Conclusions: Getting real about sex - embedding an embodied sex education in schools

GET REAL ABOUT SEX: The Politics and Practice of Sex Education explores how cultural ideas about gender, sexuality and parenthood play out in the sex and relationship education classroom. It presents new material from a detailed study and analyses the struggle to raise the status of sex and relationship education against academic and market-driven priorities. It locates the dynamics of the classroom within those of the school and asks: What do the different parties in teaching and learning - both staff and pupils - say about how sex education is and should be taught in the classroom? How do ideas about masculinity, femininity and parenthood operate in the classroom and in policy? What different agendas and professional perspectives are revealed in the views of teachers, PSHE coordinators, school nurses and head-teachers? The complex picture that emerges of forces at work within a single school is, in turn, situated within an analysis of the broader cultural forces at work in contemporary Britain. It considers how young people negotiate intensified pressure on them regarding academic attainment in an increasingly sexualised culture, and it develops a critique of the Achievement Agenda in education policy, contributing another arm to the critique of market rationalities in education. This book analyses the challenges facing the provision of quality sex and relationship education at the classroom level and at the political level, and makes sometimes provocative suggestions for changes at both these levels

Teachers’ views of teaching sex education: pedagogies and models of delivery

This paper is based on a study of 17 secondary schools in an inner-city area of England deemed to have very high levels of teenage pregnancies. The New Labour Government argued that academic achievements and effective labour-market participation are inhibited by early or 'premature' parenthood (Social Exclusion Unit 1999). It therefore set in place policies to address these issues efectively in schools, through a revised school achievement agenda and a revised Sex & Relationship Education (SRE) programme. In this paper, we concentrate on the role and views of personal, social and/or health education coordinators charged with the delivery of SRE in secondary schools. We consider the way a broad-based, inclusive curriculum and pastoral programme fits into the subject-based and assessed curriculum of secondary schools for 11-16 where there is no tradition of open discussion of sexual matters. The legitimacy of teaching about sex and relationships in school has been hotly contested. The question of how to deal with teenage pregnancy and sexuality remains politically charged and sensitive and the teacher's role is thus contentious. We present a range of views about the professional or other pressures on schools, especially teachers, discussing difficulties within each of the main models of delivery. Teachers reprt considerable anxiety about SRE as a subject and its low status inthe curriculum, committed though they are to teaching it. This links with what is now seen as an overarching culture of anxiety regarding sex in contemporary society. Many teachers think that attending to young people's personal and social development - and especially their sexual identities - could help their education careers and academic achievement. Thus, from the teachers' accounts, we argue that there are important links between the revised sex education curriculum and the new emphasis on the achievement agenda in secondary schools in the UK

Lessons learned from CHIPPS (Care Homes Independent Pharmacist Prescribing Study): How feasibility studies informed ultimate randomised controlled trial design

The use of medicines in care homes could be improved and as a result, the health of residents would be better. Pharmacist prescribers (i.e. pharmacists specifically trained and qualified to prescribe), have been shown to provide safe, quality care in other patient groups. We proposed to test if making ‘pharmacist prescribers’ part of the care home team, working alongside general practitioners, could improve the use of medicines and the care of residents. These pharmacist prescribers authorised monthly prescriptions whilst carefully monitoring how each resident responded. We believe that such a change to the management of medicines in care homes is likely to be a good use of NHS money. This paper describes a series of developmental studies that were undertaken as part of a programme of work which followed the MRC Framework for developing and evaluating a complex intervention. The rationale for each study is described and for the final of these feasibility studies, when all components were tested together, we consider what went well, some of the challenges we encountered, and how they informed our decision to progress to a definitive randomised controlled trial

Pharmacist prescribing in the United Kingdom and the implication for the Nigerian context

Background: Non-medical professionals including pharmacists have been granted the right to prescribe medicines in the United Kingdom. In Nigeria, only medical doctors, dentists and some nurses in primary care facilities have the legal right to prescribe medicines and patients' access to prescriptions can be seriously affected by a shortageof prescribers and long waiting times in hospitals. Objective: This article presents a review of pharmacist prescribing in the UK including its model, impact, facilitators and barriers and discusses the implications for the Nigerian context. Methods: A literature search was conducted in Medline, Embase, International Pharmaceutical Abstracts and Cumulative Index to Nursing and Allied Health Literature databases for studies investigating pharmacist prescribing in the UK between 1990 and August 2013. Results: The review identified that legislative change in the UK has enabled pharmacists to prescribe first as supplementary prescribers then as independent prescribers. This policy change was driven by the desire to increase patients' access to medicines and promote the utilisation of the skills of non-medical professionals while maintaining patient safety. Although more robust research evidence is needed to demonstrate the effectiveness of pharmacist prescribing, available evidence shows that it has had an impact on patient access to medicines. Conclusion: Pharmacist prescribing has the potential to promote access to prescription medicines, free doctors' time to enable them deal with complex cases and promote efficient use of pharmacists' clinical skills in Nigeria as it does in the UK. Factors which can promote the extension of prescribing rights to pharmacists in Nigeria include the current level of pharmacists' training and the clinical roles of pharmacists in some tertiary hospitals

Enhancing deprescribing : a qualitative understanding of the complexities of pharmacist-led deprescribing in care homes

Funding statement This research is funded by the National Institute for Health Research (NIHR) Policy Research Programme (project reference NIHR202053). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. Acknowledgements Thank you to the pharmacists, GP practice and care home staff who took part in the interviews. We would also like to acknowledge the Norfolk and Waveney Clinical Commissioning Group as the study sponsor and our patient and public involvement colleagues Janet Gray and Christine Hanford who were supported by Jacqueline Romero, manager of PPIRes.Peer reviewedPublisher PD

Pharmacist-independent prescriber deprescribing in UK care homes : Contextual factors associated with increased activity

ACKNOWLEDGEMENTS We would like to thank the residents, families, pharmacists, medical practice staff and care home staff who contributed to CHIPPS. Funding information: This study is funded by the National Institute for Health Research (NIHR) for Health Research (NIHR) Translating Research into Policy funding scheme (Award ID: NIHR202053). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.Peer reviewedPublisher PD

GAP WORK project report: training for youth practitioners on tackling gender-related violence

This project sought to challenge gender-related violence against (and by) children and young people by developing training for practitioners who have everyday contact with general populations of children and young people (‘youth practitioners’). Through improved knowledge and understanding practitioners can better identify and challenge sexist, sexualising, homophobic or controlling language and behaviour, and know when and how to refer children and young people to the most appropriate support services. This summary outlines the Project and our initial findings about the success of the four training programmes developed and piloted.Co-funded by the DAPHNE III programme of the EU

'Treated as a number, not treated as a person': a qualitative exploration of the perceived barriers to effective pain management of patients with chronic pain

Open Access articleObjectives To identify barriers to effective pain management encountered by patients with chronic pain within the UK’s National Health Service (NHS). Design Secondary analysis of face-to-face, semistructured qualitative interviews using thematic analysis. Setting A community-based chronic pain clinic jointly managed by a nurse and pharmacist located in the North of England. Participants Nineteen adult (>18 years) patients with chronic pain discharged from a pain clinic, with the ability to understand and speak the English language. Results In general, patients were highly disappointed with the quality of pain management services provided both within primary and secondary care, and consequently were willing to seek private medical care. Barriers to effective pain management were divided into two main themes: healthcare professional-related and health systems-related. Three sub-themes emerged under healthcare professionals-related barriers, namely (1) healthcare professionals’ lack of interest and empathy, (2) general practitioners’ (GP) lack of specialised knowledge in pain management and (3) lack of communication between healthcare professionals. Three subthemes emerged under health system-related barriers: (1) long waiting time for appointments in secondary care, (2) short consultation times with GPs and (3) lack of an integrated multidisciplinary approach. Conclusions The patients expressed a clear desire for the improved provision and quality of chronic pain management services within the NHS to overcome barriers identified in this study. An integrated holistic approach based on a biopsychosocial model is required to effectively manage pain and improve patient satisfaction. Future research should explore the feasibility, effectiveness and cost-effectiveness of integrated care delivery models for chronic pain management within primary car

Evaluation of a training programme for Pharmacist Independent Prescribers in a care home medicine management intervention

Background: The provision of independent prescribing rights for United Kingdom (UK) pharmacists has enabled them to prescribe within their area of competence. The aim of this study was to evaluate an evidence-based training programme designed to prepare Pharmacist Independent Prescribers (PIPs) to safely and effectively assume responsibility for pharmaceutical care of older people in care homes in the UK, within a randomised controlled trial. Methods: The training and competency assessment process included two training days, professional development planning against a bespoke competency framework, mentor support, and a viva with an independent General Practitioner (GP). Data on the PIPs’ perceptions of the training were collected through evaluation forms immediately after the training days and through online questionnaires and interviews after delivery of the 6-month intervention. Using a mixed method approach each data set was analysed separately then triangulated providing a detailed evaluation of the process. Kaufman’s Model of Learning Evaluation guided interpretations. Results: All 25 PIPs who received the training completed an evaluation form (N=25). Post-intervention questionnaires were completed by 16 PIPs and 14 PIPs took part in interviews. PIPs reported the training days and mentorship enabled them to develop a personalised portfolio of competence in preparation for discussion during a viva with an independent GP. Contact with the mentor reduced as PIPs gained confidence in their role. PIPs applied their new learning throughout the delivery of the intervention leading to perceived improvements in residents’ quality of life and medicines management. A few PIPs reported that developing a portfolio of competence was time intensive, and that further training on leadership skills would have been beneficial. Conclusions: The bespoke training programme was fit for purpose. Mentorship and competency assessment were resource intensive but appropriate. An additional benefit was that many PIPs reported professional growth beyond the requirement of the study

Evaluation of effectiveness and safety of pharmacist independent prescribers in care homes : cluster randomised controlled trial

Acknowledgments We thank all participating care home residents, care homes, and general practices; the pharmacist independent prescribers; our patient and public involvement group; our pharmacist trainers and assessors; Norwich Clinical Trials Unit; Comprehensive Research Network Eastern; our sponsor (Norfolk and Waveney CCG); members of our Programme Steering Committee and Data Monitoring and Ethics Committee; our funders; and all the many other people who supported the delivery of the programme of research that culminated in this trial. Funding: This work was funded by National Institutes of Health Research (NIHR) through their Programme Grant for Applied Research (PGfAR) stream (RP-PG-0613-20007). The funder had no role in design, data collection, data analysis, data interpretation, or writing of this paper.Peer reviewedPublisher PD