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Summary: Objectives: Commentators and professional organisations note that an expanding market in human milk-based products (HMBPs) could reduce breastfeeding, compromising maternal and infant health, and undermine public milk bank donations. We investigate whether English NHS trusts purchased these products and whether HMBP companies have marketed to them. Design: Freedom of Information (FOI) requests asking: (1) whether trusts obtained human milk; (2) if so, how; and (3) whether HMBP companies had approached them. We analysed trusts' responses qualitatively. In 2023, an FOI request to the Food Standards Authority (FSA) following a product recall. Setting: England. Participants: One hundred and ninety-four NHS trusts, the FSA. Main Outcome Measures: Obtaining human milk, approaches by companies, and trust responses to approaches. Results: One hundred and seventy-six trusts responded, 102 reporting human milk from milk banks. No trusts reported purchasing from companies in 2022. In 2023, the FSA confirmed six English hospitals used HMBPs from one company; an FOI for trusts' names was refused on law enforcement grounds. Two trusts reported participating in clinical trials funded by companies. Twenty-one reported approaches, using several strategies, including uninvited ward visits. Trusts rejected marketing based on guidance from: (1) trust dieticians or physicians; (2) regional regulatory bodies; (3) professional bodies; and (4) perceived application of an International Code on breastfeeding. Conclusions: Companies market to trusts, adopting methods previously used by the formula industry. Trusts express confusion over whether this infringes agreements designed to promote breastfeeding. We encourage clarification and guidance for professionals and trusts to ensure safety, infant and maternal health, and protect public provision. [ABSTRACT FROM AUTHOR]

This article contributes to the theoretical understanding of institutions as fundamental in shaping the demand for migrant labour by investigating labour market regulation as possible explanation for cross-country differences in labour market segmentation and the presence of migrant workers. It compares the adult social care sector in England and the Netherlands with important cross-country differences in the reliance on migrant labour amid similar cost saving policies and marketization drives. The analysis draws on data collected between 2009 and 2019 and consisting of sectoral survey data, policy documents, interviews with relevant actors, and the observations of trade union and care workers' meetings. The findings highlight the importance of path-dependent features of the national industrial relations systems in explaining observed differences but also how the specific nature of the regulatory outcomes depends on unions' strategies and power. [ABSTRACT FROM AUTHOR]

Social work regulation in England has experienced a considerable period of change in recent years. The profession's latest regulator, Social Work England, faces similar challenges to sister professions—and to social work internationally—to improve and focus regulatory activity to better protect the public. In examining activity around poor performance and fitness to practice (FTP), the author explores the potential for shifting the emphasis of a regulatory gaze to practice before problems occur, rather than always dealing with the after-effects (known as 'upstreaming'). A case is also made for developing 'formative spaces'—where organisations might construct interventions to address professional performance before recourse to regulatory structures. To examine the readiness of organisational structures to take on this task, a series of qualitative, semi-structured interviews were undertaken with experienced practitioners. Thematic analysis of the data illustrates a range of current strategies for dealing with these issues. In conclusion, this article promotes the idea of shifting the balance of regulatory activity away from FTP areas to more positive, proactive endeavours that might better protect the public and help the profession manage the challenges faced by the complexity of contemporary practice. [ABSTRACT FROM AUTHOR]

Owing to the managerial and regulatory setup of Private Water Supplies (PWS) in England and Wales, the attention and resource required to achieve 'wholesome' drinking-water, a regulatory term reflecting quality standards, is often limited. The requirement to risk assess PWS was first included in the English and Welsh Regulations in 2009 and 2010 respectively. However, compliance rates with risk assessment requirements remain low with concerns raised regarding the lack of subsequent action. Using a mixed methods approach of interviews and surveys, this research seeks to: (i) identify available data sources for the completion of risk assessments by Local Authorities; (ii) understand factors which facilitate or hinder decisions made and action taken based on risk assessments; (iii) investigate the influence of the regulatory environment on (i) and (ii); and (iv) pose suggestions for more efficient data use to help improve the drinking-water quality of PWS in England and Wales. Findings highlight gaps in the legislation which impact the national level understanding of PWS drinking-water quality and subsequently impact national level prioritization and resource allocation. The assigned stakeholders responsible for risk assessment are reviewed and discussed. Recommendations include the development of an environmental health database to support institutional data sharing; a greater recognition of the differing resource type and enforcement strategies required to undertake risk assessment, in comparison to water quality sampling alone; introduction of Sanitary Inspection forms to PWS operators and financial support structures to facilitate remedial action. Methods which may support reduced sampling data, such as hydrogeological modeling, are discussed. • An integrated environmental health database is needed for institutional data sharing. • Hydrogeological modeling could support reduced sampling, leveraging resources. • Sanitary Inspections could support operator action through knowledge and empowerment. • Enforcement strategies need to be revised to consider the shift to risk assessments. [ABSTRACT FROM AUTHOR]

The financialization of everyday life has received considerable attention since the 2008 global financial crisis. Financialization is thought to have created active financial subjects through the ability to participate in mainstream financial services. While the lived experience of these mainstream financial subjects has been the subject of close scrutiny, the experiences of financial subjects at the financial fringe have been rarely considered. In the UK, for example, the introduction of High-Cost, Short-Term Credit [HCSTC] or payday loan regulation was designed to protect vulnerable people from accessing unaffordable credit. Exploring the impact of HCSTC regulation is important due to the dramatic decline of the high-cost credit market which helped meet essential needs in an era of austerity. As such, the paper examines the impact of the HCSTC regulation on sixty-four financially marginalized individuals in the UK that are unable to access payday loans. First, we identify the range of socioeconomic strategies that individuals employ to manage their finances to create a typology of financial subjectivity at the financial fringe. Second, we demonstrate how the temporal and precarious nature of financial inclusion at the financial fringe adds nuance to existing debates of the everyday lived experience of financialization. [ABSTRACT FROM AUTHOR]

This study ascertains the views of UK stakeholders on the actual, and possible, impact of a public health licensing objective in their day-to-day work. Twenty-eight interviews were conducted with members of public health teams who were actively engaged in alcohol licensing in their local area between 2017 and 2019. Six teams were based in Scotland (where there is a public health licensing objective) and 14 in England (where there is no similar objective). Scottish participants reported that while challenges remained in applying the public health licensing objective, progress had been made and the objective was beneficial to their work. Participants in England felt that an objective would increase the legitimacy, value and impact of their contributions. In both Scotland and England, constructive relationships between PHTs, licensing authorities and other key stakeholders were developing suggesting that PHTs could have a sustainable and positive role in licensing. In many Scottish areas, the alcohol licensing system is evolving to take constructive account of its public health objective. In England, PHTs that have invested resources in engaging in this area have demonstrated an ability to work effectively within licensing systems. Strong support for the adoption of a public health licensing objective among these PHTs adds weights to calls for the UK Government to reconsider its previous decision not to introduce such an objective. [ABSTRACT FROM AUTHOR]

Developments in improved monitoring, asset management, and resource efficiencies led to the water industry promising a step‐change in the design and operation of these facilities: the "blending" of traditional engineering equipment with digital technologies. These apparent benefits inevitably produce new challenges of regulating an emerging techno‐political landscape. One of the regulations is Europe's Network and Information Systems Security Directive, which aims to improve cyber security across critical infrastructure providers. This paper focuses on the implementation of Network and Information Systems in the context of the water sector in England. At the national and supranational levels, Network and Information Systems acts as a boundary object that gathers diverse communities of practice without the need to establish common goals. Further, in the process of transposing the Directive into the sectoral context, Network and Information Systems requires interpretation by expert communities. We show how translating the regulatory scope to the sectoral landscape involves prioritizing some water governance goals over others. As diverse expert communities converge in their collaboration practices, their priorities align or stand in tension with public interests. We argue that cyber security regulations have potential to reconfigure water governance by refocusing strategic priorities away from traditional concerns of environmental governance. We suggest ways to maintain diverse collaborations across engineering, computing, and water expertise that Network and Information Systems implementation remains aligned with the goals of water governance. [ABSTRACT FROM AUTHOR]

INTRODUCTION: In December 2019, Social Work England (SWE) officially took over as the regulator of the approximately 100,000 social workers in England. This article explores the foundations and first two years of SWE, suggesting that, as a regulator, it has earned the collective dissent of social workers. APPROACH: Initially, a brief history of social work regulation in England is provided, before moving on to explore the founding of SWE and the makeup of the organisation. The regulator's standards and rules, approach to consultation and representative role are also discussed. DISCUSSION: This culminates in a discussion about the dissent that many social workers in England have already started to demonstrate towards SWE, with a particular focus on the new continuing professional development (CPD) requirements. The potential to translate this largely individual dissent into collective action and mutual support is explored. [ABSTRACT FROM AUTHOR]

We consider the wholesale electricity market prices in England and Wales during its complete history, where price-cap regulation and divestment series were introduced at different points in time. We compare the impact of these regulatory reforms on the dynamics of electricity prices. For this purpose, we apply flexible distributions that account for asymmetry, heavy tails, and excess kurtosis usually observed in data or model residuals. The application of skew generalized error distribution is appropriate for our case study. We find that after the second series of divestments, price level and volatility are lower than during price-cap regulation and after the first series of divestments. This finding implies that a sufficient horizontal restructuring through divestment series may be superior to price-cap regulation. The conclusion could be interesting to other countries because the England and Wales electricity market served as the benchmark model for liberalizing energy markets worldwide. [ABSTRACT FROM AUTHOR]

Performance assessments of water utilities are essential to protect the interests of citizens, because utilities operate under natural monopolies and their costs are recovered from customers through water tariffs. In this study, a four-error component model was applied to estimate cost efficiency (CE), persistent efficiency (PE) and transient efficiency (TE) for a sample of English and Welsh water utilities over 25 years (1993–2018). This approach economies of scale and technical change of the water utilities to be estimated. The average estimated CE was 0.703, indicating that water utilities could reduce costs by almost 30% for the same production. Average PE and TE were 0.875 and 0.805, respectively, indicating that the privatization of the water industry positively impacted the efficiency of water utilities. The analysis also showed that the UK industry exhibited decreasing economies of scale, whereby mergers did not cause lower production costs. Technical regression was present, but minimal. Through linking, CE, TE and PE with the regulatory cycle, the impact of the different regulatory policies on the performance of water utilities in England and Wales was shown. [ABSTRACT FROM AUTHOR]

Uterus transplantation (UTx) is fast evolving from an experimental to a clinical procedure, combining solid organ transplantation with assisted reproductive technology. The commencement of the first human uterus transplant trial in the United Kingdom leads us to examine and reflect upon the legal and regulatory aspects closely intertwined with UTx from the process of donation to potential implications for fertility treatment and the birth of the resultant child. As the world's first ephemeral transplant, the possibility of organ restitution requires consideration and is discussed herein. Uterine transplantation warrants a closer look at the legal frameworks on fertility treatment and transplantation in England. Uterine transplantation warrants a closer look at the legal frameworks on fertility treatment and transplantation in England. [ABSTRACT FROM AUTHOR]

This article explores the interplay between the medical marketplace and print culture in the seventeenth- and eighteenth-century Dutch Republic. The starting point and inspiration is Mary Fissell's analysis of the role of print in the English medical marketplace. In the early-modern Dutch Republic, as elsewhere in Europe, we observe a growing competition between all kinds of medical practitioners. These practitioners searched for effective forms of communication to disseminate and promote their competence, skills, remedies, treatments, and books. To achieve this, regular (physicians, surgeons, and apothecaries) and irregular (stonecutters, oculists, empirics, "quacks" etc.) practitioners used a range of printed media, varying from newspaper advertisements, leaflets, and bills to pamphlets and books. By studying these sources systematically, we gain a better insight into the dynamics of the medical world. In this article, I investigate to what extent newspaper advertisements, one of the pivotal and widespread forms of communication, reflected the degree of regulation of the medical marketplace in Amsterdam and to what extent this situation differed from England. [ABSTRACT FROM AUTHOR]

The water industry plays an important role in reducing greenhouse gas (GHG) emissions and therefore, moving to a low-carbon urban water cycle is of great importance. However, traditional performance assessment of water companies ignores GHG emissions. To overcome this limitation and to compare productivity change estimations of water companies excluding and including GHG emissions, this study computes the Luenberger productivity indicator (LPI) and the Malmquist-Luenberger productivity index (MLPI), respectively. Moreover, in a second stage, we investigate the impact of exogenous variables on environmentally sensitive productivity change estimations. The empirical application conducted for a sample of water and sewerage companies in England and Wales over the period 201–2019 has illustrated that when GHG emissions were considered in the assessment (i.e., MLPI estimations), average productivity decreased. By contrast, when productivity estimation ignored GHG emissions (i.e., LPI), average productivity increased. Hence, it is concluded that the inclusion of GHG emissions in productivity analysis impacted the results. This finding is very relevant from a policy perspective as it illustrates the importance of considering GHG emissions when evaluating the performance of water companies for regulatory purposes. [ABSTRACT FROM AUTHOR]

This article examines the challenges in regulating patient safety during hospital discharges in England through the lens of liminality. Hospital discharges are internationally recognised as being a dangerous time for patients, and yet the role that regulators should play in addressing this has received little attention in any jurisdiction. Liminality's spotlight on the in-between highlights how the discharge process can give rise to patient safety incidents that fall between regulator's boundaries. Falling between boundaries results in a dearth of effective regulatory responses to address these incidents. By positioning the new role of Patient Safety Commissioner (PSC) as that of a 'Representative of Order', this article proposes a means by which this poorly regulated space could be navigated more successfully. This analysis suggests that the remit of the PSC role be expanded to include improving patient safety with regard to processes – not just medicines and medical devices. The full implications of this are also addressed. [ABSTRACT FROM AUTHOR]

The regulation of housing quality has a long history in England. As the state itself increasingly became a housing developer in the twentieth century, design standards were subject to self-regulation. Through this, the idea that housing quality includes minimum dwelling sizes – space standards – has entered public consciousness. The 2010–2015 coalition government introduced suggested space standards through planning control, but also extended the range of 'permitted development' – a form of deregulation – where space standards could not be applied. In this paper we explore the history of space standards in England and what these tell us about planning regulation. [ABSTRACT FROM AUTHOR]

The Grenfell Tower fire has brought the regulatory system that permitted combustible materials on high-rise buildings in England into question. At the heart of that system is the BS 8414 test, and the BR 135 criteria used to demonstrate compliance with the Building Regulations. The test is empirical and the criteria arbitrary: there is no scientific link between test performance and how a building will perform in the event of a fire; nor any detailed analysis of why fires spread through façade systems which have passed the test. Following the Grenfell tragedy, the UK government commissioned a series of tests on Grenfell Tower-type facades, using BS 8414. This paper critically analyses BS 8414, the BR 135 criteria and the government tests. It shows that important aspects of the standard are poorly defined: the heat flux imposed on the façade is not measured and the fire load can vary by at least a factor of 2; the ambient ventilation has a significant impact on the thermal attack but is not adequately controlled; judicious location of the cavity barriers can confer compliance or failure on a façade system. As the vehicle for allowing combustible products on tall buildings, the test does not specify the extent of cavity barrier deployment, while ignoring features present in real buildings, such as windows, vents or other openings, despite a test rig height of more than 8 m. There is no restriction on debris, or molten or burning droplets falling from the façade during the test. The BR 135 criteria only specify that the test must run for the full 60 min duration without flames reaching the top, and the temperature rise at thermocouples 5 m above the fire chamber must only remain below 600°C for the first 15 min. It is unclear how the fire safety of the occupants behind the façade system can be ensured, when the criteria specify such a high temperature for such a short period, so early in the test. There is no direct connection between the façade system in the test and the actual façade system the results deem compliant. Worse, "desktop studies", using large-scale test data, have been allowed to confer compliance on systems which have never been subject to the test. The UK government tests used heavy-duty welded aluminium "window pods", preventing flames from entering the cavity within the façade. They also used a disproportionately large number of vertical and horizontal cavity barriers of a higher specification than required by statutory guidance. These aids to meeting the criteria are not proscribed by BS 8414-1 but are not commonly found in actual rainscreen system designs. [ABSTRACT FROM AUTHOR]

Throughout the 19th century, midwives were depicted as incompetent slatterns in both popular imagery and medical literature. We examine how, between 1500 and 1800, midwifery was regulated by a combination of formal licensing by the Church and informal oversight within the community. We argue that episcopal licensing demanded that midwives demonstrate knowledge and competence in midwifery, not only that they were spiritually fit to baptise dying infants. Although episcopal licensing lacked statutory authority, the symbiosis of formal and informal systems of regulation ensured good midwifery practice and midwives were regarded as experts in all matters relating to childbirth. The Midwives Act 1902 introduced statutory regulation of midwives, restoring their 'professional status' if in a subordinate role. We show that the history of the regulation of midwives across four centuries casts light on the interplay between formal and informal regulation and matters of gender and professional status. [ABSTRACT FROM AUTHOR]

In this article, we draw on recent scholarship on home, property and regulation to develop an idea of home as being co-constituted by, and through, three different types of regulation – regulation of the self, regulation of life, and regulation as enforcement. We demonstrate how a focus on the mundane in regulation, as opposed to the spectacular, impacts on the making and unmaking of home in this context. Rather than draw on traditional housing tenures to make our point, we de-dramatize the relationship between home and tenure (ownership or renting) by drawing on a case study of a particular type of owned but precarious housing – those living in boats on a canal in England. [ABSTRACT FROM AUTHOR]

Coase's publication of "The Lighthouse in Economics" (1974) sparked a polarizing debate over his claim that government intervention is not necessary for the existence of a private lighthouse market. The purpose of this paper is to reframe this debate by asking the following question: why was nationalization the outcome of lighthouse regulation? We answer this question by utilizing the Austrian theory of interventionism to illustrate how regulation of the lighthouse market distorted the entrepreneurial market process. We argue that the nationalization of the lighthouse market in England and Wales was a result of prior government failure to exclude private lighthouses from the market, not a failure of the entrepreneurial market process to privately provide lighthouses. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to describe the current situation in relation to restrictive interventions, and some actions that could be taken to reduce them. The quality of care provided by inpatient services for people with intellectual disabilities has come under increasing scrutiny in recent years – from Winterbourne View in 2011 to Whorlton Hall in 2019, there has been increasing concern that admission to hospital does not always result in a good outcome for the patients. For some people, it has resulted in further deterioration in their physical and mental health, separation from families and supports and reduced probability of living as part of their community. This is in spite of knowledge and evidence of what good practice looks like. Design/methodology/approach: This paper examines the extent to which inpatient services deliver good practice in treatment and care and, where this is not happening, the extent to which they are subject to effective governance. Findings: People admitted to inpatient services can be at risk of poor-quality care and the overuse of restrictive interventions. There is guidance available that addresses what should be in place for them to receive high-quality care and treatment, and this clearly is available to many people. However, others can find themselves placed in increasingly restrictive environments and in circumstances where their human rights are at risk of being breached. There is increasing evidence that these services do not follow good practice guidance in terms of staff skills, development and implementation of effective care plans and governance arrangements that address these issues. Regulators, commissioners and managers could, and should, focus on these issues to ensure that the most vulnerable receive the care and treatment they need while in hospital. Originality/value: Service providers are aware of the difficulties in developing alternative community services. This places even more importance on the need to ensure that care and treatment in hospital is of a good standard, and that the use of restrictive interventions is minimised. McGill et al. (this issue) describe the features of a capable environment and it may be that hospitals consider that the requirements are unlikely to be implemented effectively in a ward/unit setting. However, a shift of focus in doing this could result in a reduction in restrictive interventions and a better experience – potentially for both the staff and the patients. And families could have some reassurance that their relative was receiving the best quality care and treatment, and that their human rights were being upheld. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to explore whether performance indicators in children's services can be used to predict the outcome of Ofsted inspections. Every local authority in England is inspected by Ofsted (the Office for Standards in Education, children's services and skills) and given a single, overall rating – outstanding, good, requirements improvement or inadequate. These ratings carry immense significance. Persistently inadequate authorities are liable to have legal responsibility for providing services outsourced to another organisation. Ofsted have been criticised in the past for focusing too much on procedure, and previous research has highlighted the importance of deprivation and spending levels. In this paper, we describe a new study using more recent Ofsted and local authority data to see what patterns there might be now between performance indicators and inspection results. Design/methodology/approach: We report an analysis of 45 variables in relation to children in need, children in care and young adults with care experience. Using statistical analysis, we consider to what extent performance measured by these variables differs between authorities based on their Ofsted ratings and which of the variables can be used to predict Ofsted inspection outcomes. Findings: We identified no consistent patterns of difference between local authorities in relation to Ofsted ratings. Deprivation was the best single predictor of Ofsted inspection outcomes. Originality/value: This study uses relatively recent Ofsted and local authority data and builds on previous research findings which are increasingly highlighting the significance of deprivation as a factor to help explain variable performance between different authorities. [ABSTRACT FROM AUTHOR]

There is a disproportionate number of complaints about social workers in England to the Health and Care Professionals Council (HCPC) as compared with the other health care professionals regulated by HCPC. This paper discusses findings from interviews and focus groups that formed part of a mixed methods study that aimed to find out the reasons for complaints and the strategies that may reduce complaints. Four themes were identified: social work as an evolving profession; social work involves challenging practice; social work takes place in a pressurised environment; and public perceptions and expectations of social work are often negative and unrealistic. Findings highlight explanations that focus on organisational culture and public responses to social workers' control functions. We argue that, at a time of change for the profession, there is a need for public education regarding the role and function of social workers and for regulators to have more proactive engagement with registrants and employers. [ABSTRACT FROM AUTHOR]

The Forensic Science Regulator has the role of setting quality standards for forensic science in the Criminal Justice System (CJS) in England andWales. The current requirement is for organisations carrying out digital forensics to gain accreditation to the international standard ISO/IEC 17025 and the Forensic Science Regulator's Codes of Practice and Conduct. The aim of this requirement is to embed a systematic approach to quality, including understanding methods, validating software and systems, understanding risks, ensuring that all involved in the crime scene to court process have the skills and competence they need and the appropriate equipment and environment for the work, and providing ongoing assurance of quality through audit and proficiency tests. However, the challenge of implementing the standards in digital forensics should not be underestimated, particularly in an environment where there is insufficient capacity to meet a growing demand for services in an area of increasing complexity and fragmented delivery. It is therefore timely to review available data to determine the extent to which accreditation to ISO/IEC 17025 is addressing quality issues in digital forensics and consider what changes and resources could be made available to assist with implementation of quality systems. [ABSTRACT FROM AUTHOR]

The anticipated change of social work regulator in England from the Health and Care Professions Council to Social Work England in 2019 will herald the third, national regulator in seven years for the social work profession. Social Work England will be a new, bespoke, professionally specific regulator established as a non-departmental public body with a primary objective to protect the public. Looking globally, we can observe different approaches to the regulation of the social work profession—and many different stages of the profession's regulatory journey between countries. Using a comparative policy analysis approach and case studies, this article looks more closely at three countries' arrangements and attempts to understand why regulation might take the shape it does in each country. The case studies examine England, the USA (as this has a state approach, we focus on New York) and New Zealand, with contributions from qualified social work authors located within each country. We consider that there are three key elements to apply to analysis: definition of role and function, the construction of the public interest and the attitude to risk. [ABSTRACT FROM AUTHOR]

Estimating productivity change and its determinants is of great importance when measuring the performance of a firm. A true random effect cost model was employed to measure the cost efficiency of water companies in England and Wales from 1993 to 2016. Subsequently, total factor productivity change was estimated and decomposed into cost-efficiency change, technical change, scale efficiency change, output effect and residual price effect. The results indicate that the English and Welsh water industry increased its productivity over the period examined at a rate of about 2.1%, and it was influenced primarily by technical change. The price reviews appear to have a positive impact on the productivity of water-only companies during the whole period examined. In the case of water and sewerage companies, the 1994 and 1999 price reviews had a positive impact on productivity, whereas the last two price reviews had an adverse impact. [ABSTRACT FROM AUTHOR]

Background and Aims: Debate exists about whether health professionals (HPs) should advise smokers to use nicotine vaping products (NVPs) to quit smoking. The objectives were to examine in four countries: (1) the prevalence of HP discussions and recommendations to use an NVP; (2) who initiated NVP discussions; (3) the type of HP advice received about NVPs; and (4) smoker's characteristics related to receiving advice about NVPs. Design Cross‐sectional study using multivariable logistic regression analyses on weighted data from the 2016 ITC Four Country Smoking and Vaping Survey (ITC 4CV1). Setting: Four countries with varying regulations governing the sale and marketing of NVPs: 'most restrictive' (Australia), 'restrictive' (Canada) or 'less restrictive' (England and United States). Participants: A total of 6615 adult smokers who reported having visited an HP in the last year (drawn from the total sample of 12 294 4CV1 respondents, of whom 9398 reported smoking cigarettes daily or weekly). Respondents were from the United States (n = 1518), England (n = 2116), Australia (n = 1046), and Canada (n = 1935). Measurements Participants' survey responses indicated if they were current daily or weekly smokers and had visited an HP in the past year. Among those participants, further questions asked participants to report (1) whether NVPs were discussed, (2) who raised the topic, (3) advice received on use of NVPs and (4) advice received on quitting smoking. Findings Among the 6615 smokers who visited an HP in the last year, 6.8% reported discussing NVPs with an HP and 2.1% of smokers were encouraged to use an NVP (36.1% of those who had a discussion). Compared with Australia (4.3%), discussing NVPs with an HP was more likely in the United States [8.8%, odds ratio (OR) = 2.15, 95% confidence interval (CI) = 1.41–3.29] and Canada (7.8%, OR = 1.87, 95% CI = 1.26–2.78). Smokers in Australia were less likely to discuss NVPs than smokers in England (6.2%), although this was not statistically significant (OR = 1.47, 95% CI = 0.98–2.20). Overall, the prevalence of HPs recommending NVPs was three times more likely in the United States than in Australia (OR = 3.07, 95% CI = 1.45–6.47), and twice as likely in Canada (OR = 2.28, 95% CI = 1.06–4.87) than in Australia. Australia and England did not differ (OR = 1.76, 95% CI = 0.83–3.74). Just over half (54%) of respondents brought up NVPs themselves; there were no significant differences among countries. Conclusions: Discussions in Australia, Canada, England, and the United States between smokers and health professionals about nicotine vaping products appear to be infrequent, regardless of the regulatory environment. A low percentage of health professionals recommended vaping products. This was particularly evident in Australia, which has the most restrictive regulatory environment of the four countries studied. [ABSTRACT FROM AUTHOR]

Social work education in England will have a new regulator from 2019. According to official sources, this is 'as part of wider reforms to improve confidence in social work and raise the status of the profession'. In the background of any changes to social work education are the reports by Croisdale-Appleby (2014) and Narey (2014). Both reported that the existing regulatory regime was inadequate and made a combined total of 40 recommendations for improvement. Specifically, on the subject of social work teaching in higher education institutions, Narey expressed concern about both the content and quality and recommended that the teaching should be observed. If the incoming regulator were to introduce direct observations of teaching in inspections it would represent a new development. Previous regulators have not adopted this method. This discussion paper reviews selected literature on what teaching observation can and cannot achieve as an inspection method. It reflects on how social work education might gain if inspectors observed teaching. However, it also argues that to be a meaningful and credible process teaching observations need to take heed of a range of interrelated issues which, if not thought through properly, will invalidate the whole exercise. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to address a gap in the comparative research literature on vocational education and training (VET) and skill formation systems. It examines the impact of international technical standardisation and regulation on the design, organisation and delivery of apprenticeships in the aeronautical and aerospace sectors in England and Germany. Design/methodology/approach: The research design was informed by insights from economics, workplace and work-based learning and comparative education. Academic experts in the fields of aerospace and aeronautical standardisation and regulation, VET, human resource development and business organisation were consulted. The generic occupation of "aircraft mechanic" was selected as being the closest match for comparison. Interviews and non-participant observation in workplaces and training centres were carried out involving three companies in England and four in Germany. Findings: Findings show that there is considerable convergence across the pedagogical approaches to apprenticeships in England and Germany related to fostering the capacity to take responsibility for the quality of one's work, to work in and lead teams, and to respond to and work with customers. Increasing international regulation and technical standardisation underpins a shared language about learning through practice in technologically advanced workplaces. Originality/value: This paper is original because it turns the lens of inquiry to workplace processes to reveal the level of convergence in training philosophies and practices in an internationally highly regulated sector. It shows how international technical standardisation and regulation is leading to pedagogical innovation. The findings have implications for VET and apprenticeship policy at the national and international level. [ABSTRACT FROM AUTHOR]

The Office for Standards in Education, Children's Services and Skills (Ofsted) is responsible for inspecting services that care for children and young people in England and Wales. This paper presents findings from an independent study of Ofsted inspections into children's social care in England, covering reports under three inspection frameworks during the period 2009 to 2016. The research aimed to identify the main themes of recommendations made in Ofsted reports and to explore similarities and differences between frameworks and between local authorities. The methodological approach was document analysis. A stratified sample of 60 reports was prepared on the basis of inspection framework and local authority characteristics such as local deprivation, Ofsted rating, and urban/rural category. A thematic analysis was conducted of the recommendations in each report, with emerging themes subjected to an iterative process of coding and categorization. The findings identified nine categories of themes, the most common of which were performance management, casework, oversight of practice, and multiagency working. Overall, the recommendations were strongly oriented towards process issues and compliance with standards. Recommendations were found to differ somewhat between inspection frameworks but remained largely consistent between local authorities with different characteristics. The paper concludes by examining the implications of findings for the current regulatory framework in children's social care. [ABSTRACT FROM AUTHOR]

Background: High profile failures of care in the NHS have raised concerns about regulatory systems for health‐care professionals and organizations. In response, the Care Quality Commission (CQC), the regulator of health and social care in England overhauled its regulatory regime. It moved to inspections which made much greater use of expert knowledge, data and views from a range of stakeholders, including service users. Objective: We explore the role of service users and citizens in health and social care regulation, including how CQC involved people in inspecting and rating health and social care providers. Design: We analyse CQC reports and documents, and 61 interviews with CQC staff and representatives of groups of service users and citizens and voluntary sector organizations to explore the place of service user voice in regulatory processes. Results: Care Quality Commission invited comments and facilitated the sharing of existing service user experiences and engaged with representatives of groups of service users and voluntary sector organizations. CQC involved service users in their inspections as "experts by experience." Information from service users informed both the inspection regime and individual inspections, but CQC was less focused on giving feedback to service users who contributed to these activities. Discussion and conclusions: Service users can make an important contribution to regulation by sharing their experiences and having their voices heard, but their involvement was somewhat transactional, and largely on terms set by CQC. There may be scope for CQC to build more enduring relationships with service user groups and to engage them more effectively in the regulatory regime. [ABSTRACT FROM AUTHOR]

• Methane measurements show that a high proportion of landfill gas can be captured. • A methane collection index (MCI) can be calculated from methane measurements. • A MCI is a direct measure of landfill gas management performance. • The MCI can be used to trigger improvements in landfill gas collection. Methane emissions from landfills are an important source of greenhouse gases in the UK and worldwide. This paper considers how measurements of methane emissions could be used to regulate landfills in England in order to reduce the contribution of landfilling to climate change. The paper presents the results of a number of UK studies undertaken to quantify methane emissions from landfills. The methods used have included the DIAL (Differential Absorption Lidar) technique and a tracer gas dispersion method. A method based on aerial measurements has been developed. Methane emission rates were measured at 15 biodegradable waste landfills. All of the landfills where measurements took place had an active landfill gas extraction system. A methane collection index (MCI) is calculated for each landfill using the ratio of the methane collection rate to the sum of the collection and emission rates. The values of the index in the campaigns reported here ranged from 0.28 to 0.90. The modern operational landfills surveyed achieved MCI values with a much narrower range of between 0.64 and 0.90 with an average of 0.76. This has demonstrated that it is possible for these landfills to collect a high proportion of the landfill gas. A proposed approach is presented for regulating landfills using the measured MCI. This would involve an annual measurement campaign to quantify the methane emissions and the use of the data provided by these surveys to develop an achievable but challenging MCI limit. A limit value of 0.75 for the MCI is used to illustrate the approach. An MCI that falls below the limit would trigger actions to reduce the methane emissions from the landfill. [ABSTRACT FROM AUTHOR]

In recent years, England and Wales have suffered droughts. This unusual situation defies the common belief that the British climate provides abundant water resources and has prompted the regulatory authorities to impose bans on superfluous uses of water. Furthermore, a large percentage of households in England consume unmetered water which is detrimental to water saving efforts. Given this context, we estimate the shadow price of water using a panel data from reports published by the Office of Water Services (Ofwat) for the period 1996 to 2010 (three regulatory periods). These shadow prices are derived from a parametric multi-output, multi-input, input distance function characterized by a translog technology. Following O'Donnell and Coelli (2005), we use a Bayesian econometric framework in order to impose regularity-monotonicity and curvature-conditions on a high-flexible technology. Consequently, our results can be interpreted at the firm level without requiring the need to base analysis on the averages. Our estimations offer guidance for regulation purposes and provide an assessment of how the water supply companies deal with water losses under each regulatory period. The relevance of the study is quite general as water scarcity is a problem that will become more important with population growth and the impact of climate change. [ABSTRACT FROM AUTHOR]

The assessment of productivity change across companies and over time is of great importance for water utilities managers and regulators. In this paper, for the first time, we apply the Färe-Primont productivity index (FPI) to evaluate the productivity change for the 10 water and sewerage companies (WaSCs) and 12 water only companies (WoCs) in England and Wales during the years 2001-2008. The FPI is the only index that without price data allows making comparisons involving many firms and many periods. The results indicate that during the years 2001-2004 productivity improved which was mainly attributed to gains in efficiency whereas technical change remained constant, the exception being the year 2004. During the years 2005-2008 productivity showed a declining trend and any gains in efficiency were lost to the highly negative technical change on productivity growth. From a policy perspective, it has been illustrated the importance of using a reliable index to compute the productivity change of water companies when the performance of companies is used to set water tariffs. Finally, the decomposition of productivity change into several drivers allows water utilities and managers to identify the main factors on which they should act to improve productivity of the company. [ABSTRACT FROM AUTHOR]

Discretion used to be considered a feature of individuals, but growing literature shows that it has collective features as well. To develop an understanding of the individual and cooperative work of inspectors in using discretion and the discretionary room granted to them, we compared two inspectorates: the Care Quality Commission ( CQC) in England and the Joint Inspectorate for Youth ( JIY) in the Netherlands. Our analysis reveals that inspectors engage with colleagues, managers, and stakeholders to include other perspectives, gain mandate, and broaden their repertoire. At the CQC, inspectors use their discretion collectively; on their own initiative, they involve others in balancing and interpreting rules to reach judgments. At the JIY, teamwork is central and regulatory teams are granted collective discretionary room. We argue that collective work permits both responsiveness and consistency. In studying the judgments of inspectors and other street-level bureaucrats, it is vital to look at collective work and how it combines consistency and responsiveness. [ABSTRACT FROM AUTHOR]

The credibility of a regulator could be threatened if stakeholders perceive that assessments of performance made by its inspectors are unreliable. Yet there is little published research on the reliability of inspectors’ assessments of health care organizations’ services. Objectives We investigated the inter-rater reliability of assessments made by inspectors inspecting acute hospitals in England during the piloting of a new regulatory model implemented by the Care Quality Commission (CQC) during 2013 and 2014. Multi-professional teams of inspectors rated service provision on a four-point scale for each of five domains: safety; effectiveness; caring; responsiveness; and leadership. Methods In an online survey, we asked individual inspectors to assign a domain and a rating to each of 10 vignettes of service information extracted from CQC inspection reports. We used these data to simulate the ratings that might be produced by teams of inspectors. We also observed inspection teams in action, and interviewed inspectors and staff from hospitals that had been inspected. Results Levels of agreement varied substantially from vignette to vignette. Characteristics such as professional background explained only a very small part of the variation. Overall, agreement was higher on ratings than on domains, and for groups of inspectors compared with individual inspectors. A number of potential causes of disagreement were identified, such as differences regarding the weight that should be given to contextual factors and general uncertainty about interpreting the rating and domain categories. Conclusion Groups of inspectors produced more reliable assessments than individual inspectors, and there is evidence to support the utility of appropriate discussions between inspectors in improving reliability. The reliability of domain allocations was lower than for ratings. It is important to define categories and rating levels clearly, and to train inspectors in their use. Further research is needed to replicate these results now that the model has been fully implemented, and to understand better the impact that inspector uncertainty and disagreement may have on published CQC ratings. [ABSTRACT FROM AUTHOR]

Faced with acute housing crises, some governments are inclined to strip away the 'bureaucracy' of planning, relaxing rules on the scrutiny of planning applications and seeking to accelerate the building of new homes. The planning that remains becomes a 'client service' for the development industry – a system of housing licensing that follows on from a basic consideration of legal compliance. Such a system has been introduced in England, rooted in the extension of permitted development rights (PDR) for office-to-residential conversions. This article examines the determinants of housing quality through the conversion process, comparing the deregulated approach to conversion in England with Italy's regulated approach, set within its zonal planning system. The conclusion drawn, after the examination of case studies, is that good quality housing cannot be delivered from the conversion of buildings without either the retention of strong case-by-case planning control or a much more detailed prescriptive approach to housing standards, which would have halted the majority of recent office-to-residential conversions in England. • Explores the processes of adaptive reuse of buildings (office to residential) under two planning systems. • Contrasts outcomes achieved through 'PDR' in England with regulated and codified adaptive reuse in Italy. • Italian case studies show how regulation supports the creation of new value, social and economic. • English case studies show how deregulation green-lights projects where there is little extractable value. • Concludes on the value of regulation in support of housing quality. [ABSTRACT FROM AUTHOR]

Aim: System leadership is the requirement for a leader of a single organisation to operate on behalf of a wider system, rather than their individual organisation. The current policy landscape does not incentivise system leadership, as many national structures emphasise a focus on individual organisations. This study aims to understand how chief executives in the National Health Service (NHS) in England implement system leadership in practice when faced with decisions that benefit the system to the detriment of their own trust., Methodology: Semistructured interviews were conducted with ten chief executives from various NHS trust types to understand their perceptions and decision-making process in practice. Semantic thematic analysis was used to draw out themes in relation to how chief executives approach decisions which weigh up the system and organisation., Results: Interviewees expressed advantages (such as support in managing demand) and disadvantages (such as increased bureaucracy) of system leadership and practical considerations in operationalisation (such as the importance of interpersonal relationships). Interviewees endorsed system leadership in principle, but did not feel that current organisational incentives support the implementation of system leadership in practice. However, this was not seen as a major challenge or impediment to effective leadership., Conclusion: As a specific policy area, a direct focus on systems leadership is not necessarily helpful. Chief executives should be supported to make decisions in a complex environment, without a specific focus on healthcare systems as a unit of operation., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

Background and aims Regulation of electronic cigarettes has moved to the top of the addiction policy agenda, as demonstrated by the recent focus across the United Kingdom on introducing age-of-sale restrictions. However, the views of those affected by such regulation remain largely unexplored. This paper presents the first detailed qualitative exploration of adolescents' perceptions of existing, and opinions about potential e-cigarette regulation. Methods Sixteen focus groups, including a total of 83 teenagers between the ages of 14 and 17 years, were conducted in deprived, mixed and affluent urban areas in Scotland and England between November 2014 and February 2015. Transcripts were imported into Nivivo 10, coded thematically and analysed. Results Participants critically considered existing evidence and competing interests in regulatory debates and demonstrated sophisticated understanding of the advantages and disadvantages of regulation. They overwhelmingly supported strong e-cigarette regulation and endorsed restrictions on sales to minors, marketing and e-cigarette use in public places. Concern about potential health harms of e-cigarette use and marketing increasing the acceptability of vaping and smoking led these adolescents to support regulation. Conclusions In focus group discussions, a sample of UK adolescents exposed to particular communications about e-cigarettes supported strict regulation of e-cigarettes, including banning sales to minors and use in indoor public areas. [ABSTRACT FROM AUTHOR]

This paper examines recent transformations in state organization and practices following the 2008 global financial crisis, especially with regard to urban development. It is argued that the financial crisis revealed the fallacy of the erosion of the nation state under neoliberal globalization, with its manifest resurgence as the key scale of crisis administration: nexus for both the financial rescue of the banking system and the re-scaling of regulation at the sub-national scale. After a review of recent trends in state theory in urban and regional studies, the paper describes the political geography of the financial crisis before exploring in greater detail the unfolding of spatial policy and institutional change in two contrasting cases: Birmingham in the UK and Medellín in Colombia. In both cases, evidence is provided which indicates renewed and probably durable processes of recentralization of regulatory powers and greater intervention in local affairs, as well as new forms of state territorial conflict. [ABSTRACT FROM AUTHOR]

In this paper, we analyse the way in which social work, as a profession, has coped with and responded to the various forms of regulation to which it has been subject in England. First, we briefly detail the rise of external regulation of the professions, discussing both the rationale for, and criticisms of, such developments. Second, we take a closer look at developments within social work and the operation of the General Social Care Council (GSCC)'s conduct proceedings from its inception in 2001 until its dissolution in 2012. Third, we focus on the Health and Care Professions Council (HCPC) and consider how it has begun its regulation of social workers since it took on this responsibility from August 2012. We conclude by outlining some of the concerns we have as well as discussing reasons as to why we feel this area of work needs to be explored further. [ABSTRACT FROM AUTHOR]

In a competitive market, the exit of those suppliers who cannot offer an attractive product at an attractive price is seen as desirable. However, the consequences for consumers when their own supplier leaves the market in an unplanned or disorderly way may be undesirable. Exit regimes exist in regulated markets to ensure that consumers are not unduly harmed by these disorderly exits. This article considers the scope for an exit regime in the English higher education sector. It particularly considers how consumers (students) can be protected from the disorderly closure of their higher education providers, whilst retaining the principle of competitive neutrality, or the ‘level playing field’. The article also proposes actions which the sector could take in advance of Government regulation, in order to develop the form of exit regime which will give the greatest protection to students. [ABSTRACT FROM AUTHOR]

Purpose -- Winterbourne and Mid-Staffordshire scandals have had a significant impact on how Care Quality Commission inspects and regulates intellectual disability services (IDS). The purpose of this paper is to describe the changes and development of regulation of these services and future work. Design/methodology/approach -- The paper is a descriptive paper. Findings -- A new regulatory model is currently implemented for IDS. It has been developed in consultation with patients, carers, providers and other stakeholders. There will be ongoing development and refinement of the inspection methodology. Originality/value -- This is an original descriptive paper which will provide useful information to readers on how the regulatory process works in IDS. [ABSTRACT FROM AUTHOR]

From 1 August 2012, responsibility for regulation of social work transferred from the General Social Care Council (GSCC) to the Health and Care Professions Council (HCPC). Professional regulation is seen as a way to safeguard the general public from dangerous and unsafe practice. Conduct processes and decision making must be seen to be reliable, appropriate and proportionate in order to assure this. This article reports on the findings and an analysis of GSCC conduct hearings held between April 2006 and July 2012. It considers some of the characteristics of appellants along with the types of sanction and proven misconduct. It is important that the HCPC maintains professional standards by investigating and taking action against those social workers who breach standards. Some comparisons will be made between the factors that have informed the decision making of GSCC and HCPC conduct panels in order to determine differences in the conduct decision-making process and identify ways that the regulator, educators and employers can support and encourage training and qualified social workers to practise competently and appropriately. [ABSTRACT FROM AUTHOR]

The separation between religion and the state is widely regarded as a central feature of modernization processes, but sociological research has tended to neglect the extent to which even 'secular states' continue to manage religion in such institutions as prisons, hospitals and military establishments. This article extends the understanding of the state's management of religion by focusing on responses to the growth of religious diversity among prisoners and chaplains. In particular, it analyses the integration of Muslim chaplains into the prison systems of Canada and England & Wales. It is based on research - conducted between 2010 and 2012 - that investigated the frameworks governing religion in these two prison systems. This research involved analysis of official policies and regulations as well as transcripts of telephone interviews with a small sample of Muslim chaplains in both jurisdictions. The main focus of the findings reported in this article is on the implications that each prison system's arrangements for chaplaincy have for the work of Muslim chaplains and for questions about religious freedom and equality. These questions are timely in the context of controversies currently surrounding the increasing size of the Muslim prison population in England & Wales and Canada and the need for prisons in both jurisdictions to strike a fair balance between the recognition of religious diversity and the imperatives of security and equality. [ABSTRACT FROM AUTHOR]

Concern for space in new homes in England grew during the mid-2000s, largely as a result of unfavourable floor space comparisons with housing being built elsewhere in Europe. English homes were getting smaller, but space standards in other countries appeared to be preventing the cramming of too many rooms onto shrinking floor plates. Therefore, government in England faced calls to prescribe national space standards as a way of guaranteeing a basic level of domestic functionality and liveability. Strict standards elsewhere were assumed to result in better housing products, albeit in the context of different planning and finance regimes. This paper uses interviews with regulators, architects and house-builders in Turin, Italy, to challenge this assumption and to argue that an appropriate, context-sensitive, balance between flexible regulation and innovations in design (frequently activated by site or space constraints) is often the more effective route to achieving greater functionality and liveability in new housing. [ABSTRACT FROM AUTHOR]

This paper draws upon two research projects to evaluate a decade of reform concerning the professionalisation of further education teachers, and discusses future prospects under the new coalition government. It suggests that policy initiatives to regulate further education (FE) teachers have taken place within an industrial or occupational paradigm of the past that keeps FE separate from the more professional frameworks of schools and higher education. Drawing upon research, the paper also shows that after a decade of reform, successive standards and regulatory frameworks have not brought about national coherence. Rather, it has fragmented the system even further and diverted attention away from addressing more fundamental weaknesses such as developing stronger mentoring and workplace support. In conclusion, the analysis looks to the future, arguing that the threatened revocation of the 2007 regulations, combined with the present economic situation facing colleges, will lead to the marketisation of FE initial teacher training. This has profound implications for the quality of provision and the professional status of FE teachers, who seem to be returning to their voluntarist past. [ABSTRACT FROM PUBLISHER]

Flood maps play an increasingly prominent role in government strategies for fl ood-risk management. Maps are instruments not just for defi ning and communicating fl ood risks, but also for regulating them and for rationalizing the inevitable limits and failures of those controls. Drawing on policy document analysis, offi cial statistics, and 66 key-informant interviews, this paper explores the institutional confl icts over the use of the Environment Agency (EA) Flood Map to support decision making by English local planning authorities (LPAs), whose local political mandate, statutory obligations, and professionalized planning culture put them at odds with the narrower bureaucratic imperative of the Agency to restrict developments at risk of fl ooding. The paper shows how the Flood Map was designed to standardize and script the planning process and ensure that LPA decisions were aligned with EA views about avoiding development in zones at risk of fl ooding without actually banning such development outright. But technologies are also shaped by their users, and so the paper documents how planners accommodated and resisted this technology of indirect rule. Their concerns about sterilizing areas depicted as being at risk of fl ooding and about the diffi culties of actually using the Flood Map for speedy and defensible development-control decisions were crucial in its eventual replacement by a new decision-support technology, Strategic Flood Risk Assessments, which then led to the descripting of the Flood Map to infl uence a new set of users: the public. The paper closes with some wider refl ections on the signifi cance of the case for risk-based governance. [ABSTRACT FROM AUTHOR]