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Since the 2014 Care Act was passed, key observers have continued to present it as offering adult social work significant opportunities: first, to make a central contribution in delivering the Act's core principles; and, second, to realise adult social work's liberation from narrow 'care management' practice. The primary source in implementing the Act was its 2014 Statutory Guidance, studied in a previous paper for its potentially key contribution to the promised liberation (Whittington, 2016). In March 2016, that Guidance was withdrawn and replaced by a second, revised edition, marking a potentially significant step. Building on the earlier study, this paper analyses the 2016 Guidance and its endorsements of social work roles and practice, with three aims: to assess how far endorsements converge with published social work aspirations; to consider changes since the first edition; and to examine the further implications for social work liberation. The analysis finds types of endorsement of front line social work largely unaltered between 2014 and 2016 Guidance. However, the 2016 version introduces significant content about Principal Social Workers. These findings are considered together with parallel social work influences and wider contexts that identify the multiple political dimensions of the social work liberation project. [ABSTRACT FROM AUTHOR]

In January 2021, we assessed the implications of temporary regulations in the United Kingdom allowing pubs and restaurants to operate on a takeaway basis without instigating a change of use. Local authorities (LAs) across the North‐East of England were unaware of any data regarding the take‐up of these regulations, partially due to ongoing capacity issues; participants also raised health concerns around takeaway use increasing significantly. One year on, we repeated the study aiming to understand the impact of these regulations on the policy and practice of key professional groups. Specifically, we wanted to understand if LAs were still struggling with staff capacity to address the regulations, whether professionals still had public health trepidations, and if any unexpected changes had occurred across the local food environment because of the pandemic. We conversed with 16 public health professionals, planners and environmental health officers across seven LAs throughout the North‐East of England via focus groups and interviews. Data collated were analysed via an inductive and semantic, reflexive‐thematic approach. Through analysis of the data, three themes were generated and are discussed throughout: popular online delivery services as a mediator to increased takeaway usage; potential long‐term health implications and challenges; continued uncertainty regarding the temporary regulations. This paper highlights important changes to local food environments, which public health professionals should be aware of, so they are better equipped to tackle health inequalities across urban and sub‐urban areas. [ABSTRACT FROM AUTHOR]

Aims: The United Kingdom and Australia have developed highly divergent policy responses to electronic nicotine delivery systems (ENDS). To understand the historical origins of these differences, we describe the history of tobacco control in each country and the key roles played in setting ENDS policy in its early stages by public health regulations and policy networks, anti‐smoking organizations, 'vaper' activist networks and advocates of harm reduction policies towards injecting drug use. Methods: We analysed key government reports, policy statements from public health bodies and non‐government organizations (e.g. cancer councils and medical organizations) on ENDS; submissions to an Australian parliamentary inquiry; media coverage of policy debates in medical journals; and the history of tobacco control policy in Australia and England. Key discourses about ENDS were identified for each country. These were compared across countries during a multi‐day face‐to‐face meeting, where consensus was reached on the key commonalities and divergences in historical approaches to nicotine policy. This paper focuses on England, as different policy responses were apparent in constituent countries of the United Kingdom, and Scotland in particular. Results: Policymakers in Australia and England differ markedly in the priority that they have given to using ENDS to promote smoking cessation or restricting smokers' access to prevent uptake among young people. In understanding the origins of these divergent responses, we identified the following key differences between the two countries' approaches to nicotine regulation: an influential scientific network that favoured nicotine harm reduction in the United Kingdom and the absence of such a network in Australia; the success of different types of health activism both in England and in Europe in opposing more restrictive policies; and the greater influence on policy in England of the field of illicit drug harm reduction. Conclusions: An understanding of the different policy responses to electronic nicotine delivery systems (ENDS) in England and Australia requires an appreciation of how actors within the different policy structures, scientific networks and activist organizations in each country and region have interpreted the evidence and the priority that policymakers have given to the competing goals of preventing adolescent uptake and encouraging smokers to use ENDS to quit smoking. [ABSTRACT FROM AUTHOR]

• Childcare policy responses towards Covid-19 differed in European welfare states. • Policy responses cause informalization of childcare to different degrees. • Informalization of childcare is mainly connected with social risks for women. • Cultural and institutional differences help to understand varying policy responses. The closure of extra-familial childcare facilities by European governments in 2020 was an important part of interventions against the spread of the COVID-19 pandemic. One consequence was that childcare was provided by parents at home, mainly by women. As a result, women mainly experienced financial and employment risks related to this "informalization" of childcare. The childcare policies of European welfare states differ in the extent to which they include measures to reduce the social risks related to informalization. Against this backdrop, this paper asks: How should one understand cross-national differences in childcare policies during the pandemic? We are also particularly interested in the effects of childcare policies on the social risks connected with the informalization of childcare and what these mean for the gendered division of paid work and care. Differences in childcare policies during the pandemic are commonly explained in terms of the path dependence of such policies. Using the theoretical approach of "care arrangement," this article introduces a broader theoretical framework that considers the role of cultural and institutional factors for understanding the cross-national differences in childcare policies during the pandemic. We introduce the findings of a comparative empirical study of childcare policies in three European welfare states—Denmark, Germany and England—that represent different types of care arrangements. This paper uses policy and media documents, quantitative data on childcare and women's employment, cultural ideas and secondary analysis of empirical studies. We find that governments did not per se respond to the pandemic based on institutional path dependence regarding childcare policies, while the integration of culture into the theoretical framework allows for a more comprehensive understanding. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to make the case that there is a need to move beyond a focus on an approach to leadership development which is confined to health care only. It argues that, given the economic, financial, social and organisational context within which health and social care organisations in the UK operate, there is a need to develop leadership within health and social care systems, rather than within the existing "siloed" sectors. Design/methodology/approach: The paper considers the context within which health and social care organisations in the UK operate; examines the nature of those organisations; makes the case for focusing on the health and social car system through systems leadership; and identifies the need for leadership, rather than leader development. Findings: There is a danger of health and social care organisations "walking backwards into the future" with eyes fixed on the past. The future lies with treating health and social care as a system, rather than focusing on organisations. The current model is individual leader focused, but the emerging model is one of collective multi-agency teams. Originality/value: The paper seeks to go beyond a health-care-only focus, by asserting that there is a need to regard health and social care as a single system, delivered by a multiplicity of different organisations. This has implications for the kind of leadership involved and for how this might be developed. [ABSTRACT FROM AUTHOR]

Purpose: Strategic socio-political views are notably scarce among contemporary discourses on the causes of abuse of vulnerable older people in care and nursing homes. This paper aims to catalyse higher order consideration and discussion of one socio-political characteristic that has relevance to the issue of abuse, that is, the market-like environment in which care and nursing homes in England operate. In doing so, the paper argues that the now firmly established but imbalanced "quasi-market" of care that has developed over many years fosters conditions under which both poor care and abuse are more likely to occur. The evidence presented in the paper focusses primarily on the rise to dominance of for-profit care home provision and the contraction of public sector provision. The paper does not examine in detail the characteristics and market presence of the not-for-profit sector because it has not held a numerically significant market share either historically or contemporarily. Design/methodology/approach: Outcomes of the marketisation of the care home sector that has its origins in the political landscape prevailing in 1979 and thereafter, along with the concurrent development of its regulation and oversight, are narrated and analysed. From this, a mythos of the motives behind the transition to a market-like economy that has taken place over four decades is developed and used to explain how prevailing market conditions contribute to the perpetuation of poor care and abuse. Findings: In the opinion of the author, there are identifiable consequences arising from the evolution of the current care economy that dispel the beliefs that providing care by means of current market-like arrangements is advantageous, that the independent regulation and monitoring of such a market is unproblematic and effective, and that the "consumers" in this market are exercising personal choice, in accord with classical economic theory. Practical implications: The paper offers the opportunity for the reader to consider how the development of a "quasi" market of care and nursing home services that has come to be dominated by for-profit private providers, and that is subject to ineffective oversight, may have contributed to conditions where abuse is more likely to occur and endure. Originality/value: This is a conceptual paper that explores the consequences of the creation of the market-like economy of care in which care and nursing homes now operate and suggests that it is time for prevailing market conditions to be re-visited and subjected to remedial strategic intervention. [ABSTRACT FROM AUTHOR]

The paper provides a theoretical insight into bank regulation and the process of internationalisation by examining the concepts of regulatory push and market pull within the context of Japanese bank entry into London during the 1980s. Rugman and Verbeke's [(1998). Corporate strategy and international environmental policy. Journal of International Business Studies, 29(4), 819-833] Consistency of Home and Host Government Goals model is utilised to structure the discussion, which centres on a situation where there is a conflict of goals between multinational enterprises (MNEs) and the home government but goal alignment between MNEs and the host government. As such the paper examines a relatively under-researched aspect of internationalisation and concludes that in certain circumstances internationalisation can occur despite great 'psychic distance'. The paper also argues that although bank regulation can lead to a conflict situation it can also be conducive to the development of a strong home base and the development of firm specific advantages. [ABSTRACT FROM AUTHOR]

A correction to a paper printed in a prior issue is presented, written by Berridge et al., which discusses policy around electronic nicotine delivery systems.

In English law, the conventional view is that human personhood is produced by live birth, kinship is produced by relations between persons, and corpses are produced on the death of persons, which are then buried or cremated. Beings produced by human pregnancy which do not fit these discursive categories are classified as 'pregnancy remains', have no personhood or kinship, and their disposal is regulated as human tissue. However, this paper argues that the governance of the dead, born, foetal body in England, in fact, produces forms of foetal personhood, through the regulation of the material dead bodies of foetuses and babies. Furthermore, the assignment of responsibility for disposal and post-mortem decisions to kin of the dead foetal being also produces a relational form of foetal personhood. The examination of second-trimester pregnancy loss in England through fieldwork with women who have experienced foetal death, premature labour, and termination for foetal anomaly before 24 weeks' gestation reveals how governance of the dead, born, foetal body in England is incoherent.It also illustrates the effects of this incoherence on parental choices about the range of actions available after pregnancy loss in relation to the material body of the foetal being or baby. [ABSTRACT FROM AUTHOR]

Purpose -- Winterbourne and Mid-Staffordshire scandals have had a significant impact on how Care Quality Commission inspects and regulates intellectual disability services (IDS). The purpose of this paper is to describe the changes and development of regulation of these services and future work. Design/methodology/approach -- The paper is a descriptive paper. Findings -- A new regulatory model is currently implemented for IDS. It has been developed in consultation with patients, carers, providers and other stakeholders. There will be ongoing development and refinement of the inspection methodology. Originality/value -- This is an original descriptive paper which will provide useful information to readers on how the regulatory process works in IDS. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to introduce the concept of the assumption of altruism argued by the author to be a tendency among both the lay public, professionals and politicians, a generalised assumption that contributes to the long standing and obstinate presence of abuse of adults who are at risk throughout England, particularly older people living in care and nursing homes.Design/methodology/approach By examining available figures that depict the continuing abuse of vulnerable adults, and by drawing on research, the author offers a partial explanation for the longevity of abuse in English society.Findings The paper demonstrates how the concept of the assumption of altruism can explain to a degree the apparent enduring levels of abuse of adults who are at risk.Practical implications The paper offers the opportunity for the reader to consider some of the fundamental, higher order reasons for the persistent levels of abuse in England, abuse that endures despite the oversight by government of care provided to adults who maybe at risk by virtue of the activities of the statutory regulator and health and social care commissioners.Originality/value By presenting the incontrovertible evidence of enduring abuse, the paper introduces the concept of the assumption of altruism as a partial explanation for its continuing occurrence despite decades of policy and practice guidance designed to overcome it. [ABSTRACT FROM AUTHOR]

The potential impacts of fracking on the environment and health, as well as impacts on local communities and their "quality of life," are well documented. This paper outlines the potential human rights impacts of fracking and argues for a human rights-based, participatory, and justice-based approach to regulation. In particular, it discusses the findings of the recent Permanent Peoples' Tribunal session on human rights, fracking, and climate change, held in Oregon, United States, and the potential impact of the tribunal's decision on other jurisdictions where fracking takes place, particularly England., Competing Interests: Competing interests: None declared.

This paper explores the development, in both practical and theoretical terms, of the Centre for Excellence in Teacher Training (CETT) based at Northumbria University. This is the only one of 11 new centres in England focusing on inclusive learning. CETTs are a critical component of a range of government reforms to teacher training within the learning and skills sector. CETTs are built on a partnership of organisations and the focus of the CETT for inclusive learning is to provide a source of expertise for those who teach or support learners with learning difficulties and/or disabilities (LDD). The partnership brings together teacher educators, teachers, trainers, researchers and learners as a 'community of practice' (CoP). In doing so, the CETT has developed an inclusive community of local providers working in higher education, further education, adult and community learning, work-based learning, offender learning, specialist colleges and voluntary sector organisations. Early evaluations of this new community indicate that it is helping to reduce the isolation felt by some practitioners and provide peer and financial support to an area of work that is often overlooked. With reference to the CETTs own and external evaluative work, this paper goes on to examine the challenges and opportunities faced in setting up this project and the lessons learned in terms of both the meaning of inclusion within this group and how the training and research conducted by the CETT can effect change within the wider CoP. In presenting the track of this ongoing project, it is hoped that similar endeavours will have a better understanding of how inclusive practice can be obtained for such a complex and diverse group of participant organisations. [ABSTRACT FROM AUTHOR]

School food provision is an important lever to shape the eating behaviours and dietary intake of school‐aged children and young people, and may help to address issues of childhood obesity, inadequate nutrient intakes and the widening gap of health inequalities. The regulation of school food has been an issue since the 1940s, with the challenges of developing a school food policy that supports health and wellbeing and that can be effectively translated in practice remaining to the present day. This paper examines changes to school food provision in England since the 1940s, with regard to the political structure and decisions made by each respective government. It considers the lessons learned from the development of school food policies over this period and possible ways to improve the standards of school food in the future. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to give a brief background to the Deprivation of Liberty Safeguards (DoLS), and studies which factors Best Interests Assessors consider when making a judgement on Deprivation of Liberty. It examines some of the reasons why professionals may be under-using DoLS, including lack of knowledge, complex processes and paperwork, and the pejorative nature of the word "deprivation", and looks at a possible way forward. Design/methodology/approach -- The paper looks at the evidence to the House of Commons and House of Lords Committees on the Mental Health Act and Mental Capacity Act, as well as previous and current research papers. It examines the nuances of difference between restriction and deprivation, and the cumulative impact of several restrictions, which may, in fact, amount to a deprivation, illustrated by case studies from the author's own practice. Findings -- It makes the case that health and social care professionals should err on the side of caution, by making precautionary DoLS applications, arguing that MCA DoLS is a forerunner of good practice, and that good care planning allied to judicious application of the MCA leads to better, more robust and more defensible decision making. Originality/value -- And it points the way to a possible future, citing the recommendations of the Select Committee on the MCA for a clearer link between DoLS and the principles underpinning the MCA, and for simplifying and clarifying the legislative provisions and the associated paperwork. [ABSTRACT FROM AUTHOR]

Prison settings have been neglected in the growing literature on drug-related deaths. This paper explores policy and practice issues regarding the governance of drug-related deaths in prisons in England and Wales from 2015-2021. Thematic documentary analysis was conducted on national level policy documents published between 2015-2021 (e.g. drug strategies, prison policy documents, Her Majesty's Inspectorate of Prisons and Prison and Probation Ombudsman (PPO) annual reports and guidance for staff). At the local (prison) level, all of the PPO fatal investigation reports and their associated action plans relating to 171 drug-related deaths from 2015-2021 were analysed thematically. Various modes of governance were identified using Head's 'wicked problems' conceptual framework including avoidance and denial, coercive controls, compartmentalised micro-management, incremental and pragmatic adjustment and technocratic problem-solving. There was strong evidence of the dominance of denial of the problem of drug-related deaths, coercive controls, micro-management and reliance on technological solutions in the early years (2015-2018). In some prisons, there developed a move towards the adoption of more pragmatic and incremental policies and push towards comprehensive policies over time. In others, remnants of denial and coercion remained. In our analysis, the focus on new psychoactive substances came to dominate attention, to the relative neglect of other substances and of the contribution of mental and physical illness to these deaths. Staff are not equipped, supported or resourced adequately to deal with the two 'wicked problems' of increasing rates of drug use and mental illness which collide in the prison setting. The PPO investigations repeatedly recommend reducing supply and improving monitoring and surveillance and the emergency response. There is less focus on prevention and reducing demand or improving the wider environmental context and culture in which the deaths occur. Policy needs to pay more attention to the fundamental issues driving the current deterioration in conditions in prisons. [ABSTRACT FROM AUTHOR]

The rationale for the principles of effective school governance in England, as set out in government regulations, has never been made explicit. This article addresses that issue and develops and proposes such principles. We argue that effective school governance secures the legitimacy of schools as institutions. Such institutional legitimacy is achieved through the institutionalization processes in which the institutional primary task is central. Effective governance is therefore concerned with overseeing and ensuring the processes of institutionalization. We identify two general principles that relate to ensuring the school's legitimacy and ensuring that the school's institutionalization processes enable it to be a legitimate institution. We also distinguish six specific principles that relate to: the school's work on the institutional primary task, the resources required and deployed for work on the institutional primary task; the school's compliance with the rules and regulations that apply to the institution; the school's conformance to the norms expected of a school; the way the school operates on a day-to-day basis in relation to wider society's expectations; calling the headteacher or principal (HT/P) to account for the functioning of the school; and ensuring the HT/P's development. Our analysis is relevant to school governance in other countries. [ABSTRACT FROM AUTHOR]

Background: Society is failing in its moral obligation to improve the standard of healthcare provided to vulnerable populations, such as people who lack decision making capacity, by a misguided paternalism that seeks to protect them by excluding them from medical research. Uncertainties surround the basis on which decisions about research participation is made under dual regulatory regimes, which adds further complexity. Vulnerable individuals' exclusion from research as a result of such regulation risks condemning such populations to poor quality care as a result of 'evidence biased' medicine.Main Text: This paper explores the research regulation provisions for proxy decision making for those unable to provide informed consent for themselves, and the subsequent legal and practical difficulties for decision-makers. There are two separate regulatory regimes governing research involving adults who lack capacity to consent in England and Wales. The Mental Capacity Act 2005 governs how incapacitated adults can be involved in research, however clinical trials of medicinal products are separately regulated by the Medicines for Human Use (Clinical Trials) Regulations 2004. There are significant differences under these dual regimes in the provisions for those lacking capacity to participate in medical research. The level of risk permitted differs, with a greater requirement for justification for participation in a clinical trial than other types of research. Who acts as proxy decision maker, how much information is provided to the person lacking capacity, and whether they retain the power of veto also significantly differs.Conclusion: The development of two separate regulatory regimes has resulted in significant differences between the provisions for clinical trials and other forms of research, and from usual medical practice. The resulting uncertainty has reinforced the tendency of those approving and conducting research to exclude adults lacking capacity to avoid difficult decisions about seeking consent for their participation. Future developments, such as the incoming EU Regulations, may address some of these differences, however the justification and level of risk permitted requires review to ensure that requirements are appropriate and proportionate to the burdens and risks for the individual, and also to the benefits for the wider population represented. [ABSTRACT FROM AUTHOR]

Background and aims Regulation of electronic cigarettes has moved to the top of the addiction policy agenda, as demonstrated by the recent focus across the United Kingdom on introducing age-of-sale restrictions. However, the views of those affected by such regulation remain largely unexplored. This paper presents the first detailed qualitative exploration of adolescents' perceptions of existing, and opinions about potential e-cigarette regulation. Methods Sixteen focus groups, including a total of 83 teenagers between the ages of 14 and 17 years, were conducted in deprived, mixed and affluent urban areas in Scotland and England between November 2014 and February 2015. Transcripts were imported into Nivivo 10, coded thematically and analysed. Results Participants critically considered existing evidence and competing interests in regulatory debates and demonstrated sophisticated understanding of the advantages and disadvantages of regulation. They overwhelmingly supported strong e-cigarette regulation and endorsed restrictions on sales to minors, marketing and e-cigarette use in public places. Concern about potential health harms of e-cigarette use and marketing increasing the acceptability of vaping and smoking led these adolescents to support regulation. Conclusions In focus group discussions, a sample of UK adolescents exposed to particular communications about e-cigarettes supported strict regulation of e-cigarettes, including banning sales to minors and use in indoor public areas. [ABSTRACT FROM AUTHOR]

Purpose Whether social workers should have a power of entry in cases where individuals seem to be hindering safeguarding enquiries for community-dwelling adults at risk is a topical question in England. The purpose of this paper is to present the findings of a re-examination of relevant sections of the 2012 Government Safeguarding Power of Entry Consultation.Design/methodology/approach Re-analysis of responses to question three of the 2012 Government’s Safeguarding Power of Entry Consultation was undertaken in late 2015-early 2016. The consultation submissions were located and searched for information on views of the prevalence of the situations where access to an adult at risk (with decision-making capacity) is being hindered by a third party and the nature of examples where a new power of entry might be considered appropriate by consultation respondents.Findings The majority of respondents to the consultation generally reported that situations when a new power of entry would be required were not encountered regularly; however a minority of respondents stated these situations occurred more frequently. Examples of situations where third parties appeared to be hindering access were given across the different categories of adults at risk and types of abuse and current practices were described. Respondents observed that the risks of excessive or inappropriate use of any new powers needed to be considered carefully.Originality/value This re-analysis sheds light on the prevalence and circumstances of the problems encountered about access to adults at risk. The legal framework of adult safeguarding continues to be of interest to policy makers, researchers and practitioners. [ABSTRACT FROM AUTHOR]

Background: The relevance and quantity of clinical research has caused concern and regulation is claimed to hinder clinical research. This paper compares clinical research regulations in Finland to those of England, Canada, and the USA around 2010-2011., Methods: Several approaches and data sources were used, including semi- or unstructured interviews of experts. For the analysis, a theoretical framework was made, data from various sources was synthesized, and features of the systems were simplified and classified. The various specific names and terms used in the data were changed into general ones., Results: Common structures for the regulation existed in all four countries, but the details and scope varied. The research regulated within the main system was determined by research type (Finland), the financer of the health system (England), or research site (Canada, USA). Only Finland had specific legislation on medical research. The overriding impression of the regulatory systems was one of complexity. All countries had extra regulation for drug research. The types of drug research covered varied from trials with unlicensed (new) products or new indications (USA and Canada), to all types of interventional drug research (England), where 'interventional' was interpreted broadly (Finland). The complexity of regulations had led to the creation of various big and small businesses to help researchers and sponsors. There was notable variation in the role played by the public research funder. The role played by health care was difficult to study and seemed to involve varying interests as researchers were also health care employees. Research ethics committees were important and their tasks also included aspects other than ethics., Conclusions: This study revealed that a comparison between countries can provide useful insights into the distinctive aspects of each country's system, as well as identifying common features that require international action.

Background: The Nottingham and Nottinghamshire Hospital for Diseases of the Throat, Ear and Nose existed in Nottingham for over 60 years, but there is little knowledge or documentation regarding its existence. Methods: The following resources were searched to find out more about the hospital: the Nottinghamshire Archives; Manuscripts and Special Collections at the University of Nottingham Libraries; and Nottingham Central Library. Information was also obtained from the founders' relatives. Results: The hospital was founded in 1886, by Dr Donald Stewart, supported by political and clerical leaders. Initially, it treated out-patients only; in-patients were admitted for surgical treatment from 1905. Suitable accommodation was purchased in 1925, on Goldsmith Street, but required much building extension and alteration. Building restrictions during and following World War II prevented expansion. The National Hospital Survey conducted in 1945 considered the clinical work undertaken to be of a minor character, and recommended closure and amalgamation with the services provided by the Nottingham General Hospital. The hospital closed in 1947. Conclusion: The specialist hospital was deemed unfit and unsuitable to compete with the comprehensive service provided by the Nottingham General Hospital. [ABSTRACT FROM AUTHOR]

Objectives: The introduction of medical revalidation in 2012 has been a controversial and radical change to medical regulation in the UK. It involved changes to the way organizations manage medical performance, and to the relationships between doctors, their employers and the professional regulatory body. In this paper, we explore the implementation of medical revalidation, analysing the change process and its consequences for doctors and organizations. Methods: We conducted a qualitative investigation of the implementation of revalidation in 15 case study organizations in 2016–2017, collecting documents and undertaking a total of 80 interviews with medical and non-medical staff. We used Normalization Process Theory to frame and structure the analysis. Results: Revalidation reforms were largely implemented successfully within and across our case study organizations, with evidence of growing acceptance of the purpose and processes of revalidation. There was an emergent shift from securing doctors' compliance towards the use of revalidation to strengthen clinical governance, and towards evaluating revalidation processes and seeking to make them more effective. However, there was substantial variation in the implementation and impact of revalidation; it was still not fully understood by many doctors, and revalidation processes were highly reliant on a few key individuals in each organization. The changes brought about by revalidation have had consequences for the way in which doctors construct their identity and the way they relate to the organizations in which they work. Conclusion: Despite considerable early scepticism and overt opposition in the medical profession, revalidation has become gradually accepted, embedded and even valued over time. Its impact and effectiveness are still questioned by many stakeholders, and the focus of attention has now shifted towards revising and improving the way revalidation works in practice. [ABSTRACT FROM AUTHOR]

After a decade of rapid spending increases under New Labour, this paper seeks to explain the pattern of growth in the range of strategic actions undertaken by police services during that period. Referring to a longitudinal analysis of documents, including annual reports, which related to strategic actions taken by one English police service (Blueshire), the common perception that ‘police mission’ has been subject to expansionary pressures is placed under scrutiny. An analysis is conducted which differentiates between new and cyclical policy issues and whether the strategic response is locally or centrally directed. Content analysis derived data has been supplemented with information secured during interviews with police leaders, to provide greater contextual depth. While it was observed that the capacity of police leaders to focus on core policing roles has, to some extent, been compromised, this cannot be explained purely in terms of central government pressure. The concept of path dependency is used to explain how this has occurred. A discussion is provided of the implications for the strategic direction of policing. [ABSTRACT FROM AUTHOR]

The Mental Capacity Act 2005 introduced legal safeguards (which came into force in April 2009) aimed at protecting the liberty of people lacking capacity admitted to institutions in England and Wales. This paper discusses the adequacy of the Deprivation of Liberty Safeguards for protecting the liberty of residents in social care settings and the role of regulation in monitoring their implementation. In particular, the potential impact of planned unitary regulation on the regulator's ability to protect residents' liberty is critiqued, centring on people with dementia living in care homes. It is suggested that the capacity of the safeguards to adequately protect the liberty of residents with dementia may be limited by under-recognition of the extent to which deprivation of liberty can actually occur in care homes, insufficient resourcing and a lack of critical independence in their proposed implementation. In addition, the planned contraction of regulation--especially a reduction in inspections--will constrain the regulator's ability to ensure that residents' right to liberty is protected. The author concludes that the new model of regulation adopted by the UK government has prioritised economic efficiency over safeguarding the right to liberty of vulnerable residents in institutions.

The regulation of market activities, by both local and central authorities, has been studied in some detail, but the interrelationship between the two has received considerably less attention. This paper examines market regulations and their enforcement in London prior to the Black Death, including measures to control prices, wages, forestalling, product quality, etc. It argues that, although London officials were often obliged to enforce royal orders relative to market activities, the economic policies elaborated by the mayor and aldermen had a significant impact on those adopted by the Crown and applied throughout the realm, particularly on the Ordinance of Labourers of 1349. [ABSTRACT FROM PUBLISHER]

This article reviews Bernard Barker's claims that ‘the pendulum is swinging’, in relation to school markets and competition. Barker's arguments are complex in this regard. He rejects markets and competition as a means of improving outcomes and equity, but supports some of the system features that are often associated with marketisation, such as school autonomy and differentiation. With this in mind, the article reviews the underpinning ideology and design of market and competition policies in England under different governments since 1988, as well as the evidence on the impact of these policies. It argues that the pendulum is not swinging away from markets and competition, although ideological shifts are discernible in the policies of the new Coalition government. One reason for this is that the evidence for the damaging effects of marketisation is not nearly as conclusive as Barker suggests. The pendulum is, however, swinging away from central regulation, including from regulatory mechanisms to protect against the worst effects of market policies on social justice. This may accelerate demands for a progressive post-market alternative, although the article concludes by pointing to the difficulties in practice of reconciling the values of equity, opportunity, social mobility, choice and community within system design. [ABSTRACT FROM PUBLISHER]

The authors describe the incremental approach to the marketisation of the English National Health Service (NHS) since the introduction of an 'internal market' in 1990 until the 2010 White Paper, 'Equity and Excellence: Liberating the NHS', and the subsequent Health and Social Care Bill published in January 2011. The introduction of a competitive market for a universal, tax-financed health system requires fundamental changes in regulation in order that market bureaucracy can be substituted for direct management. The components of reform are insufficiently captured by the framework of hierarchies and networks in new public management theories of decentralisation. [ABSTRACT FROM AUTHOR]

There is growing international interest in the impact of regulatory controls on the supply of housing. Most research focuses on the supply impacts of prescribed limits on land use but housing supply may also be affected by the process of planning monitoring and approval but this is hard to measure in detail. The UK has a particularly restrictive planning regime and a detailed and uncertain process of development control linked to it, but does offer the opportunity of detailed site-based investigation of planning delay. This paper presents the findings of empirical research on the time taken to gain planning permission for selected recent major housing projects in southern England. The scale of delay found was far greater than is indicated by average official data measuring the extent to which local authorities meet planning delay targets. Hedonic modelling indicated that there is considerable variation in the time it takes local authorities to process planning applications. Housing association developments are processed more quickly than those of large developers and small sites appear to be particularly time-intensive. These results suggest that delays in development control may be a significant contributory factor to the low responsiveness of UK housing supply to upturns in market activity. [ABSTRACT FROM PUBLISHER]

The purpose of this paper is to explore an apparent disjunction between espoused professional ethics and ethics in practice, and between law in statute and law in action. Social work in England is used as the main case study, however, research from other jurisdictions is drawn upon to demonstrate wider concern about departures from moral and legal rules. The evidence of the disjunction is presented, drawing principally from judicial review cases, investigations by the Commissioner for Local Administration (Ombudsman), inquiry evidence and government reports. The article critiques the current regulatory apparatus in England and the mechanisms by which staff and service users can hold public organisations, particularly councils with social services responsibilities, accountable. The interface between law and ethics is reviewed. The paper concludes with observations about strengthening legal and ethical literacy in practice. [ABSTRACT FROM AUTHOR]

In England and Wales, Domestic Homicide Reviews (DHRs) examine domestic abuse-related deaths to identify lessons to be learned. However, their emergence as a policy initiative has been little considered. To address this gap, a thematic discourse analysis of policy documents to 2011 was undertaken, examining the justification for, and conceptualization of, DHRs before their implementation. It is argued that DHRs were constructed as a taken-for-granted good, through which multi-agency partners would generate learning while the (gendered) subject was silenced. Attending to aspirations, contradictions, and tensions in the emergence of DHRs has implications for their understanding and operationalization in the present. [ABSTRACT FROM AUTHOR]

Legal problems can be cause and consequence of ill‐health and homelessness, necessitating efforts to integrate responses to these challenges. How to respond to legal issues within the context of health services for people who are homeless is though unclear. Groundswell piloted providing legal support to peer advocates (who have current or past experience of homelessness) and clients currently homeless in addition to their health‐focused work. A participatory action‐research design evaluated the emerging programme. Groundswell staff, both researchers and those involved in service delivery, co‐led the research alongside an external researcher. Qualitative methods were used to understand the experiences of legal support. We interviewed peer advocates and volunteers (n = 8), Groundswell clients (n = 3) and sector stakeholders (n = 3). Interviews were linked to regular reflective recorded meetings (n = 7) where Groundswell staff and researchers discussed the programme and the evaluation. Data were analysed thematically. The findings focus on three themes. First, peer advocates' and clients' legal needs involve an experience of being overwhelmed by system complexity. Second, the legal support to peer advocates aided in brokering and signposting to other legal support, in the context of a supportive organisational culture. Third, support to clients can be effective, although the complexity of legal need undermines potential for sustainable responses. In conclusion, legal support for peer advocates should be developed by Groundswell and considered by other similar agencies. Legal support to people who are currently street homeless requires significant resources and so health‐focused third‐sector organisations maybe unable to offer effective support. Other modes of integration should be pursued. Findings also have implications for how the third sector relates to the government agencies implicated in the legal challenges facing people who are homeless. [ABSTRACT FROM AUTHOR]

This article explores the response of the Science and Engineering Library team at Manchester Metropolitan University to the Covid-19 pandemic. It examines how the team's experience supporting distance-learning programmes acted as both a dress rehearsal and a road map for Library provision during the pandemic. In particular, the changing role of staff members whilst operating in the Covid-19 setting is carefully reflected upon. The article is structured into three sections, discussing support for distance-learning programmes, distance learning and Covid-19, and the changes Covid-19 prompted within the team's operation. [ABSTRACT FROM AUTHOR]

Background:In 2019 the Association of Visually Impaired Chartered Physiotherapists, originally the Association of Blind Certificated Masseurs, celebrated the centenary of its formation and becoming the first ever Specific Interest Group admitted to the Incorporated Society of Trained Masseuses which, later in the 20th century, became the Chartered Society of Physiotherapy. These landmarks motivated the author to research for this chronological, descriptive, narrative review of the history of blind physiotherapy and its contribution to physiotherapy in the United Kingdom. Purpose:The early training and practice of massage by blind practitioners, the organizational milestones in mainstream and blind physiotherapy and the inter-relationship between the two is considered. Key developments, challenges, innovations and opportunities throughout the history are reviewed including the impact of World War 1 and contribution of blind physiotherapy to the profession. Conclusion:Significant changes in physiotherapy educational and training arrangements for blind students and changes in physiotherapy practice generally over the last four decades engender serious questions about whether blind physiotherapy will still "belong", despite the increasing aspiration within society toward acceptance of diversity and inclusion. The author challenges the profession about whether it will facilitate blind physiotherapy to continue making its valuable contribution and be included. Will it still "belong?" [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]

Social workers are increasingly globally mobile, pursuing employment opportunities that combine professional and lifestyle projects. Social work skills and practice are embedded in cultural, linguistic and nation-specific legislative competencies. The current article engages with the interplay of a fast-moving social work and immigration policy context and the role of inter-European social workers, using England as a case study of destination. Based on registration data of non-UK qualified social workers (2003–2017), a survey of 97 stakeholders from 27 European Union countries and focus group discussions, it investigates trends and challenges of transnational social workers (TSWs) in England. The findings highlight a dynamic process of social work education and immigration policy reforms during the past decade that was associated with a significant change in the volume and profile of TSWs registered to work in England. Data from European stakeholders further highlight two key findings: first, there is evidence of an increased role of inter-European social workers in most of Western European countries; second, the process of social work qualifications' recognition within Europe remains considerably variable. The implications of the findings are discussed within the context of continued inter-European policy and political changes. [ABSTRACT FROM AUTHOR]

This article draws on findings from the first cross-national study of school exclusions in the four jurisdictions of the UK. It sketches factors associated with the past research with reductions in exclusions. It then reports interview data gathered in England in 2018 from five specialist officers working in two Local Authorities and a senior officer working for a national voluntary organisation. The officers describe good practice but also national, local and school level developments contributing to a deteriorating situation. These developments include unhelpful government guidance and regulations; school accountability frameworks affecting curriculum and leading to the neglect of Special Educational Needs; loss of Local Authority powers and funding resulting in reductions in support services. Data gathered for this study in other UK jurisdictions suggests that in Scotland and Northern Ireland, and to a lesser extent in Wales, a practice that avoids school exclusions has persisted more than in England. [ABSTRACT FROM AUTHOR]

Background Cumulative impact zones (CIZs) are a discretionary policy lever available to local government, used to restrict the availability of alcohol in areas deemed already saturated. Despite little evidence of their effect, over 200 such zones have been introduced. This study explores the impact of three CIZs on the licensing of venues in the London Borough of Southwark. Methods Using 10 years of licensing data, we examined changes in the issuing of licences on the introduction of three CIZs within Southwark, relative to control areas. The number of licence applications made (N = 1110), the number issued, and the proportion objected to, were analysed using negative binomial regression. Results In one area tested, CIZ implementation was associated with 119% more licence applications than control areas (incidence rate ratios (IRR) = 2.19, 95% confidence intervals (CI): 1.29–3.73, P = 0.004) and 133% more licences granted (IRR = 2.33, 95% CI: 1.31–4.16, P = 0.004). No significant effect was found for the other two areas. CIZs were found to have no discernible effect on the relative proportion of licence applications receiving objections. Conclusions CIZs are proposed as a key lever to limit alcohol availability in areas of high outlet density. We found no evidence that CIZ establishment reduced the number of successful applications in Southwark. [ABSTRACT FROM AUTHOR]

Existing Deprivation of Liberty Safeguards (DoLS) are being replaced in England and Wales by new Liberty Protection Safeguards (LPS) and the change is set to have a major effect on the work of learning disability nurses. [ABSTRACT FROM AUTHOR]

The ineffectiveness of leadership across maternity services in England has been a recurrent theme over a number of years, with reports continuing to identify the same issues. These reports reflect the concerns previously identified by the Healthcare Commission in its review of maternity services in England, which drew attention to the links between poor morale and ineffective or authoritarian leadership, as well as highlighting the overemphasis on financial pressures, all of which were concluded to be detrimental to the care provided for women. This article will explore the history of midwifery leadership, examining the reasons why midwives in particular have been perceived as failing to have developed the necessary skills to lead and manage maternity services. [ABSTRACT FROM AUTHOR]

This article examines the status of intercountry adoption (ICA) within adoption and family policy in England by analysing the extent to which the preventive ideals of 'kinship by design' are applied to ICA, particularly in the provision of adoption support. The discussion is set in the context of adoption reform under the New Labour and Coalition governments, broader family policy ideals of prevention and early intervention and state objectives in adoption, as well as global policy standards. This article argues that 'kinship by design' is not equally applied to intercountry adoptive families in England. [ABSTRACT FROM AUTHOR]

The 2014 Care Act ('the Act') has been called the most significant reform of adult social care in England since 1948, introducing a core legal entitlement of adults to care and support based on the principle of promoting the well-being of the person and their carers through a person-centred, holistic approach. Key national social work interests in England welcomed the Act for its close congruence with particular aims and values of social work and for the promise the Act holds for liberation of social work practice, mired for years in a narrow 'care management' model. Qualitative content analysis is used to critically examine prospects for this promised liberation. Definitive government guidance on how the Act should be implemented is compared with a guide promoting a vision of the liberated social work role required to deliver the aims of the Act and with related literature. Analysis identifies areas of real convergence between them, but also significant disparities at odds with a liberated model of adult social work. Concluding reflections on these findings and on the contemporary political and economic environments identify further issues that threaten to compromise not only the predicted social work renaissance, but the progressive elements of the Act itself. [ABSTRACT FROM AUTHOR]