Search results

Working for Patients (1989), implemented in 1991, introduced into the National Health Service (NHS) the purchaser‐provider split, which created an “internal market” for health care. The key feature of this internal market was the concept of buying and selling of health services, with competition between provider units for the “business” of purchasers. Turning to industry where buying and selling has always been normal practice between organizations, this paper looks at a strategy that may help provider units to survive in this new marketplace. An examination of buyer‐supplier relationships focuses on the specific organizational strategy of relationship marketing as a potential way forward.

Knight's Industrial Law Reports goes into a new style and format as Managerial Law This issue of KILR is restyled Managerial Law and it now appears on a continuous updating basis rather than as a monthly routine affair.

Aarhus Kommunes Biblioteker (Teknisk Bibliotek), Ingerslevs Plads 7, Aarhus, Denmark. Representative: V. NEDERGAARD PEDERSEN (Librarian).

Engagement in meaningful active and relationships is important for quality of life but, for those with intellectual and developmental disabilities, engagement depends on the quality of support received from those around them. This paper describes the process of implementing person‐centred active support in the Avenues Trust, and the findings from the evaluation of the implementation in six pilot residential services. Attention was paid both to training staff and to the motivational structures within the organisation. Both the quality of support provided by staff and the level of engagement increased significantly after the introduction of person‐centred active support. In addition, people experienced decreased self‐stimulatory and injurious behaviour, increased opportunities for choice and control, and higher levels of participation in tasks of daily living, without compromising their community involvement. Staff experienced more and better practice leadership, and staff morale improved within the services, with staff generally more positive about management, more satisfied and less likely to leave. Lessons learnt about the implementation are provided.

Research on the social determinants of health demonstrates that workers who feel insecure in their jobs suffer poorer health as a result. However, relatively few studies have examined the relationship between job insecurity and illegal substance use, which is closely related to health. In this study, we develop a theoretical model focusing on two intervening mechanisms: health and life satisfaction. Additionally, we examine differences in this relationship between women and men. We test this model using logistic regression models of substance use for women and men based on longitudinal data from the National Survey of Midlife Development in the United States. The results indicate that job insecurity is associated with a significantly higher probability of illegal substance use among women but not men. We interpret this as further evidence of the gendering of precarious employment. This relationship is not channeled through health or life satisfaction, but there is evidence that job insecurity has a stronger association with illegal substance use for women with poorer overall health.

“A rose would smell as sweet by any other name,” but does the name make any difference to the composition of a member of the sausage family? Apparently, it does. In two recent cases at Hull (see Legal Proceedings, this issue), it was contended that a meat‐burger should contain 80% meat, similar to the recommendation of the Food Standards Committee for canned meat, and it was shown that meat‐burgers in the district had an average meat content complying with this standard—84% in 42 samples. In one case in question, the meat content was 31% and the retailer claimed in defence that when informed by inspectors of the 80% requirement, he decided to call his products just burgers, which left him free to adopt any composition he desired. The comments of the magistrates are not known, except that they considered the case an interesting one and dismissed it!

The purpose of this paper is to describe the first 15 months of operation of an innovative specialist national public health observatory for intellectual disability.

The paper provides a narrative account of aims and achievements of the service.

In the first 15 months of operation the observatory has: made available to those involved in commissioning health and social care services, a wealth of information on the health needs of people with intellectual disabilities; identified specific improvements that could viably be made to increase the quality of future information; and begun working with local agencies to support them in making the best use of the available information.

People with intellectual disabilities experience significant health inequalities. This paper describes an innovative approach to helping local agencies make the best use of available information in order to commission services that may reduce these inequalities.

In total, 40% of the deaths of patients with learning disabilities have been classed as avoidable, and there is a known increased risk of harm while inpatients in hospital. This paper aims to look at the current experiences and treatment of people with learning disabilities within a general hospital setting to examine factors that affect their care.

A comprehensive literature search was conducted of primary research between 2013 and 2019 to evaluate what is known about the quality of care and treatment that learning disabled patients experience within a general hospital.

The research suggests that people with learning disabilities receive haphazard care in hospital settings, with inconsistent implementation of reasonable adjustments, insufficient arrangements to support family and other carer input, and poor knowledge of learning disability amongst hospital staff.

Previously, reviews focussing on hospital care have mainly focussed on access to health care rather than its delivery. This review has found evidence of significant failings in delivering care to this patient group, identifying a gap of knowledge in this field regardless of policies and laws already in place. There should be stricter monitoring of the Equality Act’s enforcement, along with improved and mandatory training for all general health-care staff. It is crucial that health-care professionals learn from mistakes to improve the care and experiences of learning disabled inpatients.