Intersectoral interagency partnerships to promote financial capability in older people

From the second quarter of 2008, the UK economy entered a period of economic decline. Older people are particularly vulnerable during these times. To promote ways in which older people can be better supported to maintain their financial well-being, this study explored the sources older people utilize to keep themselves financially informed. Interviews with older people (n = 28) showed that older people access trusted sources of information (e.g. healthcare professionals) rather than specialist financial information providers (e.g. financial advisors) which highlighted the need for interagency working between financial services in the private, public and voluntary sectors. An example of how such interagency partnerships might be achieved in practice is presented with some recommendations on directions for future research into interagency working that spans public, private and voluntary sectors

Childcare, choice and social class: Caring for young children in the UK

This paper draws on the results of two qualitative research projects examining parental engagements with the childcare market in the UK. Both projects are located in the same two London localities. One project focuses on professional middle class parents, and the other on working class families, and we discuss the key importance of social class in shaping parents' differential engagement with the childcare market, and their understandings of the role childcare plays in their children's lives. We identify and discuss the different "circuits" of care (Ball et al 1995) available to and used by families living physically close to each other, but in social class terms living in different worlds. We also consider parents' relationships with carers, and their social networks. We conclude that in order to fully understand childcare policies and practices and families' experiences of care, an analysis which encompasses social class and the workings of the childcare market is needed

Union renewal in historical perspective

This article revisits contemporary union renewal/revival debates through comparison with the late 1930s resurgence of trade unionism in the UK’s engineering industry. It is argued that the 1930s union renewal arose from more favourable contextual conditions than those currently obtaining. It was led by political activists, with better-articulated organisation and greater resonance in the working class than their contemporary counterparts, and who were assisted by state policy and pro-worker forces. Conclusions are drawn in relation to current debates

Understanding the health and wellbeing challenges of the food banking system: A qualitative study of food bank users, providers and referrers in London.

In the UK, food poverty has been associated with conditions such as obesity, malnutrition, hypertension, iron deficiency, and impaired liver function. Food banks, the primary response to food poverty on the ground, typically rely on community referral and distribution systems that involve health and social care professionals and local authority public health teams. The perspectives of these key stakeholders remain underexplored. This paper reports on a qualitative study of the health and wellbeing challenges of food poverty and food banking in London. An ethnographic investigation of food bank staff and users was carried out alongside a series of healthcare stakeholder interviews. A total of 42 participants were interviewed. A Critical Grounded Theory (CGT) analysis revealed that contemporary lived experiences of food poverty are embedded within and symptomatic of extreme marginalisation, which in turn impacts upon health. Specifically, food poverty was conceptualised by participants to: firstly, be a barrier to providing adequate care and nutrition for young children; secondly, be exacerbated by lack of access to adequate fresh food, food storage and cooking facilities; and thirdly, amplify existing health and social problems. Further investigation of the local government structures and professional roles that both rely upon and serve to further embed the food banking system is necessary in order to understand the politics of changing welfare landscapes

Debt Counselling for Depression in Primary Care: an adaptive randomised controlled pilot trial (DeCoDer study)

Background: Depression and debt are common in the UK. The DeCoDer trial aimed to assess the clinical and cost effectiveness of the addition of Primary Care debt counselling advice service to usual care, for patients with depression and debt. However, the study was terminated early during the internal pilot trial phase because of recruitment delays. This report describes the rationale, methods and findings of the pilot study, and implications for future research. Objectives: The overarching aim of the internal pilot was to identify and resolve problems, thereby assessing the feasibility of the main trial. Specific objectives were to: confirm methods for practice recruitment, ability to recruit patients via the proposed approaches, determine acceptability of the study interventions and outcome measures; assess contamination, confirm the randomisation method for main trial, the level of participant attrition; and check robustness of data collection systems. Design: Adaptive parallel two group multi-centre randomised controlled pilot trial with nested mixed methods process and economic evaluation. Both individual and cluster (General Practice) level allocation were used in the pilot phase to assign participants to intervention or control groups. Setting: General practices in England and Wales.Participants: Individuals age ≥18 years, scoring ≥14 on the Beck Depression Inventory and self-identifying as having debt worries were included. Main exclusion criteria were: actively suicidal or psychotic and/or severely depressed and unresponsive to treatment, severe addiction to alcohol/illicit drugs, unable/unwilling to give written informed consent, currently participating in other research including follow-up phases, received Citizen’s Advice Bureau (CAB) debt advice in past year, and not wanting debt advice via GP practice. Interventions: Intervention: debt advice provided by CAB and shared biopsychosocial assessment in addition to treatment as usual (TAU) and two debt advice leaflets; Control: advice leaflets provided by GP and TAU only. Outcomes of pilot trial: Proportion of eligible patients who consented; number of participants recruited compared to target; assessment of contamination; assessment of patient satisfaction with intervention and outcome measures.Participant outcomes: Primary: Beck Depression Inventory II; Secondary: Psychological wellbeing, health and social care utilisation, service satisfaction, substance misuse, record of priority/non-priority debts, life events and difficulties and explanatory measures. Outcomes were assessed at baseline (pre-randomisation) and 4-months post randomisation. Other data sources: Qualitative interviews were conducted with participants, clinicians and CAB advisors.Results: Of the 238 expressions of interest screened, 61 participants (26%) were recruited and randomised (32 intervention and 29 control). All participants provided baseline outcomes and 52 provided primary outcome at four months follow up (14.7% drop out). 17 participants allocated to intervention saw CAB. Descriptive statistics are reported for participants with complete outcomes at baseline and 4-months’ follow up. Our qualitative findings suggest that the relationship between debt and depression is complex and the impact of each on the other is compounded by other psychological, social and contextual influences. Conclusions, Study Limitations and Future work: Due to low recruitment this trial was terminated at the internal pilot phase, and too small for inferential statistical analysis. We provide implications for conducting future research in this area

State, community and the negotiated construction of energy markets: Community energy policy in England

This article provides fresh insight on the political construction of markets through empirical analysis of community energy in the UK. It considers the diverse actors, understandings, processes and technologies enrolled in market creation, stabilisation and correction, while emphasising how negotiation, mediation and translation are pervasive throughout. Our starting point is an exploration of the role of the state in managing processes of socially embedding and disembedding markets, and how tensions between ideological commitments to deregulation and the social necessity of intervention are addressed by governing at a distance, in this example through the conveniently malleable notion of ‘community’. We draw attention in particular to the variegated manifestations of these processes and the plurality of actors and logics operating within the ‘black box’ of the state, as well as within and between markets and civil society. We reveal how negotiation between competing logics – the impulse to marketise and its diverse others – can be observed across different forms of organisation and action. We argue that such deliberations can be seen as fractal patterns throughout contemporary socioeconomic arrangements, emphasising how the Polanyian concept of the ‘double movement’ can be deepened through analysis of the heterogeneous associations and logics at work in ‘actually existing’ instituted action, understanding political processes as ontologically performative. Empirical material is drawn from across four research projects, each focusing on different aspects of the UK government's Community Energy Strategy, exploring the varying ways marketisation plays out through different governmental programmes

A systematic review of the health, social and financial impacts of welfare rights advice delivered in healthcare settings

BACKGROUND: Socio-economic variations in health, including variations in health according to wealth and income, have been widely reported. A potential method of improving the health of the most deprived groups is to increase their income. State funded welfare programmes of financial benefits and benefits in kind are common in developed countries. However, there is evidence of widespread under claiming of welfare benefits by those eligible for them. One method of exploring the health effects of income supplementation is, therefore, to measure the health effects of welfare benefit maximisation programmes. We conducted a systematic review of the health, social and financial impacts of welfare rights advice delivered in healthcare settings. METHODS: Published and unpublished literature was accessed through searches of electronic databases, websites and an internet search engine; hand searches of journals; suggestions from experts; and reference lists of relevant publications. Data on the intervention delivered, evaluation performed, and outcome data on health, social and economic measures were abstracted and assessed by pairs of independent reviewers. Results are reported in narrative form. RESULTS: 55 studies were included in the review. Only seven studies included a comparison or control group. There was evidence that welfare rights advice delivered in healthcare settings results in financial benefits. There was little evidence that the advice resulted in measurable health or social benefits. This is primarily due to lack of good quality evidence, rather than evidence of an absence of effect. CONCLUSION: There are good theoretical reasons why income supplementation should improve health, but currently little evidence of adequate robustness and quality to indicate that the impact goes beyond increasing income