Paying it forward and back: Regenerative tourism as part of place

The notion of regenerative tourism has gained significant attention in recent years, as have other regenerative notions such as regenerative agriculture, regenerative design, and regenerative development. It is suggested that these regenerative notions have developed in response to concerns around the effectiveness of the implementation of the sustainability paradigm. However, regenerative tourism as a potential complementary or alternative paradigm currently lacks definition and therefore clarity around what it encompasses. Without clarity, and a shared sense of what regenerative tourism could look like within the context of a place, it could risk becoming over-claimed and difficult to measure and discern. We address these issues in two ways, which comprise the distinct sections of this report

Recommendations to reduce inequalities for LGBT people facing advanced illness: ACCESSCare national qualitative interview study.

Background Lesbian, gay, bisexual and/or trans (LGBT) people have higher risk of certain life-limiting illnesses and unmet needs in advanced illness and bereavement. ACCESSCare is the first national study to examine in depth the experiences of LGBT people facing advanced illness. Aim To explore health-care experiences of LGBT people facing advanced illness to elicit views regarding sharing identity (sexual orientation/gender history), accessing services, discrimination/exclusion and best-practice examples. Design Semi-structured in-depth qualitative interviews analysed using thematic analysis. Setting/participants In total, 40 LGBT people from across the United Kingdom facing advanced illness: cancer (n = 21), non-cancer (n = 16) and both a cancer and a non-cancer conditions (n = 3). Results In total, five main themes emerged: (1) person-centred care needs that may require additional/different consideration for LGBT people (including different social support structures and additional legal concerns), (2) service level or interactional (created in the consultation) barriers/stressors (including heteronormative assumptions and homophobic/transphobic behaviours), (3) invisible barriers/stressors (including the historical context of pathology/criminalisation, fears and experiences of discrimination) and (4) service level or interactional facilitators (including acknowledging and including partners in critical discussions). These all shape (5) individuals’ preferences for disclosing identity. Prior experiences of discrimination or violence, in response to disclosure, were carried into future care interactions and heightened with the frailty of advanced illness. Conclusion Despite recent legislative change, experiences of discrimination and exclusion in health care persist for LGBT people. Ten recommendations, for health-care professionals and services/institutions, are made from the data. These are simple, low cost and offer potential gains in access to, and outcomes of, care for LGBT people.</p