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A nineteenth-century archaeological and historical report on the kingdom of Arakan, in western Burma (Myanmar), contains a list of buildings that were believed to have been imbued with magico-religious powers that would defend against or conquer various enemies of the kingdom. This paper reviews the data in the report, and asks whether any of these buildings might have been actually constructed and, if so, where. So far evidence has been found to suggest that two on the list might still exist. Locating the remaining 15 buildings will take further research into old Arakanese documents, inscriptions and architectural remains. [ABSTRACT FROM AUTHOR]

The policy implementation process is often overlooked when policy is introduced potentially leading to policy failure. This is particularly relevant in complex policy areas where there is a lack of collaborative policy‐making and where implementation is in dispersed governance. This paper discusses the findings of a study examining a novel policy implementation support programme developed by the English Department of Health for the Care Act 2014, the most significant changes to the provision of social care for 60 years. Given the complexity of the changes, the Department of Health and its key partners introduced an Implementation Support Programme to increase the likelihood of effective implementation. As part of a suite of research studies, we examined the effectiveness of the implementation support programme in helping local authorities, responsible for social care delivery, implement the key Care Act priorities. We found that the support programme was effective in supporting 'implementation readiness' particular in situations where the context and policy itself are complex. We found that while important for the delivery of policy, such support programmes do not necessarily in themselves guarantee successful implementation. However, future evaluations of policy should include examining how the implementation is, or is not supported, in order to fully understand reasons for policy success and failure. [ABSTRACT FROM AUTHOR]

Adult social care policy and provision in England has changed from a state to a market model over the past 50 years, yet its future is far from settled. Dissatisfaction with funding, the range and quality of provision, and with workforce conditions is widespread. Some major providers have collapsed or withdrawn from the market. For some the solution is to strengthen the market model, others hark after a return to state controlled provision. This article outlines a further option, a radical new model for commissioning and delivery that challenges the dominant balance of power. It identifies some of the problems associated with the current position but questions the feasibility of a simple 'renationalisation' of provision. The key to change is identified as a new approach to commissioning consisting of four dimensions: commissioning small and local; commissioning holistically; commissioning personally; and commissioning ethically. All of these involve significant challenge to the way decisions are currently taken. [ABSTRACT FROM AUTHOR]

The NHS is facing a combination of lower spending and increasing demand. In response, NHS England is requiring local areas to substantially rethink and reshape services through Sustainability and Transformation Plans. These have been devised largely without the involvement of patients and citizens, giving rise to widespread concerns about service loss. Other structural changes are also taking place that have no obvious place for citizen engagement. All of this is highlighting the problem of a lack of local accountability and legitimacy for decision-making in healthcare. This commentary describes the changes, identifies the accountability gap and suggests a framework for future development. [ABSTRACT FROM AUTHOR]

Public services are being increasingly outsourced across Europe, and especially in England. This trend raises the question of how to deal with ‘market failure’ where outsourced providers are no longer able or willing to continue with provision. The case of social care and health care in England is a critical policy arena. Following the collapse of Southern Cross – a major care provider – in 2011, policies on stronger provider regulation have been put in train in an attempt to forestall potential service failure. This commentary examines these proposals, concludes that they are insufficiently robust and suggests some alternative measures. [ABSTRACT FROM AUTHOR]

Community health services (CHSs) have never had a settled organisational existence but the turmoil has intensified since the publication of Transforming Community Services in 2009. CHSs are now beset by three dilemmas: ongoing organisational fragmentation; the extension of competition law and the spread of privatisation; inadequate workforce development and lack of clarity on the nature of CHS activity. This has left the services in a position of policy and political vulnerability. The solution may be for the service to be part of horizontal integration models such as the accountable care organisation, with a focus on locality and multiprofessional teams wrapped around patient pathways. [ABSTRACT FROM AUTHOR]

The reconstruction of Myanmar's eleventh- to fourteenth-century ce capital, Bagan, has been perhaps the most radical heritage management project in modern times. At least 1,299 Buddhist temples, monasteries and stupas have been speculatively rebuilt from mounds of rubble since 1995. A further 688 damaged buildings have received major repairs. This paper considers the contrasting views of donors who wish to make merit, of the Myanmar military regime which wishes to present a national palladium, of political interest groups who are critical of the regime's motives, of heritage architects who are critical of the methods of the reconstruction project and of archaeologists and historians who have received new data to analyse. [ABSTRACT FROM AUTHOR]

This article presents an reevaluation of an architectural site at Sriksetra, Burma, which was revealed to be much larger than previously thought. It was also discovered that it contains an extensive series of irrigation and hydraulic systems. Srikestra was a city near the Ayeyarwady River inhabited by the Pyu peoples. The date of the settlement is still being contested, though much evidence point to between 500 and 900 A.D. Early excavation was conducted by General Leon De Beylie of the French forces.

The literature on inter-professional working tends to be dominated by explanations for lack of progress rather than accounts of achievements. This paper develops two models, termed the optimistic and pessimistic models respectively, to understand the factors that may underpin different rates of interprofessional achievement. A case study of the Sedgefield Integrated Team in County Durham, UK is used to test out aspects of the models. It is concluded that the grounds for pessimism have been overstated and that the scope for professional integration is greater than tends to be assumed. [ABSTRACT FROM AUTHOR]

Children's services in England are undergoing the most radical transformation since 1948 following the Every Child Matters Green Paper and the subsequent Children Act of 2004. One of the new legislative requirements is for each locality to produce a Children and Young Person's Strategic Plan that will demonstrate how the new arrangements will be put into effect. This article explores this new obligation and assesses the extent to which it is likely to be effective. It looks at previous planning experiences in this field, examines the new context, and considers the extent to which a top-down implementation model can be effective. [ABSTRACT FROM AUTHOR]

The Laming Report into the death of Victoria Climbie reiterated the long-standing critique of inadequate communication and coordination amongst the key professions and agencies. It led directly to the Green Paper, Every Child Matters in 2003 and the subsequent Children Act 2004. Amongst other things the Act proposes the establishment of a database on every child, which would be accessible to a range of practitioners – a measure that has been hotly contested. This article examines the reasons for this contestation and explores the extent to which a compromise might be judged to have dislodged a key policy objective. [ABSTRACT FROM AUTHOR]

Children's services in England are undergoing their most radical transformation since 1948 following the passage of the Children Act 2004. A key part of these changes is the legal requirement to have an Integrated Inspection Framework to assess the extent to which the new Children's Services Authorities have succeeded in meeting five key outcomes—being healthy, staying safe, enjoying and achieving, making a positive contribution and achieving economic well-being. To this end, up to ten national inspectorates have to coordinate their activities to a hitherto unparalleled extent. This article describes the nature and scale of the new remit and identifies a number of unresolved issues that could impede progress. It is argued that the policy has the hallmarks and accompanying limitations of a top–down exercise in policy formulation and implementation. [ABSTRACT FROM AUTHOR]

Long-term conditions is a policy area that has risen rapidly up the political agenda in England, culminating in the development of the National Health Service and Social Care Model in 2005, which is to be implemented over the following 2 years. The Model draws heavily upon US ideas of case management and proposes the creation of 3000 community matrons to undertake this role with the most vulnerable patients. Although welcomed in principle, the specific proposals in the Model have been subject to some criticism, and these issues are explored in the present paper. The problematic areas include patient identification, the transplanting of US models to England, the role of case management, workforce and funding issues, and the mix of medical and social models. The author concludes that there is a danger of long-term care policy developing an unduly health-focused approach at a time when the thrust of partnership working is towards an inclusive, whole-system model. [ABSTRACT FROM AUTHOR]

This article evaluates the integrated inspection framework required for sections 20-24 of the Children Act of 2004 in Great Britain. Office for Standards in Education has been given the task of leading a multi-inspectorate group to develop this framework. The objective is to create a system within which inspectorates with some remit for children's services can work together and produce joint reviews on both quality of provision and how well agencies are working together. With an apparent consensus on the purpose of integrated inspection, the key issue is how these outcomes will be inspected and assessed. The key innovation is the proposed Joint Area Reviews (JAR). For practical purposes, at least initially the measurement of outcomes is to be restricted to existing standards, indicators and targets across the relevant partner agencies. This is an important restriction, since it is questionable whether existing measures have the necessary breadth to capture the aims and outcomes. The way in which a range of inspectorates across education, social care and beyond have worked together to meet their new statutory obligations on integrated inspecting is remarkable. However, the changes are immense and complex, and it would be surprising to find no gap between policy and implementation.

Trust is universally regarded as a ‘good thing’ at both the interpersonal level and as a means of bringing stability to social institutions and markets. However, the concept is often treated in a homogeneous and unhelpful way, and academic reflection is spread across many disciplines that frequently fail to interconnect. This article pulls together the key perspectives and ideas from these different academic traditions. It outlines the main components of trust, and goes on to identify three different types of trust, each of which is associated with a different type of trusting. It concludes that it is now time to move beyond conceptual clarification to more empirical application. [ABSTRACT FROM AUTHOR]

The transition from adolescence to young adulthood is acknowledged to be difficult for all young people, but the problems facing those with a learning disability will tend to be greater. This article identifies these additional difficulties, and considers the extent to which new policy requirements and expectations in England can address them. At the heart of this new approach is the need for partnership working between a complex range of agencies and professionals. What is at stake is not only a better system of support for some vulnerable young people, but also-in microcosm-the viability of partnership working as a policy tool for addressing complex issues. [ABSTRACT FROM AUTHOR]

Integrated care for vulnerable people is a target of governments throughout the world, but one that is thwarted by organizational and professional divisions. The 'New Labour' government in Britain came to power in 1997 with a brief to secure integrated support across health and social care through the development of partnership working – part of its much-vaunted 'Third Way'. However, just as new legislation on partnerships came into effect, the government attempted a volte-face and sought an alternative policy – the imposition of structural change. This article looks at the origin and nature of these alternative approaches. The political furore accompanying the change is examined and an attempt is made to apply an evidence-based approach to the main vehicle for structural change – Care Trusts. Ten reasons are suggested for treating the proposed model with caution. The analysis has relevance for the debate elsewhere between the relative merits of partnership working and structural integration as alternative ways of securing integrated care. [ABSTRACT FROM AUTHOR]

Partnership working is now a central plank of public policy in the UK, especially in the field of health and social care. However, much of the policy thrust has been at the level of interorganisational working rather than at the level of interprofessional partnerships. The empirical and theoretical literature is largely sceptical about the feasibility of effective joint working between separate but related professionals—the 'pessimistic tradition'. Based upon an empirical study of general practitioners, community nurses and social workers in northern England, this article challenges such a tradition and proposes an 'optimistic hypothesis' for further investigation. [ABSTRACT FROM AUTHOR]

Discusses the history and dating of historic urban center Bagan in Burma. Monuments at Bagan; Dates derived from documentary evidence; Building cycle at Bagan.

This paper reports on the findings of two investigations into the relationship between social services and Primary Care Groups (PCGs): a national postal questionnaire and a series of regional seminars. The key findings of both explorations are summarised and placed in the context of other available evidence on the development of PCGs. Issues covered include: the background and status of social services representatives; preparation and support for the board role; feedback and accountability, and early contributions. It is concluded that progress is being made in bringing together the agendas and activities of PCGs and social services, and to a lesser extent the wider local authority, but that important obstacles remain in place. The enduring significance of the resource dependency model needs to be a key factor in emerging partnerships. [ABSTRACT FROM AUTHOR]

Abstract General ideas about joint working have been commonplace in the UK for several decades and those more specifically about joint commissioning have been popular since the quasi-market reforms of the early 1990s. The Labour Government is now placing a heavy premium upon ‘partnership working’ and expects this to breathe new life into joint commissioning initiatives; especially those involving social care and primary health care. However, despite the relatively lengthy experience of joint commissioning, we still know very little about how it works in practice. This article reviews joint commissioning as a policy concept, describes some recent research findings and pulls out messages for policy and practice. It concludes that although effective joint commissioning is attainable, there can be no ‘quick fix’ at local level. [ABSTRACT FROM AUTHOR]

Evaluates the decline of the cotton and wheat crops in a particular tuman in Uzbekistan. Situation of Yazyavan in the Fergana Valley; Government intervention to the agricultural output; Investigation of the government on the increase investment and restructure management in the agriculture.

'Deinstitutionalisation' has been the twin policy to `community care' and has been a key welfare strategy in Britain for some 30 years. In the 1980s considerable political and professional activity was focused upon the shortcomings of community care, but relatively little attention was paid to the failure of 'deinstitutionalisation'. Why has it proved so difficult to close long-stay hospitals? This article examines the gulf between official strategies on closure and the reality of continuing institutionalisation. It seeks explanations not only in terms of funding crises, but also in inter-professional inter- organisational and intergovernmental relations. It concludes that the problems are deeply entrenched and that if deinstitutionalisation is to succeed, a major new initiative will be needed at the central level. [ABSTRACT FROM AUTHOR]

The notion of `rights' in relation to people with a mental handicap has become increasingly fashionable in policy statements in Britain and elsewhere. However, the concept has rarely been used in a clear way, and the application of it has been weak. This article distinguishes between `claim rights' and `moral rights' and relates each to specific discriminatory domains. It is argued that in Britain, people with a mental handicap are routinely denied both types of rights, and that this is a sobering context within which to set policies structured upon `normalisation' principles. It is suggested that more conceptual analysis is needed, alongside a clearer commitment to enforcement through a code of practice and the application of adult rights. [ABSTRACT FROM AUTHOR]

The role of local government in health care matters in Britain has never been trouble-free. From the dissolution of the Boards of Guardians in 1929, through to the creation of the NHS in the 1940s and the introduction of the internal market in the 1990s, there have been political and professional arguments surrounding the issue and, for the most part, the case for democratic local governance of health care has failed to carry the day. This paper looks back to earlier debates, examines the current policy context, and looks ahead to possible future scenarios. It argues that the changing circumstances of both the NHS and local government makes this an apposite time to rethink established structures. [ABSTRACT FROM AUTHOR]

The article reports on the publication of the report "Five Year Forward View," by National Health Service England Chief Executive Officer Simon Stevens. Topics discussed include the implications of the emerging models of care for community nursing, development of a single-service model through community foundation trusts, and the absence of any mention of competition law and privatisation from the report.

The author comments on the consultation paper published by the British government on adult social He presents data on the number of people using personal budgets to purchase their care. Also considered are the new roles of the new National Health Service (NHS) Commissioning Board. He questions whether changes in adult social care will relate to the integrated care pathways to be drafted by the National Institute for Health and Clinical Excellence (NICE).

The article presents information about the King's Fund review on social care for older people led by Derek Wanless. This review addresses two big questions as to how much will need to be spent on social care for older people in England over the next 20 years and what funding arrangements should be in place to best meet these needs. Four funding options are compared including means-tested, limited liability, partnership model and free personal care. The Department of Health of England will conduct a review of social care and will consider four key questions including long-term costs and cost pressures, payment for social care services, relevance of secondary products and options available for whole system reform.

The article considers the relationships established between the new Primary Care Groups (PCGs) in England and Social Services Departments. It reports on qualitative research into localisation and collaboration in PCGs and reviews the main factors involved in the creation of collaborative relationships. Collaboration is a required element of planning in primary care but the extent and nature of its realisation is shaped by the particular interaction of local history with the new structures. Four localities were chosen for the qualitative stage of the research in order to learn how local configurations and existing relationships affected, and were affected by, the PCG. The article identifies the complex relationships which exist between PCGs and social services and the discusses the main features in promoting or undermining collaboration. [ABSTRACT FROM AUTHOR]