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The new local government performance framework, in combination with the move towards greater personalisation in services, creates a radically new funding environment for housing with care and support. From the Public Service Agreement (PSA) on achieving settled accommodation for individuals at risk of exclusion, through to the impact of local joint strategic needs asessments and individual budgets, the principles and mechanisms of the new joint commissioning culture create more opportunities for providers to articulate the needs of the client group served, and to assert the case for more joined‐up and responsive services. This may require different skills and new styles of leadership at local level, and providers who have become adept at being competitors may need to re‐discover the skills of partnership. Meanwhile, new social exclusion policy frameworks are emerging for supported accommodation, which can support moves away from institutional care for those with mental health problems.

The purpose of this paper is to analyse the factors that are leading many international health systems to seek new ways of getting doctors to be more engaged in management, leadership and service improvement.

The paper draws on the growing research and literature that is demonstrating a strong association between extent of medical engagement and clinical and organisational performance. The current NHS reforms in England place general practitioners very much at the centre of the commissioning process and increasingly consultant medical staff are leading the drive to improve access, quality, safety and new ways of delivering care within hospitals and across health systems.

In parallel with political and organisational change, the medical profession has been redefining the characteristics of a good doctor. This includes not only the reinforcement of the need for doctors to be clinical experts but also good managers and leaders. As the custodians of the processes and micro‐systems of health care, doctors are ideally placed to lead improvements. The paper argues that there is perhaps congruence between politicians and policy makers for greater medical leadership and engagement with doctors becoming “shareholders” in the running of services, organisations and systems.

The paper concludes that perhaps the era of strong general management may be replaced by one where non‐clinical managers and clinicians work in partnership to optimise the different expertise, experience and values to achieve high quality, productive and patient‐focused care.

Patient safety remains a top priority in healthcare. Many organizations have developed systems to monitor and prevent harm, and have invested in different approaches to quality improvement. Despite these organizational efforts to better detect adverse events, efficient resolution of safety problems remains a significant challenge. The authors developed and implemented a comprehensive multimodal patient safety improvement program called SafetyLEAP. The term “LEAP” is an acronym that highlights the three facets of the program including: a Leadership and Engagement approach; Audit and feedback; and a Planned improvement intervention. The purpose of this paper is to evaluate the implementation of the SafetyLEAP program in the intensive care units (ICUs) of three large hospitals.

A comparative case study approach was used to compare and contrast the adherence to each component of the SafetyLEAP program. The study was conducted using a convenience sample of three (n=3) ICUs from two provinces. Two reviewers independently evaluated major adherence metrics of the SafetyLEAP program for their completeness. Analysis was performed for each individual case, and across cases.

A total of 257 patients were included in the study. Overall, the proportion of the SafetyLEAP tasks completed was 64.47, 100, and 26.32 percent, respectively. ICU nos 1 and 2 were able to identify opportunities for improvement, follow a quality improvement process and demonstrate positive changes in patient safety. The main factors influencing adherence were the engagement of a local champion, competing priorities, and the identification of appropriate resources.

The SafetyLEAP program allowed for the identification of processes that could result in patient harm in the ICUs. However, the success in improving patient safety was dependent on the engagement of the care teams.

The authors developed an evidence-based approach to systematically and prospectively detect, improve, and evaluate actions related to patient safety.

The article explores how the Government's framework of local strategic partnerships and local area agreements provides opportunities for greater collaboration between the strategic housing role for local authorities and leadership in health and social care, although the details of the framework are still to be developed.

This paper is an account of the discussions and recommendations by the exper t advisory panel on potential metrics and ‘sentinel indicators’ for improved outcomes in housing and mental health, as par t of an inter‐agency seminar called to advise on the development of metrics and measures for community mental health, for Fair Society, Healthy Lives: The Marmot Review (Marmot, 2010). The seminar covered all aspects of mental health in both its broadest and narrower senses.Much of the background material for these discussions, therefore, cuts across familiar knowledge silos between the fields of health and housing. Where it is necessary to elucidate the text, references are included to relevant research and policy frameworks that may be unfamiliar to the general reader. This paper is not, however, intended as a general literature review nor is it an evaluation of the available research. A paper on this subject will feature in a future issue of the Journal.1The conclusions from the panel discussion are presented in four main areas, reflecting the need to specify metrics across the wide‐ranging interface between housing and mental health, while still keeping the task manageable. Five current or potential health service metrics were proposed as having par ticular value as signal indicators. Two of these (relating to primary care prevention and public health) have no precision as yet, par tly as new services and approaches are still evolving. Among existing health datasets, the Mental Health Minimum Dataset (MHMDS) (NHS Information Centre, 2009a), SITuation REPor ts (SITREPS) (Department of Health, 2003), and the Summary Care Record data were singled out, though each is thought to need more work to improve the current data categories as well as data collection.One rather more fundamental point made was that the identifying, assessing and encouraging of effective inter‐sector par tnership work will be the key to tackling health inequalities. The use of other, non‐health services data therefore holds great potential for a better recognition both of needs and of outcomes in successful par tnership work, especially where this can be interpreted at local level. These wider comments are elaborated in the context of housing, but may be applicable to all effor ts to evidence and work with the social determinants and the social outcomes of mental health. For the future, a combination of well‐crafted nationally sanctioned metrics and the ‘soft intelligence’ of locally identified meaning may be most effective.Subsequent developments confirm the potential in cross‐sector development work, and indicate the potential for fur ther collaboration via the local performance framework. As policy frameworks continue to evolve rapidly, the ar ticle ends with a Codex, updating the relevant policy frameworks context since the seminar (in Spring 2009) and especially in the context of a new coalition government with aspirations to ar ticulate and promote public health in the context of the local performance framework and the ‘new localism’ agenda. This final section and comments therein are therefore entirely the responsibility of the author.

This paper aims to summarise key messages from a major evidence review of health inequality in England since 2010 – “the Marmot Review 10 Years on”.

Alongside “the Marmot Review 10 Years on”, which came out in February 2020, the author accessed the original Marmot review published in 2010, a 2020 article by Marmot, and Marmot’s online talk to the Royal Society of Physicians Edinburgh on 2nd of July 2020. The author drew out key messages from these sources.

Although many local authorities have taken up the 2010 Marmot review recommendations, they have been working against budget cuts under the system known as austerity. This has reduced funding to already deprived areas and probably explains worsened health inequality in England compared to other European countries. There are examples of successful local partnerships that have improved lives, but they rely on temporary charity funding. Health services can work for change locally, but central government policies must help. This has become even more urgent since the pandemic.

The original Marmot review and “the Marmot Review 10 Years on” are major evidence-based examinations of what causes and maintains health inequality, both physical and mental, and how this situation might be improved. It is impossible to study them and still believe that health is just about lifestyle choices. People need real options to choose from, and this is only possible if they live in places designed for human thriving from childhood to old age. As a nation, England can move towards this goal rather than further away from it. These reports show the way.

Robin Johnson continues his excellent series on housing issues, this time exploring the important role that support workers can have in reaching out to and engaging with individuals who would ordinarily be reluctant to put themseves in the hands of conventional care or therapy services.

The purpose of this paper is to gain insight in how South African local governments organize citizen engagement. The new South African constitution provides ways to construct and implement citizen engagement at local level. However, understanding citizen engagement at local level is still a challenge and municipalities search for proper structures and mechanisms to organize citizen engagement efficiently.

Interviews with different municipal actors were analyzed using a single case study method. As a primary unit of analysis, a specific project in which citizen engagement is organized was used. In addition, document analysis and a focus group were used to deepen understanding.

The findings reveal that citizen engagement is a viable strategy to identify the needs of the community if facilitated by a third party and that learning leadership is important when organizing citizen engagement.

The value of this research is the exploration of the citizen engagement process. It sheds light on the conditions that play a role when a local government organizes citizen engagement. As local governments search for ways to effectively organize and structure citizen engagement, insight into these conditions is helpful.

Contributing to the global dialogue on disaster risk reduction (DRR), the purpose of this paper is to address a key priority for the Post-2015 Framework for DRR (HFA2) by analysing initiatives used by one local government to increase local-level engagement in DRR.

A review of literature from the multidisciplinary areas of communication, social and political theory examines the role that communication theory and practice can play in facilitating public participation to build community resilience. Building on these insights, the authors introduce a research methodology to examine modes of communication, the quality of dialogue and opportunities for “voice” and “listening” between decision makers and local-level stakeholders during DRR planning A qualitative, case study is undertaken with data sourced from observation, document analysis and interviews to provide insights into public engagement events, policies and procedures that enhance or impede local engagement in DRR.

Communication between the DRR campaign team and publics are analysed according to the range of communication practices used and opportunities provided for dialogue between parties. Findings differentiate between public information, consultation and participation events. Factors that enable and conversely, constrain local-level engagement to build community resilience, and conditions associated with each factor, are identified.

A unique analytical framework adapted from the duel lenses of participatory communication and information flow models, is used to differentiate events using one-way information from those offering opportunities for dialogue and participation. The framework provides a method for DRR practitioners to plan and evaluate local-level engagement events to meet the communication needs of particular situations.

The framework provides a method for DRR practitioners to plan and evaluate local-level engagement events to meet the communication needs of particular situations.

Co-authored by an Australian academic and a member of Amadora’s campaign team, the paper is a combination of one city’s experience in developing strategies to build community resilience, analysed using communication, social and political theory. Findings have implications for standard command-and-control management systems and styles of leadership and crisis management. Results will assist practitioners’ advance their understanding of different ways that publics may be engaged to build community resilience.

Leadership development through a civic engagement activity in a local FFA chapter is explored. Through a case study design, researchers illuminate a project that encouraged youth leadership development through the creation and execution of a civic engagement project in their own local community. Holistically, FFA members viewed the project as a resounding success. Leadership development was experienced at many levels - individual, chapter, and community. FFA members felt particularly engaged when seen as partners with the community. This was accomplished through developing networks and participating in the planning, decision making, and execution of the project. The primary barrier cited was a lack of engagement from all chapter members. Implications include the important role civic engagement plays in youth leadership development, employing civic engagement projects to assist in developing higher level leadership skills, and the need for further research partnerships between career and technical student organizational members and local community citizens.