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Frequent attendance at emergency departments (ED) has been identified in adult protection reviews as a potential warning sign of the escalation of someone’s vulnerability. Concern has been expressed about the engagement of the National Health Service (NHS) in adult protection and the small number of NHS adult protection referrals. More specifically ED departments have been identified as an area of high patient through put where there has been little evidence around how well adult support and protection (ASP) was being delivered. The paper aims to discuss these issues.

A series of audits were undertaken in three different hospitals across a large Scottish Health Board accessing ED at different times of day on different days of the week to test out whether NHS staff working in EDs are identifying adults who meet the criteria of “an adult at risk”.

The audits identified a total of 11 patients from a total sample of 552 records examined who may have met the criteria to be considered an adult at risk, although further information would have been required to make a fully informed decision.

The main study limitation is that the hospitals are all within a single Health Board. The EDs have a large number of admissions and it is possible that a less pressurised area, might have a lower threshold of “risk” than the practitioners involved in the audits. The decision as to whether an adult was considered to meet the three-point test by the three people undertaking the audit was dependent on the quality of information recorded on the patients’ electronic hospital record.

It is essential that NHS Boards proactively support practice in ED settings so staff are able to identify adults at risk of harm under the ASP legislation so that ED staff are responsive to ASP needs.

The research evidence around adult protection in the UK is still emerging. The development of good practice based on the Scottish Government’s ASP legislation is still being shaped. In England and Wales, the principles of identification and multi-agency working underpinning the safeguarding of vulnerable individuals are broadly similar to Scotland. These audits add to the literature by challenging the assumption that patients who would benefit from local authority investigation and possible support are not being identified within EDs.

The purpose of this paper is to conduct an in‐depth quantitative and qualitative evaluation of a family‐based weight loss and healthy life style programme for clinically obese children in England.

The mixed method case study evaluation used included obtaining pre and post measurements of anthropometry and a range of attitude and behavioural attributes. The qualitative phase of the study involved in‐depth interviews and focus groups.

The programme is demanding and resource intensive and designed as an intervention for children needing most help with their weight. Participants included the families of five referred children (n=18 individuals) and the intervention team (n=7). All but one child had reduced BMI centiles at the end of the programme. There were also improvements to a number of self‐report aspects of healthy eating and levels of activity and quality of life, self‐esteem and levels of depression indicators. The qualitative evaluation generated a number of insightful data themes.

Limitations include the case study design and small sample numbers. Also weight loss is an important indicator of any weight management programme's success however the short length of time programme was run is a barrier to seeing any substantive changes in any of the participating children's weights.

The evaluation conducted gives insights into the positive aspects of the programme and can inform development of similar programmes.

There are few examples of in‐depth and comprehensive quantitative and qualitative approaches used to evaluate this type of intervention.