15 research outputs found
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Icarus Falls: The Coal Health Scandal
The handling of cases under the Coal Health Compensation Schemes, set up in 1999 to compensate miners suffering from workplace medical conditions, resulted in over 100 solicitors from more than 30 firms facing disciplinary proceedings. Three were struck off, three suspended and over forty fined following the largest investigation ever mounted by the regulator. This article examines the political and regulatory context of the scandal, describes one of the cases presented to the Solicitors' Disciplinary Tribunal and examines the relevance of theories of transgression to professional disciplinary matters. It concludes by considering the regulatory impacts and implications of the scandal
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The challenges in monitoring and preventing patient safety incidents for people with intellectual disabilities in NHS acute hospitals: evidence from a mixed-methods study.
BACKGROUND: There has been evidence in recent years that people with intellectual disabilities in acute hospitals are at risk of preventable deterioration due to failures of the healthcare services to implement the reasonable adjustments they need. The aim of this paper is to explore the challenges in monitoring and preventing patient safety incidents involving people with intellectual disabilities, to describe patient safety issues faced by patients with intellectual disabilities in NHS acute hospitals, and investigate underlying contributory factors.
METHODS: This was a 21-month mixed-method study involving interviews, questionnaires, observation and monitoring of incident reports to assess the implementation of recommendations designed to improve care provided for patients with intellectual disabilities and explore the factors that compromise or promote patient safety. Six acute NHS Trusts in England took part. Data collection included: questionnaires to clinical hospital staff (n = 990); questionnaires to carers (n = 88); interviews with: hospital staff including senior managers, nurses and doctors (n = 68) and carers (n = 37); observation of in-patients with intellectual disabilities (n = 8); monitoring of incident reports (n = 272) and complaints involving people with intellectual disabilities.
RESULTS: Staff did not always readily identify patient safety issues or report them. Incident reports focused mostly around events causing immediate or potential physical harm, such as falls. Hospitals lacked effective systems for identifying patients with intellectual disabilities within their service, making monitoring safety incidents for this group difficult.The safety issues described by the participants were mostly related to delays and omissions of care, in particular: inadequate provision of basic nursing care, misdiagnosis, delayed investigations and treatment, and non-treatment decisions and Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) orders.
CONCLUSIONS: The events leading to avoidable harm for patients with intellectual disabilities are not always recognised as safety incidents, and may be difficult to attribute as causal to the harm suffered. Acts of omission (failure to give care) are more difficult to recognise, capture and monitor than acts of commission (giving the wrong care). In order to improve patient safety for this group, the reasonable adjustments needed by individual patients should be identified, documented and monitored
The missing mobile: impacts from the incarceration of Indigenous Australians from remote communities
Britain and individual employment rights: 'Paper tigers, fierce in appearance but missing in tooth and claw'
There is much evidence that the 'European social model' is under threat, with neoliberalism increasingly dominating policy both at EU and national levels. Within this trend, Britain stands out as already having a long-established free market tradition-Anglo-American in both industrial relations and corporate governance systems. This article seeks to illustrate how British state allegiance to a 'flexible' labour market has brought new restrictions to accessing statutory employment protection, the chief defence for 'unorganized' workers those who are neither unionized nor covered by collective agreements and who now comprise the majority of workers in Britain. The New Labour government, committed to voluntarism and fiexibility, has used the very instrument it avers to avoid legal regulation to limit access to employment tribunals, the final resort for legal enforcement of employment rights. The government has thus constrained its concessions to the European social model, which comprise a range of laws since 1997 enhancing individual employment rights, in its overarching neoliberal policy, by ensuring legal regulation remains difflcult to achieve and does not 'burden' business. This article, based on research both on legal developments, and on the social support mechanisms for non-unionized workers, seeks to demonstrate the extreme vulnerability of the unorganized worker in an increasingly free market Britain. How far this portrait has relevance to the rightward drift of Europe depends on the degree to which it can be exported, how far continental European systems are sufflciently institutionally embedded to resist this, and how successfully the European social model is defended. © 2007 Arbetslivinstitutet