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This paper describes a quality improvement project to improve oversight of quality at national board level using statistical process control (SPC) methods, complimented by a qualitative experience of patients and frontline staff. It demonstrates the application of the “Picture-Understanding-Action” approach and shares the lessons learnt.

Using co-design and applying the “Picture-Understanding-Action” approach, the project team supported the directors of the Irish health system to identify and test a qualitative and quantitative picture of the quality of care across the health system. A “Quality Profile” consisting of quantitative indicators, analysed using SPC methods was used to provide an overview of the “critical few” indicators across health and social care. Patient and front-line staff experiences added depth and context to the data. These methods were tested and evolved over the course of six meetings, leading to quality of care being prioritised and interrogated at board level.

This project resulted in the integration of quality as a substantive and prioritised agenda item. Using best practice SPC methods with associated training produced better understanding of performance of the system. In addition, bringing patient and staff experiences of quality to the forefront “people-ised” the data.

The application of the “Picture-Understanding-Action” approach facilitated the development of a co-designed quality agenda item. This is a novel process that shifted the focus from “providing” information to co-designing fit-for-purpose information at board level.

Exposure to isocyanates was the leading cause of occupational asthma in the UK. Motor vehicle repair (MVR) bodyshop paint sprayers were at greatest risk, despite widespread use of air-fed breathing apparatus and ventilated booths. Most paint sprayers work in small and medium enterprises (SMEs). The purpose of the Health and Safety Executive (HSE) project, described in this paper, is to improve exposure control measures in at least 20 per cent of MVR bodyshops, and reduce the risk of occupational asthma. The paper aims to discuss this issue.

A three-stranded plan consisted of: Safety and Health Awareness Days (SHADs); workplace inspections; and third-party stakeholder communications. The impact of various parts of the project were evaluated.

Approximately 18 per cent of bodyshops in the UK attended one of 32 SHADs, following which over 90 per cent of delegates expressed an “intention to act” to improve exposure control measures. A local assessment showed that at least 50 per cent of bodyshops improved exposure control measures. An evaluation of 109 inspections found that enforcement action was taken at 40 per cent of visits. Third-party engagement produced a joint HSE-industry designed poster, new agreed guidance on spray booths and dissemination of SHAD material. Knowledge of booth clearance time has become widespread, and 85 per cent of booths now have pressure gauges. Biological monitoring data show that, post-SHAD, exposures were lower.

A sustained national project using clear, relevant, tested messages delivered via different routes, had a sector-wide impact in bodyshops. It is probable that the project has improved isocyanate exposure control in at least 20 per cent of bodyshops. The generic lessons could be applied to other widespread SME businesses.

Individual Placement and Support (IPS) is an evidence-based employment model, effective in supporting individuals with severe mental health difficulties to gain competitive employment. Irish mental health policy recognises its value and IPS is being rolled out in a national programme. Employment is recognised an important contributor to mental health recovery and social inclusion. However, research on IPS has tended to focus on competitive job outcomes. The purpose of this study was to explore the non-vocational outcomes of IPS in an Irish context.

A qualitative research approach was used to interview participants taking part in IPS within community mental health teams. Twelve interviews were included in the data analysis process which was informed by a thematic analysis approach.

Participants experienced increased confidence and positivity, both within a work context and whilst job seeking. More purposeful time use, participation in activities and engagement with society were also experienced by those employed and those at the job search stage of IPS.

This study contributes to the literature about the non-vocational benefits of IPS within an Irish context, highlights the mental health recovery benefits of taking part in IPS and supports the need for ongoing development of IPS throughout mental health services in Ireland.

The purpose of this paper is to critically review the context of adult protection in Ireland with a focus on older people. The paper traces advances and current limitations in policy, regulation, practice and legislation.

A review of historical and current contexts in adult safeguarding in Ireland is presented with consideration of key public reviews and commentaries related to care provision, governance and the legislative status of adults at risk.

While Ireland’s journey to provide adult safeguarding responses for older people has progressed since 2002, there remain many gaps. Further work needs to be addressed urgently to enable a comprehensive alignment of fit-for-purpose, responsive legislation, practice and policy to meet the complex and diverse needs of an increasing ageing population who may require safeguarding support. This includes fostering robust inter-sectorial collaboration, safeguarding legislation and cultural change related to human rights approaches.

The paper is a discussion on the context of adults safeguarding in relation to practice, policy and legislation.

Identifies the need for significant reform in the Irish system of health service. Argues for an overarching, inter-sectorial approach to addressing adult safeguarding, which focuses on prevention as well as early intervention.

The paper offers a review of the current diverse elements comprising current adult safeguarding and older people in Ireland and integrates legislative, regulatory, policy and practice realities. Challenges are illustrated within the context of reactive rather than proactive safeguarding agendas which are linked to public scandals and debates. The paper argues for a more integrated and robust inter-sectorial approach to safeguarding underpinned by adult safeguarding legislation and an overarching governance structure.