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Kent was one of the first social services departments to develop a specific adult protection policy in 1987. This paper charts the development of policy and references key landmarks on this journey from the perspective of the policy manager's role. Opportunities are also taken to identify the key learning from this experience and the main challenges for the newly emerging safeguarding agendas.

In adult protection many of the concerns that are highlighted about possible abuse relate to non‐criminal situations in which neglect may have occured. Designated lead managers, often social services team managers, act as gatekeepers. In conjunction with police, health and inspectorate colleagues they have to determine if allegations and referrals should be dealt with either as possible abuse or as poor practice, triggering different mechanisms. A tool has been developed in Wales to promote and support consistency in decision‐making in ‘grey areas’. Also, the Welsh Assembly Government(2009) has published helpful guidance on the management of escalating concerns in care homes, which helpfully informs arrangements for adult protection and provider performance to be managed in tandem.

This paper discusses how Kent Social Services addresses situations in which one vulnerable adult abuses another. This can challenge professional competencies and open up services to outside investigation but, say the authors, a punitive approach will undermine efforts to ensure that abuse by service users is recognised and dealt with appropriately.

Adult protection has been a relatively recent concept for staff working within the health economy. Priorities have focused on raising awareness, developing an understanding of safeguarding responsibilities, challenging established practices and attitudes and embedding the concept within the culture of NHS organizations and the daily work of staff at all levels. Although social services have the lead for safeguarding activities (Department of Health, 2000), statutory health bodies have now begun to integrate their adult protection activities more effectively and positively with social services and the police. This paper reviews the journey undertaken by the three primary care trusts (PCTs) in Kent and Medway in developing adult protection expertise and sharing multi‐agency adult protection practice with both social services and the police. The three safeguarding vulnerable adults leads from the PCTs have joined together to look at how far we have come and what we still need to achieve.

This paper argues for a case management rationale in adult protection management and practice, drawing insights from a series of linked training initiatives and an evaluation of the role of the specialist adult protection co‐ordinator. An explicit case managed approach contrasts with much current practice for adult protection, where responsibilities often vary widely within, between and across agencies and professional and worker roles.

This article reports on the findings of the inspections and consultations undertaken as part of the evaluation of the National Service Framework for Older People. It focuses on what was found about the implementation of adult protection systems, by synthesising the inspectors' findings, drawing on older people's comments in meetings and interviews concerning care in hospitals, as an illustration, and by reporting the results from a survey. Together these sources of information revealed that adult protection systems are in place, and that the majority of older people say that they know to whom they can report concerns, but that older people and their families weigh up the decision to make complaints carefully. Questions are raised about the interface between adult protection and concerns about dignity and quality of hospital care.

Behaviour that is in fact adult abuse may be reported through a number of different frameworks (for example complaints procedures and incident reporting procedures) without it being realised that adult protection procedures need to be activated as well. This paper will examine how adult abuse can be reported through the disciplinary framework, and therefore how adult protection and the disciplinary process need to be joined.

The findings of the UK prevalence study of abuse and neglect among older people provide unique opportunities for adult protection systems to consider possible changes to their priorities, activities, services and publicity. This article reports first on the contribution of adult protection coordinators to the design and execution of the research. It then sets out potential uses for the evidence provided by the study by the adult protection community in the UK. The article outlines some of the media reactions to the study that adult protection workers will also have to understand and navigate. It concludes with some suggestions for future research and service development in the UK context.

This article considers service delivery options for agencies working within the field of adult protection that will allow for successful forward planning and an effective application of resources. It suggests a framework for social services as the lead agency to co‐ordinate the process for dealing with allegations of abuse. The aim of the framework is to establish how best to manage cases involving the alleged abuse of vulnerable adults.An analysis is provided of three alternative organisational models for dealing with referrals and investigations. The discussion also proposes different sets of arrangements for achieving effective multi‐agency working.

The purpose of the paper is to improve the consistency and quality of the response to vulnerable adults who experience abuse and neglect within NHS, independent healthcare and social care settings is noted by practitioners, agencies and patients. Health and social care policy frameworks promote principles of service improvement and consistency, along with a focus on outcomes and resource effectiveness and interagency collaboration. The Protection of Vulnerable Adults (POVA) coordinator role carries the responsibility of coordinating a response to individual referrals of abuse and neglect as described as part of the Designated Lead Manager role in the Wales Interim POVA Policy and Procedures for the POVA from abuse (Wales Adult Protection Coordinators Group, 2013).

This paper will explore the benefits realised through a registered nurse being seconded from the Aneurin Bevan University Health Board into a newly created joint adult protection Health Coordinator post within the Caerphilly County Borough Council social services department POVA team.

This is the first example of such partnership working in adult protection in Wales and has provided a number of benefits in relation to: providing adult protection advice; coordinating the response to referrals of vulnerable adult abuse and neglect within health and social care settings; carrying out or buddying others to complete adult protection investigations; facilitating the two day non-criminal POVA investigation training course and, awareness raising within the local Health Board. The development of a student nurse placement in the social services POVA team cements the multiagency collaborative approach that this development sought to achieve.

The need to improve the consistency and quality of the response to vulnerable adults who experience abuse and neglect within NHS, independent healthcare and social care settings is noted by practitioners, agencies and patients.