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Aim To gather evidence to support the implementation of standard six of the National Service Framework for Children, Young People and Maternity Services (Department of Health and Department for Education and Skills 2004), which states that care should be provided as close to home as possible. Methods A mixed methods study comprising of a systematic review, a national survey of provision of care closer to home (CCTH), four in-depth, qualitative case studies and a cost analysis. Findings The systematic review suggests that CCTH is no less clinically effective than hospital care. Services identified by the survey fall into three distinct models of provision. Case study data show that families preferred CCTH, but staff face difficulties at organisational and practice levels. Cost analysis suggests there can be cost savings with CCTH, but several factors influence these. Conclusion CCTH may be an effective and feasible option for children and young people who are ill. [ABSTRACT FROM AUTHOR]

Between 300,000 and 1.4 million adverse events occur each year in the NHS, and about half of those that occur in inpatient settings are preventable (Department of Health Expert Group on Learning from Adverse Events in the NHS 2000). Strategies to reduce these events have focused mainly on changing systems of care and professional behaviour, but there is growing interest in involving patients in safety initiatives. This stresses the development and use of interventions to promote and support patients' and their representatives' roles insecuring their own safety in health care. This article reports the results of a series of linked studies that examined how patients might effectively promote their own safety, and to explore how this might vary by context, place or demography. [ABSTRACT FROM AUTHOR]

This article explores issues surrounding adherence to medication. Terminology associated with the use of medication, most notably the terms compliance, concordance and adherence, are discussed. The article also explores factors that can influence the use of medication and discusses the role of nurses in supporting adherence to treatment.