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People with intellectual disabilities experience poorer health outcomes than the general population, and a significantly increased risk of mental health comorbidity. Their access to healthcare has been consistently shown as inadequate, and their access to mental health support is still largely wanting. Adequate training and education should improve these shortcomings but there is limited evidence available as to the best way to achieve this. The paper aims to discuss these issues.

This paper reports on the co-production and co-delivery of a simulation training course to support healthcare professionals to provide care for people with intellectual disabilities, with a particular focus on their mental health needs. This training was designed with actors with intellectual disabilities, who participated as simulated patients in scenarios during the course and subsequently provided feedback on their experience.

This paper focusses on the positive experiences of the simulated patients, reporting on and interpreting their direct feedback on their experience of contributing to the development and delivery of the course and being involved as co-educators.

It is highlighted that the co-production and delivery of this simulation training with people with intellectual disabilities has the potential to realise some of the key principles called upon when attempting to improve how they are treated, by illustrating concrete participation, independence, and access to fulfilling lives. The value and benefits of interprofessional education to achieve these educational aims is further highlighted, particularly for the potential to generate a sense of shared responsibility within mainstream services in caring for people with intellectual disabilities.

The purpose of this paper is to discuss the role of education and training in addressing health inequalities in intellectual disabilities, before examining innovative approaches to healthcare education. Preliminary findings of a simulation training course to support healthcare professionals to work with people with intellectual disability are then presented.

This study employed a mixed methods design to assess the impact of the simulation course. Quantitative data were collected using the Healthcare Skills Questionnaire and a self-report confidence measure; qualitative data were collected using post-course survey with free text responses to open questions.

Healthcare skills and confidence showed statistical improvements from pre- to post-course. Qualitative analyses demonstrated that participants perceived improvements to: attitudes, communication skills, reasonable adjustments, interprofessional and multi-disciplinary working, knowledge of key issues in working with people with intellectual disabilities.

Encouraging findings imply that simulation training to address health inequalities in intellectual disabilities is a valuable resource that merits further development. This training should be rolled out more widely, along with ongoing longitudinal evaluation via robust methods to gauge the impact on participants, their workplaces, and people with intellectual disabilities.

The authors believe this paper to be the first to assess an interprofessional, high-fidelity simulation course, using actors as simulated patients to address the mental and physical health needs of people with intellectual disabilities. The rigorous use of co-production and co-delivery, alongside promising findings for this training method, represent a useful contribution to the literature.

This paper aims to describe evolution of a new public information web site, through evaluation‐refinement prototyping cycles.

An expanding range of participants is being engaged in formal evaluations as the site design evolves. The Flesch‐Kincaid Grade Level Score is applied to assess ease of reading in the wording used; the National Quality Forum guideline statements are applied to determine whether the prototyping design process is meeting performance expectations; and then Nielsen's heuristics are applied to evaluate ease of use of the latest prototype.

The page wordings started at a high reading grade level to be technically correct, with a strategy to progressively reduce levels without losing meaning. Reading level was reduced to an average of two and as much as six grades through editing between the third and fourth‐generation prototypes. None of the National Quality Forum principles were found missing from the development process. The prototype web site was ranked at the middle compared to official public web sites of seven other States' healthcare‐associated infection programs, some of which had been open to the public for more than a year. Many of the heuristic violations that weighed against the prototype were described as being minor and easily fixed. Collaboration between a State health department and a university to advance this evaluation‐refinement process was valuable to both parties, enhancing the ability to produce a new public information web site that is more likely to meet the needs of its intended audience.

In response to increasing expectations of transparency and accountability, a growing number of public web sites are displaying hospital performance data. Washington State's mandatory public reporting of healthcare‐associated infection rates is a recent example of this trend. The Department of Health is required by law to launch a public information web site by December 2009. The research was based on an evidence‐based approach to understand and meet the information needs of the public.

Although few studies have evaluated the usage and impact of hospital comparison web sites, these studies uniformly show relatively low usage and disappointing impact. Using the research literature, issues thought to account for poor usage and low impact, and developed design principles that address this poor past performance were identified. Throughout 2008 and 2009, successive prototypes were developed for the web site structure guided by those principles and refined each generation of prototype through focus group evaluations. This paper explains the approach, and summarizes results from the evaluations, leading to improvements before the final design first opens to the general public.

In recent years water has been the chief extraneous matter found in adulterated lard, but the results of the examination of the 2,918 samples (eight adulterated) reported upon during 1925, show cases of adulteration by substituting or adding vegetable oils and fats.

During the year the Department have approved 30 appointments of Public Analysts in England.

Individuals health with intellectual disabilities (ID) experience comorbid physical and mental health needs and have poorer outcomes resulting in early mortality. Currently, many training provisions based on ID exist; however, limited research supports their effectiveness. High-fidelity simulation is an innovative training mechanism with promising preliminary results. This study aims to evaluate the longitudinal impact of simulation training on clinical practice in ID.

A mixed-method approach was used in this study. A one-day simulation course using actors who had ID was delivered to 39 health-care professionals from across London hospitals. Nine semi-structured interviews were conducted 12–18 months post training.

High-fidelity simulation training is an effective training modality, which has a sustainable impact on participants, their clinical practice and patients. Core features of the training including debriefing, the use and type of actors, scenario design and the facilitators are crucial learning mechanisms which impacts learning outcomes and changes to behaviour in clinical practice and settings.

To the best of the authors’ knowledge, this study is the first to longitudinally evaluate high-fidelity simulation training designed to improve the physical and mental health needs of those with ID. The research begins to bridge an important gap in the current literature, with a need for more research.

A co-produced clinical practice that aims to improve outcomes through a partnership with service users is becoming increasingly important in intellectual disability (ID) services, yet these approaches are under-evaluated in forensic settings. This study aims to explore and compare the feasibility of two approaches to co-production in the completion of dynamic risk assessments and management plans in a secure setting.

A convenience sample of adults admitted to a secure specialist forensic ID service (N = 54) completed the short dynamic risk scale (SDRS) and drafted risk management plans under one of two conditions. In the first condition, participants rated the SDRS and risk management plan first, separately from the multidisciplinary team (MDT). In the second condition, participants and MDTs rated the SDRS and risk management plan together.

In total, 35 (65%) participants rated their risk assessments and 25 (47%) completed their risk management plans. Participants who rated their risk assessments separately from the MDT were significantly more likely to complete the SDRS (p = 0.025) and draft their risk management plans (p = 0.003). When rated separately, MDT scorers recorded significantly higher total SDRS scores compared to participants (p = 0.009). A series of Mann-Whitney U tests revealed significant differences between MDT and participant ratings on questions that required greater skills in abstraction and social reasoning, as well as sexual behaviour and self-harm.

Detained participants with an ID will engage in their dynamic risk assessment and management plan processes. The study demonstrates the impact of different co-production methodologies on engagement and highlights areas for future research pertaining to co-production.