Self-build in the UK and Netherlands:mainstreaming self-development to address housing shortages?

This paper examines approaches to self or custom-build in the Netherlands and the UK to offer comparative insights into self- and custom-built housing contexts and cultures, and specifically, the relationships with local and strategic planning arrangements. The paper reviews arguments for self-build as a means to address housing shortages and examines the evidence of completions in practice. It positions the discussion in light of arguments that self-build can become a mainstream source of housing provision. The paper critically considers the role of think tanks in advocating housing policy solutions. Adopting a social constructionist perspective, the paper examines the work of the National Self-Build Association which has devised and implemented an action plan to promote the growth of self-build housing in the UK. Almere, which is located east of Amsterdam, is one of the case studies explored to inform thinking around self-build in the devolved UK. The conclusions tease out some of the implications for democratic and technocratic arguments around self-development and the right to design and build one’s home

Building the next model for intervention and turnaround in poorly performing local authorities in England

This paper examines the design and implementation of the two recent models or strategies adopted for the intervention and turnaround of poorly performing local authorities in England in the two distinct periods of 2002–2008 and 2011–2015. The first was integral to the Comprehensive Performance Management regimes, while the second was developed under the Sector Led Improvement regime. The intention is not to determine which regime has, or had, the most merit or inadequacies, but rather to synthesise knowledge and identify areas that could be improved as policy and practice moves forward, particularly in the light of the recent general election in the UK. The paper finds that both models have merits as well as weaknesses, dependent upon context and policy priorities. It provides a review of when and where alternative models should be used, and a contribution to the development of the next regime. This, the authors contend, should have a greater emphasis on achieving more appropriate levels of public assurance than the current model is providing

Two Types of Planning in Neighborhoods

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68338/2/10.1177_0739456X8400300209.pd

Deliberate concealment

Purpose – Welwyn Hatfield Council v Secretary of State for Communities and Local Government [2009] EWHC 966 (Admin), Welwyn Hatfield Council v. Secretary of State for Communities and Local Government [2010] EWCA Civ 26 and Welwyn Hatfield Council v. Secretary of State for Communities and Local Government [2011] UKSC 15 (Beesley hereafter) and Fidler v. Secretary of State for Communities and Local Government [2010] EWHC 143 (Admin), Fidler v. Secretary of State for Communities and Local Government [2011] EWCA civ 1159 (Fidler hereafter) are two recent cases concerning deliberately concealed breaches of planning control. The defendants engaged in dishonest and misleading conduct, in an attempt to rely on a loophole within Section 171B of the Town and Country Planning Act 1990 (T&CPA). This study aims to critically analyse two solutions which were created to close the loophole; in addition, this study analyses various alternative remedies that have been suggested, and finally, whether the present law has been sufficient to remedy the situation. Design/methodology/approach – The T&CPA is a key piece of legislation regulating planning controls; Section 171A-C provides the time limits for taking enforcement action against a breach of planning control. To achieve the above purpose, an evaluation of those provisions will be undertaken in detail. Subsequently, this study will analyse two solutions which were created to close the loophole; firstly, the Supreme Court (SC) decision (Welwyn Hatfield Borough Council v. Secretary of State for Communities and Local Government [2011] UKSC 15) and, secondly, the governments’ decision to amend the T&CPA without awaiting the SC’s decision[1]. Findings – This research concludes that the government should have awaited the SC’s decision before amending statute to prohibit reliance upon the expiration of time where there is an element of deliberate concealment. Additionally, this study suggests that the statutory amendments were not required in light of the SC’s solution in Beesley. As a result of the governments’ ill-considered decision, uncertainty has permeated through the conveyancing process, causing ambiguity, delays and additional expense in transactions at a time when a precarious property market needs anything but uncertainty. Research limitations implications – The scope of this research is limited to deliberate concealment of breaches of planning control and the four-year enforcement period; whilst considering the consequences of the solutions proposed, this study does not provide a detailed overview of the planning system, but rather assumes prior knowledge. Originality/value – This study offers a unique assessment of the law relating to the deliberate concealment of planning breaches and offers a thorough criticism of the law with recommendations for reform. Additionally, a variety of alternative solutions are considered. Both legal academics, planning professionals and those interested in planning law will find the paper a thought-provoking digest

The relationship between buildings and health: A systematic review

© 2018 The Author(s). Published by Oxford University Press on behalf of Faculty of 268 Public Health. All rights reserved. Background The built environment exerts one of the strongest directly measurable effects on physical and mental health, yet the evidence base underpinning the design of healthy urban planning is not fully developed. Method This study provides a systematic review of quantitative studies assessing the impact of buildings on health. In total, 7127 studies were identified from a structured search of eight databases combined with manual searching for grey literature. Only quantitative studies conducted between January 2000 and November 2016 were eligible for inclusion. Studies were assessed using the quality assessment tool for quantitative studies. Results In total, 39 studies were included in this review. Findings showed consistently that housing refurbishment and modifications, provision of adequate heating, improvements to ventilation and water supply were associated with improved respiratory outcomes, quality of life and mental health. Prioritization of housing for vulnerable groups led to improved wellbeing. However, the quality of the underpinning evidence and lack of methodological rigour in most of the studies makes it difficult to draw causal links. Conclusion This review identified evidence to demonstrate the strong association between certain features of housing and wellbeing such as adequate heating and ventilation. Our findings highlight the need for strengthening of the evidence base in order for meaningful conclusions to be drawn

Integration and continuity of primary care: polyclinics and alternatives - a patient-centred analysis of how organisation constrains care co-ordination

Background An ageing population, the increasing specialisation of clinical services and diverse health-care provider ownership make the co-ordination and continuity of complex care increasingly problematic. The way in which the provision of complex health care is co-ordinated produces – or fails to produce – six forms of continuity of care (cross-sectional, longitudinal, flexible, access, informational and relational). Care co-ordination is accomplished by a combination of activities by patients themselves; provider organisations; care networks co-ordinating the separate provider organisations; and overall health-system governance. This research examines how far organisational integration might promote care co-ordination at the clinical level. Objectives To examine (1) what differences the organisational integration of primary care makes, compared with network governance, to horizontal and vertical co-ordination of care; (2) what difference provider ownership (corporate, partnership, public) makes; (3) how much scope either structure allows for managerial discretion and ‘performance’; (4) differences between networked and hierarchical governance regarding the continuity and integration of primary care; and (5) the implications of the above for managerial practice in primary care. Methods Multiple-methods design combining (1) the assembly of an analytic framework by non-systematic review; (2) a framework analysis of patients’ experiences of the continuities of care; (3) a systematic comparison of organisational case studies made in the same study sites; (4) a cross-country comparison of care co-ordination mechanisms found in our NHS study sites with those in publicly owned and managed Swedish polyclinics; and (5) the analysis and synthesis of data using an ‘inside-out’ analytic strategy. Study sites included professional partnership, corporate and publicly owned and managed primary care providers, and different configurations of organisational integration or separation of community health services, mental health services, social services and acute inpatient care. Results Starting from data about patients’ experiences of the co-ordination or under-co-ordination of care, we identified five care co-ordination mechanisms present in both the integrated organisations and the care networks; four main obstacles to care co-ordination within the integrated organisations, of which two were also present in the care networks; seven main obstacles to care co-ordination that were specific to the care networks; and nine care co-ordination mechanisms present in the integrated organisations. Taking everything into consideration, integrated organisations appeared more favourable to producing continuities of care than did care networks. Network structures demonstrated more flexibility in adding services for small care groups temporarily, but the expansion of integrated organisations had advantages when adding new services on a longer term and a larger scale. Ownership differences affected the range of services to which patients had direct access; primary care doctors’ managerial responsibilities (relevant to care co-ordination because of their impact on general practitioner workload); and the scope for doctors to develop special interests. We found little difference between integrated organisations and care networks in terms of managerial discretion and performance. Conclusions On balance, an integrated organisation seems more likely to favour the development of care co-ordination and, therefore, continuities of care than a system of care networks. At least four different variants of ownership and management of organisationally integrated primary care providers are practicable in NHS-like settings. Future research is therefore required, above all to evaluate comparatively the different techniques for coordinating patient discharge across the triple interface between hospitals, general practices and community health services; and to discover what effects increasing the scale and scope of general practice activities will have on continuity of care

Home healthcare services in Taiwan: a nationwide study among the older population

<p>Abstract</p> <p>Background</p> <p>Home healthcare services are important in aging societies worldwide. The present nationwide study of health insurance data examined the utilization and delivery patterns, including diagnostic indications, for home healthcare services used by seniors in Taiwan.</p> <p>Methods</p> <p>Patients ≥65 years of age who received home healthcare services during 2004 under the Taiwanese National Health Insurance Program were identified and reimbursement claims were analyzed. Age, gender, disease diagnoses, distribution of facilities providing home healthcare services, and patterns of professional visits, including physician and skilled nursing visits, were also explored.</p> <p>Results</p> <p>Among 2,104,978 beneficiaries ≥65 years of age, 19,483 (0.9%) patients received 127,753 home healthcare visits during 2004 with a mean number of 6.0 ± 4.8 visits per person. The highest prevalence of home healthcare services was in the 75-84 year age group in both sexes. Females received more home healthcare services than males in all age groups. Cerebrovascular disease was the most frequent diagnosis in these patients (50.7%). More than half of home healthcare visits and around half of the professional home visits were provided by community home nursing care institutions. The majority of the home skilled nursing services were tube replacements, including nasogastric tubes, Foley catheter, tracheostomy, nephrostomy or cystostomy tubes (95%).</p> <p>Conclusions</p> <p>Nine out of 1,000 older patients in Taiwan received home healthcare services during 2004, which was much lower than the rate of disabled older people in Taiwan. Females used home healthcare services more frequently than males and the majority of skilled nursing services were tube replacements. The rate of tube replacement of home healthcare patients in Taiwan deserves to be paid more attention.</p

Implications of climate change for shipping: Ports and supply chains

Ports are an important economic actor—at local, national, and international scales—that have been identified as being vulnerable to future changes to the climate. This paper details the findings from an international review of state‐of‐the‐art knowledge concerning climate risks, and adaptation responses, for ports and their supply chains. Evidence from both academic and gray literature indicates that there has already been major damage and disruption to ports across the world from climate‐related hazards and that such impacts are projected to increase in the years and decades to come. Findings indicate that while a substantial—and growing—body of scientific evidence on coastal risks and potential adaptation options is acting as a stimulus for port authorities to explicitly consider the risks for their assets and operations, only a notable few have actually made the next step toward implementing adaptation strategies. This paper concludes by putting forward constructive recommendations for the sector and suggestions for research to address remaining knowledge gaps. It emphasizes a call for collaboration between the research and practice communities, as well as the need to engage a broad range of stakeholders in the adaptation planning process

A qualitative exploration of the human resource policy implications of voluntary counselling and testing scale-up in Kenya: applying a model for policy analysis

Background: Kenya experienced rapid scale up of HIV testing and counselling services in government health services from 2001. We set out to examine the human resource policy implications of scaling up HIV testing and counselling in Kenya and to analyse the resultant policy against a recognised theoretical framework of health policy reform (policy analysis triangle). Methods: Qualitative methods were used to gain in-depth insights from policy makers who shaped scale up. This included 22 in-depth interviews with Voluntary Counselling and Testing (VCT) task force members, critical analysis of 53 sets of minutes and diary notes. We explore points of consensus and conflict amongst policymakers in Kenya and analyse this content to assess who favoured and resisted new policies, how scale up was achieved and the importance of the local context in which scale up occurred. Results: The scale up of VCT in Kenya had a number of human resource policy implications resulting from the introduction of lay counsellors and their authorisation to conduct rapid HIV testing using newly introduced rapid testing technologies. Our findings indicate that three key groups of actors were critical: laboratory professionals, counselling associations and the Ministry of Health. Strategic alliances between donors, NGOs and these three key groups underpinned the process. The process of reaching consensus required compromise and time commitment but was critical to a unified nationwide approach. Policies around quality assurance were integral in ensuring standardisation of content and approach. Conclusion: The introduction and scale up of new health service initiatives such as HIV voluntary counselling and testing necessitates changes to existing health systems and modification of entrenched interests around professional counselling and laboratory testing. Our methodological approach enabled exploration of complexities of scale up of HIV testing and counselling in Kenya. We argue that a better understanding of the diverse actors, the context and the process, is required to mitigate risks and maximise impact