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The 1950s were a period of consolidation after the upsets of the war years, and the continuing staff shortages up to the end of the 1940s. The staff shortages in the Sheffield child guidance clinic and school psychological service proved to be no exception. An advertised post for a senior psychologist in 1954 failed to attract any suitable applicants, and instead a newly qualified psychologist, Peter Portwood, was appointed as assistant psychologist. Portwood remained in the service until 1959 when he moved to Cornwall to become the senior psychologist there, and eventually Principal Educational Psychologist, taking up some important posts in the BPS Division of Education and Child Psychology. Portwood died in 2005. This article, written in the 1990s, presents Portwood's account of the Sheffield Service from 1954 to 1959.

A "crisis account" of shortages of well-qualified scientists, engineers, mathematicians and technologists has shaped education policy in the UK and the USA for decades. The apparent poor quality of school science education along with insufficient numbers of well-qualified teachers have been linked to skills shortages by government and other agencies since at least the time of the Second World War. There is, however, an alternative account that challenges the received view of a skills deficit and questions the evidence for sustained and long-term shortages across the sector. This paper provides an historical account of some of the main events that have characterised debates over the supply and demand of science and engineering professionals in the UK and the USA and the implications that this has had for science education policy. Starting from the end of the Second World War, the paper looks at the key challenges to the evidence that underpins the shortage debate and considers the consequences that more than seven decades of crisis accounts have had on the recruitment and retention of highly skilled scientists and engineers. The paper shows that while the shortage debate has a long history, it is one that is characterised by poor quality data as well as methodological and conceptual challenges. It argues that there is no consensus view about the existence of a skills deficit and that while there may have been short-lived shortfalls in specialist areas, there is little evidence in support of widespread and far reaching shortages as the rhetoric often claims.

This paper aims to provide insights into the recruitment and retention issues faced by employers in rural areas. To this end, information gathered through interviews with employers and labour market intermediaries in the predominantly rural county of Lincolnshire, UK was used as a source of data and focal point to discuss the demand side of the labour market. A distinction is made between circumstances in which there are hard-to-fill vacancies on the one hand, and the effects of an abundant labour supply on the other. The factors that affect labour retention are also discussed, including situations in which staff retention is a non-issue. Recognising the fact that economic life exists within, and is affected by the social context, the views of employers and labour market intermediaries are also analysed in the light of data from other sources. The paper concludes by suggesting that employers' recruitment and retention issues cannot be studied in isolation; the supply side as well as the demographic, economic, and political context need to be considered as well. (Contains 1 figure and 9 tables.)

A Levy-Grant Scheme (LGS) has existed in the UK construction industry since 1964 to provide financial support for companies undertaking training activities. Despite the support of the LGS for various training activities, notably apprenticeships, the construction industry continues to suffer from both labour shortages and an under-investment in training activity when compared to other sectors in the economy. This situation raises the question as to whether a LGS is an effective means for supporting training activity. This paper thus presents an in-depth review of the case for and against a UK construction LGS. It is argued that the LGS on its own is insufficient to alleviate labour shortages and poor participation levels in training. Moreover, if the LGS is to continue enjoying the support of employers it is important that levy payers (in particular) see the value of the scheme as integral to their business activities and do not regard it as a mere tax. The demonstration of the real value of the LGS becomes imperative when considering the current economic climate where companies are working with tighter budgets. (Contains 1 table and 3 notes.)

Current UK skills policy is centred on the need to drive up qualification obtainment and make the system more employer-led with Sector Skills Councils (SSCs) being given the role of articulating the "voice" of employers. Through a study of recruitment and selection processes in the fitness industry, this paper explores employers' attitudes to existing qualifications and whether their skill needs are being identified by their SSC. It also considers the broader implications of an employer-led system. The research is based upon interviews undertaken in 17 gyms, focusing on the occupation of fitness instructor. The findings reveal that managers adopt a wide range of approaches in how they recruit, train and value qualifications in the labour market. Although qualifications in this sector are important, the over-supply of "qualified" workers means there is little incentive for most employers to tackle low wages or improve opportunities for training and development. (Contains 4 tables and 1 note.)

This paper reports on the outcomes of a replication study of a survey of British employers that requested information on the qualifications sought when recruiting employees and on subsequent training and development. While the British survey was interested in the uptake and use of the British National Vocational Qualifications, the study reported in this article is primarily focused on the uptake and use of the Australian Qualifications Framework qualifications by North Australian employers. This study was prompted by the skills shortages and recruitment difficulties being experienced by organizations throughout rural and regional Australia. Previous studies have found that vocational qualifications were not valued by UK employers and few employers were encouraging employees to undertake vocational awards. If this is also the case in Australia, it may in part explain problems in recruiting skilled workers. This research clearly demonstrates that employees in regional and rural Australia are seeking to improve their knowledge and skills through vocational training and higher education qualifications. Also, employers are providing access to training and are supporting managerial and professional employees to gain higher educational qualifications. When recruiting all types of worker other than unskilled labourers, the majority of organizations prefer to recruit workers with qualifications. In rural and regional centres, however, a more pragmatic stance of recruiting unqualified employees in some areas is observed. Clearly, employers will attempt to minimize training costs by recruiting skilled employees, but in the end they will have to provide access to training and education to ensure that they have a skilled workforce that can deliver essential services and products.

In Britain, the retailing, computer services, transportation, and communications industries have hired increasing numbers of college graduates, both because of demand for skills and oversupply of graduates. This has contributed to temporary and permanent job upgrading through expansion of tasks and responsibilities in certain jobs. (Contains 14 references.) (SK)

A study of British students in Years 6, 10, and 12 found that they base their understanding of careers and work on images from personal experience, adults, and the media. Career decisions are based on pragmatic, opportunistic factors, not well matched with supply and demand. A divergent, holistic approach to guidance should challenge their assumptions. (SK)

The relationship between vocational education/training (VET) and economic growth is complex. In less-advantaged regions with low skill levels, employers may adopt strategies accommodating low skills, creating a vicious circle. A more proactive strategy may be hindered by the new VET system in Britain. (SK)

Includes "Higher-Level Skills in the UK" (Connor); "US and UK Labour Markets for New Grads" (Court); "Contribution of National Laboratories to the European Scientific Labour Market" (Smith); and "Recruitment of Nontraditional Scientists and Engineers in Europe" (Court, Jagger). (SK)

Reasons underlying a low demand for vocational skills in United Kingdom industry, relative to major competitors, are investigated. Low demand leads to a low supply of skilled labor, since the rates of return to vocational training are unattractive to potential trainees. Suggestions for reform are made. (Author)

In this paper, unemployment trends in aggregate, by faculty and by subject are examined, using data from the annual First Destination Return, first compiled for the 1961-62 university graduates, and the 1970 and 1980 graduate cohort surveys. Differences related to gender and type of institution of study are identified. (Author/MLW)

Short-term forecasting methods for assessing the number of students finishing schooling in France, Germany, Ireland, the Netherlands, and the United Kingdom are reviewed. Types of data that are available for each country are discussed, as well as suggestions for data that need to be collected for more efficient forecasting. (Author/IS)

Outlines structure of the library and information workforce in the United Kingdom, identifies its component parts, and traces developments since 1960 with emphasis on the expansion and decline of established employment markets, emerging markets, and balance between supply and demand of professionals. Future developments are predicted based on current trends. (Author/MBR)

The main thesis of this paper is that measured unemployment bears a different relationship to real excess labor supply in the 1970s than it did in the 1960s. This thesis is used to explain the increase in measured unemployment in the Netherlands, Sweden, the United Kingdom, and the United States. (Author/EB)

Practice-based education is an essential component of pre-registration physiotherapy programs, and there is a need for a contemporary review of practice-based educational experiences. The aim of this study was to explore physiotherapy practice educators' experiences of supporting learners to inform considerations for future workforce development. This was a mixed methods sequential explanatory study based in the United Kingdom (UK). Phase one of the study utilized an online survey disseminated via the Chartered Society of Physiotherapy (CSP) professional networks. Phase two consisted of three semi-structured focus group interviews with participants who expressed an interest via completion of the online survey. All were registered or associate CSP members who actively support practice-based education. A total of 208 participants completed the online survey and a sub-set of 15 participated in online focus groups. Quantitative survey data were analyzed using descriptive statistics. Initial thematic analysis of qualitative data from both phases was undertaken by one researcher. Subsequent analyses were carried out independently by the remaining research team, and comparisons were made to agree on codes, categories, and themes. The practice educator is vital in developing the future workforce (30%, n = 61, strongly agree). Identified challenges included supervising more than one learner (34%, n = 67 not at all experienced) and using technology to provide alternative placement models (45%, n = 87 not at all experienced). Practice educators need accessible opportunities for professional development. Practice-based education should be embedded as an integral component of all staff roles. A team approach is essential to developing the future physiotherapy workforce. [ABSTRACT FROM AUTHOR]

This study examines the tensions between newcomer migrants and established immigrants in the workforce in the United Kingdom. Semi-structured interviews were conducted with 23 participants in a food-manufacturing company to investigate how solidarity and conflict among groups of migrants impact their ability to integrate into the workplace. The research found that heightened levels of conflict occur between new and long-term immigrants. This engenders segregation as well as discrimination within the immigrant groups, which then hampers their career growth opportunities. The results have important consequences for diversity and inclusion in the workforce. The study shows that diversity needs a greater and wider focus than the current emphasis on the local population vs. immigrant paradigm. More attention should be devoted to tackling tensions between groups of immigrants. [ABSTRACT FROM AUTHOR]

With one‐fifth of the UK labour force employed in the public sector, public sector pay and its interaction with private sector pay is an important driver of the macroeconomy. Using new data on sector‐level earnings and sector–industry‐level pay settlements, this paper addresses the fundamental question of which sector leads and which follows in terms of earnings determination. We find that in the long run, public sector wages adjust to wages set in the private sector, maintaining a consistent relationship. We further find that there can be significant wage spillovers from the public sector to the private sector in the short run. These tend to be more pronounced for private sector industries that are domestically facing, characterized by low worker bargaining power, or reliant on public sector inputs. This paper's findings have important implications for macroeconomic policy that aims to balance inflationary forces and fiscal funding pressures. This paper is part of the Economica 100 Series. Economica, the LSE "house journal" is now 100 years old. To commemorate this achievement, we are publishing 100 papers by former students, as well as current and former faculty. Peter Dolton is a senior Fellow at the CEP, LSE. [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]

Chronic obstructive pulmonary disease (COPD) is a long-term condition affecting all aspects of an individual's life. Specialist Community practitioner district nurses (SCPDN) manage patients with multiple co morbidities on their caseload, and as such require an extensive clinical knowledge base. COPD is a highly prevalent and complex disease; therefore, individualised holistic assessments are required to ensure patients receive personalised and evidence-based care. Care delivery must include an awareness of health interventions encompassing, screening, health promotion and prevention. The SCPDN's consideration of the physical, mental and social determinants which adversely affect the health of the individual with COPD is imperative to deliver high quality care to the individuals, families and communities. [ABSTRACT FROM AUTHOR]

Introduction. New Zealand's health care system faces significant shortages in health care workers. To address workforce challenges and meet the population's health needs, health care systems around the world have introduced new clinical roles, such as physician associates/assistants (PAs) into existing health care teams. Aim. This article aims to examine the benefits, challenges, and broader implications of regulating PAs in the context of New Zealand's primary care sector, with a specific emphasis on how it may impact general practice. Methods. A range of literature surrounding the role, impact, and perception of PAs were selected and included in this article. Results. The PA profession can significantly strengthen New Zealand's primary care workforce, improving patient access and continuity of care. However, the global deployment of PAs has faced scrutiny due to concerns about its potential risks to patient safety and the overall viability of such a role. Discussion. If regulated, the PA profession can reshape New Zealand's primary care, offering a partial solution to current medical staff shortages. Trained under a generalised medical model similar to doctors, PAs possess the necessary skills to perform both routine and non-routine medical tasks. This dual capability can significantly improve primary care service provision, reduce existing workloads, and allow for a more efficient deployment of doctor expertise. However, medico-legal issues and the supervisory burden can impede widespread integration into general practice. Despite challenges, the success of the PA role relies on mutual trust, respect, and support from other clinical team members within primary health care. [ABSTRACT FROM AUTHOR]

Background: Healthcare workers (HCWs) in the United Kingdom (UK) have faced many challenges during the COVID-19 pandemic, some of these arising out of their social positions. Existing literature explicating these challenges (e.g., lack of appropriate PPE, redeployment, understaffing) have highlighted inequities in how these have been experienced by HCWs based on ethnicity, gender or, job role. In this paper, we move a step ahead and examine how the intersection of these social positions have impacted HCWs' experiences of challenges during the pandemic. Methods: We collected qualitative data, using interviews and focus groups, from 164 HCWs from different ethnicities, gender, job roles, migration statuses, and regions in the United Kingdom (UK) between December 2020 and July 2021. Interviews and focus groups were conducted online or by telephone, and recorded with participants' permission. Recordings were transcribed and a hybrid thematic analytical approach integrating inductive data-driven codes with deductive ones informed by an intersectional framework was adopted to analyse the transcripts. Results: Thematic analysis of transcripts identified disempowerment, disadvantage and, discrimination as the three main themes around which HCWs' experiences of challenges were centred, based on their intersecting identities (e.g., ethnicity gender, and/or migration status). Our analysis also acknowledges that disadvantages faced by HCWs were linked to systemic and structural factors at the micro, meso and macro ecosystemic levels. This merging of analysis which is grounded in intersectionality and considers the ecosystemic levels has been termed as 'intrasectionalism'. Discussion: Our research demonstrates how an intrasectional lens can help better understand how different forms of mutually reinforcing inequities exist at all levels within the healthcare workforce and how these impact HCWs from certain backgrounds who face greater disadvantage, discrimination and disempowerment, particularly during times of crisis like the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Historians have long remarked upon the political significance of the Allied armies from Continental Europe which were established on British soil during the Second World War. Much less attention has been devoted to the implications of maintaining and expanding these forces amid the very particular circumstances of wartime exile. This article examines three aspects of the tension between the imperatives to secure as many men as possible for military service while maintaining the distinctly 'national' character of the force as a whole. The failure to mobilize emigrants and expatriates is examined in the first section, while the second section shows how soldiers could use national identities to their own advantage and pass between foreign armies. The final section examines the far-reaching political consequences of the often-obscured ethnic diversity within the ranks, focusing particularly on Jewish soldiers. [ABSTRACT FROM AUTHOR]

There is a widespread belief that work is less secure than in the past, that an increasing share of workers are part of the "precariat." It is hard to find much evidence for this in objective measures of job security, but perhaps subjective measures show different trends. This paper shows that in the United States, the United Kingdom, and Germany, workers feel as secure as they ever have in the past 30 years. This is partly because job insecurity is very cyclical and (pre-COVID) unemployment rates very low, but there is also no clear underlying trend towards increased subjective measures of job insecurity. This conclusion seems robust to controlling for the changing mix of the labor force, and it is true for specific subsets of workers. [ABSTRACT FROM AUTHOR]

To attract and retain a more diverse workforce, organizations embrace diversity initiatives, expressed in diversity statements on their websites. While the explicit content of diversity statements influences attitudes towards organizations, much less is known about the effect of subtle cues such as emotions. In three pre‐registered studies, we tested the effect of positive emotionality in diversity statements on attitudes towards organizations. Study 1 focused on the degree to which 600 European organizations employed emotionality in their diversity statements, finding that although their statements differed in the level of emotionality, on average, organizations avoided highly emotional words. Study 2 (N = 220 UK participants) tested the effect of original diversity statements on readers' attitudes towards an organization, demonstrating that the level of emotionality in the existing statements did not influence positive attitudes towards the organization. In Study 3 (N = 815 UK participants), we thus modified the diversity statements so that they contained high levels of positive emotionality that triggered more positive emotions and resulted in more positive attitudes towards an organization. Taken together, highly emotional words (e.g. passionate; happy; wholeheartedly) are key in diversity statements if organizations wish to increase their attractiveness among potential employees. [ABSTRACT FROM AUTHOR]

Purpose: The development and implementation of a provider collaborative (PC) represents an ambitious and complex piece of work to be delivered across a geographical area for a vulnerable patient cohort. The UK East Midlands Children and Adolescent Mental Health Services (CAMHS) PC was established in April 2021, and the current study aimed to explore the views of a variety of staff members about its functioning over the first twelve months. Specifically, it explored whether the intended aims has been achieved and identified the challenges that it faced during its introduction. Design/methodology/approach: Feedback was collected through in-depth qualitative interviews and surveys with frontline (n = 20) and senior staff (n = 19) that were conducted to explore the experiences of a variety of stakeholders within the collaborative. Findings: Two main themes were identified – the achievement of the key aims and the barriers to success. A thematic analysis has shown that whilst the aim of the PC is well intentioned and is generally welcomed by the multiple stakeholders across the geographical region, it is clear that changes are required in order to ensure the inception of an efficient care service that is able to achieve the ultimate goal of providing the ultimate goal of "right care at the right time". Originality/value: This is the first study, to the authors' knowledge, to explore collaborative working in CAMHs services. The study involved staff feedback from Phases 1 and 2 of a 4-years-long evaluation. The findings demonstrate the overall aims are being met as well as identifying areas of concern; this, in turn, allows the authors to develop a series of recommendations to implement and improve collaborative working before assessing their impact in the subsequent phase. [ABSTRACT FROM AUTHOR]

Prior to the COVID pandemic, staffing levels, staff turnover and vacancies in adult social care and social work within the UK were a major concern, with staff experiencing high workloads, burnout, stress and poor morale. The paucity of published evidence in a rapidly evolving contemporary situation indicated the suitability of a scoping review. Systematic searching produced evidence published between 1 December 2019 and 9 May 2023. Out of ninety-seven articles retrieved, the final analysis included thirty nine articles. To report the review findings clearly and accessibly, the analysis used the Patterns, Advances, Gaps, Evidence for practice and Research recommendations framework. Abundant evidence emerged on psychological distress and the impact of COVID-19 on the working environment for social care and social workers, but a paucity of psychosocial resilience, supporting social care managers, Personal Assistants and moral injury. Social care needs and the statutory duties of social work are likely to become even more intense. The COVID pandemic magnified a chronic lack of funding, staffing, support and regard for adult social care, with no future planning compared to the NHS. This legacy and backlogs of social care assessment and service delivery are of concern despite the proposed actions of the Adult Social Care Reform Act in England. [ABSTRACT FROM AUTHOR]

Using data from two national surveys, the Quarterly Labour Force Survey and the Workplace Employment Relations Survey, we establish evidence of a robust disability‐related trade union membership differential in the UK. After controlling for differences in other personal and work‐related characteristics, disabled employees are found to be 3.6 percentage points (12–14 per cent) more likely to be union members than non‐disabled employees. While the differential is consistent with evidence that disabled employees have stronger preferences for union representation, we do not find evidence that union membership is associated with disproportionate benefits for disabled employees in terms of a reduction in disability‐related labour market inequality. [ABSTRACT FROM AUTHOR]

Background The study aimed to identify the causes of moral distress in public health professionals associated with the COVID-19 pandemic, and the potential ways of avoiding or mitigating the distress. Methods The survey was distributed to all members of the UK Faculty of Public Health between 14 December 2021 and 23 February 2022. Conventional qualitative content analysis was conducted to explore the situations in which moral distress arises, the moral judgments that led to distress and the proposed ways to address moral distress. Results A total of 629 responses were received from respondents broadly representative of the public health professional workforce. The main situations causing moral distress were national policy, guidance and law; public health advice; and workplace environments. Moral distress was precipitated by judgments about having caused injury, being unable to do good, dishonest communications and unjust prioritization. The need to improve guidance, communication and preparedness was recognized, though there was disagreement over how to achieve this. There were consistent calls for more subsidiarity, moral development and support and freedom to voice concerns. Conclusions The causes of moral distress in public health are distinct from other healthcare professions. Important proposals for addressing moral distress associated with the COVID-19 pandemic have been voiced by public health professionals themselves. [ABSTRACT FROM AUTHOR]

Background: Redeployment in health care can have a negative impact on the mental wellbeing of staff. Advanced planning and provisions for wellbeing support for health professionals has been recommended following previous pandemics. At the authors' institution nurses were redeployed overnight from a specialist cystic fibrosis ward to a COVID-19 high-dependency unit. Aim: To evaluate nurses' wellbeing following this redeployment during the first wave of the COVID-19 pandemic. Method: A mixed online survey, consisting of both open and closed questions, based on literature, preliminary results of the Impact of COVID-19 on the Nursing and Midwifery Workforce (ICON) study and staff feedback. This was sent to 28 nurses to explore their feelings and experiences of redeployment to a COVID-19 environment. Purposive sampling was used to select study participants while thematic analysis and descriptive statistics were used to analyse the data. Findings: The survey had an 86% response rate. Using thematic analysis three key themes emerged: redeployment anxiety, lack of organisational preparedness and newfound teamworking. More than half (57%) of respondents expressed anxiety and concern when told of their redeployment; 52% reported that they did not receive adequate support from senior staff and management. However, 74% reported that they felt their nursing was positively influenced by support and teamwork from those in patient-facing roles. Twenty-five percent reported that they were looking for a new job or leaving their current role. Conclusion: This study examines the effects that redeployment to a COVID-19 environment has had on nurses. It highlights the need for further improvement to ensure redeployed staff are supported to safeguard their mental wellbeing. [ABSTRACT FROM AUTHOR]

Internationally there is a shortage of psychiatrists, whilst clinical psychology training is generally oversubscribed. School students interested in psychological health may not be aware of the possibility of studying medicine before specialising in psychiatry. This has implications for the mental health workforce. To evaluate the knowledge and attitudes relating to a potential career in psychiatry amongst secondary (high) school students. A cross-sectional survey evaluated attitudes and knowledge relating to psychiatry and clinical psychology, targeting students from five schools who were studying chemistry, biology and/or psychology at an advanced level. 186 students completed the survey (response rate 41%). Knowledge was generally poor with only 57% of respondents knowing that psychiatrists had medical degrees, and most participants substantially underestimating the salaries of consultant psychiatrists. Attitudinal response patterns were explained by two underlying factors, relating to generally negative attitudes towards psychiatry and positive attitudes towards the effectiveness of psychiatric treatments. Females and those studying psychology reported more positive attitudes towards psychiatry. Those studying chemistry reported more negative attitudes towards the effectiveness of mental health treatment. Studying psychology predicted positive attitudes towards psychiatry. Such students could be targeted by recruitment campaigns, which emphasise factual information about the specialty. [ABSTRACT FROM AUTHOR]

Background and Objectives The increasing number of people with dementia requires transparency and quality dementia education, training, and care. This scoping review aimed to determine the key elements of national or state-wide standards on dementia education and training that could underpin the development of international standards for dementia workforce training and education. Research Design and Methods The English-language peer-reviewed and gray literature were searched (2010–20). Key search domains were training, workforce, standards/frameworks, and dementia. Results Thirteen standards were identified from the United Kingdom (n = 5), the United States (n = 4), Australia (n = 3), and Ireland (n = 1). Most standards focused on training health care professionals with some including people in customer-centric settings, people living with dementia, and informal carers or the general community. Seventeen training topics were identified in 10 or more of the 13 standards. Cultural safety, rural issues, health care professional self-care, digital literacy, and health promotion topics were less commonly reported. The barriers to standards implementation were lack of organizational support, lack of access to relevant training, low staff literacy, lack of funding, high staff turnover, ineffective past program cycles, and inconsistent service delivery. Enablers included a strong implementation plan, funding, strength of partnerships, and building on previous work. Discussion and Implications The U.K. Dementia Skills and Core Training Standard, the Irish Department of Health Dementia Together, and the National Health Services Scotland Standard are the recommended strongest standards for underpinning the development of international standards. It is essential that training standards are tailored to the needs of the consumer, worker, and regions. [ABSTRACT FROM AUTHOR]

Current evidence suggests understaffing is related to poor quality and missed care in a global context, but this relationship is complex. There is also a research gap for quality in mental health care in the United Kingdom that includes a wider set of patient outcomes. This paper aims to investigate RMN's perception of quality of care on their last shift, their self‐reported reasons for compromised care and potential impact on patient outcomes. A mixed methods approach, we used descriptive statistics to create a framework within which to qualitatively analyse data from the 2017 Royal College of Nursing (RCN) employment survey to consider the complex relationship between understaffing and care quality. We established three themes: 'Understaffing', 'Professional Code Expectations and Moral Distress' and 'Management'. In line with the current evidence; lack of resources and understaffing were consistently present throughout. Nurses also felt pressure from the Nursing and Midwifery Council (NMC) code of conduct which in turn instilled shame and fear for their registration when they were unable to achieve the standards expected. This was further exacerbated by poor management and supervision; leading nurses to reflect on poor outcomes for patients which compromised not only legal rights but safety of patients and staff alike. We conclude that focusing on staffing numbers alone is unlikely to improve care quality. [ABSTRACT FROM AUTHOR]

This article surveys the experiences of historical actors labelled 'mentally defective' and 'mentally handicapped' in Britain in the first half of the twentieth century. It decentres institutions and experiences of segregation, and instead foregrounds employment as a way to historicise and make visible the experiences of individuals with intellectual impairments who lived in communities. The article discusses significant opportunities for paid employment, both formal and informal, for disabled people. Periods of economic growth or recession rendered such workers visible, as did efforts to regulate labour markets and wages. The article argues that rather than 'mental age' becoming dominant in framing intellectual disability, vernacular and negotiable categories of 'wage age' predominated in workplaces to the mid-twentieth century. Intellectually disabled people adopted precarious strategies of 'getting by' and while they commonly experienced low wages, could also sustain degrees of community inclusion at the margins of the economy. [ABSTRACT FROM AUTHOR]

Background: General practice in the UK is under substantial pressure and practices are increasingly including paramedics as part of their workforce. Little is known about how different models of paramedic working may affect successful implementation of the role, as viewed from patient, clinician and system perspectives. This realist synthesis developed theories about 'models of paramedic working in general practice' in different UK contexts to understand their impact. Methods: The rapid realist synthesis comprised data from: (1) empirical and grey literature searches; (2) semi-structured realist interviews with system leaders involved with the implementation of the role; and (3) a stakeholder event with healthcare professionals and the public, to develop initial programme theories that can be tested in future work. Sources were analysed using a realist approach that explored the data for novel or causal insights to generate initial programme theories. Results: Empirical sources (n = 32), grey sources (n = 95), transcripts from system leader interviews (n = 7) and audio summaries from the stakeholder event (n = 22 participants) were synthesised into a single narrative document. The findings confirmed the presence of a wide variety of models of paramedic working in UK general practice. The perceived success of models was influenced by the extent to which the paramedic service was mature and embedded in practice, and according to four theory areas: (1) Primary care staff understanding and acceptance of the paramedic role; (2) Paramedic induction process, including access to training, supervision and development opportunities; (3) Patient understanding and acceptance of the role; (4) Variations in paramedic employment models. Conclusions: Variability in how the paramedic role is operating and embedding into general practice across the UK affects the success of the role. These findings provide a theoretical foundation for future research to investigate various 'models of paramedic working' in different contexts. [ABSTRACT FROM AUTHOR]

Background: Prosthetists and orthotists (POs) are the smallest of the 14 allied health profession (AHP) workforces within NHS England. Obtaining data on the workforce has always been challenging due to this information being held across different organisations. An understanding of the prosthetic and orthotic (P&O) workforce is essential to ensure that it is adequately equipped to meet the evolving needs of users of P&O services. The study aims to estimate the size and composition, for the first time, of the UK P&O workforce and P&O service provision. Methods: To gather the required information, two surveys (one for the UK P&O workforce and one for UK P&O private company) and two freedom of information (FOI) requests [one for all NHS Trusts and Health Boards (HB) in the UK and one for the higher education institutes in the UK offering programmes leading to registration as a PO were developed and distributed from September to December 2022. Results: The P&O workforce survey received a 74% response rate (863 POs) and 25 private companies reported employing one or more P&O staffing groups. From the FOI requests, 181 of a potential 194 Trusts/Health Boards and all four higher education institutions responded. The study indicated a total of 1766 people in the UK P&O workforce, with orthotists and orthotic technicians representing the largest percentage of the workforce at 32% and 30%, respectively. A greater percentage of prosthetists (65%) and orthotists (57%) were employed by private companies compared to the NHS. Only 34% of POs stated that they "definitely" planned to remain in the workforce for the next 5 years. The current UK PO employment levels are 142 to 477 short of the World Health Organisation's (WHO) recommendation. Conclusions: The low job satisfaction amongst many POs and the projected increase in the number of people who will require prosthetic and/or orthotic care in the UK are challenges for future UK P&O services. Strategies are required to create a sustainable and resilient workforce that can meet the needs of a changing healthcare landscape. [ABSTRACT FROM AUTHOR]

Aims: The study aimed to (1) discover workers' attitudes toward the use of novel video screens to improve hand sanitization in the workplace and (2) discover what workers' preferences are for hand hygiene (HH) messaging style and tone and reasons for their preferences. Background: Practicing good HH in non-medical office settings is vital to curb the spread of a range of common and infectious diseases. Despite this, workers are rarely consulting in the construction of HH messages. The qualitative views of users can provide us with the "why" rather than the "what" and can highlight areas of cynicism, concern and overall attitudes to HH. Methods: A survey was completed by 520 UK workers concerning attitudes and views toward HH messaging and the use of a video-based hand sanitizer unit. Analysis consisted of both qualitative and quantitative methods. Results: Workers were skeptical toward the use of digital technologies within HH interventions, and there were misgivings about the role that video could play. Results demonstrated a strong preference for positive and supportive messages. Educational and trustworthy qualities were well rated. Messages that emphasized surveillance, previously successful in a clinical setting, or guilt, were not well received. Visual approaches that utilized serious illustration were valued. Conclusion: This study highlights how consulting workers before the design of HH initiatives is important in guiding the design process. The resultant user-centered criteria promotes the use of positive, motivational, thought-provoking, surprising, and visual approaches to HH messaging. [ABSTRACT FROM AUTHOR]