity level 3. 88.2% of teeth were asymptomatic, and 80% demonstrated complete radiographic healing. Procedural errors inhibited achieving correct working length and taper, with more voids within root canal fillings. When patency filing was reported as being carried out, complete radiographic healing was more likely. Conclusions: It is possible to collate outcome data in the NHS system, especially if there is provision for ongoing follow up and time allocated for collection of data. Endodontic treatment provided within primary and secondary care settings are of high quality, with outcomes being better with single operators carrying out high volumes of endodontic treatment. [ABSTRACT FROM AUTHOR]

Fieldwork encounters are not only contingent to biographical subjectivities, but are mediated by a confluence of identity, place and embodiment. This paper offers reflexive accounts of researchers with various socio-cultural and disciplinary backgrounds, who collaborated as a team to examine the varied funerary experiences and needs of established minorities and recent migrants in England and Wales. Focusing on the researchers' varied personal experiences with death and bereavement and on their performances of minority and majority ethnic and migrant identities, the paper highlights the mediated and embodied nature of fieldwork. It argues that reflection on the various aspects of intersectional researcher identity is necessary for a rigorous fieldwork practice that takes transparency and politics into account. This facilitates a deeper understanding of the positionality of both researchers and interlocutors, and the situated co-production of knowledge. In doing so, the paper illustrates that conducting research with a diverse team of researchers contributes to better understanding the complexity and multifacetedness of social phenomena. [ABSTRACT FROM AUTHOR]

The most significant episode in the assetisation of housing (underpinning its financialisation) is often understood to be the economic restructuring that took place during the 1980s – particularly deregulation of the banking sector and credit liberalisation. Research has reported on the housing 'investor subject' that emerged during this time, as an integral part of the transition towards financialised economies. This article provides new evidence about the housing consumer subject, and its place in this transition, by drilling into UK housing policy history and its discourses around the consumer relationship with housing. Using archive data from the Parliamentary and National Archives alongside interviews with key informers, we illustrate three cases of housing policy development in which the consumer demand for, and relationship with, housing is discursively reconditioned. We conclude that the housing investor subject was pursued in housing policy reform and its discourses well before the 1980s and the economic reforms commonly identified as the causes of financialisation. In addition, these discourses are found to have been reconditioned in order to align with broader macroeconomic policy concerns of the time. The article therefore provides a rare view of assetisation from within the state apparatus, revealing how housing policy and its discourses around consumption became functionally integrated within wider macroeconomic goals. [ABSTRACT FROM AUTHOR]

Over the past decade, there has been a growing trend towards the use of 'big qualitative data' in applied health research, particularly when used as part of mixed methods evaluations of health policy in England. These 'big qualitative' studies tend to be longitudinal, complex (multi-site and multi-stakeholder) and involve the use of multiple methods (interviews, observations, documents) and large numbers of participants (n = 100+). Despite their growing popularity, there is no methodological guidance or methodological reflection on how to undertake such studies. Qualitative researchers are therefore faced with a series of unknowns when designing large qualitative studies, particularly in terms of knowing whether existing qualitative sampling and analysis methods are appropriate in this context. In this paper, we use our experience of undertaking a big qualitative study, as part of a national mixed methods evaluation of a health policy in England to reflect on some of the key challenges that we faced in our qualitative study, which broadly related to: sample size, data analysis and the role of patient and public engagement. Underpinning these difficulties was the challenge of being flexible and innovative within the largely positivist research climate of applied health research and being comfortable with uncertainty relating to the three issues outlined. The reflections we present are not to be viewed as a method 'how to' guide, but rather as a platform to raise key issues relating to the qualitative methods that we found challenging, in order to stimulate discussion and debate amongst the qualitative community. Through this paper, we therefore hope to demystify what it is like to undertake such a study and hope to spark much needed discussion and innovation to support the future design and conduct of qualitative research at scale. [ABSTRACT FROM AUTHOR]

City deals – place-based agreements between central and local state actors – are an increasingly common intervention for supporting economic performance in urban areas. This paper presents empirical evidence on the effectiveness of city deals by estimating the impact of the UK's City Deals scheme on rates of economic growth, productivity and job creation across England between 2010 and 2019. Because the City Deals were introduced in two waves, we estimate its effects using a differences-in-differences (DiD) with multiple time periods (MTPs) approach. Our DiD estimates indicate that, overall, the City Deals were associated with improvements in local economic performance, but that the first wave of city deals resulted in gains of around 2.5% to 3% that were not observed in the second wave. These results suggest that city deals are most effective when appropriate institutional structures are in place and highlight the value of MTP approaches. [ABSTRACT FROM AUTHOR]

In 2008, Sean Rigg, a 40-year-old Black British man died in England and Wales police custody. It was not until 4 years later at the inquest that it transpired one of the police officers involved, the custody sergeant, PS Paul White gave false information. White had claimed he saw Rigg in the van upon his arrival however CCTV footage demonstrated this did not happen. Following a deconstructive approach this paper examined the inquest transcripts to explore how belief and the possibility of being mistaken was integral to the account White provided. It is the ambiguity of truth/fiction that is significant in legal investigations for it comes to produce the justifications for the deaths of Black people in England and Wales. [ABSTRACT FROM AUTHOR]

Based on 52 qualitative interviews with working-class individuals, this paper explores the social and economic decline of a coastal locale referred to as High Town in Teesside in the North East of England. First, the paper outlines how the locality expanded as a popular seaside resort under capitalism's post-war period. It then assesses how the seaside existed together with industrial work, offering stable employment opportunities, economic security and a sense of community. Next, the article documents the shift to neoliberalism in the 1980s, specifically the decline of High Town's seaside resort, the deindustrialization process and therefore the 2015 closure of High Town's steelworks. It explicates how this exacerbated the locale's economic decline through the loss of industrial work's 'job for life', its diminishing popularity as a coastal area and the further deterioration of the town centre. The paper concludes by suggesting that High Town has lost its raison d'être under neoliberalism and faces difficulties in revival. [ABSTRACT FROM AUTHOR]

When countries are impacted by a crisis, comparisons at the national level are often drawn. Whilst useful, this approach fails to explore how local measures are enacted alongside centralised responses. This paper addresses that gap by examining England's intergovernmental response to the Covid-19 pandemic. With a focus on multi-level governance (MLG) and resilience theories the paper explores how tiers of government respond to the demands of the crisis. The focus is primarily on the responses of those involved with responding to the economic crisis with a recognition of the interlinked health and environmental crises. Adopting a case study approach, which included some of the areas hardest hit by the pandemic, the paper asks whether the application of MLG provided a resilient system to the shock of the pandemic. The findings illustrate local government sought to respond quickly, but decision-making was too often centrally controlled rather than devolved to the most appropriate scale. The paper draws lessons for how England might think constructively about its post pandemic reorientation considering the adaptation of intergovernmental roles and subnational governance that permits greater devolution to facilitate place-based recovery. Drawing on the knowledge gained throughout the pandemic, the paper argues that to Level Up in England and address the long-term economic and societal imbalances will demand a place-based recovery model. [ABSTRACT FROM AUTHOR]

'Levelling UP' has taken on considerable significance in the policy discourses of the Johnson conservative government, particularly regarding the English regions. However, what is meant by Levelling up has been far from clear, although if it is to mean anything it must at least in part mean addressing the needs of disadvantaged and left behind communities. Key premises of this paper are that young people must be considered valued members of those communities; and that, to meet their expressed needs, youth work can be the best placed service for (re)investment, not least because it has demonstrated that it consistently enables a wide variety of outcomes in their lives. The investment required must be seen in the context of the huge austerity cuts to youth services in England which disproportionately affected disadvantaged communities. To make the case for 'levelling up' to completely rebuild as well as further develop those services. This paper brings together an analysis of past and current youth policies with a range of relevant empirical data. [ABSTRACT FROM AUTHOR]

This paper seeks to learn lessons about the role of the private sector in subnational governance by analysing the UK's Local Enterprise Partnerships (LEPs). The paper outlines the public justifications for LEPs using documentary analysis, and then considers these against findings from interviews and network analysis, concluding that the justifications are problematic. LEPs were established on the assumption that civic and business leaders needed to be brought together in business-led institutions. However, network analysis shows most civic leaders also hold private sector roles, undermining the assumed need for a 'bringing together'. Three further justifications of the LEP model are also challenged. Firstly, business leaders were supposed to enable knowledge flows, but analysis shows that this knowledge is skewed by unrepresentative LEP boards. Secondly, it was assumed that LEPs would catalyse networks, but the networks have been built around individual interests, without transparency. Finally, LEPs were meant to mirror business structures, but this has undermined democratic accountability. Taken together, these findings suggest that the creation of LEPs has attempted to solve the wrong problem in the wrong way. The paper concludes by proposing guiding principles for the role of the private sector in the Levelling Up agenda: representation, transparency and accountability. [ABSTRACT FROM AUTHOR]

BACKGROUND: A greater understanding of Over the Counter (OTC) and Prescription Only Medication (POM) misuse amongst adults accessing substance misuse services (SMS) during COVID-19 is required to identify how SMS can better meet the needs of the people who require treatment. AIM: To use a questionnaire to explore OTC/POM misuse during COVID-19 in adults accessing community SMS in England. METHODS: In 2020 to 2021 anonymous self-administered online/paper questionnaires which collated quantitative and qualitative data were completed. They were piloted for suitability and ethical approval was obtained. Thematic analysis was conducted for qualitative data and chi-square tests used to assess the relationship between quantitative variables. RESULTS: Participants were Caucasian (94.6% British), majority male (58.9%), aged 18 to 61 years. Most were prescribed medication for problematic substance use, with a 92.5% self-reported adherence rate. The misuse of benzodiazepines (22.2%) codeine products (30.8%) and pregabalin (14.5%) predominated and 37.5% misused 2 or more medicines. Administration was usually oral and concomitant use of other substances was common: alcohol 44.6% (52% daily), tobacco/vaping 73.2% and illicit substances 58.9%. There were statistically significant associations identified, including between changes during COVID-19 to OTC/POM misuse and illicit use. Only 56 questionnaires were included in the analysis: we believe this low number was because of infection control measures, limited footfall in services, pressures on staff limiting their capacity to distribute the paper questionnaires and reliance upon telephone consultations limiting online distribution. Increasing OTC/POM misuse and obtaining illicit supplies were reported when access to usual supplies were restricted; however, changes to doses/dispensing arrangement liberalisation in response to COVID-19 were positively viewed. CONCLUSION: OTC/POM misuse, including polypharmacy and concomitant use of other substances occurred during COVID-19: SMS need to be vigilant for these issues and mitigate the associated risks for example with harm reduction interventions. Further qualitative research is required to explore the issues identified. [ABSTRACT FROM AUTHOR]

Despite extensive research looking at the phenomenon of burnout, little is known about how individuals working in traditionally high-burnout occupations understand the term. Interviews were conducted with six teachers working in state schools in England centring on how the term burnout was understood and how it was used or encountered. Reflexive thematic analysis was employed from a critical realist perspective to analyse the data generated. All participants described burnout as a stress-related condition, yet for some participants the point at which stress became burnout was unclear leading to an understanding that burnout was the point at which one was unable to work. Many participants highlighted an individualistic understanding of burnout, perceiving it as representing an individual deficit rather than an organisational failing. This was often reinforced by where the term was encountered (at work or in the media) and was linked to the stigma many participants associated with burnout. This paper concludes that individualistic framings of burnout obscure its organisational determinants while reinforcing notions that mental well-being is something which should be personally – and privately – managed by individuals. [ABSTRACT FROM AUTHOR]

Background: Hospice-at-home aims to enable patients approaching end-of-life to die at home and support their carers. A wide range of different service models exists but synthesised evidence on how best to support family carers to provide sustainable end-of-life care at home is limited. Aim: To explore what works best to promote family carers' experiences of hospice-at-home. Design: Realist evaluation with mixed methods. This paper focuses on qualitative interviews with carers (to gain their perspective and as proxy for patients) and service providers from 12 case study sites in England. Interviews were coded and programme theories were refined by the research team including two public members. Setting/participants: Interviews with carers (involved daily) of patients admitted to hospice-at-home services (n = 58) and hospice-at-home staff (n = 78). Results: Post bereavement, 76.4% of carers thought that they had received as much help and support as they needed and most carers (75.8%) rated the help and support as excellent or outstanding. Of six final programme theories capturing key factors relevant to providing optimum services, those directly relevant to carer experiences were: integration and co-ordination of services; knowledge, skills and ethos of hospice staff; volunteer roles; support directed at the patient–carer dyad. Conclusions: Carers in hospice-at-home services identified care to be of a higher quality than generic community services. Hospice staff were perceived as having 'time to care', communicated well and were comfortable with dying and death. Hands-on care was particularly valued in the period close to death. [ABSTRACT FROM AUTHOR]

Rural enterprise hubs are physical infrastructures designed to help rural businesses access tangible and intangible benefits. They generally operate within two main business models: 'Honey Pots' (i.e. targeting business-to-customer tenants) and 'Hives' (i.e. targeting business‐to‐business tenants). This paper focuses on the former type, Honey Pot hubs, which are best suited to tenants who sell their products/services directly to the general public, such as some creative sectors, retail and tourism. Honey Pot hubs are designed to cater to such needs by attracting footfall to the space, providing cafes and facilities for the general public and hosting events. This paper explores how these Honey Pot hubs contribute to rural and regional development, through the creative practices of their tenants. The paper draws on qualitative interviews with Honey Pot managers and tenants in remote rural locations of the North East of England. The findings are useful for Hub practitioners, policy makers and rural creative businesses who want to develop similar initiatives in their locales. [ABSTRACT FROM AUTHOR]

The article offers information on the "Human Relations" 75th Anniversary Conference to be held in London, England on April 19-21, 2023.

The World Café (TWC) method is now established as a participatory tool used in community development and qualitative research. However, there is a limited critique of TWC as a social work research method, especially with children. This paper discusses TWC as a method for understanding what matters for children on the British Overseas Territory of St Helena Island. As a social worker, the importance of supporting children's engagement and voice is well known in participation, necessitating careful ethical consideration. Within this project facilitating authentic conversations with children on a remote island required examining assumptions alongside engaging with colonial legacies to bring forward respectful participation. TWC shares several fractures of other participatory approaches evolving from critical pedagogy, which appeared aligned with social work values and ethics. Facilitated shared learning and allowed children to discuss issues that mattered to them, although handing over dialogue to children required commitment to trust and sharing control with young people. Café events revealed the complex positioning of social roles situating lived experiences, whereby children developed their learning of what mattered to them through interactions and a growing understanding of their global position. The method edged dialogue towards transformative conversations, acknowledging the oppression of marginalised peoples, requires reflection and action from children and young people themselves to elevate their positions from within their own knowledge. This supports the potential for further research to understand if creative methods can create more spaces for dialogue, allowing the emergence of more authentic children's engagement in research which is more socially just. [ABSTRACT FROM AUTHOR]

Objectives: High variation in clinical practice may indicate uncertainty and potentially low-value care. Methods to identify low value care are often not well defined or transparent and can be time intensive. In this paper we explore the usefulness of variation analysis of routinely-collected data about surgical procedures in England to identify potentially low-value surgical care. Methods: This is a national ecological study using Hospital Episode Statistics linked to mid-year population estimates and indices of multiple deprivation in England, 2014/15-2018/19. We identified the top 5% of surgical procedures in terms of growth in standardised procedure rates for 2014/15 to 2018/19 and variation in procedure rates between clinical commissioning groups as measured by the systematic component of variance (SCV). A targeted literature review was conducted to explore the evidence for each of the identified techniques. Procedures without evidence of cost-effectiveness were viewed as of potentially low value. Results: We identified six surgical procedures that had a high growth rate of 37% or more over 5 years, and four with higher geographical variation (SCV >1.6). There was evidence for two of the 10 procedures that surgery was more cost-effective than non-surgical treatment albeit with uncertainty around optimal surgical technique. The evidence base for eight procedures was less clear cut, with uncertainty around clinical- and/or cost-effectiveness. These were: deep brain stimulation; removing the prostate; surgical spine procedures; a procedure to alleviate pain in the spine; surgery for dislocated joints due to trauma and associated surgery for traumatic fractures; hip joint replacement with cemented pelvic component or cemented femoral component; and shoulder joint replacement. Conclusions: This study demonstrates that variation analysis could be regularly used to identify potentially low-value procedures. This can provide important insights into optimising services and the potential de-adoption of costly interventions and treatments that do not benefit patients and the health system more widely. Early identification of potentially low value care can inform prioritisation of clinical trials to generate evidence on effectiveness and cost-effectiveness before treatments become established in clinical practice. [ABSTRACT FROM AUTHOR]

This paper explores the potential of 'Land Value Capture' in addressing the shortfall in funding to address the biodiversity crisis through a series of interviews with Local Planning Authority officers in England. It finds heterogeneity in their responses to financial austerity and imperatives to deliver development, which heavily influences developer contribution (DC) practice. The response to these pressures differed depending upon localised planning culture and its interrelation with behavioural biases, which defined the scope of officer agency to influence developer contribution outcomes. Most LPAs placed a strong emphasis upon securing real estate investment to drive economic growth and to provide opportunities to secure DC to address socio-economic issues, with the status quo bias contributing towards inertia in policy and practice change. Elsewhere, there was a greater emphasis placed upon reconciling the need to deliver development with the preservation of environmental amenity, enabling officers to carefully frame practice changes, to successfully secure funding for ecological mitigation programs. The paper illustrates the cultural and behavioural challenges in implementing DC policy change to support funding these priorities, whilst this may be overcome by legislative changes, integrating these may be compromised by resource limitations whilst also affecting the existing delivery of public goods. [ABSTRACT FROM AUTHOR]

This paper considers the potential for the Mental Capacity Act (MCA) of England and Wales to incentivise the exclusion of people with dementia from research. The MCA is intended to standardise and safeguard the inclusion of people with cognitive impairments in research. This entails various procedural requirements, which in pressurised research contexts can lead researchers to exclude people with dementia as a means of simplifying bureaucratic constraints. I consider the risks of an 'unethical ethics', wherein procedural ethics indirectly causes the exclusion of people with dementia from research, undermining historic successes toward increased inclusivity. I suggest several solutions, including enhanced sensitivity to impairments and shifting the burden of proof from justifying inclusion to justifying exclusion. The paper responds to the 'ethics creep' tradition in procedural ethics, and critical appraisals of capacity legislation in dementia research. This approach recognises that institutional research ethics is itself a major ethical concern and can unwittingly beget unethical practices. Dementia researchers must be alert to such unethical ethics. [ABSTRACT FROM AUTHOR]

Bob Parker explains, in his first paragraph below, that George O. May was a major figure in US accounting. However, this paper was published in a location (Parker, 2012) unlikely to be noticed by many accounting historians, let alone American ones. It was the idea of Steve Zeff (whose paper on the leaders of the US profession is referred to below) to ask if Accounting History would reprint it. I am grateful to the editors for doing so. The kind permission of the Devon History Society is acknowledged. The paper was written for Devonians rather than for accountants (though, of course, May and Parker were both born into or achieved these distinctions). For the avoidance of doubt, although there are newish places called Devon in the United States, we are referring here to the county in the southwest of old England. As usual, Bob's writing provides a master class in clarity and efficiency. Typically, he does not make claims about theory, but we find by the end that he has developed one: seven pre-conditions for great success as an accountant in the late Victorian age. An obituary of Bob Parker was published in this journal in 2016 (Nobes, 2016). C Nobes, Royal Holloway, University of London, England [ABSTRACT FROM AUTHOR]

Social work case files hold rich detail about the lives and needs of vulnerable groups. Traditional case-reading studies to gain generalisable knowledge are resource-intensive, however, and sample sizes thereby limited. The advent of 'big data' technology, and vast repositories of centrally stored electronic records offer social work researchers novel alternatives, including data linkage and predictive risk modelling using administrative data. Free-text documents, however – including assessments, reports, and case chronologies – remain a largely untapped resource. This paper describes how 5000 social work court statements held by the Child and Family Court Advisory Support Service in England (Cafcass) were analysed using natural language processing (NLP) based on simple rules and mathematical principles. Thirteen factors relating to harm and risk to children involved in care proceedings in England were identified by automated computer techniques, and almost 90% agreement with professional readers achieved when the factors were clear-cut. The study represents an innovative approach for social work research on complex social problems. In conclusion, the paper discusses learning points; practical implications; future research avenues; and the technical and ethical challenges of NLP. [ABSTRACT FROM AUTHOR]

Globally, mixed martial arts has seen a staggering level of growth in participation and fandom over the past 20 years. This paper presents the results from an immersive participant ethnography of an urban mixed martial arts gym in England's North West and the experience of some of its members. Emergent is that the practices of mixed martial arts can be viewed as acts of resistance against neoliberal norms and expectations that permeate the diverse yet everyday lives of participants outside the gym's walls. This paper applies the sociological imagination of and through the body and draws from the Foucauldian notion of biopower to discuss how, in the search for athletic solidarity, an authentic community is built and maintained around this transgressive pursuit. It is evident that a diverse range of individuals are making and remaking a space in which neoliberal norms, labels and expectations are rejected in favour of a renewed connection with the body and each other. [ABSTRACT FROM AUTHOR]

This paper presents findings from a photovoice project that was aimed at engaging with a diverse range of black men in a London Borough. The key objectives were to find a different way to get men to talk about their concerns and to raise awareness about mental health. Photovoice is a participatory research action technique that was developed to enable communities to document their concerns and experiences of community life that is meaningful to them. Nineteen men participated in the project. It has been suggested that men, in particular, black men do not find it easy to talk about mental health issues. This study found that through the use of photovoice methods, black men were able to talk about a range of emotions when they were offered the right medium and safe spaces to share their experiences. It found that they can and want to take control of their lives, but at times may require life skills training. Another finding was that black men have to balance expectations about being strong whilst 'containing' vulnerabilities in racialised contexts – being hard on the outside and human on the inside, and that their experiences are characterised by journeys of significant struggle and resilience in the face of adversity. The paper concludes that mental health services should find ways of engaging with black men differently, i.e. reaching out rather than the traditional mantra of 'outreach'. [ABSTRACT FROM AUTHOR]

Although entrepreneurship is well recognised as a crucial element in fostering economic development and growth, it is yet to be viewed as a significant force in sustainability transitions. Public policy related to the performance and growth of small businesses has, to date, paid little attention to the support mechanisms that help SMEs build capacity towards sustainable development. This paper offers a framework of pro-environmental enterprise support developed through a two-round e-Delphi study, followed by a 2.5-h virtual focus group involving 21 experts across the spectrum of business support agencies, local authorities, and EU-funded projects delivering pro-environmental enterprise support in England. The findings indicate that support for pro-environmental SME capacity building includes attention to eco-innovation, environmental strategy, environmental capability development, responsible leadership, sustainable value proposition, greening of supply chains, and clean growth skills. The study also concludes that support programmes and interventions need to be more attuned to the specifics of entrepreneurial learning; the challenges small business face in accessing, capturing, and utilising resources; and that broadening the scope and reach of pro-environmental support programmes needs to be matched by the competences of business support professionals. [ABSTRACT FROM AUTHOR]

This paper considers the importance of material objects for looked after and adopted children integrated as part of life story work practices. Conducting life story work is believed to be good practice within direct work with looked after children in England and there are a range of diverse practices, including life story books, later life letters and memory boxes. Through a creative design project developing a playful memory product for looked after children, we have had the opportunity to capture sector perspectives on life story work approaches and these are interspersed throughout this commentary. Combining multi-disciplinary theoretical perspectives and these sector insights, we explore how special material objects are important for children's identity and continuity of sense of self. The paper highlights the importance of children telling their own stories of these objects, giving them agency and control over their life story narratives. In a context of austerity, life story work may not be prioritised by social workers who have many other competing demands and limited resources. We emphasise the need for professionals to recognise the value children give to objects and to provide them with opportunities to both keep these safe during placement moves and to tell their own story through their objects alongside more traditional, formal life story work. The recommendations have implications for children in out of home care in many country contexts, not just England where the research has been conducted. [ABSTRACT FROM AUTHOR]

This paper presents findings from a study of family literacy provision in England and focuses on the effects of family literacy programmes on the home literacy environment. The fieldwork took place between September 2013 and December 2014 and involved 27 school-based programmes for pupils aged between 5 and 7, and their parents. The study used mixed methods, which involved observations of family literary sessions, a quantitative pre- and post-survey of 118 parents, and pre- and post-telephone qualitative interviews with a sub-sample of 24 parents. Building on previous theoretical work, the study conceptualises the home literacy environment into four areas (family resources; parental literacy behaviours and attitudes; parental beliefs and understandings; and family literacy activities and practices). The paper develops understandings of how parents translate and implement messages from family literacy into the home setting, and it shows how participation in these programmes leads to changes in family literacies across all four areas identified. [ABSTRACT FROM AUTHOR]

The confluence of the COVID-19 pandemic, the murder of George Floyd in America and a global Black Lives Matter response triggered anew the global struggle for racial justice. Using cyber, remote, and in-person ethnographic methods, this paper explores racial identity, allyship and processes of becoming during the spring and summer of 2020. Building on theories of 'the struggle for recognition', I situate becoming within the interplay of what I call epistemic, affective and reciprocal authenticity. Within this project, I address identity, redistribution and the reconfiguration of conceptual distinctions between justice and dignity. The analysis reflects a time of racial tension in a provincial Northeastern town in England, UK – a predominantly white and marginalised location. I amplify the personal testimonies, conversations and written words of three quite different activists to highlight the nuanced refractions of lived experience and a developing antiracism. These collaborators reveal how their antiracist becomings, in the light of 2020 events, incorporate affective, epistemic and reciprocal authenticities that bring to the fore new potentialities for racial justice, white allyship and recognition. [ABSTRACT FROM AUTHOR]

The UK charity Crimestoppers supports the police by taking and passing on information about crime. However, its service has been subject to little examination. This paper explores how Crimestoppers acts as an enabler to reporting crime and assists the police in solving crime. A small-scale qualitative study, using semi-structured interviews, was conducted with participants drawn from Crimestoppers' contact centre and two Welsh police forces. Following a thematic analysis, the overarching finding submits that 'anonymity' is the golden thread which preserves Crimestoppers existence. The charity has a strong relationship with the police and exists in a network of plural policing. [ABSTRACT FROM AUTHOR]

The project on which this paper is grounded is the first in-depth empirical study of the impacts of COVID-19 on each stage of the English and Welsh Youth Justice System. We take the notion of a child's right to a fair trial as the lens by which we detail the findings from our research. The paper documents the experiences of professionals working in the courts and children who had contact with the courts during the pandemic. While we concentrate on processes in England and Wales as an exemplar of the impact of COVID-19, recognising that globally, courts were experiencing similar challenges, initiates a discourse about how to re-envision their role in wider criminal justice systems in a COVID-19 world. Our research demonstrates an urgent need for renewed consideration of what support children need to effectively participate in court, and where and how children's cases should be heard. The pandemic demonstrated that creativity is possible and creates a timely opportunity to review the evidence and think more radically about a welfare-based, trauma-informed court process for children. [ABSTRACT FROM AUTHOR]

This paper presents one aspect of a sociocultural micro-ethnographic study examining how 11- and 12-year-old children formulate meanings when working with an artist in a contemporary art gallery. My primary focus is an examination of methodological contributions emerging from an imaginative coding and analysis of children's art. Ninety-nine artworks were created in collaboration with the artist and were organised and interpreted using a constructionist interviewing coding scheme. This unorthodox approach to visual analysis unearthed information that oral accounts cannot provide alone revealing meanings which would otherwise remain dormant. By intuitively applying the coding framework I expose how participants' meanings are negotiated by appropriating and re-organising cultural concepts into personalised narratives. As such, artworks reveal participants' desires, interpretations and intentions, operating as agentic cultural producers as well as unconsciously reproducing visual epistemologies ubiquitous in Western cultures. [ABSTRACT FROM AUTHOR]

This paper identifies longitudinal predictors of weapon-carrying in a sample of 10–25 year olds in England and Wales. It conceptualises weapon-carrying as anticipation of an adverse event and proposes hypotheses about the origins of weapon-carrying derived from the field of risk analysis. Specifically, it tests if worry about victimisation and experience of violence predict later weapon-carrying and assesses the moderating influence of trust in the police. The results indicate that worry about victimisation does not predict weapon-carrying, but experience of violence does. Distrust of police and peer criminality were also identified as important precursors to weapon-carrying. The study provides further evidence that, at least over longer periods, weapon-carrying is a product of experience of violence and criminogenic factors rather than a response to concern about victimisation. [ABSTRACT FROM AUTHOR]

This paper examines the role of the police in mental health work. It explores whether the calls to 'defund the police' can be the basis for fundamental reforms of mental health services and the police role. The paper outlines the roots of the calls to ' defund the police' situating the perspective in the wider Black Lives Matter movement (BLM). The wider BLM movement seeks to overturn long standing racial and social injustices, including the disproportionate use of force against black citizens and racial biases within the Criminal Justice System. It goes further in that BLM calls for a shift in funding from policing towards an investment in welfare and community services. These calls are captured in the phrase 'defund the police'. These calls have highlighted the police role in mental health, particularly, the police response to citizens in mental health crisis. The paper examines the police role in mental health work, highlighting the historic impact of policies of deinstutionalisation and more recently austerity and welfare retrenchment. In calling for this policy shift, campaigners have highlighted the need to significant investment in mental health services. The police role in mental health services increased because of the failings of community care (Cummins, 2020a). Police officers have increasingly become first responders in mental health crises. The paper, focusing on England and Wales, uses 'defund the police' perspective as a lens to examine long standing areas of concern. Police involvement in mental health emergencies is inevitably stigmatizing. There are also concerns from the police. This is an area of police demand that has grown of austerity and the wider retrenchment in public services. Police officers often feel that they lack the skills and knowledge required to undertake their role in mental health work. In addition, there is frustration generated by poor interprofessional working. Police officers on an organizational and individual level feel that they are often left ' picking up the pieces '. There is a wide recognition that mental health services are failing to provide appropriate responses to those in crisis (Wessley, 2018). As well as being an issue of human rights and social justice, these failures place vulnerable people at increased risk. All aspects of police work involve contact with people experiencing mental health problems. People with mental health problems are first and foremost human beings who should be treated with dignity and respect. They are also citizens, family members, carers and work colleagues. Having acknowledged that core value perspective, if we accept that police officers will be involved in mental health work, we should seek to limit their role as far as is possible. The paper concludes that it is likely that there will be always be some form of police involvement in mental health–related work. However, there is a need to limit this as far as possible. [ABSTRACT FROM AUTHOR]