Search results

This paper is the sequel to the authors' earlier paper in this journal and aims to present the “future research” outlined in that paper.

The approaches being employed by Welsh local authorities in commissioning home care from the independent sector are surveyed to see how a mixed economy of care is being implemented. The observed differences are analysed to see what can be learnt for the benefit of public sector managers concerned with the development of commissioning practices. Semi‐structured interviews have been performed with home care managers and commissioning officers in 13 (60 per cent) of the local, unitary authorities in Wales. Managers at independent home care providers have been interviewed also. The study has been ongoing since September 2004. For comparison, Barnet in England has been included because, unlike any Welsh authority, it has implemented 100 per cent outsourcing of home care. Croydon has been included as it has a good practice brokerage that has helped it to expand its provision from the independent sector.

Great diversity is seen in the approaches adopted by the Welsh local authorities when commissioning home care from the independent sector. They differ in the proportion of home care that is commissioned from the independent sector, what is commissioned, the number of independent providers and the contractual arrangements. These features are used to develop a taxonomy of home care strategies that reveals high levels of diversity. It is seen that in Wales there has been less political drive and compulsion to outsource home care than in England, but the natural desire to reduce costs in the face of a growing need for home care is now driving outsourcing in Wales.

This paper provides guidance to public sector managers in local authorities seeking best practice in the commissioning of home care from the independent sector.

The existing literature contains little research into good practice in the commissioning of home care by local authorities from the independent sector. This paper is a timely contribution to addressing this shortfall.

This paper aims to help public sector managers that are formulating strategies for outsourcing home care from the independent sector.

A review was performed of relevant literature on the outsourcing of home care and its political drivers in the UK. This indicates that the future of home care services, taking into consideration outsourcing and how Best Value will be achieved, has not been researched widely. Therefore, an exploratory approach to research was adopted here using in‐depth analysis of a small number of particularly informative local authorities and private providers selected by purposive/judgemental (extreme and critical case) sampling. Personal contact was deemed necessary in order to perform an intensive investigation to pursue in‐depth information.

The British Government's Best Value regime is driving local authorities towards increasing levels of outsourcing in the provision of home care. A local authority may choose to outsource all of its home care or maintain some in‐house provision based on capacity or capabilities that are complementary to those provided by the independent sector. The 100 per cent outsourcing strategy places enabling demands on the local authority, whereas the alternative strategy requires decisions to be made on what should be outsourced. Across the authorities surveyed, six strategies for creating a mixed economy of care have been identified, with the mix being based on complementary capacity and/or capabilities. With Best Value driving authorities to consider lower‐cost options, the outcome may be a reduction in the amount of complementary capacity provided in‐house, in favour of strategies involving complementary capabilities that deliver the Best Value possible. Re‐enablement is emerging as a common, complementary or core capability that is remaining in‐house. Outsourcing also requires decisions to be made on the number of independent providers to be used and the type of contracts to be employed. This paper considers the decisions that have been made in the local authorities surveyed and critiques the alternative home care outsourcing strategies so derived.

To date, the research has focused on Wales in general plus a few local authorities in England. The next stage will be to survey England in more detail along with other countries that are implementing substantial outsourcing of home care, such as Canada.

This paper provides timely guidance to public sector and health care managers seeking Best Value in home care through outsourcing.

Little has been found in the literature on strategies for outsourcing home care, yet such strategies are needed urgently in the UK to achieve Best Value. The World Health Organization stresses that strategies should be drawn up for providing support to patients and carers at community level in order to avoid costly institutional care.

This paper seeks to address the question, “How can private home care providers compete and drive their businesses forward to deliver best value to the community?” Public sector managers in local authorities need this question answered so that they can provide their part of the solution, facilitating best value.

A review was performed of relevant literature on the commissioning (outsourcing) of home care and of best value. This indicates that the future of home care services, taking into consideration commissioning and how best value will be achieved, has not been researched widely. Therefore, an exploratory approach to research was adopted here using in‐depth analysis of a small number of particularly informative local authorities and private providers selected by purposive/judgemental (extreme and critical case) sampling. Personal contact was deemed necessary in order to perform an intensive investigation to pursue in‐depth information.

To improve value one can cut costs and/or increase quality. It is argued here that there is little immediate opportunity for private home care providers to cut costs and with fixed pricing substantial improvements in quality cannot be funded by increased prices or cost cutting elsewhere. To address this impasse, two solutions have been identified; increased economies of scale through consolidation in the marketplace and radical improvements in efficiency through the exploitation of information and communication technology (ICT). Both of these strategies have major ramifications for the “enabling local authority” taking actions to see best value delivered to its community.

This paper presents the findings of exploratory research. A more detailed study covering many more local authorities, private care providers and an international prospective will be conducted over the next two years.

This paper provides timely guidance to public sector managers in local authorities and private home care providers seeking best value in home care through commissioning.

Little has been found in the literature on strategies by which private home care providers can deliver best value, yet such strategies are needed urgently to achieve best value. This paper is a timely contribution to addressing this need.

Household food insecurity and poor well-being have increased during the coronavirus disease 2019 (COVID-19) pandemic and resulting lockdown measures. Home food growing has been associated with improved food access and well-being, but it is unknown what role it plays during food supply crises and lockdown. It is also unclear how home food growing and social restrictions may affect opinions about growing food in urban areas (i.e. urban agriculture; UA).

A cross-sectional online survey was conducted during the UK national lockdown in March-April 2020 to measure home food growing, perceived food insecurity, well-being, and opinions of UA. The participants were 477 UK-based adults (369 female, mean age 39.57 years ± 13.36); 152 participants were engaged in home food growing prior to the pandemic. Responses were compared to data collected from a separate sample of participants before the pandemic (N=583) to explore potential shifts in opinions about UA.

Participants who engaged in home food growing had lower levels of food insecurity (U_­=19894.50, z=−3.649, p<0.001, r=−0.167) and higher well-being (U=19566.50, z=−3.666, p<0.001, r=−0.168) than those not engaged in home food growing. Perceived food insecurity partially mediated the relationship between home food growing and well-being; home food growing was associated with less food insecurity, which in turn was associated with better well-being. There were no differences in opinions of UA compared to the sample of participants from before the pandemic.

Home food growing may have had a protective effect over perceived food security and well-being in the early stages the pandemic. Opinions of UA were positive and unchanged compared to data collected pre-pandemic. Policies that support home food growing and access to suitable growing spaces and resources may be beneficial for food system resilience and well-being.

Depression and anxiety are common mental health issues among young adults, particularly exacerbated by the COVID-19 pandemic. Research indicates a notable increase in global prevalence rates, especially in this demographic. Despite their prevalence, factors like stigma, cost and limited accessibility often prevent individuals from seeking professional help. Therefore, there is a pressing need for innovative and accessible interventions to address these challenges. help. Therefore, there is a pressing need for innovative and accessible interventions to address these challenges. This study aims to assess the feasibility and acceptability of newly developed “AKBAY” self-help intervention workbook among university students in managing the symptoms of depression and anxiety.

Using a pilot study with a single-group design. A total of 33 university students voluntarily participated in the study. The primary outcomes, depressive symptoms and anxiety were measured using the PHQ-9 and GAD-7, respectively, at both pre-intervention and post-intervention (eight weeks following the preintervention assessment).

Results from Wilcoxon signed rank revealed significant reductions in both depression and anxiety symptoms following the intervention. Qualitative feedback from participants highlighted the perceived benefits of the intervention, including increased self-awareness, improved coping strategies and personal growth. All participants expressed intent to recommend the intervention to others.

However, further research using larger sample sizes, randomized controlled trials and long-term follow-up assessments is warranted to validate these findings and enhance intervention effectiveness.

These findings highlight the potential feasibility and acceptability of self-help interventions in reducing and preventing the worsening of symptoms of depression and anxiety among Filipino young adults.

The “AKBAY” intervention presents a feasible and accessible approach to reducing symptoms of depression and anxiety of Filipino young adults as well as the program’s potential usefulness. The findings of this study can serve as a foundation for a randomized controlled trial of the AKBAY self-help intervention.

The purpose of this paper is to consider the dynamics of submitting arts-based research in a climate that is dominated, in the UK, by the social sciences.

It begins by taking a view on arts-based research, considering mainly Eisner and Dewey but exploring the possibilities of other forms such as baroque research. It goes on to look at some examples of arts-based research that has been carried out, funded by the Arts and Humanities Research Council. The authors conclude by saying that interdisciplinary research, while being encouraged by research councils, is also made more difficult by these same research councils’ funding structures.

The authors consider that this has an effect on defining what educational research is and could be. The authors argue that this is important not only in relation to the range of disciplinary perspectives that can be drawn upon within educational settings, for example, the need to engage with disciplines such as English, History, Philosophy, Music and Fine Art, but also in relation to methodological understandings of how research should be conducted within educational settings.

The research studies are arts based but with an original educational orientation.

Junior doctors rotating through psychiatry often practise in isolated environments with little prior experience in this field. This can cause anxiety amongst doctors, and may potentially lead to patient safety concerns. The paper aims to discuss these issues.

A novel peer-led simulation style teaching session was developed to improve junior doctor knowledge and confidence when working with psychiatry rotations out of hours.

Following successful completion of two iterations of the teaching, junior doctors reported increased confidence, reduced anxiety and a more positive attitude following the session. Facilitators were similarly positive in their feedback, being able to gain formal teaching experience and appraisal.

A novel, inexpensive and easily replicable teaching session is introduced, which can improve junior doctors’ practice and experience when working in psychiatry settings out of hours.

In this chapter, the authors argue that technology can be advantageous to children and young people’s mental health. The authors argue that social media platforms can foster social connection, social support and access to important information to support mental health. The authors also highlight the risks, particularly the research which links technology to mental ill-health. The authors argue that the digital curriculum in schools should develop young people’s knowledge of digital literacy, digital citizenship and digital resilience. Finally, the authors explore the potential role that technological applications (apps) can play in supporting children and young people’s mental health. The authors argue that although research is in its infancy, some studies have produced promising results.

THE earliest libraries in any kind of community were run by interested members of the community with enthusiasm but no special training. Their communities asked them for very little more than they could get or do for themselves but did not care to find the time for, and because the librarian was one of their own, but no longer functioning fully in their world, the members of the community tended to have, however loyally or gently, a lower opinion of the man and consequently hisoffice. For the failed academic or businessman this was little less than just, but it was quite unjust to the profession of librarianship.