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Background: Mental capacity legislation in the UK is designed to safeguard the rights of people who may need support, or may be unable, to make autonomous decisions. Very limited evidence has been published about the impact of the COVID‐19 pandemic on the application of mental capacity legislation and, to our knowledge, none on the ability of speech and language therapists (SLTs) to support people with communication disabilities to engage in decision‐making. Aims: To describe how UK SLTs supported people with communication disabilities to make decisions and participate in mental capacity assessments, best interests decision‐making and advance care planning during the COVID‐19 pandemic. Methods & Procedures: This descriptive, cross‐sectional study used an online survey to collect quantitative and qualitative data about SLTs' practice experiences between August and November 2020. SLTs working with a range of adult clinical populations in different care settings were sampled purposively from all UK jurisdictions. Participants were recruited through professional networks and social media. Quantitative data were summarized using descriptive statistics. Qualitative data were analysed thematically. Outcomes & Results: Data were collected from 107 SLTs working in a range of settings across all four UK nations. The sample included SLTs working with people with neurological conditions, learning disabilities, mental health conditions and acute confusion. The need for SLT support appeared to increase during the pandemic. Most respondents were still able to offer support; however, the amount and nature of support varied. Quality of support was impacted by adjustments associated with social distancing and infection control restrictions. Personal protective equipment (PPE) was identified as a barrier to communication. Indirect working methods (e.g., telehealth) were inaccessible to some people with communication disabilities. Most respondents felt confident that legal requirements were upheld, but suggested this group was less able to engage in decision‐making and had reduced access to support to manage their own health conditions. Conclusions & Implications: Some SLT services were limited in their ability to meet the decision‐making support needs of people with communication disabilities during the COVID‐19 pandemic due to structural and systemic barriers. This suggests that existing inequities in the provision of care for people with communication disabilities in the UK were amplified during the pandemic. What this paper adds: What is already known on the subject: People with communication disabilities may require support from healthcare professionals, including SLTs, to make decisions and communicate their wishes and preferences about their care, in line with mental capacity legislation. There is a lack of published evidence relating to how changes in staff deployment and resource during the COVID‐19 pandemic may have impacted on the ability of SLTs to provide this support. What this paper adds to existing knowledge: This study provides novel evidence about the ways in which UK SLTs supported people with communication disabilities to engage in mental capacity assessments, best interests decision‐making and advance care planning during the COVID‐19 pandemic. In some cases, the amount and quality of decision‐making support available was affected negatively due to changes in healthcare delivery and resource management and SLT working practices. What are the potential or actual clinical implications of this work?: This study suggests that some people with communication disabilities experienced greater barriers to receiving professional support to maximize their autonomy and manage their health conditions during the COVID‐19 pandemic. Speech and language therapy services and healthcare commissioners should consider how best to ensure equitable service delivery to this population in resource‐limited situations. [ABSTRACT FROM AUTHOR]

Background: Autistic people require varying levels of support at different stages of their lives. Yet, the healthcare needs of autistic adults are largely unmet. Speech and language therapy (SLT) is one healthcare service that has an important role in supporting autistic people: both with initial diagnosis, and with the ongoing support needed to navigate different communicative challenges across the lifespan. Despite recommendations for such support, currently there is no clear SLT pathway for autistic adults, and a lack of established approaches to support autistic adults' speech, language and communication needs. Aims: To seek autistic adults' views on (1) their communication skills and support needs; (2) the type of support SLT could offer; and (3) how such support could be provided. Methods & Procedures: A total of 18 autistic adults were interviewed in their preferred mode of communication (e.g., face to face, phone call, text messaging, e‐mail), expressing their views on their communication skills and needs. Interview data were analysed using thematic analysis. Outcomes & Results: Autistic adults presented complex views on communication, identifying the benefits of communication, while also emphasizing the significant negative impact that communication difficulties can have on their everyday lives. Identifying a range of internal (e.g., personal feelings) and external (e.g., the communication partner) factors, they highlighted the need for support at both individual levels (for specific life situations) and broader societal levels (to increase awareness and acceptance of communication difficulties). Conclusions & Implications: Considering the negative impact that communication difficulties can have for autistic adults, a need for support was emphasized. Despite recognition of this need within current legislation (in the UK) and positive steps toward providing support, more needs to be done. As experts in supporting individuals with communication difficulties, speech and language therapists could play a pivotal role in providing support at an individual level, as well as increasing awareness of communication differences more widely. What this paper addsWhat is already known on this subjectThere is a growing population of autistic adults with unmet support needs. A core characteristic of autism is difficulty with neurotypical social communication and interaction, which persists into adulthood and impacts across various life domains.What this paper adds to existing knowledgeAutistic adults outlined the types of communication difficulties they experience, and how these can negatively impact on physical and mental health. Results highlight how these difficulties are not just rooted within the person themselves but can be influenced by external factors (e.g., the environment and the communication partner).What are the potential or actual clinical implications of this work?Some autistic adults may benefit from direct support from SLT services. However, increased awareness and respect for communication differences at a broader societal level is also needed. Speech and language therapists can play an important role in increasing this level of awareness, positively highlighting differences in communication and ways to support people with communication difficulties/differences. [ABSTRACT FROM AUTHOR]

Adverse childhood experiences (ACEs) have been associated with negative mental and physical health consequences. Neighbourhood police officers (NPOs) are thought to be well placed to identify and support children experiencing ACEs. Within this paper, we describe a qualitative exploration of an initiative deployed by a large UK police force which aimed to aid early identification of young people with ACEs using police data and provide subsequent support given by NPOs. A thematic analysis was conducted using transcripts from three focus groups of NPOs, supplemented by questionnaires. Key themes identified in both sets of data offer reflections for policing and other public service provision seeking to target on the basis of ACEs, including: limitations in the usefulness of police data to identify childhood adversity; challenges using the ACEs framework as a means to target such 'early intervention'; and debates regarding the appropriate role of the police in supporting young people in adversity. Prior to replication of this intervention elsewhere, there are several points to consider: whether police data alone are sufficient in identifying ACEs; ensuring clarity regarding the role of the public sector agencies in such intervention; and determining an apt measure of success for the scheme. Key practitioner messages: Modelling using only police data can provide insight into the population of children who may have suffered from ACEs but may not provide significant opportunities for early interventionThere is a clear need for defining the role of UK police forces in the delivery of early interventionIt is evident that multi‐agency working/data sharing is crucial to preventing the duplication of referrals and interventions conducted with young people who have experienced ACEs 'There is a clear need for defining the role of UK police forces in the delivery of early intervention' [ABSTRACT FROM AUTHOR]

Background The speech and language therapy/pathology (SLT/SLP) profession is characterized by extreme 'occupational sex segregation', a term used to refer to persistently male- or female-dominated professions. Men make up only 2.5% of all SLTs in the UK, and a similar imbalance is found in other countries. Despite calls to increase diversity in the allied health professions more generally, research into the reasons for occupational sex segregation and gender as a potential key factor remains scarce. Aims This study aims to explore the potential role of gender/gendered discourses in people's decision to pursue a career in SLT/SLP. It seeks to illustrate how gendered assumptions/expectations/discourses continue to construct SLT as a 'gendered' profession, and to make some recommendations in this area for SLT recruitment and practice. Methods & Procedures The study adopted a qualitative design which elicited research participants' views, knowledge and experiences (in their own words) in relation to the research questions. Data collection involved two iterative phases: a preliminary data phase-which involved semi-structured interviews with newly qualified SLT graduates and practising SLTs, and the completion of questionnaires by undergraduate SLTs-and a main/focus group phase. In the focus group phase reported in this paper, six focus groups in total were held with SLTs, teachers of SLT, and careers advisors in London, UK. The data were analysed qualitatively using grounded theory principles, thematic analysis and discourse analysis. Outcomes & Results The findings extend our knowledge and understanding of gender as a parameter of people's motivations and perceptions, which can influence their choice of career (e.g. as regards pay and flexibility). The findings also show that discourses around women as carers, nurturers and communicators constitute key ways through which the SLT profession continues to be constructed as 'women's work'. The topic of structural gender inequalities in the profession was also discussed in the data. Some recommendations for change, with implications for SLT recruitment and practice, were made by the participants themselves. Conclusions & Implications Gender imbalance in SLT needs to be researched further in order to help address inequalities, re-evaluate professional practices and develop service delivery in the profession. This area also needs to be researched via analysis that goes beyond gender distribution in numerical terms to consider the complex perceptions or discourses around gender and work. Cross-disciplinary and comparative perspectives in future research would also be fruitful. [ABSTRACT FROM AUTHOR]

Objective: To explore the current practice and perceptions of health visitors in supporting multiple birth families. Design and sample: Practicing health visitors across the United Kingdom were invited to complete a cross‐sectional, descriptive, online survey. The questionnaire covered multiple birth caseload, education received about multiples and the experience of working with families. Two‐hundred and ninety health visitors completed the questionnaire. Descriptive and inferential statistics were used for analysis of the quantitative components and thematic analysis for the qualitative data. Results: Most health visitors had twins on their current workload. Most health visitors had not received any specific training or continuing professional development regarding the needs of multiple birth families. Supporting the families within the confines of reduced time and increased workload was challenging. Daily tasks of caring for multiples were the main areas that health visitors and parents wanted more information about. Conclusions: In the United Kingdom, health visitors are uniquely positioned to support multiple birth families, in particular during the more challenging early years. However, the findings of this study suggest that many health visitors are aware that the care and support that they are able to provide multiple birth families falls short of meeting their needs [ABSTRACT FROM AUTHOR]

Background: Timely information provided by clinical librarians can contribute to outcomes such as improved patient care and time savings for hospital staff. What is unknown is the return on investment (ROI) of a clinical librarian on a critical care unit. Objective: The aim of this study was to assess the ROI, from the employer perspective, of placing a clinical librarian in a critical care unit in a large UK acute hospital. Methods: Using a mixed methods approach, ROI was estimated by comparing the total costs with the total monetised benefits of implementing the clinical librarian intervention. Total costs included salary and equipment costs. Total monetised benefits included time saving for hospital staff, support for professional development and improved patient care. Results: When total monetised benefits were compared with total costs, the 15‐month clinical librarian intervention generated a positive ROI of £1.18–£3.03 for every £1 invested. Discussion: Using outcome measures derived from previous research, this novel study generated promising results indicative for commissioners seeking to improve patient care and deliver value for money. To improve generalisability, multisite studies using standardised ROI tools are recommended. Conclusion: Employing a clinical librarian in a critical care unit can generate a positive ROI. [ABSTRACT FROM AUTHOR]

Background: Although many people are satisfied with their outcome after total knee replacement surgery for osteoarthritis, around 20% report chronic post‐surgical pain. People are often disappointed and unsure about whether their pain is normal and what can be done about it. Given the high prevalence of long‐term post‐operative pain after knee replacement, there is potentially a large hidden population with an unaddressed need for care. Objective: In this study, we focus on understanding why some people choose not to consult health care for chronic post‐surgical pain after knee replacement. Methods: Semi‐structured interviews were conducted with people who had received total knee replacement, at either of two National Health Service hospitals in the United Kingdom, and who had chronic post‐surgical pain (n = 34, age 55‐93 years). Data were audio‐recorded, transcribed and analysed thematically. Results: We found an overall sense of futility amongst participants who believed that nothing further could be done for their on‐going pain. People's perception of their pain was often discordant with that of surgeons and physicians. Other factors that contributed to decisions not to seek help included low expectations about effectiveness and the risks involved in further treatment, treatment burden, participants' prioritization of other health conditions and views about candidacy. Many accepted their on‐going pain. Conclusion: Our study indicates why some people with chronic pain after knee replacement do not seek further health care. Understanding patients' beliefs and expectations about chronic post‐surgical pain can inform approaches that might enable people to seek help in the future. [ABSTRACT FROM AUTHOR]

Background: Physical inactivity is the fourth leading cause of mortality worldwide. Early childhood is a critical period when healthy behaviours can be instilled for a future active lifestyle. We explored community, societal and environmental factors affecting child and family physical activity and sought parent recommendations to support physical activity in families with young children. Methods: We interviewed 61 parents expecting a child or with a baby ≤12 months (35 mother and father paired interviews and 26 interviews with mothers only). We purposively sampled families for neighbourhood deprivation status (Townsend Index; 26 affluent; 35 deprived). We conducted thematic analysis of interview transcripts using Bronfenbrenner's socio‐ecological framework to guide interpretation. Results: We identified four themes: work family‐life balance; spaces for activity; beliefs and attitudes; and physical activity facilitators. We found that parents from deprived neighbourhoods were more likely to be underactive because of a complex web of community, social and personal factors which reduced motivation and hindered opportunity for physical activity. To increase knowledge and opportunity, respondents suggested 'help not tell' messages covering 'why', 'how' and 'where' information about physical activity, and using physical activity to support community engagement and social interaction. Conclusions: Recommendations from parents highlight effective communication about the importance of early child and family physical activity and improved community access to safe facilities and opportunities. Both parents need to be engaged in designing interventions to support greater physical activity and healthy behaviours which are relevant and achievable in individuals' lives. [ABSTRACT FROM AUTHOR]

Background: Young women's attendance at cervical screening in the UK is continuing to fall, and the incidence of invasive cervical cancer is rising. Objectives: We assessed the preferences of non‐attending young women for alternative ways of delivering cervical screening. Design: Postal discrete choice experiment (DCE) conducted during the STRATEGIC study of interventions for increasing cervical screening uptake. Attributes included action required to arrange a test, location of the test, availability of a nurse navigator and cost to the National Health Service. Setting and participants: Non‐attending young women in two UK regions. Main outcome measures: Responses were analysed using a mixed multinomial logit model. A predictive analysis identified the most preferable strategy compared to current screening. Preferences from the DCE were compared with observed behaviours during the STRATEGIC trial. Results: The DCE response rate was 5.5% (222/4000), and 94% of respondents agreed screening is important. Preference heterogeneity existed around attributes with strong evidence for test location. Relative to current screening, unsolicited self‐sampling kits for home use appeared most preferable. The STRATEGIC trial showed this same intervention to be most effective although many women who received it and were screened, attended for conventional cytology instead. Conclusions: The DCE and trial identified the unsolicited self‐sampling kit as the most preferred/effective intervention. The DCE suggested that the decision of some women receiving the kit in the trial to attend for conventional cytology may be due to anxieties around home testing coupled with a knowledge that ignoring the kit could potentially have life‐changing consequences. [ABSTRACT FROM AUTHOR]

Survivors of clerical institutional childhood abuse (ICA) experience poor mental health outcomes in adulthood. Resilience research with this group has focused on psychological adjustment and we know less about the factors across the social ecology that support positive adaptation, including the impact of migration. This study explores the influence of resilience‐enhancing factors across the social ecology on the mental wellbeing (MWB) of Irish emigrant survivors of ICA and how this compares with non‐migrant survivors. Fifty‐six survivors based in the UK and 46 based in Ireland completed a quantitative survey that assessed resilience‐potentiating resources and associations with MWB. A further nine participants, resident in the UK, engaged in a structured interview which aimed to further explain these quantitative data. Results indicate more resilience‐enhancing resources across the ecology of emigrant survivors of ICA. Personal skills and competencies, such as problem‐focused coping, altruism and defiance, and social inclusion were associated with MWB regardless of country of residence. For the migrant group, social identity not defined by institutional care facilitated social inclusion. Migration to the UK and informal instrumental support in the aftermath of institutional care were identified as key turning points towards resilience. Key Practitioner Messages: Multiple factors across the ecology influence the resilience of survivors of institutional childhood abuse (ICA).Resilience strategies for survivors of ICA are contextual and may appear maladaptive to practitioners unfamiliar with the cultural context of this abuse.For Irish emigrant survivors of ICA, problem‐focused coping, defiance, altruism, social inclusion, instrumental support and a social identity not defined by childhood abuse enhanced resilience.Resilience is dynamic and emerges over time for adult survivors of chronic childhood abuse. 'Explores the influence of resilience‐enhancing factors across the social ecology on the mental wellbeing... of Irish emigrant survivors of institutional childhood abuse' [ABSTRACT FROM AUTHOR]

Background: There is increasing recognition that dysphagia has significant implications for a person's psychological well‐being, social participation and quality of life (QOL). However, a paucity of research exists regarding the clinical management of this area. To inform future research and the development of appropriate and beneficial resources and guidelines, a better understanding of the current practice of speech and language therapists (SLTs) in this area would be useful. This information will highlight current challenges to clinical practice and the ongoing development needs of the profession, which are, as of yet, undocumented. Aims: To determine the practices of SLTs when addressing QOL issues in individuals with dysphagia, the beliefs of SLTs regarding the impact of dysphagia on QOL, the current trends in assessing and managing QOL in dysphagia, and if variations in beliefs and practices in this area exist. Methods & Procedures: An anonymous cross‐sectional, non‐experimental survey study was used. The survey consisted of 18 questions exploring participants' beliefs and opinions regarding dysphagia and QOL, current clinical practice in the area, perceived facilitators and barriers, and education, training and development needs. The survey was created on Survey Monkey and disseminated by e‐mail link to SLT professional bodies. Purposive and snowball sampling were used and participants self‐selected based on the information provided alongside the e‐mail link. Inclusion criteria for the study were a qualification in speech and language therapy, proficiency in the English language, and access to a computer with the internet. Outcomes & Results: A total of 148 SLTs working across the UK, Ireland and South Africa completed the survey. Over 90% of respondents believe that dysphagia has a negative impact on QOL, but only 25% are currently satisfied with the amount of clinical time they can dedicate to this area. Staffing, resources, a lack of best‐practice guidelines and disease‐specific QOL assessment tools were cited as contributing factors. A number of facilitators and barriers to best practice were also highlighted. Based on these findings, professional development actions for the future are suggested. Conclusions & Implications: SLTs believe they have an important role to play in supporting QOL issues in dysphagia. However, it is reported that the area is currently under‐developed, under‐resourced and under‐supported. Increased awareness raising of the role of SLT, alongside the development of best‐practice guidelines and disease‐specific QOL assessment tools, will enhance the quality of care that can be offered in this area. [ABSTRACT FROM AUTHOR]

In this article, Katie Nicholas presents the findings of a very topical piece of research into the use of eBooks in health libraries, which she completed for a Masters dissertation. Katie graduated with an MA in Library and Information Management (Distinction) from Manchester Metropolitan University in July 2017. She would like to acknowledge the support of her supervisor, Rachel Delbridge, in helping her to gain a Distinction in her dissertation. In the article, she points out that the use of eBooks in the NHS is low compared to other sectors and she presents the findings from her research, which help to explain this. She outlines the development of an electronic tool to help library and information staff make sense of the complexity around eBooks and makes further very practical recommendations for practitioners. [ABSTRACT FROM AUTHOR]

Background Systematic reviews have found limited evidence of effectiveness and impact of clinical librarians ( CLs) due to the poor quality of reporting, scale and design of previous studies. Objectives To measure specific CL impact on organisational and patient outcomes using a robust approach that helps CLs develop research skills. Methods Questionnaire and interviews. Results Clinical librarians contribute to a wide range of outcomes in the short and longer term reflecting organisational priorities and objectives. These include direct contributions to choice of intervention (36%) diagnosis (26%) quality of life (25%), increased patient involvement in decision making (26%) and cost savings and risk management including avoiding tests, referrals, readmissions and reducing length of stay (28%). Discussion Interventions provided by CL's are complex and each contributes to multiple outcomes of importance to health care organisations. Conclusion This study is unique in taking a wide view of potential and specific impacts to which CLs contribute across health care organisations. It is the largest UK evaluation of CL services to date and demonstrates CLs affect direct patient care, improve quality and save money. Future researchers are urged to use the tools presented to collect data on the same outcomes to build a significant and comprehensive international evidence base about the effectiveness and impact of clinical librarian services. [ABSTRACT FROM AUTHOR]

Context Grades are commonly used in formative workplace-based assessment ( WBA) in medical education and training, but may draw attention away from feedback about the task. A dilemma arises because the self-regulatory focus of a trainee must include self-awareness relative to agreed standards, which implies grading. Objectives In this study we aimed to understand the meaning which medical students construct from WBA feedback with and without grades, and what influences this. Methods Year 3 students were invited to take part in a randomised crossover study in which each student served as his or her own control. Each student undertook one WBA with and one without grades, and then chose whether or not to be given grades in a third WBA. These preferences were explored in semi-structured interviews. A realist approach to analysis was used to gain understanding of student preferences and the impact of feedback with and without grades. Results Of 83 students who were given feedback with and without grades, 65 (78%) then chose to have feedback with grades and 18 (22%) without grades in their third WBA. A total of 24 students were interviewed. Students described how grades locate their performance and calibrate their self-assessment. For some, low grades focused attention and effort. Satisfactory and high grades enhanced self-efficacy. Conclusions Grades are concrete, powerful and blunt, can be harmful and need to be explained to help students create helpful meaning from them. Low grades risk reducing self-efficacy in some and may encourage others to focus on proving their ability rather than on improvement. A metaphor of the semi-permeable membrane is introduced to elucidate how students reduced potential negative effects and enhanced the positive effects of feedback with grades by selective filtering and pumping. This study illuminates the complexity of the processing of feedback by its recipients, and informs the use of grading in the provision of more effective, tailored feedback. [ABSTRACT FROM AUTHOR]

Background: There are no published empirical research studies exploring transgender people's experiences of seeking and receiving counselling or psychotherapy outside of gender identity clinics within the UK. As a result, counsellors know little about why transgender people seek counselling, who they seek counselling from, and what their experiences are of receiving counselling. Aim: To address this gap in the literature, this study investigated transgender people's experiences of seeking and receiving counselling or psychotherapy outside of gender identity clinics within the UK. Funding for this study was provided by a BACP Seedcorn grant. Method: A mixed method small‐scale qualitative research design was employed, comprising an online survey and five semi‐structured interviews. Findings: Participants tended to seek counselling on two or more occasions and received between 2 and 12 sessions. Participants sought counselling for common psychological concerns as well as gender identity and coming out issues. A fear of being discriminated against and exploring gender for the first time were significant barriers in seeking help. Participants reported mixed experiences of counselling but valued a therapeutic relationship in which they felt affirmed, listened to and understood. Discussion: The findings from this study mirror aspects of previous research conducted in the USA concerning transgender clients' experiences of counselling. However, these findings point to the importance of recognising the potential vulnerability transgender clients experience when seeking counselling and the need for therapists to develop greater awareness, knowledge and competence regarding working with transgender clients. [ABSTRACT FROM AUTHOR]

This study conceptualizes politicians as political workers. It describes a multimethod study with two aims: (1) to determine whether politicians share a latent mental model of performance in political roles and (2) to test hypothesized relationships between politician self-rated characteristics (i.e., extroversion, neuroticism, conscientiousness, Machiavellianism, and political skill) and received performance ratings from political colleagues and officers. Two hundred and thirty-one local politicians provided self-ratings on a political performance questionnaire developed following a role analysis, and standardized measures of personality. One hundred and eighty-five also received performance ratings from colleagues ( n = 749) and officers ( n = 729). Exploratory and confirmatory factor analyses of self- and received performance ratings revealed five latent factors: Resilience (RS), Politicking, Analytical Skills (AS), Representing People, and Relating to Others. Regression analyses found that neuroticism and conscientiousness contribute to received ratings of RS, and neuroticism contributes to received ratings of AS. Practitioner points As political roles require political work, we argue there is potential to use research and practice from I/O psychology to improve politician performance., The existence of shared latent constructs of performance provides a basis for differentiated criterion assessment in political roles., Evidence that individual differences contribute to political performance can be used to shape support activities for individuals in elected roles. [ABSTRACT FROM AUTHOR]

ABSTRACT The translation of clinical guidelines into practice is a complex process, primarily because it is a 'top down' approach to disseminating information. The aim of this study was to determine whether current guidelines and standards have been applied to everyday urodynamic practice, and establish how health care professionals have interpreted the terminology. It was also an ideal opportunity to explore the systems in place that support personal and professional development, and identify factors that can contribute to, or obstruct, 'good' urodynamic practice. A descriptive exploratory research design was adopted using a mixed methodological approach. A purposive sample ( n = 60) of doctors, nurses and technicians who currently undertake urodynamic investigations within one NHS region were identified. Most of the participants were familiar with the International Continence Society guidelines; with over half routinely using them in their current practice. Although there was a comprehensive uptake of formal urodynamic training courses, there was limited evidence of formal assessment either before or after training/education. This was also reflected in some of the themes that emerged during the semi-structured interviews; access to supervision, multidisciplinary team meetings, team working, networking, isolation, attitudes and time, were all identified as factors that could have either a positive or negative effect on urodynamic practice. These findings confirm that guidelines, in one NHS region, are reaching their target population. However, the translation of training and assessment into practice is a complex issue to address, as it requires skills in reflective practice, self-assessment and critical analysis. Although guidelines/recommendations exist, a more robust framework may be required; incorporating structured mentoring and clinical assessment with experienced practitioners, in order to address the barriers that clearly exist. [ABSTRACT FROM AUTHOR]

Aims: To determine whether the Assistant Practitioner role has fulfilled the expectations of the original implementation plan which was to introduce this new role into the Critical Care Department of a large NHS Trust. This service evaluation will examine the introduction of Assistant Practitioners by establishing the perceptions of this new role and the impact of this change from key groups of staff, within the Critical Care Department. Background: The Department of Health (DoH) recognized the potential of assistant practitioners in a range of care settings. As a participant in this DoH initiative the Trust introduced the role into a number of areas. This service evaluation was undertaken following the training of small cohorts of Assistant Practitioners within the Critical Care Department. Methods: A literature review was conducted initially searching the key words assistant practitioner, role development and critical care. A service evaluation was undertaken using questionnaires and semi-structured interviews for data collection. The data was analysed using a thematic approach. Results: The responses from the various staff groups revealed a number of key themes including patient care skills, role, preparation and training, drug administration and patient allocation. Conclusions: Overall, the data suggests that the Assistant Practitioner role has fulfilled the expectations of the original implementation plan as they deliver care to patients in the clinical environment as required. However, the data also reveals that there are still issues to be resolved. Relevance to clinical practice: The study has shown the Assistant Practitioners to be excellent in delivering patient care; however, there are limitations due to the complexity of the patient group in critical care areas. [ABSTRACT FROM AUTHOR]