Factors influencing the rent vs. buy decision - implications for housing markets

This paper considers recent trends in regards to home ownership versus renting in the Australia housing market.<br /

Caravan parks as a provider in the affordable housing market

Caravan parks in Australian capital cities have provided a source of housing at the lower end of the market for many years. This includes opportunities for both private rental and home ownership. However, emerging trends in the property market have threatened the viability of caravan parks. In order to maintain or increase income levels, some caravan parks have focused on more profitable short-term tourist opportunities rather than traditional long-term housing. While the closure and conversion of caravan parks raise crucial questions for Australian social and housing policy, there are also implications for the broader property market. This paper examines the changing role of the operation of caravan parks, with the emphasis placed on their economic feasibility. The research is based on a survey of 30 caravan park operators in Queensland, Australia. The factors influencing caravan parks are identified, and suggestions to address the changing role of caravan parks as a provider in the affordable housing market are canvassed. <br /

‘Doing language teaching' in the adult ESOL classroom: collaborative shaping of the target language

The teaching of English to Speakers of Other Languages [ESOL] is a profession with a truly global reach. One of its defining and unusual characteristics is the dual role that language plays, as both the goal (the product) and the means to reach that goal (the process); this creates a specialised form of pedagogical interaction that justifies further investigation (Seedhouse, 2004). Additionally, the acquisition of a language (first or second) requires the development of both accuracy and fluency in the target language, which is reflected in the teaching contexts in the L2 classroom. Previous CA studies (e.g. Seedhouse, 2004; Waring, 2016) have demonstrated how talk is a collaborative endeavour, co-constructed by participants, and shaped by the context in which it is taking place. This study builds on this previous research by presenting a detailed analysis of the activities and practices that L2 teachers employ in the development and shaping of the target language in differing pedagogical contexts: form-focused and fluency-focused; with a particular focus on the meaning-and-fluency context that had received less attention in previous studies (Gardner, 2019). Furthermore, this study unpacks the practices that ESOL teachers employ to synthesise pedagogical contexts and/or create hybrid contexts. This study utilises Conversation Analysis [CA] to investigate talk in the institutional setting of the ESOL classroom. The data comprise approximately 14 hours of video and audio recordings. The findings of this study detail the actions and practices adopted by ESOL teachers, as they respond contingently to the contributions of their learners, in turn shaping the development of the target language. By presenting the data, its analysis and findings, this study adds to our understanding of ESOL teachers’ skilful and complex practices in the classroom, particularly in synthesised or hybrid contexts, thus providing more opportunities for the sharing of best practice

Outpatient services and primary care: scoping review, substudies and international comparisons

This study updates a previous scoping review published by the National Institute for Health Research (NIHR) in 2006 (Roland M, McDonald R, Sibbald B.Outpatient Services and Primary Care: A Scoping Review of Research Into Strategies For Improving Outpatient Effectiveness and Efficiency. Southampton: NIHR Trials and Studies Coordinating Centre; 2006) and focuses on strategies to improve the effectiveness and efficiency of outpatient services.Findings from the scoping reviewEvidence from the scoping review suggests that, with appropriate safeguards, training and support, substantial parts of care given in outpatient clinics can be transferred to primary care. This includes additional evidence since our 2006 review which supports general practitioner (GP) follow-up as an alternative to outpatient follow-up appointments, primary medical care of chronic conditions and minor surgery in primary care. Relocating specialists to primary care settings is popular with patients, and increased joint working between specialists and GPs, as suggested in the NHS Five Year Forward View, can be of substantial educational value. However, for these approaches there is very limited information on cost-effectiveness; we do not know whether they increase or reduce overall demand and whether the new models cost more or less than traditional approaches. One promising development is the increasing use of e-mail between GPs and specialists, with some studies suggesting that better communication (including the transmission of results and images) could substantially reduce the need for some referrals.Findings from the substudiesBecause of the limited literature on some areas, we conducted a number of substudies in England. The first was of referral management centres, which have been established to triage and, potentially, divert referrals away from hospitals. These centres encounter practical and administrative challenges and have difficulty getting buy-in from local clinicians. Their effectiveness is uncertain, as is the effect of schemes which provide systematic review of referrals within GP practices. However, the latter appear to have more positive educational value, as shown in our second substudy. We also studied consultants who held contracts with community-based organisations rather than with hospital trusts. Although these posts offer opportunities in terms of breaking down artificial and unhelpful primary–secondary care barriers, they may be constrained by their idiosyncratic nature, a lack of clarity around roles, challenges to professional identity and a lack of opportunities for professional development. Finally, we examined the work done by other countries to reform activity at the primary–secondary care interface. Common approaches included the use of financial mechanisms and incentives, the transfer of work to primary care, the relocation of specialists and the use of guidelines and protocols. With the possible exception of financial incentives, the lack of robust evidence on the effect of these approaches and the contexts in which they were introduced limits the lessons that can be drawn for the English NHS.ConclusionsFor many conditions, high-quality care in the community can be provided and is popular with patients. There is little conclusive evidence on the cost-effectiveness of the provision of more care in the community. In developing new models of care for the NHS, it should not be assumed that community-based care will be cheaper than conventional hospital-based care. Possible reasons care in the community may be more expensive include supply-induced demand and addressing unmet need through new forms of care and through loss of efficiency gained from concentrating services in hospitals. Evidence from this study suggests that further shifts of care into the community can be justified only if (a) high value is given to patient convenience in relation to NHS costs or (b) community care can be provided in a way that reduces overall health-care costs. However, reconfigurations of services are often introduced without adequate evaluation and it is important that new NHS initiatives should collect data to show whether or not they have added value, and improved quality and patient and staff experience. Funding, The NIHR Health Services and Delivery Research programme.The NIHR Health Services and Delivery Research programme

Outpatient services and primary care: scoping review, substudies and international comparisons

Aim This study updates a previous scoping review published by the National Institute for Health Research (NIHR) in 2006 (Roland M, McDonald R, Sibbald B. Outpatient Services and Primary Care: A Scoping Review of Research Into Strategies For Improving Outpatient Effectiveness and Efficiency. Southampton: NIHR Trials and Studies Coordinating Centre; 2006) and focuses on strategies to improve the effectiveness and efficiency of outpatient services. Findings from the scoping review Evidence from the scoping review suggests that, with appropriate safeguards, training and support, substantial parts of care given in outpatient clinics can be transferred to primary care. This includes additional evidence since our 2006 review which supports general practitioner (GP) follow-up as an alternative to outpatient follow-up appointments, primary medical care of chronic conditions and minor surgery in primary care. Relocating specialists to primary care settings is popular with patients, and increased joint working between specialists and GPs, as suggested in the NHS Five Year Forward View, can be of substantial educational value. However, for these approaches there is very limited information on cost-effectiveness; we do not know whether they increase or reduce overall demand and whether the new models cost more or less than traditional approaches. One promising development is the increasing use of e-mail between GPs and specialists, with some studies suggesting that better communication (including the transmission of results and images) could substantially reduce the need for some referrals. Findings from the substudies Because of the limited literature on some areas, we conducted a number of substudies in England. The first was of referral management centres, which have been established to triage and, potentially, divert referrals away from hospitals. These centres encounter practical and administrative challenges and have difficulty getting buy-in from local clinicians. Their effectiveness is uncertain, as is the effect of schemes which provide systematic review of referrals within GP practices. However, the latter appear to have more positive educational value, as shown in our second substudy. We also studied consultants who held contracts with community-based organisations rather than with hospital trusts. Although these posts offer opportunities in terms of breaking down artificial and unhelpful primary–secondary care barriers, they may be constrained by their idiosyncratic nature, a lack of clarity around roles, challenges to professional identity and a lack of opportunities for professional development. Finally, we examined the work done by other countries to reform activity at the primary–secondary care interface. Common approaches included the use of financial mechanisms and incentives, the transfer of work to primary care, the relocation of specialists and the use of guidelines and protocols. With the possible exception of financial incentives, the lack of robust evidence on the effect of these approaches and the contexts in which they were introduced limits the lessons that can be drawn for the English NHS. Conclusions For many conditions, high-quality care in the community can be provided and is popular with patients. There is little conclusive evidence on the cost-effectiveness of the provision of more care in the community. In developing new models of care for the NHS, it should not be assumed that community-based care will be cheaper than conventional hospital-based care. Possible reasons care in the community may be more expensive include supply-induced demand and addressing unmet need through new forms of care and through loss of efficiency gained from concentrating services in hospitals. Evidence from this study suggests that further shifts of care into the community can be justified only if (a) high value is given to patient convenience in relation to NHS costs or (b) community care can be provided in a way that reduces overall health-care costs. However, reconfigurations of services are often introduced without adequate evaluation and it is important that new NHS initiatives should collect data to show whether or not they have added value, and improved quality and patient and staff experience.The NIHR Health Services and Delivery Research programme

Clinical negligence and physiotherapy: UK survey of physiotherapists’ experiences of litigation

Aim To investigate the extent and impact of litigation on the UK physiotherapy profession. Design An online cross-sectional questionnaire survey design was used. The survey was open to all qualified physiotherapists who have practiced in the UK, from any speciality, of any grade and from any setting including NHS, non-NHS, and private practice. Results 688 respondents completed the survey (96% CI). All UK nations were represented. 73% were female, 44% were qualified >20 Years. Most worked in the NHS (74%) and worked in a neuromusculoskeletal setting (62%). 10% of respondents had been involved in litigation. 128 claims were reported with some respondents being involved in more than 1 case. Litigation was a highly stressful experience for those who experienced it and was a source of concern for many others. The personal impact was stress (76%) and worry and anxiety (67%). The most common professional impact was defensive practice (68%). Most respondents incorrectly identified who should provide their legal support. 46% were not satisfied with the support received. Most (77%) reported that litigation training should be included in pre-registration, as well as postgraduate (68%) programs. Conclusion This is the first UK survey that has investigated the experiences of litigation on the UK physiotherapy profession. Ten percent of physiotherapists in our survey had been involved in litigation. Litigation impacted physiotherapists’ physical and mental wellbeing and their clinical practice. Improved support, both emotional and legal is required. Clinical negligence training should be included in pre-registration and postgraduate programs

Boarding houses and government supply side intervention: Final report

Boarding houses in cities across Australia are being demolished or replaced, leading to a decline in the stock of this form of low-cost accommodation. Governments intervene reluctantly to slow the decline because boarding houses are normally run as private for profit businesses. Yet, the on-going problems faced by governments, the community and residents from the continuing loss of boarding houses are significant

A Scoping Review Protocol: Investigating the Extent and Legal Process of Cauda Equina Syndrome Claims for UK Physiotherapists

Introduction Cauda equina syndrome (CES) is a condition where early identification and treatment is crucial to avoid potentially devastating effects. There is a high number of litigation cases linked with CES given it is a relatively rare condition. This scoping review protocol proposes to explore the extent and process of CES litigation in UK healthcare context cases amongst UK physiotherapists. Methods and analysis The methodological framework recommended by Arksey and O'Malley, Levac et al. and the Joanna Briggs Institute will be used throughout this review to aid reporting and transparency. A patient and public involvement (PPI) group meeting was convened at the beginning of the review process in order to provide knowledge exchange to inform the search strategy and propose resources to be used during the scoping review. Two reviewers will independently review the literature in order to apply the inclusion and exclusion criteria. Once the studies to be included have been identified, the data from these studies will be extracted and charted. Results will show quantitative data of the studies included in the review and a narrative synthesis of the literature. Dissemination This scoping review will evaluate the existing knowledge relating to CES and litigation and will map the key concepts around this topic. Results will be disseminated to practitioners and policy‐makers through peer‐reviewed publications, conferences, reports and social media. This method may prove helpful to others who are investigating extent and processes relating to medicolegal cases involving healthcare practitioners