Implementation and the Governance Problem: A Pressure Participant Perspective

This article has two aims: to qualify the UK government's ‘problem' of governance in a comparison with Scotland and Wales, and to use implementation studies (the ancestors of the new governance literature) to explore policy developments since devolution in Britain. It presents a puzzling finding from extensive interview research: that while we may expect UK government policy to suffer a bigger ‘implementation gap' based on distinctive governance problems (such as greater service delivery fragmentation and the unintended consequences of top-down policy styles), pressure participants in Scotland and Wales are more likely to report implementation failures. Using a ‘top-down' framework, it explores three main explanations for this finding: that the size of the implementation gap in England is exaggerated by a focus on particular governance problems; that pressure participant dissatisfaction follows unrealistic expectations in the devolved territories; and that the UK government undermines devolved policy implementation, by retaining control of key policy instruments and setting the agenda on measures of implementation success

A survey of local health promotion initiatives for older people in Wales

<p>Abstract</p> <p>Background</p> <p>As the demographic profile of the UK changes, policy makers and practitioners have to respond to health challenges presented by a progressively ageing population. The health promotion plan for older people, aged over 50 years, in Wales included eight key areas: physical activity, healthy eating, home safety and warmth, emotional health, health protection, smoking, alcohol and sexual health. The aim of this study was to describe the extent, content and regional variation of existing health promotion initiatives for older people in Wales, provided by statutory, voluntary and private sector agencies.</p> <p>Method</p> <p>A questionnaire was sent to senior health promotion specialists employed in the 22 local authority areas in Wales to ascertain details of all projects promoting health and wellbeing in the eight key areas where the priority population was aged over 50, or the majority of users were older people. Additional information was sought from project leads and websites.</p> <p>Results</p> <p>Eighteen questionnaires were returned; not all were fully completed. Four areas did not return a questionnaire. Additional information was obtained from internet searches but this mainly concerned national initiatives rather than local projects. In all, 120 projects were included, 11 were throughout Wales. Best provision was for physical activity, with 3 national and 42 local initiatives, but local provision was patchy. Healthy eating, and home safety and warmth had far fewer initiatives, as did health protection, which comprised two national immunisation campaigns. Smoking and alcohol misuse were poorly provided for, and there was no provision for older people's sexual health. Evaluation arrangements were poorly described. Half of those who responded identified unmet training needs.</p> <p>Conclusion</p> <p>The reasons for patchy provision of services were not clear. Increased efforts to improve the coverage of interventions known to be effective should be made. Rigorous evaluation of projects is needed to ascertain the most effective and appropriate interventions, especially for alcohol misuse and sexual health. These conclusions are relevant to the other countries of the United Kingdom (UK), and more widely across Europe.</p

Can a case lead approach deliver the "craft and graft" of integration?

Purpose: The aim of this study was to explore the experiences and outcomes for adults with complex needs over time, within and between two teams that delivered integrated care across different Councils' services. The teams' approach to integration included two key features: a “case lead” way of working and the team itself operating as a single point of access (SPA) for residents in given neighbourhoods with high deprivation. Design/methodology/approach: The study was designed as evaluation research located in the realist tradition. Two teams acted as a case study to provide an in-depth understanding of how the case lead approach and SPA delivered the craft and graft of integrated working in the teams. Mixed methods of data collection included residents' ratings of their quality of life on five domains in an outcome measure over a six-month period. Residents and staff working in the teams also participated in semi-structured interviews to explore their respective experiences and receiving and delivering integrated care. The costs of care delivery incurred by residents were calculated based on their demands on public services in the year leading up to the teams' intervention and the projected costs for one year following this. Findings: The relationship between team context, case leads' inputs and residents' outcomes was mediated through the managerial style in the integrated teams which enabled case leads to be creative and do things differently with residents. Case leads worked holistically to prevent residents being in crisis as well as giving practical help such as sorting debts and finances and supporting access to volunteering or further education. Residents rated their quality of life as significantly improved over a six-month period and significant savings in costs as result of the teams' support were projected. Originality/value: The study used a multi-evaluation realistic evaluation methodology to explore the relationship between team context, case leads' inputs and residents' outcomes in terms that integrated services across different District and County Council Departments

Conservation in Wales: The role of science in conservation

Post prints of a one day conference held on Thursday 18th June 2009 at The Oakdale Institute, Museum of National History, St Fagans, Cardiff. Conference organised by the Federation of Museum and Art Galleries of Wales and National Museum Wales, supported by CyMAL

‘[It] isn’t designed to be assessed how we assess’:Rethinking assessment for qualification in the context of the implementation of the Curriculum for Wales

This paper reports teacher and learner perspectives on how assessment and reform influences pedagogical practices and behaviours. The research was conducted in a context of policy reform, at a time when Wales’ revised General Certificate of Secondary Education (GCSE) specifications had been implemented, and learners were preparing for their assessments; but, also during the period of debate on the development of Wales’ new curriculum, which has taken a distinct and contrasting position on assessment to the assumptions underlying the reform of Welsh GCSEs implemented from 2015. These data, therefore, offer unique insights into the affordances and limitations of two sharply contrasting systems at a time of considerable change, offering reflections on the current curriculum and its attendant assessment practices, and also a prospective analysis of how the principles embedded in the new curriculum could challenge these existing assumptions and conventions. Findings suggest that teachers and learners currently inhabit an assessment‐driven system, which encourages performative practices in pedagogy and is governed by external accountability; and that these practices are at odds with the principles of assessment articulated in Successful Futures. Consequently, teachers in this study expressed uncertainty about how assessment for certification purposes at GCSE could be compatible with the principles of the Curriculum for Wales