Search results

National and local policy supports the involvement of patients at all levels in the design, delivery and improvement of health services. Whilst existing approaches to support involvement have been described and disseminated, including the 4Pi National Involvement Standards, their application in quality improvement is rarely reported. The paper aims to discuss this issue.

A quality improvement initiative within a mental health trust was developed with a multi-disciplinary team, including those with professional experience of delivering or improving care and those with lived experience. The aim of the initiative was to improve the physical health of inpatients within an acute mental health unit. This case study aims to describe how the integration of concepts from the 4Pi National Involvement Standards (Principles, Purpose, Presence, Process and Impact) provided a framework for engaging and involving service users. The case study also aims to describe how co-design was included within the 4Pi approach and supported the development of a tool to aid improving physical healthcare.

The 4Pi National Involvement Standards provided a guiding framework for the involvement of service users within a quality improvement initiative. Value of the approach was realised through the co-design of a tool developed by service users, along with healthcare professionals, to facilitate discussion and support shared-decision making about inpatients’ physical health.

Identifying “ways that work” for service user involvement is crucial to move beyond the policy rhetoric or tokenistic involvement. Involvement in quality improvement initiatives can bring benefits both to services and the service users themselves.

Whilst the 4PI approach is recognised as a useful framework for involvement, few examples exist of its practical applications within a quality improvement setting.

Simon Cowell, the impresario behind The X Factor, a popular television talent show, has often been compared to P.T. Barnum, the legendary nineteenth century showman. This paper aims to examine the alleged parallels in detail and attempts to assess this “Barnum reborn” argument.

Putative parallels between the impresarios are considered under the aegis of two long‐standing, if contentious, historical “theories”: time's cycle and the great man thesis.

Seven broad similarities between the showmen are identified: vulgarity, hyperbole, rivalry, publicity, duplicity, liminality and history. In each case, the arguments pro and con are explored, as is humanity's propensity to personify.

In accordance with the iconic literary critic Harold Bloom, who “strikes texts together to seek if they spark”, this paper strikes two celebrated showmen together to generate historical sparks.

BRIAN COOPER, until recently in Zambia for the Ministry of Overseas Development, setting up library facilities in a new teacher‐training college, has been appointed as the first ever hospital librarian at Rampton special hospital. The appointment is made jointly by Nottinghamshire County Library (K A Stockham is County Librarian) and the Department of Health and Social Security, and is a consequence of the recent government white paper on Libraries in hospitals.

It is one thing to discuss the clauses of a prospective Bill; but to get that Bill through Parliament is a vastly different affair. It was at the Buxton L. A. Conference, in 1896, that the matter was considered, and now, after four years' working and waiting, we have advanced just so far as to have got through the House of Lords “a Bill intituled an Act to amend the Acts relating to Public Libraries, Museums, and Gymnasiums, and to regulate the liability of managers of Libraries to proceedings for libel.” At the present moment this Bill is awaiting an opportunity of coming before the Commons. With this position it must be perfectly familiar, for it was only on account of Lord Avebury's despair at finding no opening for it in the House of Commons that the Association induced Lord Windsor to pilot it through the House of Lords. If the present Parliament lives long enough there is just a chance of the measure being entered upon the statute book; but, with forecasts of an early dissolution confronting us, and with Mr. Balfour's recent announcement of the Government appropriation of private members’ days this session, the prospect is not particularly encouraging. If these slender hopes are not realised, the Bill will be none the forwarder for passing the Upper House; whilst, if it should be so fortunate as to pass the Commons without further amendment, it would at once pass into law. Lord Balcarres has been good enough to take charge of the Bill in the House of Commons, and as it is well “backed,” and has been pruned down by the Standing Committee, and has really nothing of a contentious nature in its provisions, we may reasonably hope that if it once gets a start in the House it will reach a successful finish.

FOR the student who has to choose a field of study in which to learn and exercise his bibliographic skills Sociology affords an interesting and attractive challenge. Indeed, to understand his chosen profession it must necessarily be placed within its social context. Most students at some stage of their development reflect on the social problems that beset the human situation, and some, as the mass media would have us believe, are anxious to remould the “sorry scheme of things” as represented by the existing social structure.