To flag or not to flag : identification of children and young people with learning disabilities in English hospitals

Background Children and young people with learning disabilities experience poor health outcomes and lengthier hospital admissions than those without learning disabilities. No consistently applied, systematic approach exists across the NHS to identify and record this population. This paper describes practices in English hospitals to identify children and young people with learning disabilities. Method Interviews: 65 NHS staff. Questionnaire: 2,261 NHS staff. Conducted across 24 NHS hospitals in England. Results No standardized approach exists to identify children or young people with a learning disability or for this information to be consistently recorded, communicated to relevant parties within a hospital, Trust or across NHS services. Staff reported a reliance on parents to inform them about their child's needs but concerns about “flagging” patients might be a significant barrier. Discussion Without an integrated systematic way across the NHS to identify children with learning disabilities, their individual needs will not be identified.</p

Notes on a scandal: the official enquiry into deviance and corruption in New Zealand police

Since 2004, the New Zealand Police Service has been engulfed by a series of scandals relating to allegations that officers have committed rape and sexual assault and conducted inappropriate sexual relations with vulnerable people. Moreover, it has been claimed that other officers engaged in corrupt practices to thwart the investigation and prosecution of criminal behaviour of police officers. In 2007, a Commission of Inquiry report established a program of reform intended to shape the future direction of the police service. This article provides an overview of these scandals, the context in which they have emerged, and the political and policing response to them. The analysis contained in the Commission report is compared with that offered by comparable investigations of police deviance and corruption in other countries. The methodological and conceptual limitations of the Commission are outlined and the prospects of the recommendations are considered

Current perceptions of statutory supervision of midwifery: time for change

Statutory supervision of midwifery has been in place in the UK for 113 years. Recently, however, the Nursing and Midwifery Council (NMC, 2015) have voted to accept the recommendations of the King’s fund review (2015) into midwifery regulation, which will see the end of the statutory supervision of midwifery as we know it. Much of the literature on this subject extols the virtues of statutory supervision. The aim of this study is to explore current perceptions of statutory supervision among a sample of midwifery practitioners to establish whether their views and opinions of statutory supervision supports or undermines the provision of care. The data represents a complex picture of supervision. Concerns and challenges arise for all those involved with statutory supervision, which at times does not appear to support the provision of quality care

‘We Call it Jail Craft’: The Erosion of the Protective Discourses Drawn on by Prison Officers Dealing with Ageing and Dying Prisoners in the Neoliberal, Carceral System

The UK prison population has doubled in the last decade, with the greatest increases among prisoners over the age of 60 years, many of whom are sex offenders imprisoned late in life for ‘historical’ offences. Occurring in a context of ‘austerity’ and the wider neoliberal project, an under-researched consequence of this increase has been the rising numbers of ‘anticipated’ prison deaths; that is, deaths that are foreseeable and that require end of life care. We focus here on ‘jail craft’; a nostalgic, multi-layered, narrative or discourse, and set of tacit practices which are drawn on by officers to manage the affective and practical challenges of working with the demands of this changed prison environment. Utilising findings from an empirical study of end of life care in prisons, we propose that the erosion of jail craft depletes protective resources and sharpens the practical consequences of neoliberal penal policies

Prevention of suicidal behaviour in prisons: an overview of initiatives based on a systematic review of research on near-lethal suicide attempts

Background: Worldwide, prisoners are at high risk of suicide. Research on near-lethal suicide attempts can provide important insights into risk and protective factors, and inform suicide prevention initiatives in prison. Aims: To synthesize findings of research on near-lethal attempts in prisons, and consider their implications for suicide prevention policies and practice, in the context of other research in custody and other settings. Method: We searched two bibliographic indexes for studies in any language on near-lethal and severe self-harm in prisoners, supplemented by targeted searches over the period 2000–2014. We extracted information on risk factors descriptively. Data were not meta-analyzed owing to heterogeneity of samples and methods. Results: We identified eight studies reporting associations between prisoner near-lethal attempts and specific factors. The latter included historical, prison-related, and clinical factors, including psychiatric morbidity and comorbidity, trauma, social isolation, and bullying. These factors were also identified as important in prisoners' own accounts of what may have contributed to their attempts (presented in four studies). Conclusion: Factors associated with prisoners' severe suicide attempts include a range of potentially modifiable clinical, psychosocial, and environmental factors. We make recommendations to address these factors in order to improve detection, management, and prevention of suicide risk in prisoners

The police and the far right in Greece::a case study of police voting behaviour in Athens

The electoral advance of the far right party of Golden Dawn has left a clear mark on the Greek parliamentary elections of 2012. A less debated aspect of these results involves the extent of the electoral influence of Golden Dawn among police personnel. Using electoral data from two districts in Greece’s capital city, this paper explores the extent of that influence among major front line police units based in those localities. Our analysis obtains clear indications that Golden Dawn’s presence has been much more emphatic among police personnel than among the general public. These results warrant further exploration of this development, particularly in light of the possibility that far-right ideology may influence the character of everyday policing in Greece and the use of police discretion at the detriment of vulnerable or politically undesirable groups

Independence in complaints procedures: lessons from community care

This article looks at internal complaints procedures and considers the role of independent elements in procedures which are designed to be simple, informal and low cost. Taking the example of local authority community care services as a case study, the article discusses research which looked at the views of complainants, potential complainants and those who run the procedure. Most people do not make formal complaints at all and very few people seek an independent review of their complaint. When they do seek such a review, they expect it to be transparently independent of the body complained about. The article concludes that the current system of local authority complaints review panels or committees does not provide the independent element that complainants seek

Failure to report as a breach of moral and professional expectation

Cases of poor care have been documented across the world. Contrary to professional requirements, evidence indicates that these sometimes go unaddressed. For patients the outcomes of this inaction are invariably negative. Previous work has either focused on why poor care occurs and what might be done to prevent it, or on the reasons why those who are witness to it find it difficult to raise their concerns. Here we build on this work but specifically foreground the responsibilities of registrants and students who witness poor care. Acknowledging the challenges associated with raising concerns, we make the case that failure to address poor care is a breach of moral expectation, professional requirement and sometimes, legal frameworks. We argue that reporting will be more likely to take place if those who wish to enter the profession have a realistic view of the challenges they may encounter. When nurses are provided with robust and applied education on ethics, when ‘real-world’ cases and exemplars are used in practice and when steps are taken to develop and encourage individual moral courage, we may begin to see positive change. Ultimately however, significant change is only likely to take place where practice cultures invite and welcome feedback, promote critical reflection, and where strong, clear leadership support is shown by those in positions of influence across organisations