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There is robust evidence that the places where people live have a profound influence on whether or not they are able to live healthy lives. This link between quality of place and well-being is now recognised by the UK's National Health Service (NHS) and is viewed as a key progenitor of pernicious health inequalities. Increasingly, it is also being recognised and reflected in UK national planning policy. Planning policy is weak, however, with few mandatory quality standards, and many of the new homes and places being built in the UK are of a poor quality. Unless there is an urgent effort to strengthen and co-ordinate national policy regarding public health, planning and housing, it is highly likely that the design and management of the built environment will continue to increase the already large health inequalities between rich and poor. In support of thinking anew about place-making as preventative public health, this paper reports insights and lessons arising from NHS England's Healthy New Towns project. [ABSTRACT FROM AUTHOR]

There has been a succession of policy documents related to active travel published by the British government since the implementation of a National Cycle Network (NCN) in 1995. However, as the latest National Travel Survey (NTS) reveals, the number of journeys made by bike in the UK has remained steadfastly around only 2% (Department for Transport [DfT], 2018a). By using documentary analysis of the available official policy documents and statements, the aim of this paper is to make sense of the policies that have been published concerning active travel (AT) in England. This is done from a figurational sociological perspective. Three key themes emerge from the analysis: (1) the rhetorical, advisory level of the vast majority of the policies; (2) the reliance on a wide network of local authorities to implement AT policy; and (3) the focus placed on individuals to change their behaviour. Furthermore, the analysis reveals that despite a large number of policy publications from a range of government departments claiming to promote AT, little has actually changed in this time period in terms of a national agenda. Despite the successive policies, it seems there is little appetite on behalf of recent governments to make widespread infrastructural changes, where instead the focus has largely been on persuading the individual to seek more active modes of travel, increasingly for their own, individual 'health' gains. Highlights •The paper is based on documentary analysis of available official policy documents from UK government on active travel since 1996 • The findings reveal the largely rhetorical, advisory level of the vast majority of the policies, which contributes to a lack of overall success in promoting active travel • The lack of success is compounded further by a reliance on a wide network of local authorities to implement active travel policy, when most local authorities appear more concerned with transport issues related to motorised vehicles • The findings reveal that active travel policy has becoming increasingly focussed on health gains that might be made from increasing the number of trips made by bicycle • The overwhelming focus of the policy documents analysed, however, is on encouraging individuals to change their behaviour, a process regarded as 'healthism', and one most sociologists of health suggest is likely to fail as a result • We conclude by suggesting that if the government is serious about wanting to see a 'step change' in the way in which people travel, particularly over shorter distances, then there is a need to have a more forceful approach to implementing policy within local authorities at the same time as making more substantial infrastructure changes to encourage cycling [ABSTRACT FROM AUTHOR]

This article provides a comparative review of the interpretation and implementation of clinical governance frameworks within the four home countries of the UK - England, Northern Ireland, Scotland and Wales. Clinical governance has become one of most significant and important concepts in modern health care. The article considers the policy background and the many definitions of clinical governance, but specifically compares the various strategic and operational approaches to delivery of clinical governance in different parts of the UK. It is suggested that these variations in approach, by each of the four UK countries, can lead to confusion for healthcare professionals in trying to understand, implement and monitor elements of clinical governance in practice. [ABSTRACT FROM AUTHOR]

Abstract: Aim: To compare drug recovery outcomes in commissioning areas included in a ‘payment by results’ scheme with all other areas. Design: Observational and data linkage study of the National Drug Treatment Monitoring System, Office for National Statistics mortality database and Police National Computer criminal records, for 2 years before and after introduction of the scheme. Pre–post controlled comparison compared outcomes in participating versus non‐participating areas following adjustment for drug use, functioning and drug treatment status. Setting: Drug services in England providing publicly funded, structured treatment. Participants: Adults in treatment (between 2010 and 2014): 154 175 (10 716 in participating areas, 143 459 non‐participating) treatment journeys in the 2 years before and 148 941 (10 012 participating, 138 929 non‐participating) after the introduction of the scheme. Intervention: Scheme participation, with payment to treatment providers based on patient outcomes versus all other areas. Measurements: Rate of treatment initiation; waiting time (> or < 3 weeks); treatment completion; and re‐presentation; substance use; injecting; housing status; fatal overdose; and acquisitive crime. Findings: In participating areas, there were relative decreases in rates of: treatment initiation [difference‐in‐differences odds ratio (DID OR) = 0.17, 95% confidence interval (CI) = 0.14, 0.21]; treatment completion (DID OR = 0.60, 95% CI = 0.53, 0.67); and treatment completion without re‐presentation (DID OR = 0.63, 95% CI = 0.52, 0.77) compared with non‐participating areas. Within treatment, relative abstinence (DID OR = 1.50, 95% CI = 1.30, 1.72) and non‐injecting (DID OR = 1.32, 95% CI = 1.10, 1.59) rates were improved in participating areas. No significant changes in mortality, recorded crime or housing status were associated with the scheme. Conclusion: Drug addiction recovery services in England that are commissioned on a payment‐by‐results basis tend to have lower rates of treatment initiation and completion but higher rates of in‐treatment abstinence and non‐injecting than other services. [ABSTRACT FROM AUTHOR]

Today, qualitative researchers are framing the relationship between qualitative case studies and quantitative evaluation research in positivist terms, seeking dialogue with quantitative researchers on the basis that qualitative case studies hold the potential to develop theory for evaluation programmes and to improve the quality of quantitative research. In the UK health policy literature, however, recent evaluations of major government programmes of reform have been conducted under largely quantitative and econometric strategies involving baskets of indicators, or routinely collected hospital statistics, set against the central stated aims of the programme: namely, to improve quality, efficiency, responsiveness, output and equity. For the wider evaluation literature, we detail the results of a qualitative case study of the impact of two key reforms, the 18 Week Patient Pathway and Payment by Results, on four English hospitals, demonstrating the value of the positivist frame to evaluation research based on its capacity to improve understandings of cause and effect and to direct quantitative researchers towards better measures and data sets. For the UK health policy literature, we demonstrate the value of qualitative case studies to the policy process in terms of their potential to reduce the risks for serious policy mistakes. [ABSTRACT FROM PUBLISHER]