Restorative Just Culture: a Study of the Practical and Economic Effects of Implementing Restorative Justice in an NHS Trust

Restorative justice is an approach that aims to replace hurt by healing in the understanding that the perpetrators of pain are also victims of the incident themselves. In 2016, Mersey Care, an NHS community and mental health trust in the Liverpool region, implemented restorative justice (or what it termed a 'Just and Learning Culture') to fundamentally change its responses to incidents, patient harm, and complaints against staff. Although qualitative benefits from this implementation seemed obvious, it was also thought relevant to identify the economic effects of restorative justice. Through interviews with Mersey Care staff and collecting data pertaining to costs, suspensions, and absenteeism, an economic model of restorative justice was created. We found that the introduction of restorative justice has coincided with many qualitative improvements for staff, such as a reduction in suspensions and dismissals, increase in the reporting of adverse events, increase in the number of staff that feel encouraged to seek support and a slowing down of the upward trend in absence due to illness. It also improved staff retention. The economic benefits of restorative justice appear significant. After corrections for inflation, acquisitions and anomalies, we found that the salary costs averaged over two fiscal years were reduced by £ 4 million per year, coinciding with the introduction of a just and learning culture in 2016. In addition, Mersey Care reaped around £ 1 million in saved legal and termination expenses. We conservatively attribute half of these savings to the introduction of a just and learning culture itself, and the other half to non-related factors. Using this assumption, we estimate the total economic benefit of restorative justice in the case of Mersey Care NHS Foundation Trust to be about £ 2.5 million or approximately 1% of the total costs and 2% of the labour costs

Socioeconomic differences in recruitment and sickness absence in a large NHS health organisation: a cross-sectional study

OBJECTIVE: This study investigates the distribution of the workforce of one large National Health Service (NHS) employer in relation to socioeconomic deprivation and how sickness absence rates varied across these levels of deprivation. DESIGN: Share of the working age population that was employed at the NHS organisation mapped by area deprivation. The study used negative binomial regression models to investigate the extent to which wage level, occupational group and area deprivation were associated with sickness absence among employees. SETTING: The study used electronic staff records (2018–2019) of a large NHS organisation in the North West of England. RESULTS: In the most deprived areas, an additional person per 1000 working age population were employed at this NHS organisation compared with the most affluent areas. Employees from the most deprived quintile had 1.41 (95% CI 1.16 to 1.70) times the higher sickness rates than the employees from the least deprived quintile, when adjusting for age and sex. These differences were largely explained by differences in wage levels and occupation groups, with the lowest wage employees having 2.5 (95% CI 1.87 to 3.42) times the sickness absence rate as the highest wage group and the nursing and midwifery employees having 1.8 (95% CI 1.50 to 2.24) times the sickness absence rate as the administrative and clerical group. CONCLUSION: This large NHS organisation employed people disproportionately from deprived areas. They were considerably more likely to experience sickness absence compared with people from affluent areas. This appears to be because they were more likely to be in lower wage employment and employed in nursing and nursing assistant. Workplace health policies need to target these workers, adapting to their needs while enabling improvements in their working conditions, pay and career progression

The Lifetime and Powers of FR IIs in Galaxy Clusters

We have identified and studied a sample of 151 FR IIs found in brightest cluster galaxies (BCGs) in the MaxBCG cluster catalog with data from FIRST and NVSS. We have compared the radio luminosities and projected lengths of these FR IIs to the projected length distribution of a range of mock catalogs generated by an FR II model and estimate the FR II lifetime to be 1.9 x 10^8 yr. The uncertainty in the lifetime calculation is a factor of two, due primarily to uncertainties in the ICM density and the FR II axial ratio. We furthermore measure the jet power distribution of FR IIs in BCGs and find that it is well described by a log-normal distribution with a median power of 1.1 x 10^37 W and a coefficient of variation of 2.2. These jet powers are nearly linearly related to the observed luminosities, and this relation is steeper than many other estimates, although it is dependent on the jet model. We investigate correlations between FR II and cluster properties and find that galaxy luminosity is correlated with jet power. This implies that jet power is also correlated with black hole mass, as the stellar luminosity of a BCG should be a good proxy for its spheroid mass and therefore the black hole mass. Jet power, however, is not correlated with cluster richness, nor is FR II lifetime strongly correlated with any cluster properties. We calculate the enthalpy of the lobes to examine the impact of the FR IIs on the ICM and find that heating due to adiabatic expansion is too small to offset radiative cooling by a factor of at least six. In contrast, the jet power is approximately an order of magnitude larger than required to counteract cooling. We conclude that if feedback from FR IIs offsets cooling of the ICM, then heating must be primarily due to another mechanism associated with FR II expansion.Comment: 22 pages, 20 figures. Accepted to ApJ. Added minor clarifications throughout the paper and restructured section 6.2 in response to the referee. A brief video explaining the paper can be found at http://youtu.be/DOq85qUSU-

A diffuse bubble-like radio-halo source MRC 0116+111: imprint of AGN feedback in a low-mass cluster of galaxies

We present detailed observations of MRC 0116+111, revealing a luminous, mini radio-halo of ~240 kpc diameter located at the centre of a cluster of galaxies at redshift z = 0.131. Our optical and multi-wavelength GMRT and VLA radio observations reveal a highly unusual radio source: showing a pair of giant (~100 kpc diameter) bubble-like diffuse structures, that are about three times larger than the analogous extended radio emission observed in M87 - the dominant central radio galaxy in the Virgo Cluster. However, in MRC 0116+111 we do not detect any ongoing Active Galactic Nucleus (AGN) activity, such as a compact core or active radio jets feeding the plasma bubbles. The radio emitting relativistic particles and magnetic fields were probably seeded in the past by a pair of radio-jets originating in the AGN of the central cD galaxy. The extremely steep high-frequency radio spectrum of the north-western bubble, located ~100 kpc from cluster centre, indicates radiation losses, possibly because having detached, it is rising buoyantly and moving away into the putative hot intra-cluster medium. The other bubble, closer to the cluster centre, shows signs of ongoing particle re-acceleration. We estimate that the radio jets which inflated these two bubbles might have also fed enough energy into the intra-cluster medium to create an enormous system of cavities and shock fronts, and to drive a massive outflow from the AGN, which could counter-balance and even quench a cooling flow. Therefore, this source presents an excellent opportunity to understand the energetics and the dynamical evolution of radio-jet inflated plasma bubbles in the hot cluster atmosphere.Comment: 15 pages, 8 figures. Accepted for publication in MNRA

The Lantern Vol. 74, No. 1, Fall 2006

• Seven Haikus About Insomnia • Lunch Hour • Divorced Parents and Flower Guts • 24 • Lily • Growth • Narcissistically Admiring You • Mysterious Avocado • Aloha Roast • Summer • Lines • Internalizing • San Francisco • Numb Candle • Moments No. 1 • Tanka • Euphemism • We be Malllllll • Dragon Magic • Time for the Magic Show • Green • Job • The Shire • Venom • The Seasons of Love • The Position • Fragments of an Artist • Peace • Vagabond Nights • Rerum Concordia Discorshttps://digitalcommons.ursinus.edu/lantern/1169/thumbnail.jp

An interactive and immersive human–computer interface for rapid composite part production design

This article addresses the need for better retention and exploitation of tacit knowledge for intelligent computer-aided design. It presents an automated design framework for the development of individual part forming tools for a composite stiffener incorporating parametrically developed design geometries. This work develops existing principles in knowledge-based engineering and parametric modelling beyond product design in the manufacturing planning domain. Outcomes demonstrate chronological benefits of automated process design methods as well as learning enhancements as the tacit knowledge data set can now include an applied element through an auto-generated virtual build environment. A virtual environment presenting a design concept to the planner for interactive assembly assessment was generated in twenty seconds and enabled the completion of virtual builds in support of the development of an optimal forming tool arrangement. This principle enables the addition of an experiential tacit knowledge feedback loop to further improve assembly planning for design concepts as they evolve. Challenges still exist in determining the level of reality required to provide an effective learning environment in the virtual world. Full representation of physical phenomena such as gravity, part clashes and the representation of standard build functions require further work to represent real physical phenomena robustly. </jats:p

Restorative Just Culture: a Study of the Practical and Economic Effects of Implementing Restorative Justice in an NHS Trust

Restorative justice is an approach that aims to replace hurt by healing in the understanding that the perpetrators of pain are also victims of the incident themselves. In 2016, Mersey Care, an NHS community and mental health trust in the Liverpool region, implemented restorative justice (or what it termed a 'Just and Learning Culture') to fundamentally change its responses to incidents, patient harm, and complaints against staff. Although qualitative benefits from this implementation seemed obvious, it was also thought relevant to identify the economic effects of restorative justice. Through interviews with Mersey Care staff and collecting data pertaining to costs, suspensions, and absenteeism, an economic model of restorative justice was created. We found that the introduction of restorative justice has coincided with many qualitative improvements for staff, such as a reduction in suspensions and dismissals, increase in the reporting of adverse events, increase in the number of staff that feel encouraged to seek support and a slowing down of the upward trend in absence due to illness. It also improved staff retention. The economic benefits of restorative justice appear significant. After corrections for inflation, acquisitions and anomalies, we found that the salary costs averaged over two fiscal years were reduced by £ 4 million per year, coinciding with the introduction of a just and learning culture in 2016. In addition, Mersey Care reaped around £ 1 million in saved legal and termination expenses. We conservatively attribute half of these savings to the introduction of a just and learning culture itself, and the other half to non-related factors. Using this assumption, we estimate the total economic benefit of restorative justice in the case of Mersey Care NHS Foundation Trust to be about £ 2.5 million or approximately 1% of the total costs and 2% of the labour costs

Improving equitable healthcare resource use: Developing a neighbourhood district nurse needs index for staffing allocation

Abstract Background Allocating health care resources to local areas in proportion to need is an important element of many universal health care systems, aiming to provide equal access for equal need. The UK National Health Service allocates resources to relatively large areas in proportion to need, using needs-weighted capitation formulae. However, within those planning areas, local providers and commissioners also require robust methods for allocating resources to neighbourhoods in proportion to need to ensure equitable access. We therefore developed a local resource allocation formula for NHS district nursing services for a City in the North West of England, demonstrating a novel approach for equitable resource allocation to small areas. Methods Using linked data from community health services, primary care, secondary care and social care, we used a zero-inflated Poisson regression to model the number of district nursing services contacts for each individual based on predictors of need, while including the supply of district nurses per head to account for historical supply induced patterns. Individual need was estimated based on the predictions from this model, keeping supply fixed at the average. We then compared the distribution of district nurses between neighbourhoods, based on our formula, to the current service staffing distribution. Results Key predictors of need for district nursing services were age, deprivation, chronic diseases such as, cardiovascular disease, chronic liver disease, neurological disease, mental ill health, learning disability living in a nursing home, living alone, and receiving palliative care. Need for district nursing services was highly weighted towards older and more deprived populations. The current distribution of staff was, however, more correlated with age than deprivation. Moving to a needs-based staffing distribution would shift staff from less deprived areas to more deprived areas potentially reducing inequalities. Conclusion A neighbourhood-level model for needs for district nursing is a useful tool that can potentially improve the allocation of resources, addressing unmet need and inequalities.</p

Michigan bench, men's basketball (image)

http://deepblue.lib.umich.edu/bitstream/2027.42/61043/1/2502.pd