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This article examines the spatial implications of flexible working post-Covid through the concepts of third space and the flexible work model. Whilst research to date has largely focused on city centres, this article draws on a case study of a new settlement, Worcestershire Parkway, and the views of planning/property professionals to investigate the emerging implications for planning theory and practice. In particular, it highlights and critically evaluates the importance of flexibility and future-proofing, strong private sector partnership to develop employment strategies and design codes to set parameters for development as the cardinal features of post-Covid strategic planning practice. This article was published open access under a CC BY-NC-ND licence: https://creativecommons.org/licenses/by-nc-nd/4.0/. [ABSTRACT FROM AUTHOR]

This paper assesses how strategic planning for nature can be improved for England's built and natural environment using mainstreaming and landscape-scale concepts. Whilst both concepts feature in academic literature, there has been limited attention on their role as catalytic agents for strategic planning. Addressing this gap, evidence is used from two stakeholder workshops involving 62 senior policy experts managing a range of operational and hypothetical strategic spatial planning challenges. The results reveal a significantly weakened strategic planning arena characterised by policy disintegration, short termism and uncertainty. Key findings highlight the fallacy of pursuing strategic planning for nature in isolation from wider policy integration fusing environmental, economic and social components from the outset. Current barriers to progress include institutional inertia, technocratic vocabularies and neoliberalist priorities exacerbated by a weak underlying theory. Conversely opportunities for mainstreaming processes may help knowledge generation and exchange within transdisciplinary partnerships, whilst landscape scale thinking can improve understanding of issues using natures inherent geometry transforming processes and outcomes. The paper recommends the adoption of strategic planning pathways using mainstreaming and landscape-scale approaches working in tandem. Whilst focused on the English context, our findings are transferable to other planning systems in the Global North, especially those championing neoliberal market led policies. [ABSTRACT FROM AUTHOR]

Effective integration of research within healthcare organisations is recognised to improve outcomes. A research strategy within a hospital Trust in South West England was revised, following the launch of a national Chief Nursing Officer (CNO) strategy that promotes research engagement and activity. The aim was to develop, implement and evaluate this revised strategic plan for research. High-level engagement within the organisation was established and previous initiatives evaluated. A 6-year plan with 2-year targets was defined and evaluated at year end. The four pillars of the CNO strategy were central to the revised strategy, underpinned by digital innovation. Evaluation of the earlier strategy indicated excellent engagement with the Chief Nurse Research Fellow initiative and the Clinical Academic Network. The 'Embedding Research In Care' (ERIC) unit was reconfigured to an ERIC model, which aided question generation and project development. Year one objectives were achieved within the revised plan. Implementing a research strategy within an organisation requires a cultural shift and a long-term vision is required with measurable objectives. The team demonstrated significant progress through high-level leadership, mentoring and cross-professional collaboration. [ABSTRACT FROM AUTHOR]

In 2023, the UK Government published its long-awaited reform strategy for England's children's social care system. Whilst the strategy set out planned reforms for several aspects of the wider system, an area requiring particular 'priority' was the purported workforce instability seen within child protection social work. However, the strategy has subsequently faced criticism on the basis that the suggested reforms were not satisfactorily informed by the testimonies of practicing social workers. This paper draws from a mixed-method study to report on the lived experiences of a sample of 201 child protection social workers practicing across England, in the context of better understanding the factors which they believed were impacting on workforce stability within England's child protection system. Implications that emerge are the need for an increase in the monetary commitment offered by the UK Government (especially in the context of tackling high caseloads, and improving local authority pay scales to reduce the allure of agency work); a targeted emphasis on challenging local cultures preoccupied with evidencing compliance over time spent with children; and the Government taking a more assertive role in tackling the often-counterproductive commentary perpetuated by politicians and media. [ABSTRACT FROM AUTHOR]

Context: A key task for countries around the world facing the COVID-19 pandemic was to achieve high vaccination coverage of the population. To overcome "vaccination inertia," governments adopted a variety of policy instruments. These instruments can be placed along a "ladder of intrusiveness" based on their degree of constraint of individual freedoms. The aim of this study is to investigate how the governments of three European countries moved along the ladder of intrusiveness and how the choice of policy instruments was influenced by contextual factors. Methods: The study draws on secondary data sources, including academic and gray literature, policy documents, and opinion polls, over an observation period from December 2020 to summer 2022. The study employs inductive logic to analyze data and identify the factors explaining similarities and differences across England, Germany, and Italy. Findings: The study identifies similarities and differences in how the three countries advanced along the ladder of intrusiveness. Contextual factors such as policy legacy, social acceptability, and ideological orientation contribute to explain the observations. Conclusions: Country-specific contextual factors play an important role in understanding the choice of policy instruments adopted by the three countries. Policy makers should carefully consider these factors when planning immunization strategies. [ABSTRACT FROM AUTHOR]

BACN members Sharron Brown and Constance Campion-Awwad discuss the implications of the DHSC consultation on aesthetic nurses and their patients [ABSTRACT FROM AUTHOR]

There is a clear consensus amongst both academic commentators and the professional community that current arrangements for strategic planning in England are inadequate. The withdrawal of central government from leadership of the proposed 'Oxford-Cambridge Arc' in early 2022 marks a particular nadir, not least given the ambitions for the planning of the area set out only a year earlier. This article offers a conjunctural reading of the failure of the proposed Arc spatial framework, emphasising that not only was the process of planning the Arc itself problematical, but it also faced wider governmental and political headwinds which fuelled public opposition to the scheme, reduced central government commitment and redirected political priorities elsewhere. In this context the prospects for the future of strategic planning in England appear rather bleak. This article was published open access under a CC BY licence: https://creativecommons.org/licences/by/4.0. [ABSTRACT FROM AUTHOR]

Purpose: Policies on integrated care have waxed and waned over time in the English health and care sectors, culminating in the creation of 42 integrated care systems (ICSs) which were confirmed in law in July 2022. One of the four fundamental purposes of ICSs is to tackle health inequalities. This paper reports on the content of the overarching ICS plans in order to explore how they focus on health inequalities and the strategies they intend to employ to make progress. It explores how the integrated approach of ICSs may help to facilitate progress on equity. Design/methodology/approach: The analysis is based on a sample of 23 ICS strategic plans using a framework to extract relevant information on health inequalities. Findings: The place-based nature of ICSs and the focus on working across traditional health and care boundaries with non-health partners gives the potential for them to tackle not only the inequalities in access to healthcare services, but also to address health behaviours and the wider social determinants of health inequalities. The plans reveal a commitment to addressing all three of these issues, although there is variation in their approach to tackling the wider social determinants of health and inequalities. Originality/value: This study adds to our knowledge of the strategic importance assigned by the new ICSs to tackling health inequalities and illustrates the ways in which features of integrated care can facilitate progress in an area of prime importance to society. [ABSTRACT FROM AUTHOR]

Purpose: This paper examines the role of senior personnel within Active Partnerships as the personnel seek to strategically manage UK policy developments. This paper explores how Active Partnerships engage with the policy process within an environment characterized by systemic structural changes, mounting fiscal challenges, political uncertainty and a succession of public health concerns. Design/methodology/approach: Using the Multiple-Streams Framework (MSF), a case study approach was adopted, focusing on the perspectives of senior personnel. Semi-structured interviews with individuals involved in the management and operation of five Active Partnerships across the South of England and one national stakeholder that works closely with Active Partnerships were conducted. Data were collected during the period following Andy Reed's review of the operation of Active Partnerships. The interviews were complemented by documentary analysis. Findings: Findings illustrate that while senior practitioners within Active Partnerships often behave in line with Lipsky's notion of street-level bureaucrats, by maximizing collective leverage, advocating priorities and providing a voice for local partners, the senior practitioners adopt behaviors more akin to policy entrepreneurs. In this sense, they seek to influence the policy process at critical junctures in order to promote preferred outcomes and protect sectoral interests. Originality/value: This study has explored the relationship between strategic management and the policy process in the context of the rapidly changing policy domain that frames the work of regional sports organizations known as Active Partnerships. The conceptual frame of the investigation is the concept of "policy entrepreneurship", which seeks to articulate how individuals and collectives engage in the policy process, in order to secure outcomes conducive to their objectives. This, in turn, provides a sense of context for the contemporary challenges associated with the management of sport and physical activity (PA). [ABSTRACT FROM AUTHOR]

Staff in the National Health Service (NHS) are under considerable strain, exacerbated by the COVID-19 pandemic; whilst NHS Trusts provide a variety of health and wellbeing support services, there has been little research investigating staff perceptions of these services. We interviewed 48 healthcare workers from 18 NHS Trusts in England about their experiences of workplace health and wellbeing support during the pandemic. Reflexive thematic analysis identified that perceived stigma around help-seeking, and staffing shortages due to wider socio-political contexts such as austerity, were barriers to using support services. Visible, caring leadership at all levels (CEO to line managers), peer support, easily accessible services, and clear communication about support offers were enablers. Our evidence suggests Trusts should have active strategies to improve help-seeking, such as manager training and peer support facilitated by building in time for this during working hours, but this will require long-term strategic planning to address workforce shortages. [ABSTRACT FROM AUTHOR]

Purpose: Joint Strategic Needs Assessments (JSNAs) are intended to help create evidence-based priorities for public health commissioning at local government level in the UK. They are supposed to consider the needs of people with protected characteristics, and this study aims to look at how the JSNAs for London are serving the city's lesbian, gay, bisexual, transgender and queer (LGBTQ+) population. Design/methodology/approach: JSNAs are documentary data and are in the public domain. Each of the 31 JSNAs for London was individually assessed against a series of questions designed to test their inclusion of the local LGBTQ+ population. Findings: Fewer than one in five of London's JSNAs: had a dedicated LGBTQ+ section; cited bespoke research into, or engagement with, the local LGBTQ+ population; made recommendations for specialist services for people from this community; or considered intersectionality in the context of this population. Originality/value: This study demonstrates that many of London's JSNAs contain little information on the city's local LGBTQ+ population and only minimal assessment of its health, care and wellbeing needs. Recommendations include conducting further research on this population at the local level, using available guidance and engaging best practice. [ABSTRACT FROM AUTHOR]

Background We sought to understand the impact of the COVID-19 pandemic on lipid-lowering therapy prescribing as a potential cause of the excess cardiovascular mortality seen post-pandemic in England. We examined temporal changes over 3 years in the prescribing of high-intensity and non-high-intensity statin therapy and ezetimibe. Sources of data We utilized data available via the National Health Service (NHS) Business Services Authority (NHSBSA) Information Services Data Warehouse, extracting 3 monthly data from October 2018 to December 2021 on high- and low-intensity statin and ezetimibe prescribing, (commencement, cessation or continuation) through each time period of study and those before, and after, the period of interest. Areas of agreement Optimizing lipid management is a key component of the NHS Long Term Plan ambition to reduce deaths from cardiovascular disease, stroke and dementia. Areas of controversy The COVID-19 pandemic and associated lockdown have seen a significant reduction in prescribing of lipid-lowering therapies. If cardiovascular risk is not to worsen in the forthcoming years, urgent action is needed to ensure that the impact of the pandemic upon optimization of cholesterol and the historical undertreatment of cholesterol is reversed and improved. Areas timely for developing research Prescription data available via NHSBSA can support our understanding of the implications of policy and behaviour and highlight the impact of guidelines in practise. Growing points Understanding the impact of the COVID-19 pandemic upon cholesterol management and the opportunities for newer lipid-lowering therapies delivered using a population health approach have the potential to enhance lipid-lowering and improve cardiovascular mortality and morbidity and reduce health inequalities. [ABSTRACT FROM AUTHOR]

For strategic planning of healthcare services, understanding and accounting for future demand can support resource management. A hybrid modelling approach is well-placed to address these issues using demand projections with simulation for capacity planning. We present a methodology which conceptualises each stage as a collaborative activity in a strategic process. Medium-to-long term demand is uncertain, and depends upon internal and external factors. Our novel demand projections use both drivers of internal demand, and environmental scanning to identify external influences on demand. These create demand trajectories for each of three procedures that are used with discrete-event simulation to inform strategic planning for endoscopic diagnostic services. The study involved collaboration with a major Healthcare Trust in England, and demonstrates the applicability of our methodology to support strategic change at the regional service level by aligning external demand with internal resource planning. [ABSTRACT FROM AUTHOR]

Introduction: Co‐production with communities is increasingly seen as best practice that can improve the quality, relevance and effectiveness of research and service delivery. Despite this promising position, there remains uncertainty around definitions of co‐production and how to operationalize it. The current paper describes the development of a co‐production strategy to guide the work of the ActEarly multistakeholder preventative research programme to improve children's health in Bradford and Tower Hamlets, UK. Methods: The strategy used Appreciative Inquiry (AI), an approach following a five‐step iterative process: to define (Step 1) scope and guide progress; to discover (Step 2) key issues through seven focus groups (N = 36) and eight in‐depth interviews with key stakeholders representing community groups, and the voluntary and statutory sectors; to dream (Step 3) best practice through two workshops with AI participants to review findings; to design (Step 4) a co‐production strategy building on AI findings and to deliver (Step 5) the practical guidance in the strategy. Results: Nine principles for how to do co‐production well were identified: power should be shared; embrace a wide range of perspectives and skills; respect and value the lived experience; benefits should be for all involved parties; go to communities and do not expect them to come to you; work flexibly; avoid jargon and ensure availability of the right information; relationships should be built for the long‐term; co‐production activities should be adequately resourced. These principles were based on three underlying values of equality, reciprocity and agency. Conclusion: The empirical insights of the paper highlight the crucial importance of adequate resources and infrastructure to deliver effective co‐production. This documentation of one approach to operationalizing co‐production serves to avert any misappropriations of the term 'co‐production' by listening to service users, stakeholders and other relevant groups, to develop trust and long‐term relationships, and build on the learning that already exists amongst such groups. Patient or Public Contribution: The work was overseen by a steering group (N = 17) of individuals, both professional and members of the public with experience in undertaking co‐production, and/or with some knowledge of the context of the two ActEarly field sites, who provided regular oversight and feedback on the AI process. [ABSTRACT FROM AUTHOR]

SUMMARY: Demands on health and social care are growing in quantity and complexity, with resources and staffing not projected to match this. The landmark NHS Long Term Plan calls for services in England to be delivered differently through integrated care systems (ICSs) that will better join commissioners and providers, and health and social care. The scale of these changes is immense, and the detail can feel confusing. However, they are important and will affect all clinicians in the public service. This three-part series provides a primer on integrated care, explaining why it is happening, how services are changing and why clinicians should get involved. In this first article we focus on the changing demographics, and the workforce and financial resources required to address these. [ABSTRACT FROM AUTHOR]

A growing reliance on agency workers can lead to significant risks for client organizations, especially in core organizational roles. It has been suggested while these risk can be mitigated through investments in human resource management (HRM) directed at agency workers, in reality these will be hard to implement. This article draws upon Lepak and Snell's (1999) HR architecture model and uses a comparative case study method to explore this issue, focusing on agency working in core nursing and qualified social worker roles. The findings illustrate how client organizations can become more involved in the management of agency workers than has previously been acknowledged. Our analysis also identifies the conditions that shape this client‐side involvement, including the nature of agency worker contracts, the role of temporary work agencies, competing organizational cost‐control priorities, and perceptions of the regulatory context. These conditions are brought together in a general model for understanding the largely neglected role that client organizations play in the HR management of agency workers. [ABSTRACT FROM AUTHOR]

The Green Belt is one of the most widely known and popular regional growth management policies having been adopted around the world. Drawing upon the regional spatial imaginary and historical institutionalist literature alongside a case study of the West Midlands, this paper conceptualizes the Green Belt as an enduring, regionalizing concept in the spatial vision of planners and professional campaigners. It underscores the continuing importance of planning history and critical junctures in 'framing' the perspectives and aspirations of practicing planners regarding strategic planning. The paper charts the emergence, embedding, and adaptability of the Green Belt as an institution before exploring how strategic vision has continued to be vitally important to planners and campaigners despite the abolition of statutory strategic planning in England in 2010. [ABSTRACT FROM AUTHOR]

Simple Summary: A risk-stratified approach to breast cancer screening has gained international interest as a mechanism to better balance the benefits, harms and costs of screening programmes. The aim of our agenda setting meeting was to identify key uncertainties to resolve in order to implement a risk-stratified breast screening programme within England. Findings from a 5-year programme of research assessing the feasibility of such an approach in England were presented before individual discussion groups and an open plenary session regarding what preparation needs to take place. Key findings highlight the need to further develop risk modelling to ensure equity of access to breast cancer risk assessment and ensure a risk-stratified programme is cost-effective. Other issues highlighted related to capacity and capability of the health services to offer an integrated risk assessment pathway that is accessible. Attendees identified ways in which risk-stratification could be implemented to minimise inequity of access to screening. It is now possible to accurately assess breast cancer risk at routine NHS Breast Screening Programme (NHSBSP) appointments, provide risk feedback and offer risk management strategies to women at higher risk. These strategies include National Institute for Health and Care Excellence (NICE) approved additional breast screening and risk-reducing medication. However, the NHSBSP invites nearly all women three-yearly, regardless of risk. In March 2022, a one-day agenda setting meeting took place in Manchester to discuss the feasibility and desirability of implementation of risk-stratified screening in the NHSBSP. Fifty-eight individuals participated (38 face-to-face, 20 virtual) with relevant expertise from academic, clinical and/or policy-making perspectives. Key findings were presented from the PROCAS2 NIHR programme grant regarding feasibility of risk-stratified screening in the NHSBSP. Participants discussed key uncertainties in seven groups, followed by a plenary session. Discussions were audio-recorded and thematically analysed to produce descriptive themes. Five themes were developed: (i) risk and health economic modelling; (ii) health inequalities and communication with women; (iii); extending screening intervals for low-risk women; (iv) integration with existing NHSBSP; and (v) potential new service models. Most attendees expected some form of risk-stratified breast screening to be implemented in England and collectively identified key issues to be resolved to facilitate this. [ABSTRACT FROM AUTHOR]

Exposure to cold temperatures is known to be associated with deterioration of physical and mental health as well as poorer well-being in many countries. The Winter Fuel Payment, an unconditional direct cash transfer of value between £250-£300, was designed to help older people in England cover heating costs during the winter months, to counteract the particular vulnerability of older people to the effects of cold weather. We evaluated the impact of the Winter Fuel Payment scheme on subsequent prevalence of care needs such as being unable to eat or shower independently, quality of life and the likelihood of having cold-related housing conditions. We also explored the potential effects of the Winter Fuel Payment across different sub-samples (poorer/richer individuals, those living in newer/older properties, and in the North/South of England) to explore whether its benefits (if any) are spread equally across the eligible population. We used a regression discontinuity design approach with age as running variable to analyse seven waves of a nationally representative sample, the English Longitudinal Study of Ageing, covering the period 2002/2003 to 2016/2017, and consisting of 24,651 observations. The Winter Fuel Payment had no overall effect on the outcomes of interest (care needs, quality of life, and cold-related housing problems). However, the Payment increased quality of life for poorer individuals, for those living in Northern regions of England, and for those living in newer dwellings. The likelihood of living in a property with at least one cold-related housing problem also decreased for those living in newer properties. Findings from this research provide important insights into the effectiveness of a winter cash transfer among the older population in England, and they are potentially relevant for other nations looking for strategies to deal with cold seasons and poorly insulated homes. In particular, this evaluation contributes to the 'universality versus targeting' policy debate and has implications for the development of energy-efficient policies. • The Winter Fuel Payment had no overall effect on the outcomes of interest. • However, the Payment increased quality of life for poorer individuals. • It also improved quality of life and housing quality for those living in newer dwellings. • Findings not only feed the 'universality versus targeting' debate. • But also, the discussion around the development of energy efficiency policies. [ABSTRACT FROM AUTHOR]

With many countries around the world facing deepening housing crises and searching for ways of increasing the public acceptability of new house building, academics, planners, and policy makers have generally focused on the material, economic motivations of campaigners and the public in opposing development. This article, which focuses on the green belt planning policy in England, but with wider relevance for house building internationally, argues that whilst considerations of material 'property' are sometimes a poignant motivation for campaigners, planners identified more normative concerns surrounding the 'fear of change' as equally important. Alongside campaigners themselves, planners stressed the importance of general planning 'principles', especially protection of the countryside and green belt, as well as local, 'place' concerns about development 'changing the character' of an area and its effects on local facilities/services. The article reflects on the need for planners and policy makers to pay more attention to principles and place attachment in policy formulation regarding house building, whilst more effective integration of different aspects of the planning system is needed to address campaigners' more materialistic concerns about the effects of development on local services. [ABSTRACT FROM AUTHOR]

In England, care to support people living at home is largely commissioned by local authorities (statutory organisations with responsibility for social care in specific localities) from non‐statutory home‐care providers (for‐profit, not‐for‐profit, voluntary). This paper explores how managers of these services perceive commissioning arrangements and their impact on home‐care providers, the care workforce and service users. Little formal research of providers' experiences of working with local authorities in a commissioning model is available. A qualitative study employed semi‐structured telephone interviews with 20 managers of for‐profit home‐care providers from 10 selected local authority areas in England. Data were analysed using thematic analysis to identify main and subsidiary themes. Home‐care providers reported operating in a complex and changeable partnership with commissioners, characterised by: (a) relationships ranging from transactional to collaborative, (b) providers expressing a strong sense of public service motivation, (c) commissioning practices that were complex to negotiate, time‐consuming and overly prescriptive, (d) frequent changes in commissioning practices and a perceived lack of strategic planning, which were reported as contributing to uncertainty and tension for providers and confusion for service users. Attempting to operate a market model with tightly prescribed contracts is likely to be unsustainable. An alternative approach based on a collaborative model of joint responsibility for providing home care is recommended drawing on a conceptual framework of principal–steward relationships in contracting. [ABSTRACT FROM AUTHOR]

In England, there are over half a million people living with severe mental illness (SMI) such as schizophrenia and bipolar disorder. These people die on average up to 20 years earlier than the general population and 2 in 3 deaths are from physical illnesses that can be prevented. Recent government publications such as the NHS Long Term Plan and NHS England's mental health implementation plan have highlighted the need to address the physical health needs of people with SMI in order to reduce the serious inequality of health outcomes experienced. Disappointingly, however, neither document mentions the poor oral health experienced by this cohort of the population, nor do they recognise the link between poor oral health and poor general health. This article examines the available literature and results from a recent survey that explored the oral health behaviours of service users at a secure mental health facility to raise awareness of the oral health needs of this population. Oral health is an integral aspect of general health and can positively influence wellbeing. A healthy mouth ensures individuals can eat, speak and interact socially, free from pain and embarrassment. Poor oral health can therefore not only have a profound impact on a person's quality of life (QoL) but it can also have wider implications for systemic disease. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to use systems mapping as a tool to develop an organisation-wide approach to public mental health to inform strategic direction within a national public health agency. Design/methodology/approach: Two workshops were facilitated with internal staff from a wide range of public health policy teams working in small groups to produce paper-based maps. These were collated and refined by the project team and digitised. Findings: The approach engaged a range of teams in forming a shared understanding and producing a complex system map of the influences on population mental health and well-being, where current policy initiatives were addressing them and what the gaps and priorities were. Participants valued the approach which led to further study and organisational commitment to the whole system working as part of national public mental health strategy. Research limitations/implications: The approach was limited to internal stakeholders and wider engagement with other sectors and community members would help further the application of complex system approaches to public mental health. Originality/value: It was a valuable process for developing a whole-organisation approach and stimulating thinking and practice in complex system approaches. The paper provides a practical example of how to apply systems mapping and its benefits for organising public mental health practice. [ABSTRACT FROM AUTHOR]

Strategic spatial planning (SSP) has been a key planning practice supporting spatial transformation globally. However, designing and implementing strategic spatial plans is a complex task. The process involves prioritizing planning intentions, establishing funding mechanisms and structuring governance settings, which take shape within power configurations. It is within this complexity that a participatory and integrative planning approach assumes increasing importance when addressing, strategically, societal challenges such as spatial injustice. Furthermore, a consolidated planning practice – that is the experiences in dealing with SSP are thought to influence how strategic plans are prepared and executed. Bearing in mind the influential role of preceding experiences in SSP processes as well as of participation, project promotion and policy integration, this paper synthesizes the results of a literature review reflecting three decades of SSP (1990–2020) in England. England has a well-defined history of engagements with SSP. The purpose is to discuss lessons learned from looking back 30 years and debate suggestions for how to design future SSP that account for public and private interests and align cross-sectoral policies. To overcome democratic accountability constraints and steering resource management effectively, this review pleas for more cooperative central–local relationships in shaping future SSP processes in England and beyond. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic presents challenges to substance misuse services. Patients face a higher risk of infection and transmission to others. Services were required to reconfigure quickly in response to the government lockdown. These changes had to be completed before national guidance was published. To examine the strategy and operational delivery of two London boroughs and measure how convergent they were with national guidelines. Referral data were analyzed and compared to a similar time frame pre-COVID-19. Both services adopted similar strategies and pace of change. Longer supplies of opiate substitution therapy (OST) were prescribed, with less restrictive arrangements for collection. There was an increase in opiate assessments and a reduction in alcohol assessments. There was no overall increase in mortality. There was minor deviation from national guidance when it was initially published. The services were well equipped to respond to the rapid changes demanded during early lockdown. Reduced restrictions in OST may not be associated with negative service or patient outcomes. The move to remote consultations and home working are likely to have value in substance misuse services after the pandemic. The long-term impact of lockdown presents uncertainties in terms of clinical safety and requires evaluation. [ABSTRACT FROM AUTHOR]

Purpose: Farm businesses in England are under pressure to intensify production sustainably while managing costs and meeting market demands. Commodity prices and support from Common Agricultural Policy (CAP) payments are important determinants of profitability. With the United Kingdom (UK) leaving the European Union (EU), revised policy will see farming more exposed to fluctuating commodity prices and financial support from Government more focused on encouraging environmental land management. The research reported here, investigated whether business management practices of farmers influences financial performance, and how policy could be tailored to better meet the needs of farm businesses. Design/methodology/approach: Regression models were estimated for 862 Cereals, Dairy and Livestock farms in England using official data for 2011–2012, in order to assess whether different farm characteristics, business management practices (identified from a systematic review of 102 studies), knowledge acquisition indicators and manager experience had an effect on four different financial performance ratios. The financial performance of the top 25% of the sample was also compared to the bottom 25% in terms of use of business management practices. Findings: The results show that business planning and benchmarking had a positive, statistically significant, effect on financial performance, as do business size and knowledge acquisition, albeit to a lesser extent. Originality/value: The research reported here is the most extensive examination, to date, of the impact of management practices on the financial performance of farms. Thus, it sends strong policy recommendations. [ABSTRACT FROM AUTHOR]

The aim of the present article is to explore the relationship between taxation, warfare, social unrest and economic decline in fourteenth century England. The main causes behind such tumultuous period, such as labour shortage caused by the Great Famine, the ensuing Black Death and the landowners' refusal to pay higher wages, which was the natural outcome of the increase in demand for labour. It also describes in detail the strategies adopted by the villeins and free labourers to counter the lords' attempts to keep the pre-plague wages. The strained relationship between the lords and the peasants culminated in the revolt of 1381 whose colossal character supports the idea of a classconscious movement against the tyranny of the upper class. [ABSTRACT FROM AUTHOR]

The article presents an editorial focuses on the historical and current landscape of adult social care in England, emphasizing the need for collaboration between health and social services to address persistent challenges in access, staffing, and quality of care. Topics include the evolution of social care policies, the current workforce situation, and ongoing challenges such as delayed access to care and discharge delays contributing to inadequate capacity and quality of care.

The article supports the Association for Simulated Practice in Healthcare (ASPiH) Standards 2023 as a framework for integrating simulation in healthcare education. Benefits offered by the ASPiH Standards for nursing students include quality assurance of simulated practice learnings, practical real-world scenarios recreated in a controlled setting, hands-on experience in managing patient care scenarios, interprofessional education, and handling of ethical dilemmas and emotional situations.

The article focuses on the possibility of Nursing Associates (NAs) undertaking travel health responsibilities if properly trained, addressing concerns about their role under current legislation and suggesting the Competency Assessment Tool for evaluation. It discusses the release of a new NHS vaccination strategy aimed at integrating all vaccination programs to protect communities, highlighting the need for innovative approaches in vaccine delivery.

COVID-19 created a substantial set of challenges for health communication practitioners in the process of planning, implementing, and evaluating entertainment-education (EE) campaigns. EE is a theory and evidence-based communication strategy that employs entertainment media for educational messaging. Here, we briefly review EE campaigns in response to previous health emergencies and present three cases of EE responses to the COVID-19 pandemic from leading global organizations (PCI Media, BBC Media Action, and Sesame Workshop). Responses ranged from adaptation and re-distribution of existing content to creating new content under social-distancing restrictions and utilizing transmedia. These cases demonstrate that EE initiatives responding to future pandemics may be well served by starting with existing infrastructure to quickly build capacity, support, and trust; working with partners to tailor programs to the local context; and continuing to focus on good storytelling while simultaneously considering evolving media formats and theory. [ABSTRACT FROM AUTHOR]

Emotions were, in early modern literature on diplomacy, described as a parasitic and even dangerous manifestation, and this view has endured until today. A series of recent books and articles published in the field of the history of emotions lays however the groundwork to question this traditional analysis. This article thus aims to examine the possibility of a broader and more strategic use of emotions in early modern diplomacy than is often acknowledged, and therefore the possibility of what can be called an early modern emotional diplomacy. I will first provide a summary of what the honnête homme culture of Europe's ruling class meant for an ambassador in terms of emotion control. I will then show, through a few examples from diplomatic occurrences during Charles II of England's late reign, some of the possible uses of emotion in early modern diplomacy. Thirdly, I will study through one very memorable display of emotion from the English king the way such a display could be prepared and staged in order to achieve full effectiveness. Lastly, I will put these one-time emotional displays in the perspective of Charles II's international policy, arguing that they were not conceived as isolated occurrences but as parts of a real diplomatic strategy in which emotion played a crucial role, in other words an emotional diplomacy. [ABSTRACT FROM AUTHOR]

The long-awaited NHS workforce plan, now published years after it was promised, has been met with scepticism over how its commitments will be delivered. [ABSTRACT FROM AUTHOR]

Policy PointsStrategically purchasing health care has been and continues to be a popular policy idea around the world.Key asymmetries in information, market power, political power, and financial power hinder the effective implementation of strategic purchasing.Strategic purchasing has consistently failed to live up to its promises for these reasons. Future strategies based on strategic purchasing should tailor their expectations to its real effectiveness. Context: Strategic purchasing of health care has been a popular policy idea around the world for decades, with advocates claiming that it can lead to improved quality, patient satisfaction, efficiency, accountability, and even population health. In this article, we report the results of an inquiry into the implementation and effects of strategic purchasing. Methods: We conducted three in‐depth case studies of England, the Netherlands, and the United States. We reviewed definitions of purchasing, including its slow acquisition of adjectives such as strategic, and settled on a definition of purchasing that distinguishes it from the mere use of contracts to regulate stable interorganizational relationships. The case studies review the career of strategic purchasing in three different systems where its installation and use have been a policy priority for years. Findings: No existing health care system has effective strategic purchasing because of four key asymmetries: market power asymmetry, information asymmetry, financial asymmetry, and political power asymmetry. Conclusions: Further investment in policies that are premised on the effectiveness of strategic purchasing, or efforts to promote it, may not be worthwhile. Instead, policymakers may need to focus on the real sources of power in a health care system. Policy for systems with existing purchasing relationships should take into account the asymmetries, ways to work with them, and the constraints that they create. [ABSTRACT FROM AUTHOR]

This article studies the development and implementation of a nationally drafted strategy for fraud in local government in England. The purpose, relevant to other countries which also face (or evade) problems of policy outreach, is to consider what is required to achieve effective implementation through three broad aspects: aims, ownership, and impact. There is a particular focus on the assessment of the strategy implementation process and what mechanisms translate strategies into effective delivery or what other factors may subvert that delivery. The empirical research draws on the UK government's 2006 policy review on fraud and the consequential changes between then and 2019, including a number of fraud strategies initiated by the United Kingdom central government. To review implementation in practice, it focuses on the 2011 local government strategy and uses a local-level case study to assess issues concerning aims, ownership, and impact, as well as the effect of other nationally determined policies and agendas. It concludes that without an 'owned' strategy implementation process as a whole, national strategies concerning the prevention and policing of fraud in England in the twenty-first century have had—and continue to have—modest impact on practice on the ground at the local level. We find it plausible that this is true elsewhere in the world, not only for crime control but also for other 'change' strategies in the public sector. However, testing that proposition is for researchers in other countries. Our aim here is to use this superficially parochial study to raise more universal questions about how policy designers (and academic researchers) need to take better account of circumstances on the ground, the management of strategy implementation and legitimacy, if their strategies are to be more than merely symbolic rhetoric. [ABSTRACT FROM AUTHOR]

Sustainability is an important concept in implementation science, yet little about sustainability is published in leadership journals. Leaders are charged on a daily basis with initiating programs that make a difference; however, they are often not well prepared to design effective strategies to sustain their efforts. In a value-based health care industry where facilitating access to care, enhancing the patient experience, improving health outcomes, and reducing the cost of care are imperative, creating sustainability strategies that achieve these results is key. In this article, we describe the successful efforts within an academic-practice partnership to implement a sustainable interprofessional collaborative practice model emphasizing transitional care coordination in chronic disease management for advancing population health with underserved populations. A sustainability framework is presented along with lessons learned. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the IJHG Review is to enable readers to gain a quick overview of articles contained in an individual issue. Design/methodology/approach: All current articles are read by the Review Editor who then prepares the Review. Findings: Common themes are identified and key concepts are extracted from each article. Practical implications: The Review enables readers to prioritize articles of the greatest interest to them. Originality/value: The originality value of the IJHG Review is that no other Emerald Journal offers a Review section of this kind. [ABSTRACT FROM AUTHOR]

The revocation of the regional tier of planning by the UK Coalition Government in 2010 removed the established framework of strategic planning in England. Using a case study of green infrastructure (GI), this paper examines whether revocation has negatively impacted the development of environmental, and specifically GI policies and practice. It questions if changing government policy narratives have hindered advocacy and subsequently the delivery of GI and the extent to which it has been able to position itself as a mainstream approach in planning. Using the development of the RSS in England, and the North-East and East of England sub-regional GI strategies (areas of significant policy development), as case studies, the paper presents an ex-ante evaluation prior to revocation of the evolution of GI policy at a regional scale, alongside an ex-post assessment (2011–2015) of its continued growth within sub-regional policies. The paper concludes that whilst RSSs provided a promotional forum, that revocation has not negatively impacted upon GI development, as its advocates have facilitated a supportive policy-implementation environment which has led to the development of more integrated approaches in planning praxis. [ABSTRACT FROM AUTHOR]

Objective: This paper aims to explore the nature of clinical commissioning groups (CCGs) in England as membership organizations. Utilizing the concept of meta-organization as a lens, we discuss the impact that this organizational form might have on CCGs' ability to become 'strategic commissioners'. Methods: We used a longitudinal qualitative approach to explore the adoption and implementation of primary care co-commissioning. The study was undertaken between May 2015 and June 2017 and included interviews with senior policy makers, analysis of policy documents, two telephone surveys, and case studies in four CCGs nationally. Results: CCGs operate as membership organizations with closed boundary and low stratification, whereby a consensus or majority needs to be reached by members when activities impact on membership or the CCG's constitution. While CCGs should move towards a more strategic commissioning role that is focused on local priorities agreed by their members, they are faced with a complex system of accountabilities and responsibilities, which makes this difficult to achieve. Conclusions: The nature of CCGs as membership-based meta-organizations has the potential to both help and hinder CCGs in becoming strategic commissioners. The complexities in accountability and governance that the membership approach introduces, and the potential difficulties that CCGs face with competing meta-organizations, raises questions about the future of CCGs as membership organizations. [ABSTRACT FROM AUTHOR]

In this article we address scalar issues of power in planning. In the context of the reengineering of governance, including the promotion of localism in England, we focus on local actors' beliefs in the extent of their power (de facto and de jure) over development decisions pertaining to their jurisdiction, on how misreadings arise and the consequences thereof. Our intervention highlights the extent and cost of ambiguity in England's discretionary planning system and asks whether and how this should be moderated. [ABSTRACT FROM AUTHOR]

Objectives: Our objective was to assess the health care system impacts associated with the December 2013 east coast flooding in Boston, Lincolnshire, in order to gain an insight into the capacity of the health care sector to respond to high-impact weather. Methods: Semistructured interviews were held with regional strategic decision makers and local service managers within 1 km of the recorded flood outline to ascertain their experiences, views and reflections concerning the event and its associated health impacts and disruption to health care services. A snowballing sampling technique was used to ensure the study had participants across a broad range of expertise. Interviews were recorded and transcribed verbatim, and data analysis was preformed using NVivo (v10) to apply a thematic coding and develop a framework of ideas. Results: The results of this case study provide a vital insight into the health care disruption caused by flooding. All sectors of the health care system suffered disruption, which placed a strain on the whole system and reduced the capacity of the sector to respond to the health consequences of flooding and delivering routine health care. The formal recovery phase in Lincolnshire was stood-down on 4th February 2014. The results of this work indicate limitations in preparedness of the health care system for the reasonable worse-case scenario for an east coast surge event. Conclusions: The health care sector appears to have limited capacity to respond to weather-related impacts and is therefore unprepared for the risks associated with a future changing climate. Further work is required to ensure that the health care system continues to review and learn from such events to increase climate resilience. [ABSTRACT FROM AUTHOR]

This article provides a contribution to our understanding of the knowledges and strategies developed by people living with chronic illnesses, based on an empirical study with this population in England and Portugal. The article begins by mapping out the debates in disability studies which have focused on embodiment. It continues by arguing that disabled people constantly have to negotiate codes about the body based on normative notions of the body, which I term normative corporality. The main themes arising from participants' accounts are then identified and discussed. The article ends by arguing that the knowledges and strategies developed by disabled people are often not noticed or are devalued as we tend to value knowledges of the body that come from established systems of knowledge, or from bodies our society deem normative. Thus, disabled people's knowledges can be conceptualized as subjugated knowledges. [ABSTRACT FROM AUTHOR]

The Green Belt in England is probably the most longstanding and internationally recognised Urban Growth Boundary (UBG). However, developers, think tanks and academics often accuse UGB's of being the leading cause of the housing affordability problems around the world and articulate an alternative vision of Transit-Oriented Development (TOD). This paper, based upon a regional case study of the West Midlands and 74 interviews with planners and planning stakeholders, argues that the debate around TOD in the Green Belt needs to be more cognisant of regional geographical variation in public transport provision. Moreover, drawing upon the views of planners who play a key a role in allocating land for development, the paper underlines that decisions regarding TOD need to made strategically as reflecting the policy's purpose as a regional growth management policy. Reflecting on the broader academic literature, it highlights the need for greater strategic integration of transport and land-use planning alongside reviving strategic planning to evaluate various spatial blueprints for urban growth management. The paper has broader relevance to international debates about the feasibility and potential of TOD, especially in addressing housing affordability problems around the world. [ABSTRACT FROM AUTHOR]

The article offers information on the historical journey of the NHS in England, highlighting its growth and expansion over 75 years. It discusses current challenges in the healthcare sector, such as nursing workforce shortages and the impact on patient care, emphasizing the need for collaborative efforts to address these issues and enhance the wellbeing of healthcare professionals.