The care act, personalisation and the new eligibility regulations: a discussion paper about the future of care and support services for homeless people in England

As funding for Housing Related Support (formerly Supporting People) services continues to shrink, it is timely to revisit the question as to whether ‘homeless people’ are eligible for publically funded care and support, including personal budgets, organised through the local authority. The Care Act 2014 due to be implemented from April 2015 in England, heralds some positive changes which may serve to open the door to this funding stream which has rarely been used in support of ‘homeless people’. As the law currently stands ‘homeless people’ as a service user group are not eligible for community care assessment (though people who are homeless and who fall into one of the ‘eligible groups’ by virtue of having a mental health or drug and alcohol problem may be). The Care Act 2014 removes reference to ‘eligible’ and ‘ineligible’ groups so that any adult with any level of need will have a right to an assessment. Exploring some of the ways in which homeless people have been excluded from care and support in the past, this paper outlines how homeless organisations can work with local authorities to ensure fairer and more consistent access and in so doing, potentially secure their own futures in the face of fewer ‘block contracts’ and more individualised forms of commissioning

Factors associated with access to care and healthcare utilisation in the homeless population of England

Introduction: People experiencing homelessness are known to have complex health needs which are often compounded by poor access to healthcare. This study investigates the individual-level factors associated with access to care and healthcare utilisation among homeless people in England. Methods: A cross-sectional sample of 2,505 homeless people from 19 areas of England was used to investigate associations with access to care and healthcare utilisation. Results: Rough sleepers were much less likely to be registered with a GP (OR 0.45, CI 0.30-0.66) than single homeless in accommodation (reference group) or the hidden homeless (OR 1.48 CI 0.88-2.50). Those who had recently been refused registration by a GP or dentist also had lower odds of being admitted to hospital (OR 0.67, CI 0.49-0.91) or using an ambulance (OR 0.73, CI 0.54-0.99). Conclusions: The most vulnerable homeless people appear to face the greatest barriers to utilising healthcare. Rough sleepers have particularly low rates of GP registration and this appears to have a knock-on effect on admission to hospital. Improving primary care access for the homeless population could ensure that some of the most vulnerable people in society are able to access vital services which they are currently missing out on

Prevalence and Epidemiology of Non-O157 Escherichia coli Serogroups O26, O103, O111, and O145 and Shiga Toxin Gene Carriage in Scottish Cattle, 2014-2015

International audienceCattle are reservoirs for Shiga toxin Escherichia coli (STEC), bacteria shed in animal feces. Humans are infected through consumption of contaminated food or water and by direct contact, causing serious disease and kidney failure in the most vulnerable

Abstracts from the NIHR INVOLVE Conference 2017

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The Concise Guide to PHARMACOLOGY 2023/24: G protein-coupled receptors.

peer reviewedThe Concise Guide to PHARMACOLOGY 2023/24 is the sixth in this series of biennial publications. The Concise Guide provides concise overviews, mostly in tabular format, of the key properties of approximately 1800 drug targets, and about 6000 interactions with about 3900 ligands. There is an emphasis on selective pharmacology (where available), plus links to the open access knowledgebase source of drug targets and their ligands (https://www.guidetopharmacology.org), which provides more detailed views of target and ligand properties. Although the Concise Guide constitutes almost 500 pages, the material presented is substantially reduced compared to information and links presented on the website. It provides a permanent, citable, point-in-time record that will survive database updates. The full contents of this section can be found at http://onlinelibrary.wiley.com/doi/bph.16177. G protein-coupled receptors are one of the six major pharmacological targets into which the Guide is divided, with the others being: ion channels, nuclear hormone receptors, catalytic receptors, enzymes and transporters. These are presented with nomenclature guidance and summary information on the best available pharmacological tools, alongside key references and suggestions for further reading. The landscape format of the Concise Guide is designed to facilitate comparison of related targets from material contemporary to mid-2023, and supersedes data presented in the 2021/22, 2019/20, 2017/18, 2015/16 and 2013/14 Concise Guides and previous Guides to Receptors and Channels. It is produced in close conjunction with the Nomenclature and Standards Committee of the International Union of Basic and Clinical Pharmacology (NC-IUPHAR), therefore, providing official IUPHAR classification and nomenclature for human drug targets, where appropriate

The Care Act 2014, personalisation and the new eligibility regulations: implications for homeless people

As government funding for housing related support (formerly Supporting People) services continues to shrink, it is timely to revisit the question as to whether ‘homeless people’ are eligible for publically funded care and support, including personal budgets, organised through the local authority. The Care Act 2014 which was implemented in England on April 1st 2015 may serve to provide greater entitlement to this source of funds which has rarely been used in support of ‘homeless people’. However, there are questions as to how far these changes will be embraced and actively implemented on the ground. On the one hand, social workers may be reluctant to extend their reach because there is already a shortage of resources to meet the needs of existing service users. On the other hand, there is uncertainty inside homeless organisations as to the benefits of personal budgets which may lead to a reluctance to refer ‘homeless people’ for assessment under the Care Act 2014. We outline suggestions as to how these mutually reinforcing barriers might be overcome to ensure adult social care becomes more inclusive

A Systematic Approach to Comparing Thermal Activity of the Thoracic Region and Saddle Pressure Distribution beneath the Saddle in a Group of Non-Lame Sports Horses

Thermography is a non-invasive method for measuring surface temperatures and may be a convenient way of identifying hypo/hyperthermic areas under a saddle that may be related to saddle pressures. A thermal camera quantified minimum/maximum/mean temperatures at specific locations (left/right) of the thoracic region at three-time points: (1) baseline; (2) post lunging; (3) post ridden exercise in eight non-lame sports horses ridden by the same rider. A Pliance (Novel) pressure mat determined the mean/peak saddle pressures (kPa) in the cranial and caudal regions. General linear mixed models with the horse as the random factor investigated the time point (fixed factor: baseline; lunge; ridden) and saddle fit (fixed factor: correct; wide; narrow) on thermal parameters with Bonferroni post hoc comparison. The saddle pressure data (grouped: saddle width) were assessed with an ANOVA and Tukey post hoc comparison (p ≤ 0.05). Differences between the saddle widths in the cranial/caudal mean (p = 0.05) and peak saddle pressures (p = 0.01) were found. The maximum temperatures increased post lunge (p ≤ 0.0001) and post ridden (p ≤ 0.0001) compared to the baseline. No difference between post lunge and post ridden exercise (all p ≥ 0.51) was found. The thermal activity does not appear to be representative of increased saddle pressure values. The sole use of thermal imaging for saddle fitting should be applied with caution