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Training to improve health management and leadership competence is recommended. However, there is limited evidence showing the impact of training on competence. The purpose of this paper is to evaluate the evidence for the impact of training and professional development on health management and leadership competence.

A systematic review was conducted using a mixed-methods design. Studies using qualitative, quantitative or mixed-methods design were included. The following electronic databases were searched to October 2018: CENTRAL, CINAHL, EMBASE, ERIC, NEDLINE and PsycINFO. Study eligibility and methodological quality were assessed independently by two review authors. Data from qualitative studies were synthesised using thematic analysis. For quantitative studies, odds ratio (OR) or mean difference (MD) and 95% confidence interval (CI) were calculated for each intervention. Where appropriate, qualitative and quantitative data were integrated into a single synthesis using Bayesian methods.

In total, 19 studies were identified for inclusion in the review. Training and professional development interventions using flexible, multiple training techniques tailored to organisational contexts can improve individual competence and performance. Such training is typified by a leadership development programme. There was insufficient evidence to determine the effects of interventions on organisational performance.

This is the first systematic review evaluating the impact of training and professional development interventions on health management and leadership competence.

The North Somerset Education & Training Consortium provides a wide range of education and training courses of varying lengths and intensity, with built‐in, long‐term progression opportunities. Paul Davis and colleagues describe how access to graduated learning has given confidence to people with experience of mental health problems, enabling them to progress both at personal and academic levels.

This article outlines conventional dual diagnosis outcome measures and the challenges of using these measures to evaluate interventions in medium secure units. It suggests how these challenges can be overcome by using alternative outcome measures such as measures of motivation, stages of change, beliefs, knowledge, group satisfaction, therapeutic alliance or coping strategies.

The prevalence of dual diagnosis in mentally disordered offenders is high. This paper outlines the dual diagnosis needs of service users in a north London secure forensic mental health unit and discusses the development and implementation of a group treatment programme. It describes the three stages of the group work programme and suggests ways to support facilitators and evaluate the effectiveness of the programme.

The spouses or partners of serving members of the UK Armed Forces are often subject to similar constraints to those of enlisted personnel. This paper aims to examine the experiences and wellbeing of a group of army wives. In particular, it focuses on their shared experiences of consumer vulnerability and related challenges, exploring the extent to which membership of military wives’ communities can help them to cope.

Using an interpretivist approach, data were collected through four focus group discussions involving 30 army wives, and seven individual in-depth interviews.

The paper highlights shared experiences of consumer vulnerability and demonstrates how army wives’ approaches to coping incorporate both individual and community-based approaches. It proposes that communities of coping develop within the army wives community, providing women with both practical and emotional support.

The paper acknowledges that there is a range of factors that will impact military spouses’ experiences of consumer vulnerability and strategies for coping. This heterogeneity was difficult to capture within a small exploratory study.

The UK Government should consider their duties towards military spouses and children. This would entail a significant cultural shift and recognition of military personnel’s caring responsibilities.

This research contributes to understandings regarding the potentially shared nature of both consumer vulnerability and coping strategies. The study introduces the relevance of communities of coping to consumer contexts, highlighting how members can benefit from both practical and emotional support.

Quality function deployment (QFD) is a methodology to translate the “voice of the customer” into engineering/technical specifications (HOWs) to be followed in designing of products or services. For the method to be effective, QFD practitioners need to be able to accurately differentiate between the final weights (FWs) that have been assigned to HOWs in the house of quality matrix. The paper aims to introduce a statistical testing procedure to determine whether the FWs of HOWs are significantly different and investigate the robustness of different rating scales used in QFD practice in contributing to these differences.

Using a range of published QFD examples, the paper uses a parametric bootstrap testing procedure to test the significance of the differences between the FWs by generating simulated random samples based on a theoretical probability model. The paper then determines the significance or otherwise of the differences between: the two most extreme FWs and all pairs of FWs. Finally, the paper checks the robustness of different attribute rating scales (linear vs non-linear) in the context of these testing procedures.

The paper demonstrates that not all of the differences that exist between the FWs of HOW attributes are in fact significant. In the absence of such a procedure, there is no reliable analytical basis for QFD practitioners to determine whether FWs are significantly different, and they may wrongly prioritise one engineering attribute over another.

This is the first article to test the significance of the differences between FWs of HOWs and to determine the robustness of different strength of scales used in relationship matrix.

Quality function deployment (QFD) is a planning methodology to improve products, services and their associated processes by ensuring that the voice of the customer has been effectively deployed through specified and prioritised technical attributes (TAs). The purpose of this paper is two ways: to enhance the prioritisation of TAs: computer simulation significance test; and computer simulation confidence interval. Both are based on permutation sampling, bootstrap sampling and parametric bootstrap sampling of given empirical data.

The authors present a theoretical case for the use permutation sampling, bootstrap sampling and parametric bootstrap sampling. Using a published case study the authors demonstrate how these can be applied on given empirical data to generate a theoretical population. From this the authors describe a procedure to decide upon which TAs have significantly different priority, and also estimate confidence intervals from the theoretical simulated populations.

First, the authors demonstrate not only parametric bootstrap is useful to simulate theoretical populations. The authors can also employ permutation sampling and bootstrap sampling to generate theoretical populations. Then the authors obtain the results from these three approaches. qThe authors describe why there is a difference in results of permutation sampling, bootstrap and parametric bootstrap sampling. Practitioners can employ any approach, it depends how much variation in FWs is required by quality assurance division.

Using these methods provides QFD practitioners with a robust and reliable method for determining which TAs should be selected for attention in product and service design. The explicit selection of TAs will help to achieve maximum customer satisfaction, and save time and money, which are the ultimate objectives of QFD.

Many people delay or never seek professional help for stress and depression. There is limited research on this topic using qualitative methodologies, but even less exploring the attitudes of the general population.This study explores the attitudes and preferences of the general population about when and where help is sought for stress and depression through the Somerset Health Panels. These comprised 12 two‐hour panels held across Somerset, England, involving a total of 96 people. This study reveals that a positive and non‐judgemental view of depression and stress exists within the general population. The response and support from friends and family is critical in seeking other sources of help, for which the GP is perceived as a gatekeeper. A preferred hierarchy of professional and nonprofessional sources of help exists, which is not entirely consistent with the arrangement of current services. This research adds to our understanding of how to engage with communities more generally and helps understand a general population perspective on mental health issues ‐ in particular, the way services are currently arranged does not always reflect the hierarchy in which people would prefer to seek help, and that stigma is evident but does not always act as a barrier to eventual help‐seeking.

This study is a post hoc service level investigation into the efficacy of a forensic dual diagnosis intervention. The treatment programme incorporated the principles of cognitive behavioural therapy and Motivational Interviewing, and was comprised of three stages: psycho-education into the links between mental/physical health, substance use and offending, the cultivation of coping strategies and relapse prevention planning. The paper aims to discuss these issues.

Treatment outcome was tracked using pre- and post- stage 1 and 2 measures, and included self-report questionnaires that probed service users’ readiness for change, motivations for treatment and perceived effectiveness of coping strategies (n=80 and 37 patients for stages 1 and 2, respectively). In addition, service users undertook a knowledge “quiz”, which probed information retention.

The results show that whilst psycho-education (stage 1) increased service users’ knowledge of key issues, this had no parallel effects on other measures. In contrast, completion of stage 2 led to an increase in external motivation for treatment, although this did not translate into a shift in service users’ readiness for change.

These findings are consistent with the Motivational Interviewing literature and highlight the need for a shift in internalised motivation for treatment if change is to be elicited. Further, they point towards the viability of using self-report measures to monitor treatment outcome in a secure forensic setting.

These findings have a number of implications for the design and on-going evaluation of forensic dual diagnosis services, an area of research that is currently under-represented in the literature.