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Reducing waste in health care can result in savings that could be used to meet the projected shortfall in NHS funding or to meet the care needs of vulnerable groups. Patients and their families can contribute to the identification and reduction of waste. To do so their understanding of the costs of health care and treatment needs to be increased. The paper aims to discuss these issues.

The approach formed part of the Close Partnering work stream of the NHS Future Focused Finance (FFF) programme. Included in this was a review of the literature relating to waste reduction, patient engagement and reference to experts in the field of public and patient engagement. Engagement of the patient voice in the NHS FFF programme to provide the patient perspective and engage in discussions with patients. Discussions with experts in patient and public involvement and clinicians were also undertaken.

The public and patients have little awareness of NHS finances and generally perceive efforts to reduce costs and achieve efficiencies as impacting on the quality of care. Engaging the public and patients in discussions about the costs of health care is challenging and existing methodologies for patient and public engagement may not be appropriate for what could be termed difficult conversations.

Increasing patient awareness of the costs of health care and treatment may result in patients and the public demanding greater involvement in decisions about health care expenditure and use of resources.

Difficult conversations with patients and the public about the costs of health and their role in reducing waste are rarely invited. This paper brings to the fore the issues and challenges that such discussions engender.

It is not often nowadays that food and drugs cases get headline news or present new and interesting features. They tend towards a monotonous routine, of which analysts and inspectors sometimes complain, and new case law seems to belong to the past, although Edwards v. Llaethdy Merion Ltd. and Southworth v. Whitewell Dairies Ltd., clarifying the law relating to “foreign bodies” in food and a few other cases have illuminated the food and drugs firmament in recent years. The recent “Mushroom Soup” case brought by the West Sussex County Council at Chichester, however, attracted a great deal of publicity and without presenting any new law, did in fact illustrate in an interesting manner certain well‐worn legal principles. In particular, it showed the tardiness of Courts to confer upon “general terms”—in the case in question, the general term “mushroom”—a narrower and more specific meaning that general usage allows. To construe general terms in a general sense is a principle as old as Equity itself and in ruling that Boletus edulis was properly described as mushroom, the Court merely followed the usage of people in the country areas where mushrooms grow of including in the term a number of edible varieties, with no clear definition other than that shall be edible. As well as the home‐grown varieties, in the rapidly growing foreign communities of our big seaports and cities, there are other edible varieties, unknown in this country.

Customers can be territorial, which results in reactive behaviors that can hurt firm profitability. This study aims to expand the typology of customer territorial responses previously identified in the environmental psychology and marketing literature.

The authors use a mixture of quantitative and qualitative approaches. The exploratory studies elicit and test a typology of consumer territorial responses using critical incident technique and factor analysis. Two surveys use the typology. Study 1 examines intrusiveness in grocery store settings. Study 2 expands the model with specialty store shoppers to examine how rapport, employee greed, entitlement and time pressure interact with intrusion pressure and relate to customer territorial responses.

The results indicate a new category of territorial responses – deferential verbalizations – and show relationships between intrusion pressure and deferential actions, retaliatory verbalizations, retaliatory actions and abandonment. The relationships are affected by the moderators, including rapport, which interacts with intrusion pressure to increase the likelihood of switching.

Collecting data near closing time restricted observations and consumer time to participate using self-report data. The results should be replicated with other populations and service providers.

Managers should monitor customer treatment during closing time. The results indicate consumer responses to closing time cues not only impact their shopping trip but also affect whether they will patronize the store in the future.

The study provides an expanded typology of territorial responses, identifies moderating factors that may affect responses and links employee intrusiveness and territorial responses to store patronage.

NZTrio is more than a traditional piano trio that performs music from the classical repertoire: it is a professional chamber ensemble with a difference. The members of the Trio, totalling three musicians and two administrators have a community orientation. Their vision is to forge links into other artistic, educational and business fields and in doing so they create and participate in events that evoke visceral encounters. In this way they confirm Esposito’s view that communitas is disruptive of stasis and that to belong is to change. In community, identity is disrupted and new possibilities of the self can emerge. This becomes possible through provocative performances that implicate the body. For instance, shouting commands through a megaphone in Jack Body’s O Cambodia and the repeated pattern of chords in the third movement of Shostakovich’s Piano Trio No. 2 are emotionally and physically encountered as audiences feel what it is like to be both perpetrators and victims of violence. NZTrio uses music like this as well as works from the standard repertoire to create aesthetic experiences rich in options for communion. Furthermore, through professional development events, business leaders and young people gain the opportunity to understand how the physicality of leadership works in a high performing team.

Retailers, it is said, are behaving as brands. Tests whether retailers can be considered to be brands by comparing the current practices of British retailers against four criteria for a brand which are developed from the existing literature on branding. The four criteria are that the brand should: differentiate; be capable of a separate existence; command a premium price and; offer the customer some psychic value. Concludes that retail brands not only exist but also exist in two forms: the more obvious merchandise brands, commonly known as own‐brand that are now marketed as more than generic commodities; and the less obvious process brand that represents the experience that retailers provide. Argues that the process brand is purchased with the shoppers′ time rather than with their money. The process brand has value to the retailer as it generates customer flow, customer loyalty and higher expenditure.

The purpose of this paper is to examine the impact of the digital culture on football supporters through analysis of official and unofficial websites and media reports. At first glance it would appear that technology has brought about greater opportunities to communicate, to share views which previously could not be widely published, and to organise against the commercial power of the large football clubs. However, surveillance, censorship and control continue to impact on supporters to restrict and ultimately prevent the ideal speech situation that is necessary to empower fans and promote greater participation in their clubs. Current media manipulation and corporate interests restrict and alienate fans who often have more of a historically constituted (over generations) sense of ownership and culture within their local clubs.

A critical social theory approach is adopted to examine structures and processes related to communication between fans, the media, football clubs and the public. Habermas' theory is draw upon using the concepts of “colonization of the Lifeworld” and “communicative action” to inform a theme and discourse analysis of official and independent football club websites and media reports. How corporate interests (the system) are manipulating public opinion and freedom to speak openly within an overall goal of profit maximization for club owners and the large media corporations are explored.

Although steps to enable free communication have been made we are still a long way off supporters having a powerful enough voice to organise against the commercial power of the large football clubs and media conglomerates. The ideal speech situation remains elusive and the hegemonic state remains unchallenged. Football supporters are increasingly constructed as “consumers” and the ultimate power remains in mass media and broadcast rather than personal “narrowcast”.

This paper extends debate on the impact of the developing “digital culture” focusing on football supporters, a specific and prevalent community within British society. It raises issues for further research in this area.

Corporations and businesses have been a major influence on society since before the industrial revolution, but academic focus on corporate responsibilities is a recent phenomenon which focuses predominantly on globalised multi-national corporations of the late twentieth century. The purpose of this paper is to consider the evolution of the corporate responsibility and community involvement tracing the development of corporate behaviours in the UK from medieval guilds to the modern form of corporation seen at the end of the last century.

The analysis considers the institutional forces which have shaped responsible business behaviours in a context of changing power and influence.

Drawing on Weber's notion of the ideal-type, this paper demonstrates that many “modern” corporate social responsibility (CSR) concepts such as codes of conduct, stakeholder consultation, and corporate donations have considerable heritage.

This paper develops an important precedent by examining the evolution of CSR and other aspects of corporate engagement. It develops a long-term instrumental context for corporate donations, whilst revealing that practices such as employee volunteering are considerably more recent, and less institutionally developed.

In this chapter, we take up the distinction between applied and general fields of study in order to consider how patterns of gender stratification between them may differ. Purporting to offer industry- and firm-specific skills, applied fields of study are often differentiated from general education pathways that are offered within the university sector. However, as our research demonstrates, there is considerable interplay between these two forms of education when higher education engagement over the life course is examined. Using sequence and cluster analysis, we illustrate five ideal-typical higher education pathways in a sample of males and females over a 22-year period in the Canadian province of British Columbia. The gendered patterns of how individuals choose and move between general and applied fields of study offer a deeper account of stratification within general and applied skill acquisition and provide nuance concerning how vocational education can be conceptualised in relation to the actual higher education pathways students undertake. In Canada, where a high percentage of students gain university-level credentials, vertical and horizontal gender stratification within applied and general fields of study is distinctive and highlights system-specific engagement.

Community mental health services are of increasing importance for people with an intellectual disability (ID), as the government aims to reduce the number of people treated within inpatient services. However, due to limited evidence base, it is unclear which service models are most effective for treating people with both ID and a mental health condition. Therefore, the purpose of this paper is to carry out a survey in order to gain a better understanding of the current state of ID community services.

The survey was e-mailed to 310 consultant psychiatrists based in England and whose main specialism was in ID. In total, 65 consultants responded to the survey with 53 complete data sets.

In total, 84 per cent of consultants identified themselves as working in a generic community ID team. The majority of services were not integrated with social care (71 per cent). Regional differences were found. In contrast to the rest of England, the majority of services in London were integrated with social care. The Health of the Nation Outcome Scale for people with Learning Disabilities (HoNOS-LD) was found to be the most common outcome measure used by services. A range of interventions are widely available across services including psychological therapies and specialist memory assessments. The survey also provides evidence for increased decommissioning of specialist inpatient units and a need for more robust community services.

Findings limited by low return rate (21 per cent) and because responses could not be matched to specific services. The implications of this survey are that there is still a variable level of integration with social care and that lack of integration could affect the quality of service. While HoNOS-LD is used consistently across services, there may be a need to supplement it with other outcome measures. There is a need for larger scale and higher quality studies in this area to strengthen the evidence base and therefore demonstrate the benefits of integration and specialisation more convincingly to health professionals and commissioners.

This survey presents an overview of the current state of community services for adults with ID in England. This information can be harnessed to add to revised approaches to mental health service models for people with ID.