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Children's social services in England and Wales deal with a wide range of referrals of children who are or may be ‘in need’. Finding ways of describing the issues that present in such referrals is important if we wish to understand the nature of the work of children's services and explore different interventions and outcomes. Yet there have been few attempts to describe the full range of needs presenting to social services, and no studies of the reliability or validity of attempts to define the types of need. In this article the legal definitions of need, a typology developed by Sinclair et al, a related one used by the Department of Health and one developed within the current study were compared for reliability and construct validity. There were two main findings. First, it was found that while the presence of needs could generally be agreed on in all the schemes, ascriptions of a ‘main’ need were not made reliably. This is important because a ‘main’ need has been used in both research and statistical returns to government. Second, while existing schemes appeared well suited to describing allocated cases, they were less able to describe the range of needs presenting in all referrals to social services.

While it has long been established that social factors, such as housing, transportation, and income, influence health and health care outcomes, over the last decade, attention to this topic has grown dramatically. Reforms that promote high-quality care as well as responsibility for total cost of care have shifted focus among health care providers toward upstream determinants of health care outcomes. As a result, there has been a proliferation of activity focused on integrating and aligning social and medical care, many of which depend critically on cross-sector alliances. Despite considerable activity in this area, cross-sector alliances in health care remain largely undertheorized. Both literatures stand to gain from more attention to carefully knitting together the theoretical and management literature on alliances with the empirical, health policy and health services literature on cross-sector alliances in health care. In this chapter, we lay out what exists in the current scientific literature as well as a framework for considering much needed work in this area. We organize the literature and our commentary around the lifecycle of alliances: alliance formation, including factors prompting alliance formation, partner selection, and alliance goals; alliance maturity, including the work of these cross-sector alliances, governance, finance and contracts, staffing structure, and rewards; and critical crossroads, including alliance timelines, definitions of success, and dissolution. We also lay out critical areas for future inquiry, including better theorizing on cross-sector alliances, developing typologies of these cross-sector health care alliances, and the role of policy in cross-sector alliances.

This paper aims to explore the links between being lonely and isolated, and increased risks of abuse for adults with care and support needs.

Thematic analysis was used to explore features of loneliness and social isolation present in South Yorkshire Safeguarding Adults Reviews (SARs) published since 2014.

Ten out of fifteen SARs indicated there had been issues of loneliness and/or social isolation for the person who was the subject of the SAR.

The limitations of this paper are that it only included SARs from the South Yorkshire area. Future research should explore national and international perspectives on these issues.

Safeguarding Boards should include actions to address loneliness and social isolation as part of prevention strategies and services to develop approaches that can minimise or prevent abuse before it occurs. Practitioners should routinely explore whether the people they work with feel lonely and/or isolated and support people to take appropriate action to mitigate these risks.

This paper uses the existing body of literature about loneliness and social isolation to explore the risks of abuse and neglect for adults with care and support needs.

The purpose of this qualitative study was to investigate how the proceedings of a vulnerable adult protection policy is understood by referrers to affect the psychological and emotional well‐being of adults with a learning disability. During the research process seven referrers of vulnerable adults discussed twelve different cases in in‐depth interviews. The interviews and matching case notes of protection meetings released by social services were analysed by the application of grounded theory techniques. The result is a model that highlights how appraisals of the experience the emotional and behavioural reactions of the vulnerable adults are shaped by the nature of the abuse, the actions taken by protection meetings, the expectations of the vulnerable adults and the availability of support.

The patient journey from detection of an eye problem by optometrists to assessment and treatment by ophthalmologists can be streamlined by direct referral from optometrist to hospital eye service (HES). This requires locally agreed guidelines and training and feedback for optometrists to ensure high diagnostic competence. The purpose of this paper is to evaluate the quality of the West Suffolk Direct Referral Scheme, one of the first direct referral schemes in the UK to include all ophthalmic sub‐specialties.

Two‐cycle audit of existing practice, including all new patients referred by optometrists and seen at West Suffolk Hospital during a three‐month period in 2003 and a seven‐week period in 2006. Three interventions: direct referral clinics for urgent patients; introduced in 2003; six‐monthly training sessions for optometrists; and regular, prompt feedback via letter about individual consultation outcome. Prospective data collection via proforma in both cycles; additional retrospective data collection in the second cycle. Diagnostic accuracy, perception of urgency and request of subspecialty clinic were evaluated.

The direct referral scheme streamlines the patient journey, and patients with acute problems have fast access to HES. In total, 99 per cent of referrals are appropriate. Diagnostic competence is high (87 per cent), and has improved with tighter communication between HES and optometrists. Agreement is less for referral urgency (75 per cent) and choice of subspecialty clinic (74 per cent).

The West Suffolk Direct Referral Scheme provides an efficient service of high quality. Good communications and continued feedback between community‐ and hospital‐based eye care services improve standards and facilitate efficient use of resources.

The purpose of this paper is to investigate the treatment effects of Quest cognitive hypnotherapy (QCH) on anxiety and depression, and make comparisons with published data from the Improving Access to Psychological Therapies (IAPT) project.

Adult clients of QCH therapists were invited to enrol in a Practice Research Network (PRN) and completed pre- and post-therapy measures of anxiety (GAD-7) and depression (PHQ-9).

Post-treatment scores were available for 83 of the 106 clients reaching caseness (above the clinical cut-off on either or both measures) on their pre-treatment scores. Totally, 59 clients had moved to recovery, representing 71 per cent of cases where post scores were available and 56 per cent of the intent to treat (ITT) population (106 clients). Additionally, including all cases (both above and below cut-offs) 118 clients had post-treatment measures. In total, 86 (73 per cent) clients improved reliably. The mean number of treatment sessions was between three and four. This compares favourably with 2012-2013 IAPT findings using the same measures.

This study was exploratory involving a client group paying privately for treatment. There was no randomised control group or attempt to evaluate the effectiveness of specific components of therapy.

QCH may offer a brief effective treatment for clients with clinically significant levels of anxiety and/or depression, widening client choice.

As the first study to explore the effectiveness of private QCH this study offers an example of how to use a PRN to compare with published IAPT data using the same measurement tools.

The purpose of this paper is to investigate how referral reward programs (RRPs) utilizing scarcity messages influence bank credit holders’ referrals to and adoptions by close or distant friends.

A 2×2 experiment is implemented with 760 consumers solicited through Amazon’s Mechanical Turk worker panel. Logit transformation and general linear models are used to test the proposed hypotheses.

Results showed that offering RRPs with limited available referrals (quantity scarcity) increases the overall number of referrals to and adoptions by close and distant friends. The percent of strong ties also increases with RRPs. As quantity scarcity is relaxed, the percentages of referrals to and adoptions by close friends decrease.

The inclusion of tie strength with scarcity framing greatly enhances our understanding of the effectiveness of RRPs for bank credit cards. To the authors’ knowledge, this is the first research attempt on this topic.

Based on theories related to coopetition, the purpose of this paper is to examine the patterns of business-to-business digital referrals inscribed in businesses’ digital content.

A complete industry-wise digital data set is formed by extracting digital referrals in all the content pages. The authors outline how digital referrals are strategically used among peer businesses in the peer-to-peer digital network and in the augmented digital network, taking into consideration geographical framing and physical distance.

The authors reveal how geographical framing and physical distance influence peer-to-peer referral patterns in the digital space. Quite counter-intuitively, businesses are more likely to give digital referrals for peers residing in the same region, as well as for peers located in closer proximity. Further, results from the augmented digital network show that peer businesses in closer proximity exhibit greater strategic similarity in their digital referring strategy.

The findings extend the understanding of business-to-business coopetition to the digital space and suggest that geographical framing and physical distance can induce reciprocated relationships between peers by offering each other digital referrals.

The findings shed light on the formation of a business-to-business digital coopetition strategy using digital referral marketing.

This study highlights the impact of digital referrals in business-to-business relationship management, especially in the digital coopetition context.

This paper combined an at-destination decision-making model with the theory of tie strength to find out information related to the referrals that travelers received and used at a major tourist destination in the southeastern United States. At-destination decisions included lodging, eating and dining, entertainment, recreation, and travel. The data indicated eating and dining, recreation, and entertainment decisions are made in large numbers at the destination. The first research question involved referral source and frequency for at-destination decisions, revealing many third-party decision-makers. Friends and family members were the most requested and local residents the least requested referral sources. The second research question inquired as to whether satisfaction scores from the referred experience differed across referral source. The researchers suggested that referrals have different perceived levels of trust, expertise, and ties, and potentially will render different sales levels. Due to this, the satisfaction outcome was measured by referral source. Results showed that referred satisfaction scores were highest from local resident referrals followed by friends and relatives – one a strong tie and one a strong–weak tie. Finally, more neutral satisfaction scores were reported from other information sources. The article closes by offering possible explanations for these differences and by providing suggestions for additional at-destination decision-making and outcome research.

The purpose of this paper is to investigate how the effects of referral rewards in referral reward programs (RRPs) are moderated through perceived social risk of a recommender.

A total of 717 consumers are accessed through Amazon's Mechanical Turk worker panel. The authors use t-test and analysis of variance to test the proposed hypotheses.

The findings show that consumers with high perceived social risk balance financial rewards with social risks, while low social risk consumers largely ignore these social risk elements surrounding a referral decision.

The inclusion of perceived social risk provides the opportunity to fully understand how a consumer goes about balancing social risk and referral rewards in making referral decisions. The concept of social risk has not been previously applied to this context.