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The purpose of this paper is to examine how practices influence service systems.

Data across three service contexts (crafts, healthcare and fitness) were collected through depth interviews and netnographic analysis, and analyzed with a two-study multi-method approach focusing first on the micro- (individual) level and then on the macro- (network) level of service systems. Study 1 focused on a micro-level analysis using qualitative techniques (Spiggle, 1994). Study 2 focused on a macro-level analysis using partial least squares regression.

The results illustrate how practices can change service systems. This occurs when a nuanced practice (i.e. a practice style) orders and roots a service system in a specific form of value creation. The findings reveal four practice styles: individual-extant, social-extant, individual-modified and social-modified practice styles. These practice styles shift in response to event triggers and change service systems. These event triggers are: service beneficiary enhancement, service beneficiary failure, service provider failure and social change. Thus, the findings show that practices – when shifting in response to event triggers – change service systems. This transpires in the understudied meta-layer of a service system.

The study identifies four practice styles that can serve as the basis for segmentation and service design.

Service systems are dynamic and ever changing. This study explores how service systems change by proposing a practice approach to service systems.

The assessment of fitness to drive after stroke is an emerging area of occupational therapy practice in Ireland. Despite this, little is known about occupational therapists’ evaluation practices, and there are no internationally agreed clinical guidelines to inform best practice. The purpose of this paper is to investigate occupational therapy evaluation practices for fitness to drive after stroke in Ireland.

This is a cross-sectional study design targeting occupational therapists working with people after stroke using an online survey. Summary and descriptive statistics were used to analyse the returned surveys.

In total, 47 occupational therapists participated. Off-road driving assessment was completed by 68 per cent of respondents. Functional assessment and non-driving-specific assessments were most widely used and perceived to be the most useful in informing the off-road assessment. A total of 89 per cent referred clients for on-road assessments; however, some referred without first completing an off-road assessment. The therapists who completed formal post graduate education/training in driving assessment reported greater confidence and competence in their skills and ability to assess fitness to drive. A vast majority of participants agreed that clinical guidelines regarding best practice in this area would be beneficial.

A majority of occupational therapists are assessing fitness to drive after stroke in Ireland with non-driving-specific assessments and functional observations; however, there are many gaps and wide variations between services. Education/training in evaluating fitness to drive after stroke is recommended. The development of clinical guidelines to inform practice would facilitate a consistent approach nationally.

This is the first study completed in Ireland to investigate occupational therapy evaluation practices for fitness to drive after stroke.

The purpose of this paper is to summarise the Law Commissions’ final report and draft Bill on the regulation of health and social care professionals.

To summarise the key recommendations that are relevant to adult safeguarding.

The final report concludes that new legislation is needed to govern the UK regulators of health and social care professionals.

The paper sets out the recommended new legal framework.

The purpose of this paper is to set out the Law Commission's proposals for the reform of the law relating to UK health professional regulation and, in England only, social workers.

The paper summarises the main provisional proposals from the consultation paper.

The consultation paper argued for the reform of the law in this area.

There are suggestions for reforming the law which could form the basis of a new legal framework introduced in 2014.

The paper sets out the proposed new legal framework.

The purpose of this paper is to assess if the GOC considers relevant factors at all stages of its deliberations into misconduct, as required by the determinations in the cases of Cohen, Zygmunt, and Azzam, and to assess whether those circumstances described in the Hearings Guidance and Indicative Sanctions as warranting removal of an optician from the relevant registers lead to that outcome.

The consideration of specific factors in determining impairment of fitness to practise was compared with their subsequent consideration when determining the severity of sanction. Additionally, cases that highlighted aggravating circumstances deemed as serious enough to warrant removal were monitored. Pearson’s χ² test was used to detect any variation from the expected distribution of data.

In total, 42 cases met the inclusion criteria. Each of the four factors considered was more likely to be heard when determining sanction having first been factored in to the consideration of impairment. Where risk of harm was identified as an aspect of an optician’s misconduct, the sanctions of suspension or removal were no more likely to be imposed. Where dishonesty was involved, they were more likely to result in suspension or removal.

The GOC do, in general, factor the rulings of High Court appeal cases into their deliberations on the impairment of fitness to practice and, where dishonesty is involved, consider their own guidance in determining which sanction to apply. The authors were unable to show that placing the safety of patients at risk was more likely to result in removal from the register.

This paper aims to clarify the potential to use data on doctors and fitness to practise (FTP) cases held by the UK General Medical Council (GMC) for wider regulatory purposes, such as identifying risk factors. The paper aims to concentrate on how data are shaped by the GMC's functions and organisational concerns, and by the configuration and use of their electronic database.

The GMC provided samples of their data, access to documentation surrounding the configuration and use of the database, and meetings with staff able to provide background on the database, GMC procedures, and the GMC as an organisation.

The FTP database is designed to process cases within complex legal rules, and to provide for accountability. The database and its use are adapted to these purposes. Attempts to use it for other purposes are likely to find it difficult to use, the scope and quality of data uneven and some codes unsuitable. The register data are very narrow in scope. While combining register and FTP data to identify risk factors is by itself of limited value, the database can contribute to closer study of risks to patient safety from poorly performing doctors.

The research was exploratory. It provides initial insights and the basis for further research.

The data have potential policy use for the GMC, but it is essential to understand the limitations.

The paper examines previously unanalysed influences on the GMC's data. It also develops new angles on questions in the regulation literature about organisational risks and the creation of risk data.

This paper provides a description of statutory regulation as it applies to currently regulated professions and as a model for practitioners of psychological therapies. It discusses the safety drivers for regulation, the issues involved in identifying roles, competences and training as a basis for regulation, and how regulation can promote quality of practice as careers develop in a changing workforce.

The purpose of this paper is to consider the final report of the Mid Staffordshire NHS Foundation Trust Public Inquiry and the Law Commissions’ review of health and social care professional regulation – and how these will impact on the professional regulation bodies.

Summary and discussion of the relevant recommendations made by the Mid Staffordshire NHS Foundation Trust Public Inquiry and the initial Government response, and consultation responses to the Law Commissions’ provisional proposals for law reform of health and social care professional regulation.

Future legislation is likely to be based on the recommendations of the Mid Staffordshire NHS Foundation Trust Public Inquiry and the Law Commissions.

Overview of the Mid Staffordshire NHS Foundation Trust Public Inquiry and the initial Government response, and consultation responses to the Law Commissions.

The Disability Rights Commission's Formal Investigation into the impact of professional regulation on disabled people's access to nursing, social work and teaching professions identified that unclear regulatory fitness requirements and their inconsistent implementation can have discriminatory effects. This article explores the relevance of the Investigation's findings for other health and social care professions, demonstrating that they similarly have a range of regulatory fitness requirements that may be interpreted and implemented in different ways, potentially discouraging disabled people from entering the professions or from disclosing their conditions. Regulations and guidance across health and social care professions need to be reviewed, bringing them up to date with current disability and anti‐discrimination legislation. A more proactive stance towards disability equality is required if the professions are to achieve the aim of a more diverse workforce.