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This article discusses the Law Commission's proposals for the reform of adult social care, with a particular emphasis on the specific proposals relating to adult protection. It argues that a future adult social care statute should clarify the existing legal position by placing a duty on local social services authorities to make enquiries and take appropriate action in adult protection cases. The definition of an adult at risk for the purposes of the duty to investigate is also considered and a proposal is put forward for how this might be defined in the statute. The article also proposes that the compulsory removal power under section 47 of the National Assistance Act 1948 (HM Government, 1948) should be repealed, that adult safeguarding boards should be placed on a statutory footing and that duties to co-operate in adult protection should be introduced. Finally, concerns are raised that the current lack of statutory provision for adult protection may mean that there is confusion over the precise legal status of the guidance No Secrets (Department of Health & Home Office, 2000) and In Safe Hands (Welsh Assembly Government, 2000) and what actions this can authorise. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to critically examine the effects of COVID-19 social discourses and policy decisions specifically on older adult volunteers in the UK, comparing the responses and their effects in England, Scotland, Wales and Northern Ireland, providing perspectives on effects of policy changes designed to reduce risk of infection as a result of COVID-19, specifically on volunteer involvement of and for older adults, and understand, from the perspectives of volunteer managers, how COVID-19 restrictions had impacted older people's volunteering and situating this within statutory public health policies. Design/methodology/approach: The study uses a critical discourse approach to explore, compare and contrast accounts of volunteering of and for older people in policy, and then compare the discourses within policy documents with the discourses in personal accounts of volunteering in health and social care settings in the four nations of the UK. This paper is co-produced in collaboration with co-authors who have direct experience with volunteer involvement responses and their impact on older people. Findings: The prevailing overall policy approach during the pandemic was that risk of morbidity and mortality to older people was too high to permit them to participate in volunteering activities. Disenfranchising of older people, as exemplified in volunteer involvement, was remarkably uniform across the four nations of the UK. However, the authors find that despite, rather than because of policy changes, older volunteers, as part of, or with the help of, volunteer involving organisations, are taking time to think and to reconsider their involvement and are renewing their volunteer involvement with associated health benefits. Research limitations/implications: Working with participants as co-authors helps to ensure the credibility of results in that there was agreement in the themes identified and the conclusions. A limitation of this study lies in the sampling method, as a convenience sample was used and there is only representation from one organisation in each of the four nations. Originality/value: The paper combines existing knowledge about volunteer involvement of and for older adults. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to highlight the issue of carers as victims and perpetrators of domestic abuse. The issue of carers as victims, and sometimes perpetrators, of domestic abuse is being overlooked by statutory organisations because they often do not fit the traditional patterns of abusive relationships, and the complexities of the caring role can make typical safety options unsuitable. However, caring responsibilities are a feature of an increasing number of domestic homicide reviews, and current statutory safeguarding options exclude most carers from support and risk not identifying perpetrators. Design/methodology/approach: This short paper highlights some of the shortfalls around identifying the needs of carer victims/survivors of domestic abuse and carer-perpetrators of domestic abuse and explores ways in which identification and support could be improved. Findings: Carers as victims/survivors of domestic abuse, and as abusers, is an issue that requires more attention from researchers and Adult Social Care, NHS, Carer Support Organisations and Domestic Abuse specialists need to work together to explore these issues and offer workable options. Originality/value: Little data or research exists around carers as victims or perpetrators of domestic abuse. [ABSTRACT FROM AUTHOR]

Purpose: Supporting the mental health of children and young people is a global priority. The issue is not specific to England. However, evidence suggests that one in ten children and young people in England has a mental health need. This represents approximately three students in every classroom. The purpose of this paper is to highlight the role of schools in supporting children and young people's mental health. Whilst the paper acknowledges that teachers are not trained health professionals, it is argued that a whole-school approach to mental health can support individuals in schools to remain mentally healthy. The elements of a whole-school approach are identified and discussed and some of the challenges in relation to implementation are considered. Critical to the development of a whole-school approach is the commitment from the school leadership team to promoting student and staff wellbeing. Design/methodology/approach: This is a policy paper not an empirical study. Findings: This paper has outlined the policy context in the UK in relation to children and young people's mental health. It has addressed the risk and protective factors which can cause or mitigate against mental ill health and it has outlined the elements of a whole-school approach to mental health. Originality/value: This paper explores the contribution that schools can make to supporting students' mental health. There is limited research which addresses mental health in young people from a non-therapeutic angle. [ABSTRACT FROM AUTHOR]

Purpose: There is an apparent disconnect between the understanding of best practice and service delivery in the support of people with learning disabilities at risk of behaviours that challenge. We suggest, is a problem of implementation. The purpose of this paper is to explore reasons why this might be the case: a failure to recognise the collective works of successive generations of research and practice; and a failure to address the macro-systems involved and systems changes needed to support implementation. Design/methodology/approach: This paper reviews the consensus that exists in respect of best practice. Drawing upon ideas from implementation science the paper highlights the complexities involved in the implementation of all evidence-based practices and uses this as a framework to propose ways in which an infrastructure that facilitates the delivery of services in the learning disabilities field might be built. Findings: This paper highlights core recommended practices that have been consistent over time and across sources and identifies the systems involved in the implementation process. This paper demonstrates that many of the necessary building blocks of implementation already exist and suggests areas that are yet to be addressed. Critically, the paper highlights the importance of, and the part that all systems need to play in the process. Originality/value: In the absence of any generalised implementation frameworks of evidence-based practice in the learning disabilities field, the paper suggests that the findings may provide the basis for understanding how the gap that exists between best practice and service delivery in the support of people with a learning disability at risk of behaviours that challenge might be closed. [ABSTRACT FROM AUTHOR]

Purpose: The influx of refugees and asylum-seekers over the past decade into the European Union creates challenges to the health systems of receiving countries in the preparedness and requisite adjustments to policy addressing the new needs of the migrant population. This study aims to examine and compare policies for access to health care and the related health outcomes for refugees and asylum-seekers settling both in the UK and Germany as host countries. Design/methodology/approach: The paper conducted a scoping review of academic databases and grey literature for studies within the period 2010-2017, seeking to identify evidence from current policies and service provision for refugees and asylum-seekers in Germany and the UK, distilling the best practice and clarifying gaps in knowledge, to determine implications for policy. Findings: Analysis reveals that legal entitlements for refugees and asylum-seekers allow access to primary and secondary health care free of charge in the UK versus a more restrictive policy of access limited to acute and emergency care during the first 15 months of resettlements in Germany. In both countries, many factors hinder the access of this group to normal health care from legal status, procedural hurdles and lingual and cultural barriers. Refugees and asylum-seeker populations were reported with poor general health condition, lower rates of utilization of health services and noticeable reliance on non-governmental organizations. Originality/value: This paper helps to fulfill the need for an extensive research required to help decision makers in host countries to adjust health systems towards reducing health disparities and inequalities among refugees and asylum-seekers. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to present an examination of the development of adult safeguarding policy from the perspectives of both policymakers and those who have sought to influence policy, to empower individuals with a learning disability to have a say in how policies, that influence their life and impact their right to independence, are developed. Design/methodology/approach: This paper is based on a project which was led by a UK-wide interdisciplinary and multi-agency team, which included the central involvement of peer researchers who had lived experience of learning disability. It was based on a participatory disability research design. Findings: Factors which enabled or restrained individuals with a learning disability, and their supporting organisations, from getting their voice heard in policy development, are identified. Originality/value: This paper builds on policy theory and research, making recommendations for policy makers, disabled people and their supporting organisations as to how adult safeguarding policy, could be more effectively informed and influenced. [ABSTRACT FROM AUTHOR]

Purpose: Secure mental health services in one UK region have acted within a network to develop a range of involvement practices. A new quality benchmarking tool has been created to appraise the implementation of these involvement practices. The purpose of this paper is to report upon a qualitative evaluation of this development. Design/methodology/approach: Staff and service users involved in the co-production of the benchmarking tool were engaged in a series of focus groups and participatory inquiry approaches enacted in the course of scheduled network meetings. Data thus collected was subject to thematic analysis. Findings: Four distinct themes were identified which were titled: Taking time, taking care; The value not the label; An instrument of the network; and All people working together. These are discussed in relation to recent theorising of co-production. Research limitations/implications: Effectively, this study represents a case study of developments within one region. As such, the findings may have limited transferability to other contexts. Practical implications: Staff and service users can work together effectively to the benefit of each other and overall forensic services. The benchmarking tool provides a readymade mechanism to appraise quality improvements. Social implications: Despite a prevailing culture of competition in wider health-care policy, cooperation leads to enhanced quality. Originality/value: The benchmarking tool is a unique development of a longstanding involvement network, demonstrating the positive implications for enacting co-production within secure services. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to present the findings of an early stage, exploratory case study of a proposed housing with care initiative (the Crichton Care Campus (CCC)). This sought the perspectives of a range of key stakeholders on the proposed model and how it might be best realised. The analyses of these findings show their relevance to debates on integrated housing with care, and reflect on the methodology used and its potential relevance to similar projects.Design/methodology/approach The study used a transactive planning approach, where grounded views are sought from a variety of stakeholders. A purposive sample identified informants from relevant health, social care and housing organisations and nine semi-structured interviews were conducted. These were transcribed and data analysis was undertaken on an “interactive” basis, relating care theory to empirical expressions.Findings The authors identify two contrasting orientations – inclusive “community-oriented” and professional “service-oriented”. This distinction provides the basis for a rudimentary conceptual map which can continue to be used in the planning process. Two significant variables within the conceptual map were the extent to which CCC should be intergenerational and as such, the degree to which care should come from formalised and self-care/informal sources. The potential to achieve an integrated approach was high with stakeholders across all sectors fully supporting the CCC concept and agreeing on the need for it to have a mixed tenure basis and include a range of non-care amenities.Originality/value This paper offers originality in two respects. Methodologically, it describes an attempt to undertake early stage care planning using a needs led transactive methodology. In more practical terms, it also offers an innovative environment for considering any approach to care planning that actively seeks integration – based on an acknowledgement of complexity, a variety of perspectives and possible conflicts. The authors propose that the concepts of “community-orientation” and “service-orientation” are used as a helpful basis for planning negotiations, making implicit divergences explicit and thus better delineated. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to explore how the next government could develop a better deal in relation to work, pensions and poverty. The paper argues that given the changing face of poverty, the next government should focus on creating better jobs if it is really to encourage people to work longer and save more for retirement. Furthermore, it could do more to support those who are currently under-saving for retirement. Design/methodology/approach - The paper draws on evidence from a number of recent qualitative and quantitative JRF research reports and government statistical data. Findings - The paper suggests policy recommendations for the next government focused on creating better jobs and helping those on lower incomes increase their pension pots. This includes: ensuring that the minimum wages is set with regard to the changing price of essentials and changing average earnings; raising awareness of the Living Wage and playing a leadership role; industrial strategies for low paid sectors; mid-life career reviews and increased rights for those aged 60 and over; the redistribution of tax relief on pension contributions and the auto-escalation of workplace pensions. Originality/value - This paper looks at the issue of an ageing society, work and pensions through a poverty lens. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to start a debate about older people who are in groups that are not readily visible to policy makers and practitioners. Design/methodology/approach -- The paper is based on information obtained from academic literature, government statistics and other publications from relevant organisations. The authors investigated one "invisible" group each and comparisons and conclusions were then made collaboratively. Findings -- Many groups of older people seem to be absent from statistics and from policy making. The paper suggests that there needs to bemore research to identify the scale of any problems and how they may be solved. Research limitations/implications -- This is not a systematic review but a preliminary account of the problem. Practical implications -- There are practical implications for health and social care professionals if they do not recognise that there are groups in society about whom little is known. Lack of knowledge and empathy may affect their approach to these groups. Social implications -- There are implications for society if these groups are not taken into account in decision making and especially over the allocation of resources. Originality/value -- There is little written which brings together the lack of attention paid to these groups as a whole. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to, first, provide some background to the treatment of older workers; second, highlight the distinction between a "fuller" and an "extended" working life; third, note the importance of separating out different groups within the category "older worker"; finally, identify areas for action to suppose those now facing working into their 60s and beyond. Design/methodology/approach -- Commentary paper analysing development of policies towards older workers. Findings -- This paper identifies problems implementing policy of extending working and provides various areas of action to support older workers. Research limitations/implications -- This paper suggests extending work unlikely to be achieved without ensuring greater security for older workers. Practical implications -- Importance of developing more support for older workers. Social implications -- Challenge of resolving insecurity in the labour force as an impediment to extended working. Originality/value -- This paper outlines a critical assessment of current government policy towards older workers. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to explore the link between age discrimination and the injustices that have taken place in our care homes during the COVID-19 pandemic in this country. It seeks to show how destructive age discrimination is to those who live in our care homes and attempts to shake up our attitudes to older people, as the pandemic continues. It is hoped that shifts in attitude would lead to a societal revolution in care and support for older people as the pandemic shows us how the current system is breaking down. Design/methodology/approach: This is a personal insight into the plight of the care home sector during the COVID-19 pandemic in the UK. The writer has worked in the field of social care and older people's services for many years and felt compelled to share her learning and observations. This led to venturing more deeply into understanding why those who live, work and visit care homes have been so neglected and "cast into the shadows" in the face of such desperate danger. Whilst tracking the media narrative during the first wave, she attempts to apply her knowledge, in particular gained from working for Help the Aged (now Age UK) as a policy manager for Quality Care, but also draws on experiences as a social worker, commissioner and care provider from the 1980's to the present. By "shining a light" on care homes, revealing that the darker practices that have taken place contravene the Human Rights Act 1998, it is hoped that the recognition of age discrimination will happen at every level and become better known in its application. The paper observes how deeply rooted it is in us all. Findings: Having highlighted some shocking examples of bad practice from the authorities relating to care homes, the article concludes that Government policy on care homes from March to July 2020 was discriminatory and questions how far lessons have been learned. The legislation is in place in the form of the Human Rights Act 1998 to protect older people in care homes but is not being widely implemented at regional policy level. Government rhetoric remains far from reality Instead of redressing the gap and admitting mistakes, there is evidence at a high level of continued denial and the projection of blame on to the care homes themselves. Originality/value: The author's professional background includes meeting the founder of the Gray Panthers, Maggie Kuhn, in the United States in the 1988. This was a defining moment that gave her an original insight into age discrimination and influenced her entire career. It eventually led to her working in national policy for one of the most influential charities for older people at the turn of the millennium, Help the Aged. Here, she co-founded the My Home Life Programme (promoting quality of life in care homes). The paper offers a unique insight into why it is so challenging to achieve quality of life for older people needing care and should be of interest to policymakers, clinical commissioning groups, local authorities, older people's care providers and carer and user organisations. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to present an overview of the extant literature on diabetes in people with learning disabilities (LD) and discuss implications for policy, practice and research. Design/methodology/approach: The key findings are extracted from qualitative and quantitative studies and recent systematic literature reviews. These findings are discussed in the areas of prevalence, treatments and implications. Findings: The complex health needs of people with LDs who are diagnosed or at risk of developing diabetes are gaining wider recognition, and recent studies have begun to implement and evaluate potential solutions. Further analysis and alignment between services is required. Originality/value: Following a dearth of studies on diabetes in people with LD, the past decade has seen a sudden upsurge in large and diverse set of studies. This paper provides an overview on the extent of this study. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to understand the components of a high-quality prison healthcare system and the impact, ten-years on, of the transfer of accountability in England, from a justice ministry to a health ministry. Design/methodology/approach A rapid the evidence review was undertaken, which included a review of 82 papers and qualitative interviews with key informants. The concepts and themes identified were summarised and analysed through a framework analysis, designed to improve population outcomes and address health inequalities. The use of a rapid evidence assessment, rather than a systematic review methodology, the use of abstracts (rather than full-text articles) to extract the data, and limiting the search strategy to articles published in the English language only might mean that some relevant research papers and themes were not identified. The need for the evidence to be produced within a limited time frame and with limited resources determined these pragmatic approaches. Findings The review found that English prison healthcare has undergone "transformation" during this period, leading to increased quality of care through organisational engagement, professionalisation of the healthcare workforce, transparency, use of evidence-based guidance and responsiveness of services. The review also highlighted that there is still room for improvement, for example, relating to the prison regime and the lack of focus on early/preventive interventions, as well as specific challenges from limited resources. Research limitations/implications Time and resource constraints meant a rapid evidence review of papers in the English language was undertaken, rather than a systematic review. This might mean relevant papers have been missed. The review also only covered small number of countries, which may limit the transferability of findings. The lack of qualitative data necessitated the use of quantitative data gathered from key informants. However, this enabled a good understanding of current practice. Practical implications The review findings support the World Health Organisation position on the value of integrated prison and public health systems in improving quality of healthcare. It also recommends future policy needs to take account of the "whole prison approach" recognising that healthcare in prisons cannot operate in isolation from the prison regime or the community. Originality/value This is unique research which has great value in supporting prison reform in England. It will also be of interest internationally due to the paucity of data in the published peer-reviewed literature on the impact of commissioning models on healthcare or health outcomes. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to explore the equalities’ dimension of falls prevention services in light of the Equality Act 2010 and its protected characteristics. Research and policy are discussed in light of the Act and public services’ duties to be aware of their responsibilities.Design/methodology/approach An initial research review was undertaken in 2012 and updated in 2016.Findings The research on falls prevention services does not always collect data on users of the service and services do not always collect data about their users that would enable them to build a picture of their users in line with the Equality Act 2010.Practical implications Services and commissioners will need to be able to show that the services funded by the public purse are accessible, acceptable and appropriate to the UK’s increasingly diverse older population. This paper describes some of the existing resources and research papers that contain elements of attention to the protected characteristics of the Equality Act 2010.Originality/value This is an update on a research review undertaken in 2012. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to outline relevant policies on the integration of health and social care (HSC) in the four home nations: Scotland, Wales, Northern Ireland and England and offer a comparison of emphasis and approaches and draw out general insights on the implementation of integrated care policy.Design/methodology/approach The paper is written as a piece of critical reflection by drawing on the authors’ knowledge and expertise and wider evidence where available.Findings Since 2010, HSC integration has started to diverge significantly in the four constituent countries of the UK. Although England and Wales have undergone considerable re-organisation of the NHS, Scotland and Northern Ireland have largely been marked by organisational continuity. However, beyond organisational differences, policy approaches, policy emphases and implementation strategies have also started to show considerable dissimilarity across the UK. An important contributory factor may be different ideological perspectives on the role of competition and pilots, partnership, patient choice and organisational incentives to bring about change in the field.Research limitations/implications The paper identifies a serious lack of comparative research in integration policy, despite the considerable opportunities for quasi-experimental studies. This lack of empirical research impedes shared learning across the home nations.Originality/value The paper presents a descriptive comparison of current integration policy between HSC providers in the four home nations. It reveals considerable opportunities for further research and comparative modelling of integration approaches. [ABSTRACT FROM AUTHOR]

Purpose – The aim of this paper is to examine public spending cuts and welfare reforms to assess winners and losers amongst older people, children, young people and families. It proposes ways in which intergenerational fairness could be achieved through taxing wealthier older people. Design/methodology/approach – The paper reviews and analyses spending and policy plans from 2010 onwards, and draws conclusions. Findings – The paper concludes that children, young people and families are the relative losers of government spending cuts and reforms; older people have been relatively protected; the focus should be on taxing wealthier older people; intergenerational fairness needs to be addressed. Originality/value – Research tends to focus on one age group, so there have not been many studies which contrast the impact of public policy on different age groups. The concept of intergenerational fairness is only beginning to be discussed. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to set out the Law Commission's proposals for the reform of the law relating to UK health professional regulation and, in England only, social workers. Design/methodology/approach – The paper summarises the main provisional proposals from the consultation paper. Findings – The consultation paper argued for the reform of the law in this area. Practical implications – There are suggestions for reforming the law which could form the basis of a new legal framework introduced in 2014. Originality/value – The paper sets out the proposed new legal framework. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to outlines the findings of the first qualitative evidence synthesis of empirical research on the impact of the No Recourse to Public Funds (NRPF) rule which prevents most temporary migrants from accessing social security benefits in the UK. Design/methodology/approach: The review used the 2020 Preferred Reporting Items for Systematic reviews and Meta-Analyses protocol guidelines. Data were analysed by using Thomas and Harden's (2008) thematic synthesis methodology. An initial 321 articles were identified from 13 databases, of which 38 studies met the inclusion criteria. Findings: The key insights were that NRPF causes destitution and extreme poverty and has a disproportionate impact on racialised women. Studies found that support services were underdeveloped, underfunded, inconsistent and had a culture of mistrust and racism towards migrants. Migrants were often fearful of services due to concerns around deportation, destitution and state intervention around children. Research limitations/implications: The review focussed on qualitative research. Future empirical and theoretical research is needed in the following areas: NRPF as a practice of everyday bordering, the role of the Home Office in creating and sustaining the policy; differing gendered experiences of NRPF; and a broader geographical scope which includes all four UK nations and takes an international comparative approach. Originality/value: Despite an estimated 1.4 million people in the UK with NRPF (Citizens Advice, 2020), there is little policy or theoretical discussion of the experience of having NRPF or the implications of the rule. This lack of analysis is a significant gap in both our understanding of the landscape of poverty in the UK, and the ways in which immigration policies create extreme poverty. To the best of the authors' knowledge, this paper is the first systematic qualitative review on NRPF, bringing together the research evidence on how NRPF negatively affects outcomes for migrants, local authority and voluntary sector responses to NRPF and theoretical perspectives on NRPF. [ABSTRACT FROM AUTHOR]

Purpose The landscape of adult social care, and in particular of adult safeguarding, has shifted considerably over the last decade. Alongside policy changes in the responses to adult abuse, there have been shifts in professional and public understanding of what falls within the remit of this area of work. This results, arguably, in differing understandings of how adult safeguarding is constructed and understood. Given the increasing emphasis on multi-agency inter-professional collaboration, service user involvement and lay advocacy, it is important to consider and reflect on how both professionals and lay people understand this area of work. The paper aims to discuss these issues.Design/methodology/approach This study employed Augusto Boal’s model of Forum Theatre to explore how a variety of professional and lay groups understood, related to and engaged with how the Care Act 2014 defines and describes “adult safeguarding”.Findings Lay participants responded to the scenario in a variety of ways, upholding the construct validity of “adult safeguarding” and the authority of the social worker. Social care and health practitioners sought orderly, professionalised and sometimes ritualistic solutions to the “adult safeguarding” scenario presented, seeking carefully to structure and to manage lay involvement. Inter-professional collaboration was often problematic. The role of lay advocates was regarded ambiguously and ambivalently.Originality/value This paper offers a number of practice and research recommendations. Safeguarding practitioners could benefit from more effective and reflexive inter-professional collaboration. Both practitioners and service users could benefit from the more thoughtful deployment of the lay advocates encouraged within the Care Act 2014 and associated guidance. [ABSTRACT FROM AUTHOR]

Purpose – Across the UK integrated commissioning is seen as important to achieving integrated care. In Great Britain this has largely meant separate health and social care agencies coming together to assess need and the planning and delivery of services. Achieving integrated commissioning has proved difficult in the context of different funding systems and different organisational and professional values and cultures. Northern Ireland is the only part of the UK to have a system of total structural integration of all health and social care. The purpose of this paper is to examine the challenges of operationalising integrated commissioning in Great Britain and to assess whether the Northern Ireland model of structural integration has resolved such difficulties. Design/methodology/approach – The paper reviews how integrated commissioning is working through analysis of published research. The authors draw on policy documents to assess and evaluate the structure and process of integrated commissioning in Northern Ireland. Findings – It is concluded that structural integration is not a pre-requisite for integrated care and that there may be risks to social care in moving toward structural integration. While there is a rhetorical commitment to integrated care across the UK this is not followed through in commissioning practice. Originality/value – The paper presents an original assessment of the operation of integrated commissioning in Northern Ireland that has relevance for debates in Britain about the integration of health and social care. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to highlight the strategic role of housing for older people and how it can address some of the key challenges facing politicians. The paper aims to encourage decision-makers and service providers to collaborate in new ways locally. Design/methodology/approach - The paper seeks to highlight the strategic role of housing for older people and how it can address some of the key challenges facing politicians. It aims to encourage decision makers and service providers to collaborate in new ways locally. Findings - The paper argues that: Housing for older people is rising up the political agenda, but as a niche issue rather than one of strategic and economic importance. A multi-agency and outcomes-based approach to the wellbeing of older people, based on place-shaping principles, needs to be mainstreamed locally. Older people have not escaped the impact of austerity measures and this has heightened the need for a range of high quality housing options, in supportive communities, in later life. Good housing options for older people could address the key issues vexing politicians, but there are obstacles to older people accessing such options. Originality/value - The paper suggests a radical, systemic approach is required to ensure better outcomes for older people and, in turn, to generate savings for the public purse. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to outline the first stage of an innovative developmental study addressing the educational and emotional needs of dementia care home staff using arts-based materials. Design/methodology/approach -- The arts workshop was developed using a mixed methods approach. This included ethnographic observation within a dementia care home, in-depth interviews with senior care home managers, a thematic analysis of focus groups and the development of a comic. At all stages, the multi-disciplinary project team collaborated closely with the care home staff. A comprehensive literature review of the policy, practice and academic background to dementia workforce education provided a contextual framework for the study. Perspectives from the medical humanities informed the project. Findings -- Despite the high prevalence of people living with dementia in care homes, there is a lack of appropriate training for the workforce that provides their care. This study found that an arts-based workshop offering an interactive mode of education was an effective way to engage this workforce. The workshop empowered participants to recognise their skills and focus on person-centred care; reflecting current recommendations for dementia care. Research limitations/implications -- The workshop was delivered in a single dementia care home and therefore findings may not be generalisable. In addition, the management did not take a direct part in the delivery of the workshop and therefore their views are not included in this study. Practical implications -- The arts-based approach can offer a means of engaging the dementia care workforce in education linked to their experience of caring. Originality/value -- The paper identifies the gap in relevant education for the dementia care workforce and outlines one possible way of addressing this gap using the arts. [ABSTRACT FROM AUTHOR]

Purpose: In this work, the authors present some of the key results found during early efforts to model the COVID-19 outbreak inside a UK prison. In particular, this study describes outputs from an idealised disease model that simulates the dynamics of a COVID-19 outbreak in a prison setting when varying levels of social interventions are in place, and a Monte Carlo-based model that assesses the reduction in risk of case importation, resulting from a process that requires incoming prisoners to undergo a period of self-isolation prior to admission into the general prison population.Design/methodology/approach: Prisons, typically containing large populations confined in a small space with high degrees of mixing, have long been known to be especially susceptible to disease outbreaks. In an attempt to meet rising pressures from the emerging COVID-19 situation in early 2020, modellers for Public Health England's Joint Modelling Cell were asked to produce some rapid response work that sought to inform the approaches that Her Majesty's Prison and Probation Service (HMPPS) might take to reduce the risk of case importation and sustained transmission in prison environments.Findings: Key results show that deploying social interventions has the potential to considerably reduce the total number of infections, while such actions could also reduce the probability that an initial infection will propagate into a prison-wide outbreak. For example, modelling showed that a 50% reduction in the risk of transmission (compared to an unmitigated outbreak) could deliver a 98% decrease in total number of cases, while this reduction could also result in 86.8% of outbreaks subsiding before more than five persons have become infected. Furthermore, this study also found that requiring new arrivals to self-isolate for 10 and 14 days prior to admission could detect up to 98% and 99% of incoming infections, respectively.Research Limitations/implications: In this paper we have presented models which allow for the studying of COVID-19 in a prison scenario, while also allowing for the assessment of proposed social interventions. By publishing these works, the authors hope these methods might aid in the management of prisoners across additional scenarios and even during subsequent disease outbreaks. Such methods as described may also be readily applied use in other closed community settings.Originality/value: These works went towards informing HMPPS on the impacts that the described strategies might have during COVID-19 outbreaks inside UK prisons. The works described herein are readily amendable to the study of a range of addition outbreak scenarios. There is also room for these methods to be further developed and built upon which the timeliness of the original project did not permit. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to demonstrate how access to vaccination for older people in the UK can be both improved and used as a tool for healthy ageing. Design/methodology/approach – ILC-UK released a report “Adult Immunisation in the UK”, which applied a UK perspective to a 2013 Supporting Active Ageing Through Immunisation (SAATI) report on immunisation. The ILC report combined the SAATI findings with a traditional literature review, a policy review incorporating grey literature and the outcomes of a focus group discussion. This paper highlights the key findings of the ILC-UK report. Findings – Vaccination needs to be included as part of proactive strategies to promote healthy and active ageing. Initiatives need to be explored that increase the rate of delivery of vaccinations. Barriers to the vaccination of health and social care professionals working with older people need to be removed. The government should explore using psychological insights into human behaviour to improve the take-up of vaccinations amongst adults. The range of settings where older people can receive vaccination needs to be expanded. Information on the potential benefits of immunisation should be made readily available and easily accessible to older people. Practical implications – The paper calls for a structural shift in how vaccination services in the UK are organised. Social implications – The paper calls for a cultural shift in how society views immunisation and the role it has to play in the healthy ageing process. Originality/value – The paper uses new European research on immunisation and applies it to the UK's situation. [ABSTRACT FROM AUTHOR]

Purpose – This paper aims to provide a summary of where peer support currently sits in the UK mental health services policy and practice. It presents an overview of models of peer support; the UK national policy on peer support; evidence of the benefits of peer support; case studies of recent and continuing peer support in action; challenges facing peer support; and suggestions for developing peer support in the future. Design/methodology/approach – The paper selects and discusses evidence from academic literature and policy and practice on peer support within the UK. Findings – The evidence base demonstrating the benefits of peer support in mental health across the UK is increasing. This has persuaded UK governmental bodies to encourage the development of peer support services, of which there is a number of models and examples, although the current economic climate poses challenges to their development. Originality/value – Historically, peer support in mental health services across the UK has developed piecemeal. But at a time when policy-makers, health practitioners and people who use mental health services are increasingly recognising the benefits of peer support, this paper draws key evidence together and provides pointers towards the future development of such services. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to examine the extent to which the two visions of recovery that are now being developed in the UK are consistent with each other and question what impact the development of parallel approaches will have on people at the intersections between them. Design/methodology/approach – The paper looks first at the origins and current implementation of the two approaches and then examines the commonalities and differences in the context of what they might mean for people using both sets of services simultaneously. Findings – The ideas behind Recovery in mental health and substance misuse services have some differences but significant common ground in focusing on improving quality of life. Research limitations/implications – This paper points to the need to understand recovery in both services from the perspectives of those who have a dual diagnosis and need support from each service. Practical implications – This paper could be used to develop new approaches to supporting people with a dual diagnosis with a consistent Recovery focus. Originality/value – Placing personal recovery at the heart of both mental health and substance misuse services may, over time, improve their efficiency and effectiveness. [ABSTRACT FROM AUTHOR]

Purpose -- The paper's aim is to explain the development of the concept of personalisation and its dependence upon prior innovations such as independent living, person-centred planning and individual budgets and explore its meaning, limitations and future prospects. Design/methodology/approach -- The paper takes the form of an analytical and historical review of ideas that have been important in the recent history of public policy for people with learning disabilities. Findings -- People with learning disabilities, along with other disabled people, have been engaged in a struggle to achieve full citizenship. The recent reforms that go by the name of "personalisation" may mark an important stage in the development of a fairer system, but on their own they will be insufficient to achieve that objective. Originality/value -- Personalisation is placed, with all its strengths and limitations, within the wider context of the development of policies for people with learning disabilities. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to ascertain the training status of staff in care homes for people with intellectual disabilities managed by the non-health sector in High Wycombe, with regard to administering emergency antiepileptic medication and to identify training needs. Design/methodology/approach – Management of seizures in people with intellectual disabilities and epilepsy comes with its challenges. Although there are clear guidelines for the same, implementing them in the community, especially in the non-health sector setting, raises the issue of training staff in the administration of emergency antiepileptic medication. A survey was undertaken in response to the varying staff training needs. A short semi-structured questionnaire was designed and administered over the telephone to the managers of these care homes. Findings – Less than half of the care homes had staff trained to administer emergency antiepileptic medication. The commonest reason cited was their policy of admitting only patients with well controlled seizures. This paper identified the need for staff training and raising awareness amongst relevant healthcare professionals. Practical implications – The survey highlights the practical difficulties arising in the implementation of national and trust level healthcare policies in the community. Originality/value – This paper is of value to clinicians working with people with intellectual disabilities and epilepsy, GPs, and staff and management in the care homes in the health and non-health sectors. It raises questions around delineation of responsibility and communication between various professionals in various levels of care involved in managing people with intellectual disabilities and epilepsy to ensure provision of safe and effective care for this population. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to detail developments in UK alcohol policy for older people over the past 20 years, based on evidence for a growing public health problem with alcohol misuse in older people. Design/methodology/approach: A literature search was carried out using health and social care databases, including grey literature. Findings: There has been considerable progress in areas such as screening and brief intervention, low-risk drinking and service provision for integrated care in older people with dual diagnosis. Research limitations/implications: There remains a dearth of research and policy for older people with alcohol misuse and dual diagnosis prior to 2011. Although there remains limited empirical evidence for public health interventions to improve health outcomes from alcohol-related harm, improvements in population health from implementation of recent policy changes and intervention programmes remains to be seen. Practical implications: This review has implications for best practice in the provision of integrated care to reduce harm and improve health and social outcomes in older people with alcohol misuse and dual diagnosis. Originality/value: This review draws together a large area of research and policy on alcohol misuse in older people that has the potential to improve public mental health for older people who are at risk of alcohol-related harm. [ABSTRACT FROM AUTHOR]

Purpose: The purpose this paper is to explore walking with purpose in extra care, retirement and domestic housing settings to better understand and support people living with dementia in these settings, develop recommendations and inform practice. Design/methodology/approach: A mixed-methods study was used: scoping literature review; online survey of extra care and retirement housing managers in the UK; case studies involving interviews with staff and family carers (n = 14) of ten individuals who engaged in walking with purpose in the different housing settings. Findings: Although residents who walk with purpose constitute a minority (0–2 residents), managing walking with purpose can be challenging and time consuming. Distraction or redirection was the most common response. Other strategies included identifying the resident's motivations and accommodating their wishes or walking with them. Culture of care, staff training and dementia-friendly design are keys to effective support for safe walking with purpose. Responses to walking with purpose in the domestic housing settings have raised serious deprivation of liberty issues. Research limitations/implications: This study had a number of limitations. The completed survey questionnaires represent a self-selected sample of extra care and retirement housing settings, and responses are based on the perceptions of the staff members completing the survey. There were a relatively small number of case study sites (three extra care housing and three retirement housing), and it was not possible to interview family members for all of the residents who walked with purpose. Originality/value: This study provides unique data on walking with purpose in extra care and retirement housing setting in the UK. [ABSTRACT FROM AUTHOR]

Purpose — To consolidate and review current literature that relates children's health to their housing and living environments. Design/methodology/approach — A range of published sources which review the relationship between children, housing and health. The sources consolidate research that applies specifically to children and their domestic situation. The paper also reviews literature around municipal tower block estates and the unique health/architecture relationship before turning to children living in temporary bed and breakfast accommodation. An overview of current public health policy that seeks to reintegrate housing and well-being is undertaken. Findings — Decent housing lies at the heart of health for all. Generally, the picture is more positive, but action remains slow. Children's needs must be given a higher priority in housing in future to promote physical and emotional well-being. Research limitations/implications — It is not an exhaustive list and the sources are mainly UK publications. Practical implications — The UK approach to children, housing and health may be of interest to a number of overseas countries in Eastern Europe, Africa and Asia. Originality/value — This paper fulfils an identified information/resources need and offers readers such as students, academics and practitioners an overview of the UK approach. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to draw attention to commissioning and service structures enabling implementation of evidence-based cost-effective care as illustrated by the “1419” young people’s service treating mild to moderate severity mental health difficulties in teenagers old 14 to 19 years. The authors describe relevant local contextual factors: “relational commissioning”, demand capacity planning and a receptive and safe clinical context. Design/methodology/approach – The authors used a participant observer qualitative research design to describe commissioning and service design. Treatment outcomes were analysed using a quantitative design and found significant improvement in service user mental health and daily function. These results will be reported elsewhere. Findings – The dynamics and structures described here enabled clear shared goals between service user, service purchaser, service provider and service partners. The goals and design of the service were not static and were subject to ongoing development using routine outcome measures and conversations between referrers, commissioners, service users and within the team about what was and was not working. Research limitations/implications – The methods are limited by the lack of a prospective systematic evaluation of the implementation process and by the time limitations of the service. Practical implications – Implementation of whole system change such as that envisioned by Children and Young People’s Improving Access to Psychological Therapies requires consideration of local context and process of implementation. The authors suggest key factors: consideration of “relational commissioning” with purchasers, providers and service users designing services together; case-level collaboration between services and partner agencies; smaller child and adolescent mental health teams eliminating competing task demands, permitting speed of action, providing psychological safety for staff, promoting shared goals and innovation; rigorous demand/capacity planning to inform funding. Social implications – The failings of child and adolescent mental health services (CAMHS) are detailed in the Department of Health report “Future in mind: promoting, protecting and improving our children and young people’s mental health and wellbeing” (2015). The aims of the report are contingent on the ability of local health providers to implement its recommendations. The authors provide a theoretical approach to enable this implementation. Originality/value – To date there are no published papers addressing the key characteristics enabling implementation of evidence-based practice within CAMHS. The unique experience in forming the“1419” service has important implications nationally and brings together evidence of an effective service within a theoretical underpinned context. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to explore the changing meaning of personalisation from the New Labour era of bespoke, integrated family support to the more recent implementation of personal budgets for disabled children to deliver “choice and control”. The paper explores the discursive change from early help to “intervention”, the shifting conceptualisation of parents and the turn away from family support towards a focus upon individualised commissioning to meet needs. Design/methodology/approach – In addition to a literature review of policy shifts, findings presented are taken from an ethnographic case study of one team of children’s disability social workers. Observations were undertaken of the team in the office space and at meetings, in addition interviews were conducted with all team members and with seven families. An interpretivist and qualitative approach was adopted throughout. Findings – Findings reveal the frontline and familial challenges of delivering choice and control in a climate of austerity and child-centricism. Salient points for integration around families and between organisations as personalisation narrows in scope are also considered. Research limitations/implications – Findings are taken from one case study site; further research in different sites is required to consider the array of understandings and experiences across the social care landscape and to provide a strong empirical baseline. Originality/value – The paper reports on one of the first ethnographic studies of personalisation in children’s services. The paper is of value to practitioners and managers in social care and the NHS. It is also of value to academics exploring the conceptual and practical issues of individualised care. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to describe how NHS Sutton Clinical Commissioning Group (Sutton CCG) is working with nursing homes, residential homes and other health and social care organisations in Sutton to improve the quality of provision for residents in nursing and residential homes “care homes”. Design/methodology/approach – The paper explains how Sutton CCG engaged with care homes initially to seek their views on whether they wanted support and what support they would value. It describes what arrangements Sutton CCG put in place for managers and staff in local care homes to provide support face-to-face. The paper outlines the key areas for improvement that Sutton CCG and the care homes are focusing on. It includes examples of work carried out jointly by the care homes and Sutton CCG to improve the quality of care for residents. It goes on to describe joint-working arrangements between the CCG, London Borough of Sutton and other health and social care organisations to ensure the overall quality of care homes in Sutton. Findings – The paper outlines feedback from care home managers and staff who were invited to share their views about what support they wanted from Sutton CCG. It includes early feedback from care homes about the support put in place and the areas where they have found it most useful. Practical implications – In the UK many older people live in care homes. Britain has an ageing population so the need for residential and nursing homes and the numbers of people living in care homes is only likely to increase. Our ageing population also places additional demands on the NHS, with residents in care homes often spending time in A&E and lengthy spells in hospital. This paper highlights how CCGs and other health and social care organisations can work with care homes to improve the health and wellbeing of older residents in care homes and reduce pressures on other health services. Originality/value – Sutton CCG has put in place new arrangements for working with care homes that aim to support carers to improve the lives of their older residents. The paper shares practical examples of support that the CCG has provided which has successfully improved care and decision making in care homes; early indications show this has reduced 999 calls and conveyances to hospital. Sutton CCG, London Borough of Sutton and other statutory organisations with responsibility for care homes in Sutton have also set up a joint intelligence group to gain an overall picture of the quality of the borough’s care homes. [ABSTRACT FROM AUTHOR]

Purpose - The issues of concern to older people and likely to shape their voting behaviour need to be understood and appreciated. The paper aims to discuss these issues. Design/methodology/approach - This policy-oriented review draws on recent research, including surveys, focus groups and ethnographic interviews to identify such issues in the UK older population. Findings - Older people are more likely to vote and to prioritise policy issues relating to immigration, the NHS and the economy - but the outcome of their vote is more likely to be determined by affinity with a party's broader ideological position than with the specific policies contained in their manifesto?. Practical implications - Older people appear more likely to support Conservative party values and priorities, but their potential growing support for UKIP may be underestimated as several major surveys do not prompt for this party. The less certain standing of both Conservative and Labour may therefore be further undermined by unappreciated shifts in the "grey vote". Originality/value - This commentary highlights the increasing importance of the "grey vote" at a time of increasing unpredictability in support for mainstream parties. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to appraise local absent without leave/missing persons policy in use across the nine NHS mental health trusts providing services across the Greater London region. Design/methodology/approach -- A review of the literature on best practice management was conducted, evidence collated and an appraisal tool produced. This tool was used to systematically appraise individual policies. Findings -- Despite some core consistency in policy, there was some notable variability in guidance. Novel and unique approaches to management were also identified. Research limitations/implications -- It is recognised that policies often arise from pragmatic approaches using local multi-agency agreements and therefore some variability across London was expected. It is also recognised that the audit tool produced is unvalidated but does reflect the best available evidence. Practical implications -- The authors have shown policy variability in the management of what is a common psychiatric problem across a relatively homogenous population. Standardisation of policy is likely to improve the efficiency in managing these incidents as well as encourage sharing of innovative practice. The authors also illustrate practical implications for local policy benchmarking in the absence of clearly defined national standards. Originality/value -- This study has shown the variability of policy in managing a common problem faced on psychiatric wards. It also highlights issues related to policy development on a local and regional level. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to report on a personalisation project run by the Challenging Behaviour Foundation (CBF) which aims to share the identified barriers and solutions to personalisation for people with severe learning disabilities and behaviour described as challenging. Design/methodology/approach – A small project team consisting of a project manager, housing specialist and positive behavioural support specialist worked as consultants with selected East Midlands local authority and NHS commissioners and with six families from other areas. Findings – The main barrier to personalisation was the volume of, and priority given to, safeguarding referrals by frontline commissioning social care workers. This reduced capacity for a proactive approach to support planning. Workers who participated in the project appreciated the expertise and support of the project team and the opportunity to reflect on their work. However, a major project limitation was a lack of time for commissioning workers and managers to engage with the project. Practical implications – The project report provided a series of recommendations for action for commissioners of health and social care support and for families. The Winterbourne View scandal broke as the project was established and its findings are helpful to anyone taking forward action plans to improve commissioning practices to avoid the continued commissioning of poor quality care. Originality/value – The project sought direct engagement in planning in "real time" with frontline commissioning staff and the families of people with severe learning disabilities and behaviour described as challenging. It is hoped that the value of the paper will be to influence NHS and LA commissioners to improve their response to people with severe learning disabilities. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to examine the impact of young people's participation in organised sport on their educational outcomes. Design/methodology/approach – Systematic review of the literature. A comprehensive search was used to identify all research evidence about engagement, impact and value in culture and sport. A combination of manual and automated screening was used to select studies for inclusion in this review based on pre-specified criteria. Included studies had to use a "high"-quality experimental research design, focus on children and young people and have quantitative educational outcome measures. Results from the individual studies were transformed into a standardised effect size and meta-analysis was used to combine the results from individual studies where appropriate. Findings – Young people's participation in sport may lead to improved educational outcomes. Young people's participation in organised sports activities, when compared to non-participation, improves their numeracy skills. Young people's participation in organised sport linked with extra-curricular activities, when compared to non-participation, improves a range of learning outcomes for underachieving pupils. These findings are based on six "high"-quality studies conducted in the UK and North America. Study populations included young people within the range of four to 16 years old. Originality/value – This paper builds on the existing evidence base in two main ways. First, it focuses specifically on the impacts associated with organised sport whereas previous reviews have had a broader focus. Second, it uses meta-analytic methods to synthesise study findings. This paper provides pooled effect sizes for overall educational impacts and translates these into potential changes in test/grade scores. [ABSTRACT FROM AUTHOR]

Purpose Measuring “impact” is an important aspect of the dissemination of evidence-based practice and relevant to all disciplines. However, it has only recently become a focus of enquiry and is not commonly directly researched within the learning disabilities field. The purpose of this paper is to describe the process of developing a logic model for the UK Positive Behavioural Support (PBS) Academy as part of an evaluation and impact study of its work to date.Design/methodology/approach Logic models are a visual representation of the relationship between a project’s resources, activities and outputs and identified outcomes, in relation to key stakeholder groups. This representation allows for key impact measures to be identified and can be a useful tool for evaluation purposes. The authors used the process outlined by McLaughlin and Jordan (1998) to develop a bespoke logic model for the PBS Academy.Findings The model was particularly helpful in making clear the distinction between output and impact, identifying impact criteria differentiated by stakeholder group and across time scales, and highlighting areas of activity that are needed to increase the impact of the work of the PBS Academy in the longer term.Originality/value In the absence of any generalised impact evaluation frameworks in the learning disabilities field, the authors suggest that logic models may provide a useful framework for evaluating the impact of policy, practice, and research interventions. [ABSTRACT FROM AUTHOR]

Purpose: In this article, we outline our views on the appropriateness and utility of Return on Investment (ROI) for the evaluation of the value of healthcare quality improvement (QI) programmes. Design/methodology/approach: Our recent research explored the ROI concept and became the genesis of our viewpoint. We reflect on our findings from an extensive research project on the concept of ROI, involving a multidisciplinary global systematic literature review, a qualitative and Delphi study with mental healthcare leaders from the United Kingdom National Health Service. Research participants included board members, clinical directors and QI leaders. Our findings led to our conclusions and interpretation of ROI against the broad QI governance. We discuss our views against the predominant governance frameworks and wider literature. Findings: ROI is in-line with top-down control governance frameworks based in politics and economics. However, there is evidence that to be of better utility, a tool for the assessment of the value of QI benefits must include comprehensive benefits that reflect broad monetary and non-monetary benefits. This is in-line with bottom-up and collaborative governance approaches. ROI has several challenges that may limit it as a QI governance tool. This is supported by wider literature on ROI, QI as well as modern governance theories and models. As such, we question whether ROI is the appropriate tool for QI governance. A more pragmatic governance framework that accommodates various healthcare objectives is advised. Practical implications: This article highlights some of the challenges in adopting ROI as a QI governance tool. We signal a need for the exploration of a suitable QI governance approach. Particularly, are healthcare leaders to be perceived as "agents", "stewards" or both. The evidence from our research and wider literature indicates that both are crucial. Better QI governance through an appropriate value assessment tool could improve clarity on QI value, and thus investment allocation decision-making. Constructive discussion about the utility and appropriateness of ROI in the evaluation of healthcare QI programmes may help safeguard investment in effective and efficient health systems. Originality/value: The article raises awareness of QI governance and encourages discussions about the challenges of using ROI as a tool for healthcare QI governance. [ABSTRACT FROM AUTHOR]

Purpose – This paper aims to present an overview of the current state of evidence on the effect of housing circumstances, and housing-related interventions, on adult mental health and well-being. It covers the entire range of health from chronic illness to positive thriving, and both individual and community-level/public health. Design/methodology/approach – The paper is based upon a purposive review, commissioned originally for the UK Department of Health; and therefore is selective in giving priority to research relevant to public policy considerations, and to the UK context. Research with a variety of methodological foundations is considered, where robust enough by its own standards. Findings – The available evidence gives conditional support to policies accentuating empowerment at individual and community levels; early intervention; locality or place-based interventions; and integrated working practice. The complexity of methodological issues emerges as a key challenge for research in this field, and for the prospect of evidence-based national policy. Meanwhile local knowledge and interpretation of data in context may be more reliable than context-blind studies. Research limitations/implications – Where "hard evidence" is unavailable, reports of the lived experience of individuals and in communities remain a legitimate basis for policy and commissioning. Originality/value – This appears to be the first attempt in print to cover such a wide canvas in one overview. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to indicate the policy thinking that underpins the statutory provisions on adult safeguarding in the Care Act 2014. Design/methodology/approach – The paper draws out the key themes and features of the Care Act that are relevant to safeguarding adults. Findings – The author articulates the key messages from the Care Act regarding safeguarding adults. Research limitations/implications – As new legislation, the impact of these changes is yet to be established. Practical implications – The paper summarises aspects of the statutory guidance which all agencies are required to comply with. Social implications – The paper emphasises the involvement of people in safeguarding enquiries. Originality/value – The author is the policy lead at the Department of Health for adult safeguarding. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to discuss the issue of social inclusion for people with autism spectrum conditions.Design/methodology/approach - Drawing on current policy and good practice guidelines as well as the experience of people with autism and those who support them, this paper considers how well legislation, policy, and good practice are currently implemented with regard to improving the social inclusion of children and adults with autism spectrum conditions.Findings - International and UK policy sets out the rights of children and adults with disabilities to live a good life in the community, with reasonable adjustment to be made by society to ensure this is possible. However, the practical and strategic implementations of policies to ensure these rights for people with autism are still not fully in place.Originality/value - This discussion takes into consideration the views of carers and support professionals and the direct experiences of those with autism as well as policy and published guidance. [ABSTRACT FROM AUTHOR]

The author reflects on the problems faced by the people with learning disabilities in Great Britain and discusses various government and private works done for such people. He states that people with disabilities face inequalities in the field of health care, housing and employment and the National Health Service (NHS) is not providing adequate opportunities to them. Also, he argues that much work is need on the part of the government and NHS and public to give equal status to these people.

The article presents a research paper exploring the issues associated with putting into practice the government policy for the development of new generation primary health care centres in Great Britain. It outlines the government policy issues propelling the development of such centres and describes five issues linked with the research subject, including health care quality, the location and accessibility, and the shifting balance of the private and the public provision. It also highlights the considerable controversy provoked by the British government's plan to develop the said centres amid the period when a rising number of property companies are entering the primary health care market.

Purpose The purpose of this paper is to relate the health services' prevention imperative to a new priority area, youth suicide.Design/methodology/approach The content is based on the latest UK policy documents and participation in recent events for policy-makers.Findings Suicide among young people is increasing, and traditional approaches are not reducing these deaths. Involving young people as researchers or trainers has been helpful, and policy-makers need to address the present social and cultural risk factors.Research limitations/implications Evidence differs between countries, and a local context may be important.Practical implications In the UK, local profiles are being developed and there is an increasing need identified for relevant training for a wide range of professionals.Social implications The participation of young people in developments may be emancipatory, for all concerned.Originality/value Because this year, young persons' mental health will be an international priority, this may be the time to galvanise action for improved planning and resources for the prevention of youth suicide. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to draw on multiple streams analysis (MSA) and to investigate how policy change emerged from two inquiries into allegations of abusive hospital care in National Health Service (NHS) hospitals in the United Kingdom (UK) in the 1960s. Design/methodology/approach: The methodology of this study is regarding a historical case study of two inquiries. Findings: The Sans Everything and Ely inquiries had the same legal standing and terms of reference, but the second put psychiatric hospital reform on the agenda, while the first did not. The main factor making Ely rather than Sans Everything the turning point seems to have been concerned with "agency", linked with a few key individuals. Research limitations/implications: A study of 1960s event necessarily relies heavily on documentary and archival sources, and cannot draw on interviews which are an important ingredient of many case studies. Originality/value: The originality of the study is to examines inquiries, which have been largely neglected in MSA, despite their obvious potential role in placing issues on the agenda. Previous studies of MSA have devoted little attention to the ability of the media to provide the focus on "focusing events". [ABSTRACT FROM AUTHOR]