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This paper reports the use of situational analysis as a systems methodology to evaluate the voices of independence change and empowerment in the Stoke-on-Trent (VOICES) partnership project.

Using situational analysis and drawing on a range of secondary data sources, a three-stage conceptual mapping process provided a detailed picture of both the non-linear interlinkage and complexity of the local system that VOICES was working to influence, as well as the processes that shaped the experiences of those who act within the situation.

Data highlighted the systemic challenges facing VOICES customers (e.g. stigma and marginalisation and lack of legal literacy), progress made by VOICES in each of their priority areas and an overarching theme of VOICES promoting equity (rather than equality) to address failure demand in the system of support for people with multiple needs and disadvantage.

The authors present the novel application of situational analysis to demonstrate a substantial impact of VOICES while demonstrating the value of this methodology for complex systems thinking research and evaluation.

The purpose of this paper is to understand the lived experience of people who have experienced homelessness and street activity, and professional stakeholders’ views about the challenges faced by this client group. The study sought to identify measures to improve the current situation for both individuals experiencing homelessness and professionals working with them.

Peer researchers with lived experience of multiple and complex needs conducted semi-structured interviews/surveys with 18 participants (eight individuals experiencing homelessness and street activity and ten professional stakeholders). The authors of the paper conducted a thematic analysis of the data.

This paper offers insights into both the current challenges and assets for people who are or have been homeless in an urban setting. Key findings include the need for a coordinated partnership approach to address pathways to support, and the importance of developing opportunities for meaningful activity and building on local resources including giving homeless people a voice. These findings are discussed within the context of current policy (Housing First) and legislation (Homelessness Reduction Act 2017) and the impact on integrated care for people who have experienced homelessness.

The views explored in this study are specific to one city centre in the West Midlands; thus, generalisability may be limited.

This study presents a participatory research approach with peer researchers exploring the perspective of individuals experiencing homelessness and wider stakeholders. The findings of this research are considered with reference to the provisions of the HRA 2017.

The purpose of this paper is to develop a nursing quality indicator (NQI) framework and provide a comprehensive reporting mechanism for nursing care.

Mixed method, including patient records audit, patient experience questionnaire, nurse self-report questionnaire and collecting ward-level information. The sample was 53 patients and 22 nurses.

Outputs from the NQI framework domains offer a more comprehensive understanding of nursing quality compared to when domains are analysed separately. The NQI framework also provides a more inclusive mechanism for assuring nursing care.

Sample size was limited to 53 English-speaking patients who consented to participating in the study.

One design strength was the ability to describe individual patient care across the four domains and subsequently show relationships between nursing knowledge, nursing interventions and patient outcomes/experiences. Additionally, corroborated information from three sources (documentation review, patient and nurse responses) strengthened the conclusion that the NQI framework could provide more comprehensive assurances on nursing quality and identify care improvements.

Outlines a health promotion programme run in conjunction with a local Asda supermarket in Ayr. The event focused on the store itself. Community dietitians were available for specific advice, and a team of student dietitians conducted evaluations, circulated special discount coupons, and handed out health promotion material. Throughout the store there were specific health messages following NACNE and COMA report guidelines. A treasure hunt and food pyramid both acted as additional activities for customers. Publicity prior to the event included local radio and press advertising. The event was evaluated as a success and shoppers said they would like more such events.

Protection of those deemed vulnerable has received increasing attention since 2000. This article reports this aspect of a research study in which care staff views relating to vulnerability and abuse of adults with learning disabilities were explored. In this study, informants' perspectives were explored using semi‐structured interviews. The aim of the study was to conduct a detailed analysis of interpretations of the terms vulnerability and abuse within learning disability services. The results revealed that most informants felt that all people with learning disabilities are vulnerable and that this definition allows staff the authority to take protective measures in order to ensure their safety, based on risk management approaches. An alternative person‐centred approach to safety planning is proposed.

This study aims to assess service user characteristics, uptake and outcomes for drug checking services offered to over 250,000 English festival-goers in summer 2018 and to compare findings with earlier years, wider festival-goers and the general population.

A total of 2,672 substances of concern were submitted by the public and tested by chemists in mobile laboratories on 24 show days at seven festivals. Results were embedded in 2,043 individually tailored brief interventions (BI) delivered by health professionals to 4,240 service users. Comparative data were collected through anonymous self-report surveys with 1,291 respondents at five of the same festivals.

Three percent of drug-using festival-goers received BI, 95% of whom had not previously accessed health services regarding their alcohol or other drug use. Drug checking service users were significantly more likely to be younger, male and past month polydrug users with a wider range of drugs consumed in the last month compared with the general festival population. For samples matching purchase intent, nearly half intended to reduce dosage, with younger and female service users significantly more likely to reduce dosage. For substances identified as other than expected, nearly two thirds disposed of them.

Festivals are potential sites to deliver innovative health interventions and to monitor their outcomes, reduce the risk of poisoning and overdose, and facilitate access to follow-up support services.

This study suggests that there is value in event-based services that provide risk reduction communications directly to young adults engaged in higher risk drug use compared with wider event and general populations.

Patients with extended hospital admissions had no recreation facilities in the ward. They were often confined to spaces around their beds, using the ward corridor for rehabilitation. The purpose of this paper is to outline a quality improvement (QI) intervention-provision of a recreational space for long-stay patients.

An exploratory quantitative pre-, post-test design was utilised, and executed in three phases: patients, visitors and staff survey to explore recreation and comfort needs and preferences; store room refurbishment; and patient, visitor and staff satisfaction with the recreation room.

Overall, 77 questionnaires were completed (n=49 staff; n=28 patient/visitor). Almost two-thirds (64.7 per cent; n=11) of patients had a stay greater than six weeks. Insufficient private space and concerns about disturbing other patients were identified as barriers to taking part in activities. Consequently, a store room was refurbished as a recreation room (9.0 m × 6.0 m) and furnished in three distinct areas. Following refurbishment, over 90 per cent (n=24) of respondents agreed that there was a suitable space where patients could “go and chat” and spend time with family and visitors or speak to the healthcare team.

The physical environment in acute hospitals is seldom prioritised. Needs-based QI projects can improve patient hospital experiences.

This case study highlights how nursing staff can be informed by patients’ and families’ needs and preferences, and initiate QI projects that improve patient hospital experiences.

Abuse has received much attention over the past decade and many definitions abound. However, there has been a lack of research into the interpretations that care staff give to this concept. This article describes this aspect of a research study in which care staff views relating to vulnerability and abuse of adults with learning disabilities were explored (Parley, 2007). Using semi‐structured interview informants, perspectives were explored. The results showed that contact abuse (physical and sexual) was readily identified by most informants. However bullying, neglect and infringement of rights were less frequently identified. Furthermore, when prompted, some did not consider these to be abuse.

Janette1 is a young woman with both a mild intellectual disability and moderate physical disabilities who experienced a major depressive disorder at a stage in her life when many young adults leave home. This case study exemplifies the success of a multi‐disciplinary, multi‐agency and multi‐element intervention for severe depression in relation to the tasks of adolescence. The impact of a combination of treatments (including attendance at an assessment day unit, electro‐convulsive therapy (ECT) and cognitive behavioural therapy (CBT)) on Janette's mood has been assessed regularly using the Glasgow Depression Inventory ‐ Learning Disability (GDS‐LD) scale (Cuthill, 2003). There is currently very little literature on either using ECT with people with learning disabilities or assessing depression in this population. The multiple inputs, in Janette's case, have had the desired effect of greatly improving her mood, which has been sustained via outpatient follow‐up and tailoring of day and respite services.

The primary aim of the research presented in this paper is to address the gap in the literature with regard to the factors that affect the uptake and application of e‐procurement within the public sector.

This analysis was achieved through five in‐depth case studies – based upon extensive interviews, observation and documentation reviews ‐ conducted within central and local government organisations.

The study shows that despite being very different in terms of their form and function, each of the five case study organisations had achieved similar levels of progress in terms of their adoption of e‐procurement technologies. In short every organisation had already adopted BACS, all five were also actively planning to implement: e‐tendering; e‐award; e‐contract and e‐catalogue systems, but none had any intention of adopting e‐marketplaces or e‐auctions.

The results of this study will help individual organisations to better understand their current situations and the barriers that will need to be overcome before they can significantly expand their adoption of e‐procurement technologies.

In addition to presenting one of the first detailed studies of the adoption of e‐procurement technologies, this study also breaks new ground through its use of the lens of “Institutional theory” to help interpret the findings.