Improving well-being and outcomes for looked after children in Wales: a context sensitive review of interventions

Improving outcomes for looked after children and young people has been a longstanding concern in Wales. This article reports the findings of a scoping study which sought to identify interventions aimed at improving outcomes for looked after children that are effective or promising. The study was commissioned by an independent funding body to inform a £5 million investment programme for Wales. It comprised a rapid review of literature, informed through consultation with an expert advisory panel and groups of young people who had been in care. The article outlines the rapid review method, provides details of shortlisted interventions and describes the interventions subsequently approved for investment. It concludes that although there are many promising interventions which address the factors associated with poor outcomes for looked after children, the evidence base is weak. It is argued that decision-making on interventions should be informed by appraisal of the empirical evidence available, but should also be guided by professional judgement that considers the needs, priorities and preferences of service users, carers, practitioners and policy-makers

Working towards co-production in rehabilitation and recovery services

PurposeThis paper outlines the work of a service provider, service user and carer group created to develop a strategy for service user and carer co-production.ApproachA reflective narrative account is given of the process through which the group formed and began to develop a working model aimed at shaping a cultural shift towards more co-produced services. The paper has been co-produced and includes the collaborative voices of service users, carers, multi-disciplinary staff, third sector representatives, managers and colleagues from associated services.FindingsThe model developed outlines 3 stages for services to work through in order to achieve meaningful and sustainable co-produced services. The importance of developing associated policies related to such areas as recruitment, payment, support and training is also outlined. Challenges to co-production are noted along with suggested approaches to overcoming these.Implications and ValueThe ethos of co-production is relatively new in the UK and so knowledge of the process and model may help guide others undertaking similar work

Welfare reform in the UK 2010-16: Expectations, outcomes and local impacts

Welfare reform has been central to UK government policy since 2010. This article compares initial expectations with key outcomes by 2016. The article shows that although the financial savings to the Treasury have been large, they have been rather less than the government first anticipated, mainly because the reduction in spending on incapacity‐related benefits has proved far smaller than expected. The financial losses have also been spread highly unevenly across the country, and the evidence from a pilot study in Scotland suggests that the reforms have had little impact on levels of worklessness. The article concludes that whilst forecasting the financial savings from welfare reform is an inherently uncertain activity, the United Kingdom's reforms should be understood first and foremost as about reducing public spending in the poorest places

Using Geographic Information Systems to investigate variations in accessibility to ‘extended hours’ primary healthcare provision

There are ongoing policy concerns surrounding the difficulty in obtaining timely appointments to primary healthcare services and the potential impact on, for example, attendance at accident and emergency services and potential health outcomes. Using the case study of potential access to primary healthcare services in Wales, Geographic Information System (GIS)‐based tools that permit a consideration of population‐to‐provider ratios over space are used to examine variations in geographical accessibility to general practitioner (GP) surgeries offering appointment times outside of ‘core’ operating hours. Correlation analysis is used to explore the association of accessibility scores with potential demand for such services using UK Population Census data. Unlike the situation in England, there is a tendency for accessibility to those surgeries offering ‘extended’ hours of appointment times to be better for more deprived census areas in Wales. However, accessibility to surgeries offering appointments in the evening was associated with lower levels of working age population classed as ‘economically active’; that is, those who could be targeted beneficiaries of policies geared towards ‘extended’ appointment hours provision. Such models have the potential to identify spatial mismatches of different facets of primary healthcare, such as ‘extended’ hours provision available at GP surgeries, and are worthy of further investigation, especially in relation to policies targeted at particular demographic groups

Editorial [to] Themed issue on sustainability in energy and buildings, part 1

This themed issue includes the selected papers from the proceedings of the seventh International Conference on Sustainability and Energy in Buildings 2015 (SEB15), which was successfully held in the vibrant city of Lisbon, Portugal and was organised by the Universidade Nova de Lisbon (New University of Lisbon) in partnership with KES International. Annually, the conference brings together researchers and government and industry professionals to discuss the future of energy in buildings, neighbourhoods and cities from a theoretical, practical, implementation and simulation perspective

Information-sharing with respite care services for older adults:a qualitative exploration of carers’ experiences

This study was financially supported by the Queen’s Nursing Institute Scotland (QNIS Project ELCRI01), Edinburgh, Scotland.Respite services play an important role in supporting older adults and their carers. When an older person is unable to fully represent themselves, provision of respite care relies on effective information-sharing between carers and respite staff. This study aimed to explore, from carers’ perspectives, the scope, quality and fit of information-sharing between carers, older people and respite services. An explorative, cross-sectional qualitative study involving a purposive sample of 24 carers, recruited via carer support groups and community groups in voluntary organisations, was undertaken in North East Scotland. Data were collected from August 2013 to September 2014, with participants taking part in a focus group or individual interview. Data were analysed systematically using the Framework Approach. The multiple accounts elicited from carers identified how barriers and facilitators to information-sharing with respite services changed over time across three temporal phases: ‘Reaching a point’, ‘Trying it out’ and ‘Settled in’. Proactive information-sharing about accessibility and eligibility for respite care, and assessment of carers’ needs in their own right, were initially important; as carers and older people moved on to try services out, time and space to develop mutual understandings and negotiate care arrangements came to the fore; then, once shared expectations had been established, carers’ chief concerns were around continuity of care and maintaining good interpersonal relationships. The three temporal phases also impacted on which modes of information-sharing were available to, and worked best for, carers as well as on carers’ perceptions of how information and communication technologies should be utilised. This study highlights the need for respite staff to take proactive, flexible approaches to working with carers and to make ongoing efforts to engage with carers, and older people, throughout the months and years of them utilising respite services. Information and communication technologies have potential to enhance information-sharing but traditional approaches will remain important.PostprintPeer reviewe