Supreme Court closes another vicarious liability loophole: Woodland V Swimming Teachers Association

On 23 October 2013 the Supreme Court closed another vicarious liability loophole when it handed down its judgment in Woodland. The respondent education authority was set to escape any potential liability for a negligently conducted swimming lesson simply because the lesson had been carried out by an independent contractor, rather than an employee. For this reason, both parties agreed that the respondent could not be vicariously liable, yet to deny the claimant any possibility of seeking compensation from the authority for the incident on that basis would have been unpalatable. Accordingly, the court kept the education authority in the frame by endorsing and expounding a concept little-used in English law but supported by some powerful dicta: the non-delegable duty of care. In contrast to vicarious liability, the non-delegable duty is a personal one, which requires a defendant not merely to take reasonable care, but to ensure that reasonable care is taken; a task may be delegated to an independent contractor, but the duty may not. The Supreme Court explained that a non-delegable duty would arise where: (1) the claimant is especially vulnerable or dependent on the defendant's protection against risk of injury; (2) there is an antecedent relationship between the two which puts the claimant in the defendant's custody, charge or care and from which it is possible to say that the defendant has assumed a duty to ensure care is taken; (3) the claimant has no control over how the defendant chooses to perform its obligations; (4) the defendant has delegated a function which is an integral part of the positive duty it assumed, such that the delegate now exercises custody, charge or care over the claimant on the defendant's behalf; and (5) the defendant has delegated its duty to a third party, who has performed it negligently. Reversing the decision of the lower courts and remitting the case for trial, the Supreme Court unanimously decided that the education authority owed the claimant a non-delegable duty, which could give rise to liability for any negligence in this case. Following Woodland, it is now clear that, when exercising their core functions, schools, hospitals and other similar organisations will owe personal, non-delegable duties towards those persons entrusted into their custody, charge or care. In such cases, claimants who suffer loss by reason of the negligent performance of the defendant's core functions will be entitled to seek redress from the defendant by an alternative route, where they cannot establish vicarious liability. Against the backdrop of a climate where outsourcing is now common place, this judgment is a particularly pertinent one and its practical implications will need to be factored into operational decision-making. However, any objections from potential defendants are easily outweighed by the policy justifications for closing this particular loophole

Are public managers more risk averse? Framing effects and status quo bias across the sectors

The article of record as published may be found at https://doi.org/10.30636/jbpa.21.3Modern reforms meant to incentivize public managers to be more innovative and accepting of risk are often implicitly based in the longstanding assumption that public employees are more risk averse than their private sector counterparts. We argue, however, that there is more to learn about the degree to which public and private managers differ in terms of risk aversion. In order to address this gap, we field a series of previously validated experiments designed to assess framing effects and status quo bias in a sample of public and private sector managers. Our results indicate that public managers are not more risk averse or anchored to the status quo than their private sector counterparts; in fact, the findings suggest the opposite may be true under some conditions. In addition, our results fail to confirm previous findings in the literature suggesting that public service motivation is associated with risk aversion. We conclude with a discussion of the implications of these results for the study of risky choice in the public sector and for modern public management reforms

The stages of nonprofit advocacy

This dissertation argues that advocacy is a two-stage decision in which organizations must first decide whether or not to undertake political activity through advocacy or lobbying and then choose between the set of strategic actions that, based on available financial and human resources, are available to them. These are separate decisions with separate constraints. The decision to advocate is a strategic stance taken by nonprofit organizations in policy environments that necessitate such activity and in which it is politically conducive for them to undertake the cost of such actions. Once an organization has decided that it will undertake advocacy activities, it must determine the specific activities, collaboration, grassroots advocacy, or direct lobbying, that will help it to pursue that course most effectively. These hypotheses are tested in an analysis of the advocacy activities of over 500 nonprofit reproductive health service providers. Data for this study were gathered from the National Center for Charitable Statistics within the Urban Institute and directly from IRS Form 990s filed by the organizations. The findings suggest that there are strong and consistent relationships between policy and politics and the political activity of nonprofit service providers. In states with more restrictive reproductive health policy environments, nonprofit organizations that provide these services are more likely to engage in advocacy activity. The findings also suggest that, even when controlling for the policy environment, 501(c)(3)s are more likely to become politically active in states where they have a larger number of political allies. Additional analyses suggest that there is a negative relationship between government monies and the aggressiveness of advocacy and the use of multiple advocacy strategies. Interestingly, this finding is consistent with the expectations offered in the resource dependence literature and the results suggest only a tenuous relationship between institutional variables and decisions regarding organizational aggressiveness in the choice of advocacy strategies

Making a difference for children and families: an appreciative inquiry of health visitor values and why they start and stay in post

The study aimed to develop an understanding of health visitor recruitment and retention by examining what existing staff and new recruits wanted from their job, their professional aspirations and what would encourage them to start and stay in employment. Following a period of steady decline in numbers, the health visitor workforce in England has recently been invested in and expanded to deliver universal child public health. To capitalise on this large investment, managers need an understanding of factors influencing workforce retention and continuing recruitment of health visitors. The study was designed using an interpretive approach and involved students (n = 17) and qualified health visitors (n = 22) from the north and south of England. Appreciative inquiry (AI) exercises were used as methods of data collection during 2012. During AI exercises students and health visitors wrote about ‘a practice experience you have felt excited and motivated by and briefly describe the factors that contributed to this’. Participants were invited to discuss their written accounts of practice with a peer during an audio-recorded sharing session. Participants gave consent for written accounts and transcribed recordings to be used as study data, which was examined using framework analysis. In exploring personal meanings of health visiting, participants spoke about the common aspiration to make a difference to children and families. To achieve this, they expected their job to allow them to: connect with families; work with others; use their knowledge, skills and experience; use professional autonomy. The study offers new insights into health visitors’ aspirations, showing consistency with conceptual explanations of optimal professional practice. Psychological contract theory illustrates connections between professional aspirations and work commitment. Managers can use these findings as part of workforce recruitment and retention strategies and for building on the health visitor commitment to making a difference to children and families

The challenges of training, support and assessment of healthcare support workers: A qualitative study of experiences in three English acute hospitals

Background: Ever-growing demands on care systems have increased reliance on healthcare support workers. In the UK, their training has been variable, but organisation-wide failures in care have prompted questions about how this crucial section of the workforce should be developed. Their training, support and assessment has become a policy priority. Objectives: This paper examines: healthcare support workers’ access to training, support and assessment; perceived gaps in training provision; and barriers and facilitators to implementation of relevant policies in acute care. Design and settings: We undertook a qualitative study of staff caring for older inpatients at ward, divisional or organisational-level in three acute National Health Service hospitals in England in 2014. Participants: 58 staff working with older people (30 healthcare support workers and 24 staff managing or working alongside them) and 4 healthcare support worker training leads. Methods: One-to-one semi-structured interviews included: views and experiences of training and support; translation of training into practice; training, support and assessment policies and difficulties of implementing them. Transcripts were analysed to identify themes. Results: Induction training was valued, but did not fully prepare healthcare support workers for the realities of the ward. Implementation of hospital policies concerning supervision and formal assessment of competencies varied between and within hospitals, and was subject to availability of appropriate staff and competing demands on staff time. Gaps identified in training provision included: caring for people with cognitive impairment; managing the emotions of patients, families and themselves; and having difficult conversations. Access to ongoing training was affected by: lack of time; infrequent provision; attitudes of ward managers to additional support workforce training, and their need to balance this against patients’ and other staff members’ needs; and the use of e-learning as a default mode of training delivery. Conclusions: With the current and unprecedented policy focus on training, support and assessment of healthcare support workers, our study suggests improved training would be welcomed by them and their managers. Provision of training, support and assessment could be improved by organisational policy that promotes and protects healthcare support worker training; formalising the provision and availability of on-ward support; and training and IT support provided on a drop-in basis. Challenges in implementation are likely to be faced in all international settings where there is increased reliance on a support workforce. While recent policies in the UK offers scope to overcome some of these challenges there is a risk that some will be exacerbated

Findings from Year Two of the External Evaluation of the Healthy & Active Communities Initiative

The Missouri Foundation for Health has funded 33 projects under its Healthy & Active Communities (H&AC) Initiative in two-year funding cycles. A set of 15 projects was funded beginning in 2005 while a set of 18 was funded starting in 2006. This report is the second of three annual reports that assess the extent to which the H&AC Initiative is achieving its objectives. The report builds upon the findings described in “Findings from Year One of the External Evaluation of the Healthy & Active Communities Initiative.” The Missouri Foundation for Health contracted with the Institute of Public Policy, Truman School of Public Affairs at the University of Missouri to provide an evaluation of the success of the Initiative as a whole. This focus differs from the typical evaluation where evaluators are assessing and reporting on the success of individual funded projects. Instead, the evaluation looked across the funded projects to identify common factors of success. Continuing from the framework established in 2006, the evaluation team worked from a socio-ecological model. This model assumes that complex prevention programs such as the H&AC projects must use a multi-faceted approach in order to change behavior on individual, organizational and community levels simultaneously. To evaluate programs with multiple approaches such as these, the evaluators determined that cluster evaluation, a strategy developed by the Kellogg Foundation, could be used to identify successful features of the Initiative as a whole. This method enables the evaluators to identify successful program and community conditions that transcend the individual projects

Murine Typhus in Austin, Texas, USA, 2008

Physicians should be alert for possible cases in this area

Training and Embedding Cybersecurity Guardians in Older Communities

Older adults can struggle to access relevant community expertise when faced with new situations. One such situation is the number of cyberattacks they may face when interacting online. This paper reports on an initiative which recruited, trained, and supported older adults to become community cybersecurity educators (CyberGuardians), tasked with promoting cybersecurity best practice within their communities to prevent older adults falling victim to opportunistic cyberattacks. This initiative utilised an embedded peer-to-peer information dissemination strategy, rather than expert-to-citizen, facilitating the inclusion of individuals who would ordinarily be unlikely to seek cybersecurity information and thus may be vulnerable to cyberattacks. We report on ways the CyberGuardians used informal methods to create more aware communities, served as role models for behaviour change and indirectly improved their personal wellbeing. We discuss considerations for supporting CyberGuardians, including implications for sustainability and for replicating this model in other digital contexts, e.g., recognising misinformation or improving mental health

Can Healthcare Assistant Training (CHAT) improve the relational care of older people? Study protocol for a pilot cluster-randomised controlled trial

Background People aged 75 years and over account for one in four of all hospital admissions. There has been increasing recognition of problems in the care of older people, particularly in hospitals. Evidence suggests that older people judge the care they receive in terms of kindness, empathy, compassion, respectful communication and being seen as a person not just a patient. These are aspects of care to which we refer when we use the term 'relational care'. Healthcare assistants deliver an increasing proportion of direct care to older people, yet their training needs are often overlooked. Methods/design This study will determine the acceptability and feasibility of a cluster randomised controlled trial of 'Older People's Shoes' a two-day training intervention for healthcare assistants caring for older people in hospital. Within this pilot, two-arm, parallel, cluster randomised controlled trial, healthcare assistants within acute hospital wards are randomised to either the two-day training intervention or training as usual. Registered nurses deliver 'Older People's Shoes' over two days, approximately one week apart. It contains three components: experiential learning about ageing, exploration of older people's stories, and customer care. Outcomes will be measured at the level of patient (experience of emotional care and quality of life during their hospital stay), healthcare assistant (empathy and attitudes towards older people), and ward (quality of staff/patient interaction). Semi-structured interviews of a purposive sample of healthcare assistants receiving the intervention, and all trainers delivering the intervention, will be undertaken to gain insights into the experiences of both the intervention and the trial, and its perceived impact on practice. Trial registration The study was registered as an International Standard Randomised Contolled Trial (ISRCTN10385799) on 29 December 2014

Ecological, Economic and Policy Alternatives for Texas Rice Agriculture

An interdisciplinary research team, working in collaboration with and under the auspices of the Institute for Science, Technology and Public Policy in the George Bush School of Government and Public Service at Texas A&M University, conducted a two-year research project entitled Ecological, Economic, and Policy Alternatives for Texas Rice Agriculture. This project was sponsored by the Texas Water Resources Institute (TWRI). Principal investigators were Dr. Letitia T. Alston, Dr. Thomas E. Lacher, Dr. R. Douglas Slack, Dr. Arnold Vedlitz, and Dr. Richard T. Woodward. They were assisted by Dr. James C. Franklin, post-doctoral research associate, and the following research assistants: Nicole Canzoneri, April Ann Torres Conkey, Deborah F. Cowman, Jeanine Harris, April Henry, Elizabeth Iennedy, Michelle Irohn, Ielly Mizell, Jill Nicholson, Kelly Tierce, and Yong-Suhk Wui. The objectives of this research were: (1) to develop a reliable first estimate of the environmental consequences of reduction in rice acreage; (2) to analyze economic consequences of changes in rice acreage that may occur due to the changes in the system of price supports; and (3) to critically review existing policy and explore the kinds of institutional arrangements that might be developed to encourage the preservation of the environmental amenities provided by rice farming