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Improving the competence of frontline services to support people who challenge has long been recognised as a key service objective. Exactly how this objective should be achieved has been unclear, however. This article describes how web‐based e‐learning technology is being used to achieve widespread dissemination of knowledge and skill about positive behavioural support. The drivers for this development are described, together with an account of the historical development of the programme. The advantages of using this medium are outlined, and the benefits of a whole‐organisation approach to learning are identified.

A system of evidence‐based periodic service review (PSR) was implemented in specialist health services for people with challenging behaviour, to support the adoption of a positive behavioural approach. The extent and accuracy of PSR implementation, its impact on staff knowledge and attitudes, and its value as a practice leadership tool were assessed. The results indicated that PSR was implemented regularly, scoring was based accurately on tangible evidence, and increased scores over time indicated service improvement in line with PSR principles. Staff generally welcomed PSR as a quality monitoring tool, and greater knowledge of the rationale and process for PSR was associated with more positive attitudes. Managers regarded PSR as a valuable aid to practice leadership and had used innovative implementation methods to maximise its acceptance by staff teams. The style of management and need for support from the wider organisational structure are discussed as critical factors in successful implementation.

The paper considers the kinds of treatment available for people with learning disabilities and challenging behaviour. It draws on research data on the use of reactive strategies and behaviour plans for 235 children and adults rated by carers as extremely challenging, and 276 rated as very challenging, to identify any trends in the management and treatment of challenging behaviour. It finds an increase in written plans for adults but not for children, and no information on the extent to which plans are based on sound functional analyses and contain proactive as well as reactive strategies. Only half the plans were said to have been drawn up with any support from behavioural specialists, and there was no discernible change in the use of reactive strategies.

Couched within the author’s memories and correspondence with Kathy Charmaz, this chapter considers the philosophical nature of Constructivist, or Charmazian Grounded Theory, and contrasts it with the philosophical underpinnings of Critical Grounded Theory. Using an autopoietic framework, this chapter sees Charmazian and Critical Grounded Theory as interconnected, complementary, but distinct in the way they each approach research participants and interpret social processes. The chapter ends with reflections on Kathy Charmaz's contribution to critical grounded theory and where she had hoped the next generation of grounded theorists might expand the methodology.

The development of telecare services across the UK has been supported by grants from the respective governments of Scotland and Wales, and by the DH in England. New services are being established to sometimes operate alongside existing community equipment services and community alarm services. Elsewhere they are embracing a wider range of services including rehabilitation, intermediate care and health services designed to reduce the use of unscheduled care services. This paper discusses the difficulties in understanding the scope of telecare services, and the definitions of services that will need to be confirmed so that service users can choose appropriately if offered direct payments. Two different service models are offered, one of which uses telehealth as an umbrella term to cover all telecare, e‐care and m‐care, and telemedicine where the former includes all such services offered in the service user's home, including those of a medical nature. The second model views telecare alongside assistive technologies and telemedicine as one of three different technology groups designed to make people more independent or to bring care closer to home. There is significant overlap between the three groups, which justifies the introduction of a new term ‐ ARTS (assistive and remote technology services) ‐ to describe this area of support.