Cancer diagnosis in Scottish primary care: results from the National Cancer Diagnosis Audit

The National Cancer Diagnosis Audit (NCDA) in Scotland received enabling support from Cancer Research UK and the Scottish Government. ACKNOWLEDGEMENTSThis audit used data provided by patients and collected by the NHS as part of their care and support. The authors would like to thank all GPs and health professionals who participated in the NCDA in Scotland and England, the members of the NCDA Steering Group (National Cancer Diagnosis Audit (2014) Steering Group: Sue Ballard (patient †), Patricia Barnett, David H Brewster, Cathy Burton, Anthony Cunliffe, Jane Fenton-May,Anna Gavin, Sara Hiom(chair),Peter Hutchison, Dyfed Huws, Maggie Kemmner, Rosie Loftus, Georgios Lyratzopoulos,Emma McNair, John Marsh (patient), Jodie Moffat, Sean McPhail, Peter Murchie, Andy Murphy, Sophia Nicola, Imran Rafi, Jem Rashbass, Richard Roope, Greg Rubin, Brian Shand, Ruth Swann, Janet Warlow, David Weller and Jana Witt.) and contributing staff at Cancer Research UK; Information Services Division (NHS Scotland); Scottish Government; the National Cancer Registration and Analysis Service (Public Health England); NHS England; the Royal College of General Practitioners; and Macmillan Cancer SupportPeer reviewedPostprin

Results from the Scottish national HAI prevalence survey

A national point prevalence survey was undertaken over the period of one calendar year in Scotland from October 2005 to October 2006. The prevalence of healthcare-associated infection (HAI) was 9.5% in acute hospitals and 7.3% in non-acute hospitals. The highest prevalence of HAI in acute hospital inpatients was found in the following specialties: care of the elderly (11.9%), surgery (11.2%), medicine (9.6%) and orthopaedics (9.2%). The lowest prevalence was found in obstetrics (0.9%). The most common types of HAI in acute hospital inpatients were: urinary tract infections (17.9% of all HAI), surgical site infections (15.9%) and gastrointestinal infections (15.4%). In non-acute hospitals one in ten inpatients in two specialties (combined) medicine (11.4%) and care of the elderly (7.8%) was found to have HAI, and one in 20 inpatients in psychiatry (5.0%) had HAI. In non-acute hospital patients, urinary tract infections were frequent (28.1% of all HAI) and similarly skin and soft tissue infection (26.8% of all HAI). When combined, these two HAI types affected 4% of all the inpatients in non-acute hospitals. This is the first survey of its kind in Scotland and describes the burden of HAI at a national level

The development of Scotland’s Curriculum for Excellence: Amnesia and Déjà Vu

Scotland’s new Curriculum for Excellence (CfE) has been widely acknowledged as the most significant educational development in a generation, with the potential to transform learning and teaching in Scottish schools. In common with recent developments elsewhere, CfE seeks to re-engage teachers with processes of curriculum development, to place learning at the heart of the curriculum and to change engrained practices of schooling. This article draws upon well-established curriculum theory (notably the work of both Lawrence Stenhouse and A.V. Kelly) to analyse the new curriculum. We argue that by neglecting to take account of such theory, the curricular offering proposed by CfE is subject to a number of significant structural contradictions which may affect the impact that it ultimately exerts on learning and teaching; in effect, by ignoring the lessons of the past, CfE runs the risk of undermining the potential for real change

Challenging the 'New Professionalism': from managerialism to pedagogy?

In recent years there have been changes made to the conceptualisation of continuing professional development for teachers in both the Scottish and English systems of education. These changes have been instigated by successive UK governments (and more recently, by the Scottish Executive), together with the General teaching Council for Scotland (GTCS) and the General Teaching Council for England (GTCE). This paper argues that these changes have not provided a clear rationale for CPD, but instead have introduced tensions between the concept of teacher education and that of training. The need for a less confused understanding of CPD and its purposes is underlined, as is the need for school based approaches to continuing teacher education. Arguably, teacher education must move from technicist emphases to a model which integrates the social processes of change within society and schools with the individual development and empowerment of teachers

Developing Employment Opportunities for Care Leavers

This article describes an action research project carried out in North West England that aimed to assist Children’s Services Departments and Care Trusts in developing their strategies for supporting care leavers into employment and training. The study found a range of models and approaches that can be utilised to develop local and regional partnerships offering employment and training opportunities designed to meet the needs of care leavers. Relevant questions about the extent to which such opportunities should be ring-fenced or targeted on particular fields of employment are identified

Social capital theory: a cross-cutting analytic for teacher/therapist work in integrating children's services?

Reviewing relevant policy, this article argues that the current 'integration interlude' is concerned with reformation of work relations to create new forms of 'social capital'. The conceptual framework of social capital has been used by government policy-makers and academic researchers to examine different types, configurations and qualities of relationships, including professional relations, and how these may function as resources. Focusing on the co-work of teachers and speech and language therapists, this analysis introduces social capital as a means of understanding the impact of integrating children's services on professional practitioner groups and across agencies. Social capital theory is compared to alternative theoretical perspectives such as systems and discourse theories and explored as an analytic offering a multi-level typology and conceptual framework for understanding the effects of policy and governance on interprofessional working and relationships. A previous application of social capital theory in a literature review is introduced and analysed, and instances of the additionality provided by a social capital analysis is offered. The article concludes that amongst the effects of current policy to re-design children's services are the reconstruction of professionals' knowledge/s and practices, so it is essential that such policy processes that have complex and far-reaching effects are transparent and coherent. It is also important that new social capital relations in children's services are produced by groups representative of all involved, importantly including those practitioner groups charged in policy to work differently together in future integrated services

The potential impact of reforms to the essential parameters of the council tax

Council Tax was introduced in Britain in 1993 and represents a unique international property tax. There is a growing belief that it is time to reform the number and structure of council tax bands but such views have a minimal empirical base. This paper sets out to assess the impact on personal and local government finances, and extends the analysis to the role of the tax multipliers linked to each band. The research is based on the experience of a representative sample of local authorities in Scotland. A statistical revaluation for 2000 is estimated for the existing eight band system, and from this base a ten band system is calculated. Financial implications are then simulated for each local authority taking account of central resource equalisation mechanisms. The results indicate that increases in bands will have little impact on the burden of the council tax compared with regular revaluations. Changing the tax multiplier range has the greatest impact on local authority finances and council tax payments

Community professionals' management of client care : a mixed-methods systematic review

This is the final draft, after peer-review, of a manuscript published in Journal of Health Services Research & Policy. The definitive version, detailed above, is available online at www.rsmjournals.com.Peer reviewedPostprin

Venue Shift Following Devolution: When Reserved Meets Devolved in Scotland

This article examines the means used to address blurred or shifting boundaries between reserved UK and devolved Scottish policy. It outlines the main issues of multi-level governance and intergovernmental relations in Scotland and the initial problems faced in identifying responsibility for policy action. While it suggests that legislative ambiguities are now mainly resolved with the use of ‘Sewel motions', it highlights cases of Scottish action in reserved areas, including the example of smoking policy in which the Scottish Executive appears to ‘commandeer' a previously reserved issue. However, most examples of new Scottish influence suggest the need for UK support or minimal UK interest