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As the Ministry of Justice looks to develop a 'new generation' of programmes to reduce reoffending, we reflect on what can be learnt from the only accredited domestic abuse programme in England and Wales, Building Better Relationships (BBR). Findings from an ethnographic study of BBR are situated within the Probation Inspectorate's recent inspection of domestic abuse work within the newly unified Probation Service which revealed a fractured and overstretched workforce. Our central argument is that if we are to avoid making matters worse, practitioners must be equipped with the time, supervision and skill needed to maintain something akin to a 'therapeutic alliance', that will endure in moments of crisis in their own lives as well as those of their clients. [ABSTRACT FROM AUTHOR]

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]

Aim(s) Background Design Methods Discussion/Conclusion Implications for the Profession and/or Patient Care Impact Reporting Method Patient or Public Contribution The aim of this study is to understand factors that challenge retention and support nurses to stay in general practice.One in four general practice nurse positions in England expected to be left unfilled within the next 10 years. Cultural and structural issues associated with working in general practice have been linked with nurses leaving general practice, re‐evaluating their professional futures, adjusting work‐life balance and bringing forward retirement. This has implications for the future of the general practice nursing workforce and patient care more broadly.Exploratory qualitative interview study funded by the General Nursing Council Trust for England and Wales. University of York ethics approval (Ref: HSRGC/2023/586/A) was gained in September 2023. The study will be conducted between September 2023 and August 2024.Qualitative interviews will be conducted with a range of nurses working in, or who have worked in, general practice as well as nurse leaders associated with general practice across England and Wales. Recruitment will be via professional and social media networks and snowballing techniques. We aim to purposively recruit 30–40 participants for maximum variation. Cultural and structural influences which may contribute to retention decisions will be explored. Data will be analysed following framework analysis.This study will explore how underpinning cultural and structural issues may impact on retention of this highly skilled professional group and identify factors to support retention.By exploring factors that support or discourage nurses to remain in general practice, retention strategies can be better planned on order to address the general practice nursing workforce crisis.What problem did the study address? This study will address the retention crisis in nursing in general practice by exploring how cultural and structural issues may impact on retention of this highly skilled professional group and identify factors to support retention.Where and on whom will the research have an impact? From the study findings, recommendations will be developed to inform future policy and practice. Key factors to address attrition will be generated to support employers and policy makers in future primary care workforce planning, as well as supporting nurses, at an individual level, in negotiating their roles in practice.Standards for Reporting Qualitative Research (O'Brien et al., 2014).As this is a workforce study protocol, there is no patient or public contribution. [ABSTRACT FROM AUTHOR]

Social work is one of the core professions within mental health services in the UK, though its position as local authority 'outsider' excludes it from health-based workforce planning, leaving the exact national composition of mental health social work shrouded in mystery. In the context of increasing demand and limited resources, this lack of clarity precludes effective use of the mental health workforce. This study aimed to map the provision of mental health social work across England and Wales. A cross-sectional design was used, with brief surveys issued to all local authorities and National Health Service trusts responsible for providing social work or mental health services. These surveys collected the number of mental health social workers in each agency and their employment contexts for subsequent descriptive statistical analysis. Responses were received from 96.6 percent of agencies, employing 6,584 social workers. Findings indicated that mental health social work varies widely across both nations, with little clear rationale for, or consistency in, how social work is structured within mental health services. While these findings establish the first robust framework for understanding the size and scope of mental health social work provision, further research is required to establish temporal and contextual understandings to inform future service planning. [ABSTRACT FROM AUTHOR]

Since the 1990s, the hospitality industry has been increasingly characterized by temporary and insecure forms of employment, a development, which has coincided with rising numbers of students seeking part-time employment. This provides increased job competition for non-students and would appear to be of primary benefit to the employer in terms of an enhanced labour pool. This study reports the findings from seven semi-structured interviews with hospitality employers and six student focus groups (31 participants) in South-West England and Wales. It suggests that hospitality employers manage students and non-students to complement each other, particularly with reference to working time preferences. There is evidence that employers pay more attention to the welfare and needs of non-student workers in order to protect their core of full-time and permanent part-time staff. However, when employing students, employers and students take a pragmatic commercial view of their symbiotic relationship and both parties report satisfaction with this arrangement. Employers also consider both student and non-students as potential leaders. Finally, the study shows that student-employees can, and frequently do, provide long-term commitment to employers, contradicting the usual view of student work as transitory within the hospitality industry. [ABSTRACT FROM AUTHOR]

Introduction: Trauma is one of the leading causes of mortality worldwide, but little is known of the temporal variation in major trauma across England, Wales and Northern Ireland. Proper workforce and infrastructure planning requires identification of the caseload burden and its temporal variation. Materials and Methods: The Trauma Audit Research Network (TARN) database for admissions attending Major Trauma Centres (MTCs) between 1st April 2011 and 31st March 2018 was analysed. TARN records data on all trauma patients admitted to hospital who are alive at the time of admission to hospital. Major trauma was classified as an Injury Severity Score (ISS) >15. Results: A total of 158,440 cases were analysed. Case ascertainment was over 95% for 2013 onwards. There was a statistically significant variation in caseload by year (p < 0.0001), times of admissions (p < 0.0001), caseload admitted during weekends vs weekdays, 53% vs 47% (p < 0.0001), caseload by season with most patients admitted during summer (p < 0.0001). The ISS varied by time of admission with most patients admitted between 1800 and 0559 (p < 0.0001), weekend vs weekday with more severely injured patients admitted during the weekend (p < 0.0001) and by season p < 0.0001). Discussion and Conclusion: There is a significant national temporal variation in major trauma workload. The reasons are complex and there are multiple theories and confounding factors to explain it. This is the largest dataset for hospitals submitting to TARN which can help guide workforce and resource allocation to further improve trauma outcomes. [ABSTRACT FROM AUTHOR]

We investigate the impact of the 2005 UK Disability Discrimination Act on the educational and employment outcomes for older children with disabilities, using data from the UK Labour Force Surveys. The Act established new legal requirements on employers and qualification awarding bodies to accommodate individuals with disabilities. Furthermore, prior to 2013 children in England and Wales could leave education at age 16, providing a unique opportunity to analyse the 2005 Act's influence on their educational and employment outcomes. Compared to children without disabilities, we found the 2005 Act reduced the likelihood of continuing in education and increased the likelihood of entering the labour market (employed or unemployed) for children meeting both the 1995 Disability Discrimination Act definition of disability and who were reported as work-limited. We also 'decompose' average outcomes between children's groups, identifying effects attributable to observable characteristics, discrimination, and unobservable health-related productivity gaps. [ABSTRACT FROM AUTHOR]

Treatment choice is a key component of quality, person-centred care, but policies promoting choice often ignore how capacity to choose is unequally distributed and influenced by social structures. In abortion care, the choice of either medication or a procedure is limited in many countries, but the structuring of treatment choice from the perspective of people accessing abortion care is poorly understood. This qualitative study explored comparative experiences of abortion treatment choice in England and Wales, using in-depth interviews with 32 people who recently accessed abortion care and had one or more prior abortions. A codebook approach was used to analyse the data, informed by a multidisciplinary framework for understanding the relationship between choice and equity. Abortion treatment choice was structured by multiple intersecting mechanisms: limitations on the supply of abortion care, incomplete or unbalanced information from providers, and participants' socio-economic environments. Long waiting times or travel distances could reduce choice of both treatment options. In interactions with providers, participants described not being offered procedural abortions or receiving information that favoured medication abortion. Participants' socio-economic environments impacted the way they navigated decision-making and their ability to manage the experience of either treatment option. Individual preferences for care were shaped in part by the interplay between these structural barriers, creating an illusion of choice, as the health system bias towards medication abortion reinforced some participants' negative perceptions of procedural abortion. The erosion of choice, to the point it is rendered illusory, has unequal impacts on quality of care. People's needs for their abortion care are complex and diverse, and access to varied service models is required to meet these needs. Treatment choice could be expanded by integrating public and private non-profit sector provision, aligning time limits and workforce requirements for abortion care with international standards, addressing financial pressures on service delivery, and revising the language used to depict each treatment option. • Constraints on treatment choice produce inequities in person-centred abortion care. • Supply constraints, provider interactions and socio-economic factors limit decisions. • These structural factors interact with demand factors to unequally constrain choice. • Inadequate treatment choice impacts the quality of abortion experiences. • Abortion care needs are complex and diverse, requiring varied service models. [ABSTRACT FROM AUTHOR]