Why Have We Made Neglect So Complicated? Taking A Fresh Look At Noticing And Helping The Neglected Child

The experience of chronic neglect is extremely harmful to children’s physical, emotional, cognitive and behavioural development. As an area of resaerch it has been traditionally described as neglected and as an arena of practice it is viewed as complex and intractable. Over the last few decades, however, there has been a body of evidence building up to help with the understanding of the impact of neglect upon children and to guide intervention. This paper argues that this evidence is not being used to best effect and that curernt protective systems, like those in the UK, are still struggling to provide an effective response to neglected children. The language of neglect has become over-complicated and the systems and processes for assessment, planning and intervention are mired in bureacracy. Some of these complexities are explored in more detail and a model is proposed that would support a more direct and straightforward response to children whose needs are not being met

Improving access for patients – a practice manager questionnaire

BACKGROUND: The administrative and professional consequences of access targets for general practices, as detailed in the new GMS contract, are unknown. This study researched the effect of implementing the access targets of the new GP contract on general practice appointment systems, and practice manager satisfaction in a UK primary health care setting. METHODS: A four-part postal questionnaire was administered. The questionnaire was modified from previously validated questionnaires and the findings compared with data obtained from the Western Health and Social Services Board (WHSSB) in N Ireland. Practice managers from the 59 general practices in the WHSSB responded to the questionnaire. RESULTS: There was a 94.9% response rate. Practice managers were generally satisfied with the introduction of access targets for patients. Some 57.1% of responding practices, most in deprived areas (Odds ratio 3.13 -95% CI 1.01 – 9.80, p = 0.0256) had modified their appointment systems. Less booking flexibility was reported among group practices (p = 0.006), urban practices (p < 0.001) and those with above average patient list sizes (p < 0.001). Receptionists had not received training in patient appointment management in a quarter of practices. Practices with smaller list sizes were more likely than larger ones to utilise nurses in seeing extra patients (p = 0.007) or to undertake triage procedures (p = 0.062). CONCLUSION: The findings demonstrated the ability of general practices within the WHSSB to adjust to a demanding component of the new GP contract. Issues relating to the flexibility of patient appointment booking systems, receptionists' training and the development of the primary care nursing role were highlighted by the study

What is an "adult protection" issue? Victims, perpetrators and the professional construction of adult protection issues

Drawing on data from a Scottish research study, this paper explores the relationship of professionals&rsquo; perceptions about specific perpetrators and victims to their constructions of &lsquo;adult protection&rsquo; issues in practice. It finds that professionals&rsquo; perceptions of victim distress did not consistently coincide with the construction of adult protection issues, whilst the connection to any assessment of victims&rsquo; heightened vulnerability in specific cases was not clear. With respect to perpetrators, implicit practice rules were evidenced which differed from explicit policy criteria. In particular, there were different rules for relatives, staff and service user perpetrators, whilst harms attributed to institutions were de-emphasized. Explanations of the findings are advanced based on the complex power relations underpinning practice but unacknowledged in policies. More research is recommended to deepen this analysis in a changing policy context, to foreground service user perspectives, and to contextualize harms potentially resolvable through adult support and protection/safeguarding routes with respect to harms better addressed in other ways

Improving Mental Health Assessments for Looked After Children

As part of the UK\u27s National Health Service modernisation agenda, the Department of Health, Social Services and Public Safety, Northern Ireland set up a Service Improvement Unit (SIU). The aim of the SIU was to identify key areas in the Health and Social Services that needed improvement and to provide a structured framework in which to achieve the necessary developments. A key area identified was the interface between children in care and the Child and Adolescent Mental Health Services. It was believed that a lot of work needed to be undertaken to identify those children and young people in the care system that had mental health difficulties and to ensure they received the necessary interventions in an appropriate and timely manner. In order to take forward this improvement, a multi-disciplinary project team was set up under the SIU scheme to look at this issue. The project\u27s title was Knowing to Care! which reflects the basic notion that the more we know about the children and young people the better we are caring for them

Men, maternity and moral residue:negotiating the moral demands of the transition to first time fatherhood

This article discusses men's transition to first time fatherhood, with a focus on the way they recognise various in-tension moral demands and negotiate an appropriate role for themselves. The findings are taken from a longitudinal study, drawing on elements of grounded theory, comprising a series of face-to-face and telephone interviews with 11 men over a 9-month period from the 12(th) week of pregnancy to 8 weeks after the birth. The analysis focuses on men's feelings and experience of exclusion and participation, and their response and reaction to that experience. The findings present two descriptive themes, ‘on the inside looking in’ and ‘present but not participating’, followed by third theme ‘deference and support: a moral response’ that exposes the dilemmatic nature of men's experience and explains the participants’ apparent acceptance of being less involved. The discussion explores the concept of moral residue, arguing that while deference and support may be an appropriate role for fathers in the perinatal period it may also be a compromise that leads to feelings of uncertainty and frustration, which is a consequence of being in a genuinely dilemmatic situation