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The purpose of this paper is to show how the new arrangements for commissioning services in the English NHS can facilitate innovations in service delivery leading to improvements in outcomes and cost effectiveness.

The study uses cost modelling based upon the Hospital Episodes Statistics compiled by the NHS Information Centre to calculate recent expenditure upon treatment of routine childhood illnesses managed as short stay hospital admissions, and then uses a case study of a children's walk‐in centre to show how an alternative service can be provided, and a new service embedded in general practice to show a further alternative type of provision.

The study finds that large sums are currently being spent on inappropriate treatment of routine childhood conditions, especially in large urban conurbations. It demonstrates that in the case studies, the alternative provision can provide a viable and effective alternative.

The research is based upon historical data by necessity. The new commissioning groups are not co‐located with the historical PCTs on which this study is based. The data are collected by providers and co‐ordinated by the NHS Information Centre. Therefore the investigators do not have control over the data quality. The second case study is a new service and therefore is used as an illustration of other service types.

This study suggests that paediatric ambulatory services can be provided at lower cost with better outcomes.

This study provides the basis for a pilot study in Salford, where additional social benefits are targeted including better school attendance and increased self‐awareness over child health amongst local families.

The study provides quantitative evidence for commissioning alternative paediatric ambulatory services.

The purpose of this paper is to show how competency models can be used to govern the increased autonomy of advanced practitioners in nursing, and to assist in workforce development.

The study shows how competency frameworks for advanced nurse practitioners (ANPs) have evolved in the UK. It compares the current thinking in the UK to the latest competency models from the USA. The article uses the authors' own adaptation of Benner's novice‐to‐expert framework to derive a framework from the current approaches. The authors then demonstrate how the resulting framework can be deployed to target development of new ANPs to address workforce development and governance issues over ensuring the right skill mix for safe autonomous practice. Finally, they argue for registration of advanced practitioners as a distinct professional group to address medico‐legal concerns over increased autonomy.

The study shows that there are currently limited numbers of ANPs constraining the development of new nurse‐led services, for example paediatrics. The study argues that current developments in the UK are unhelpful to the development of new nurse‐led initiatives that could flourish under the new commissioning arrangements. The study demonstrates how an enhanced framework can be used to target potential new ANPs for bespoke training, to assure that existing role holders have the correct level of competency for safe autonomous practice, and could form the basis of professional registration of advanced practitioners.

The small numbers of existing ANPs and the early stage of development of nurse‐led services limit the opportunities for evaluation.

This study suggests that competency modelling can contribute to the effectiveness of ANP education, help to address workforce planning issues and provide re‐assurance for commissioners in terms of governance and safety.

Competency modelling for ANPs in the UK is in its infancy, but the lack of a safe and competent workforce is a barrier to innovation for commissioners of services.

The purpose of this paper is to enable busy clinicians to review the contents of the journal quickly. They can then choose which articles have the most relevance for them and focus on these.

The paper provides a brief synopsis of the main content of the journal prepared by the review editor.

Changes to healthcare commissioning and delivery will have long‐term consequences for the way in which the NHS functions.

It is important that all NHS staff have a clear understanding of recent and proposed changes so that they can participate in dialogue about the implications for their roles.

The review editor has no affiliation with any of the authors and no financial or other interest in commissioning and therefore is able to provide an independent overview of the journal contents.

Somehow, without loading up on games or owning a sound card, the author has 28 CD‐ROMs at home, with more on the way. How did all these discs get there and what do they say (if anything) about the CD‐ROM marketplace? When are CD‐ROMs marvelous new publishing media, when are they essentially compact diskette replacements, and when are they wastes of good polycarbonate? The author goes through his motley collection, noting some highlights and some messy situations. After all this grumbling, the author adds notes on the personal computing literature for April through September 1994.

The vast majority of political scandals reported in the news center around male politicians. Yet, when women are involved, the nature of the scandals and coverage are sometimes different. Whereas powerful men are rarely, if ever, accused of “sleeping their way to the top,” powerful women frequently are. What happens when women politicians are involved in a scandal that blurs the lines between corruption – i.e., abuse of public authority for private gain – and a simple moral transgression? We designed an original survey experiment to assess participants’ responses to a Congresswoman having an extramarital affair with someone who has the power to advance her career. We find that participants are less likely to suggest they will punish Congresswomen at the polls for involvement in a simple “morality” scandal than for the scandal that blurred the line between a sex and corruption scandal. Moreover, we observe that political conservatives are more likely than liberals to punish the hypothetical Congresswoman, indicating that some voters' negative reactions to women politicians are motivated by concerns about sexual morality, and not necessarily by a perceived abuse of power for professional gain.

Clinicians working in UK child mental health services are faced with several challenges in providing accurate assessment and diagnosis of attention deficit hyperactivity disorder (ADHD). Within the South London & Maudsley (SLaM) NHS Trust, community Child & Adolescent Mental Health Services (CAMHS) are developing structured pathways for assessing and diagnosing ADHD in young people. To date, these pathways have not been formally evaluated. The main aims of this evaluation are to evaluate all ADHD referrals made to the service in an 18-month period, including the number of completed assessments and proportion of children diagnosed with ADHD; and investigate adherence to the National Institute for Clinical Excellence (NICE) guideline for diagnosing ADHD in children and young people.

Retrospective data analysis was performed using service databases and electronic patient records. Adherence to the clinical guideline was measured using the NICE data collection tool for diagnosing ADHD in children and young people. All completed ADHD assessments were compared to four key recommendation points in the guideline.

Within the time frame, 146 children aged 4-17 years were referred and accepted for an ADHD assessment. Of these, 92 families opted in and were seen for an initial appointment. In total, 36 ADHD assessments were completed, of which 19 children received a diagnosis of ADHD and 17 did not. Aside from structured recording of ADHD symptoms based on ICD-10 criteria (69%) and reporting of functional impairment (75%), adherence to all guidance points was above 90%. The study also found that although a greater proportion of children referred to the service were male and identified as White, these differences narrowed upon receipt of ADHD diagnosis.

Relationship to the existing literature is discussed in relation to the assessment process, demographic characteristics and rates of co-occurrence.

The findings demonstrate that in child mental health services, gold standard practice for diagnosing ADHD should be the adoption of clear, protocol-driven pathways to support appropriate access and treatment for young people and their families.

This article is unique in that it is, to the best of the authors’ knowledge, the first to describe and report clinician-adherence to a structured pathway for diagnosing ADHD in young people within a community CAMHS service in South London.

This paper describes the sustainability partnership between the City of Vancouver and the University of British Columbia (UBC) and, in particular, the co-curricular Greenest City Scholars graduate student internship program, which has been developed by the two organizations. Through the program, UBC graduate students work on projects at the City that help to advance sustainability targets. The paper aims to explore the successes, challenges and lessons learned from the program.

This case study uses literature and document review, observations, program participant evaluation surveys and project impact survey feedback.

The Greenest City Scholars program model has contributed to the sustainability goals at UBC and the City of Vancouver and has supported the partnership between the two organizations. The program has grown over its five-year history and is considered to be a central part of the partnership. Breadth of student participants from across the university and high participation from City departments have been achieved. The model is now being adapted to be delivered within other partnerships.

The experiences presented in this case study can help other higher education institutions understand how a co-curricular graduate student work experience program could help to bolster their own sustainability partnerships.

This paper makes a contribution by providing insight into the use of a graduate student program to advance the goals of a university–community sustainability partnership.

Higher levels of participation in school are linked to greater academic performance, better health and well-being and positive long-term outcomes for young people. Evidence shows that for students with emotional and behavioural difficulties (EBD), participation in school-based occupations is often restricted in comparison to their peers. Given the recent advancements towards introducing a new model of school-based occupational therapy in Ireland, this paper aims to discuss how occupational therapy can support students with EBD to increase their participation within the post-primary school context. The opinions in this paper are derived from the authors’ experience in the development of this practice in the Republic of Ireland.

The authors reviewed current literature and reflected on current practice to describe the unique role of occupational therapy in supporting students with EBD in the school environment.

Occupational therapists have potential to play a key role in school-based support for students with EBD. The authors describe how occupational therapists can promote whole school understanding of EBD and enable skill development, self-regulation, participation and school belonging, among youths with EBD. There is a significant lack of literature guiding practice in this area. Further research is required to explore professional issues and identify best practice.

This paper aims to provoke consideration of how school-based occupational therapists can play a crucial role in supporting students with EBD who are otherwise at risk of occupational injustice.

This chapter introduces the argument that pervades the collection that families are in motion both conceptually and in practice. It articulates the motion of family and families, which are made through space and time, and explains the ways in which the book develops current thinking on family. It also situates the concept and practices of family within wider debates and contexts. The chapter then details the contribution of each of the chapters to this argument, which are organised around three thematic parts: moving through separation and connection; uneven motion and resistance; and traces and potentialities. The chapter draws out six conclusions from the chapters in the collection.