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A region’s transforming care partnership identified that autistic adults without an intellectual disability (ID) may be falling through gaps in services when presenting with a significant emotional and/or behavioural need in the absence of a mental health diagnosis. The region’s intensive support teams (ISTs) for adults with ID therefore piloted a short-term “behavioural support service” for this population. The purpose of this paper is to evaluate this pilot.

This study represents a mixed-methods service evaluation over a four year pilot period. The quantitative component examined referral rates and demographic data of accepted and declined referrals; and length of referral episodes and Health of The Nation Outcomes Scores (HoNOS) for accepted referrals. The qualitative component used thematic analysis to identify key themes relating to reasons for referral, clinical/therapeutic needs, and the models of support that most informed assessments and interventions at individual and systems levels.

The ISTs accepted 30 referrals and declined 53. Most accepted referrals were male (83%), and under 24 years old (57%). Average HoNOS scores were above the thresholds generally associated with hospital admission. Key qualitative themes were: transitional support; sexual risks/vulnerabilities; physical aggression; domestic violence; and attachment, trauma and personality difficulties. Support mostly followed psychotherapeutic modalities couched in trauma, attachment and second- and third-wave cognitive behavioural therapies. Positive Behaviour Support (PBS) did not emerge as a model of preference for service users or professionals.

This project represents one of the first of this type for autistic adults without an ID in the UK. It provides recommendations for future service development and research, with implications for Transforming Care policy and guidance.

To share a case study of a service improvement review of practice and ambition for Health and Wellbeing Boards in the English West Midlands in the changing context of Integrated Care Systems.

Mixed qualitative methods: 33 semi-structured interviews with senior care and health leaders; a computer-based self-assessment tool for Health and Wellbeing Boards; and desktop analysis of Joint Health and Wellbeing Strategies.

“Place-based partnership” is a motivating concept, embracing the agency of leaders in pursuing local strategies and solutions. The need for strong leadership was recognised. The opportunity for Integrated Care Systems to contribute to narrowing health inequalities was welcomed by building on local place-based models, maximising council expertise in managing population health and wellbeing in their areas.

The case study is a snapshot of a developing area at a time when further government guidance for Integrated Care Systems was pending. More specific analysis of place-based partnerships in the West Midlands in the context of Health and Wellbeing Boards and Integrated Care Systems would seem beneficial. In addition, further research of subsequent changes such as the Hewitt Review is also considered important.

The review shows the assertion of “place” as a unifying concept for Health and Wellbeing Boards and Integrated Care Systems. It suggests closer involvement of leaders in children's services with local Health and Wellbeing Boards is needed.

Health and Wellbeing Boards and Integrated Care Partnerships share common aims of improving the health and wellbeing of local populations. Maximising integration especially on preventative approaches and fully engaging communities in health would have positive social impact.

The case study adds to the relatively less well-developed literature on Health and Wellbeing Boards and their link with Integrated Care Partnerships.

This study aims to analyze the facilities managers’ involvement over the project life cycle phases (PLP), based on theoretical knowledge, consensus from empirical assessment of facilities managers and consultants’ practices.

A literature review was undertaken to determine the different tasks that facilities managers typically handle, identify project phases and their underlying activities in which facilities managers would be involved. This was followed by targeting a group of consultants to build a consensus, upon the identified involvement of facilities managers, over the PLP, while measuring the level of involvement from a representative group of facilities managers in Saudi Arabia. A matching between the perceptions and practice has been performed to serve as recommendations for future research on improving the practice in Saudi Arabia.

The involvement of facilities managers in the PLP is relatively low, according to the consultants’ perceptions. Consultants perceive that facilities managers should be involved in more professional activities, which would ultimately improve projects’ delivery to clients.

The involvement of facilities managers over the PLP ensures effective delivery of projects and reduces the multiplicity of challenges at the operation and maintenance phase. The viewing of facility managers’ involvement adds to the effectiveness of their role within the building industry.

This paper investigates the consultants’ perception of the involvement venues for facility managers to perform activities which are evaluated to be “mandatory,” “advantageous” or “not necessary.” The study reflects the state of facilities management practice, and the consensus of consultants toward the role of the facility managers through the PLP.

The purpose of this paper is twofold: to explore the existing evidence around dementia services and interrogate the overarching UK policy development relating to service inclusion of black and minoritised groups. The paper will go on to identify the implications for the dementia wellness pathway and make recommendations regarding how services can be more inclusive.

This paper examines the policy/practice landscape around dementia care provision and observes if lessons can be learnt to improve health outcomes for people living with dementia from black and minoritised communities.

A review of dementia policy demonstrates how opportunities to improve the awareness, diagnosis and post-diagnostic support for minoritised communities are being missed. The outcomes of this mean that individuals are denied vital treatment and support, which could enhance quality of life and delay the progression of dementia.

The authors’ premise is that not meeting the dementia support needs of less-heard communities has negative financial as well as social and health-related outcomes and has wider resonance and implications for all stages of the dementia wellness pathway. Moreover, there is a legal responsibility for public services to provide culturally sensitive, responsive, appropriate and available care, to all people, without discrimination.

This paper offers a valuable review of policy and practice around dementia care in the UK and makes recommendations to improve health outcomes for people living with dementia from black and minoritised communities.

This paper aims to use doctrinal legal investigative methods combined with economic analysis to investigate the efficacy of the Law.

The purpose of this paper is to explain the inherent absurdity in the modern law of town and village greens (TVGs). The author wishes to show that the public understanding of what constitutes a green worth protecting is incomparable with how the Law currently operates, instead providing a crude vehicle to prevent development.

Applying an efficiency maximisation framework to the law of TVGs the Law fails to protect land worth protecting, as well as prevents allocatively efficient bargaining from taking place.

This research has not presented empirical evidence to suggest the extent of the damage identified. This is a separate question to the marginal impacts of the damage.

A Law and Economics analysis of TVG Law in England and Wales has not been attempted before.

Many countries have a renewed focus on health inequalities since COVID-19. In England, integrated care systems (ICSs), formed in 2022 to promote integration, are required to reduce health inequalities. Integration is supported by population health management (PHM) which links data across health and care organisations to inform service delivery. It is not well-understood how PHM can help ICSs reduce health inequalities. This paper describes development of a programme theory to advance this understanding.

This study was conducted as a mixed-methods process evaluation in a local ICS using PHM. The study used Framework to analyse interviews with health and care professionals about a PHM tool, the COVID-19 vaccination uptake Dashboard. Quantitative data on staff Dashboard usage were analysed descriptively. To develop a wider programme theory, local findings were discussed with national PHM stakeholders.

ICS staff used PHM in heterogeneous ways to influence programme delivery and reduce inequalities in vaccine uptake. PHM data was most influential where it highlighted action was needed for “targetable” populations. PHM is more likely to influence decisions on reducing inequalities where data are trusted and valued, data platforms are underpinned by positive inter-organisational relationships and where the health inequality is a shared priority.

The COVID-19 pandemic accelerated a shift toward use of digital health platforms and integrated working across ICSs. This paper used an evaluation of integrated data to reduce inequalities in COVID-19 vaccine delivery to propose a novel programme theory for how integrated data can support ICS staff to tackle health inequalities.

The purpose of this papers is to set out the advantages to local communities of independent representation of older people by older people through active and vibrant older people’s forums and groups and the rationale for Councils in Wales to support their revitalisation and development.

This paper describes how semi-structured action research and follow-up discussion and analysis over a two-year period was undertaken by older people with representatives of Older Peoples Forums and groups to identify a strategy to restart and revitalise independent forums post pandemic to represent the voice of older people to government at all levels.

Facilitation of the independent and self-determined voice of older people through genuine co-production with Forums can help Councils meet statutory duties and ensure their policies and services for older people are developed and informed from the direct experience of those receiving them. This will also help address the impacts of an ageing population and meet the national aim to create age-friendly communities across Wales.

This research provides a basis for Councils to work with Independent Older Peoples Forums and groups to restart and regenerate the forums and promote the self-determined voice of older people to government at all levels.

In an ageing society older people should be empowered and enabled to make their own decisions. The principle of self-determination by older people for older people directly and through co-productive engagement with them by local authorities has meaning and purpose that should be promoted and implemented. If age-friendly communities are to be developed across Wales, then collaboration on this basis is required including through independent 50+ forums in localities.

Family planning (FP) services through the lens of human rights are not well known in Nepal. This study aims to assess Family Planning 2020: Rights and Empowerment Principles for Family Planning and identify factors affecting contraceptive use among HIV-infected women living in rural Far Western Nepal.

This study conducted a cross-sectional survey using self-designed proforma. To assess the association between contraceptive use and independent variables, this study calculated adjusted odd ratio (AOR) with 95% confidence interval (CI) using statistical package for social sciences (SPSS) V.20.

Only 37.8% of participants had access to full range of contraceptive methods, and only 57.5% of participants received proper counseling. Agency/autonomy, transparency/accountability and voice/participation were practiced by 43.7%, 23.4% and 19.7% of participants, respectively. Husband’s support (AOR = 4.263; 95% CI: 1.640–11.086), availability of FP services in their locality (AOR = 2.497; 95% CI: 1.311–4.754), employment (AOR = 3.499; 95% CI: 1.186–10.328) and postpartum period (AOR = 0.103; 95% CI: 0.023–0.475) were significantly associated with contraceptive use.

Health-care providers’ and program managers’ perspectives were not examined.

Findings of this study will be useful for making strategic plan on human rights-based approach to FP.

Expanding access to contraceptive information and services and strengthening autonomy, accountability and participation are key to human rights-based approach to FP.

This study identified that inadequate counselling, nonavailability of full range of contraceptive methods, low level of autonomy, accountability and participation were key bottlenecks in fulfilling human rights-based approach to FP.

This paper aims to examine the processes of sustainability reporting assurance (SRA) and the influence they have on shaping perception from disclosures. Given the evidence of inconsistencies and ambiguities in assurance processes, this paper examines how legitimacy is attained and maintained at different stages of SRA.

Evidence collected from 23 semi-structured interviews with assurance providers (APs), consultants, professionals and non-governmental organisations (NGOs) (non-APs) was used to conduct a thematic analysis from the perspectives of interviewees.

APs and non-APs are united in recognising the value of SRA, although, perspectives on transparency between the two groups differ. Experience and industry knowledge are essential to SRA delivery with non-APs preferring accounting APs. Nevertheless, non-APs are concerned about the role of companies in deciding assurance scope, as it can affect scrutiny. APs favour data accuracy (as opposed to data relevance) assurance due to team dynamics and internal review influences, with the latter also restricting assurance innovation. APs are interested in accessing better evidence and stakeholder engagement evaluations. Providing advisory services was not rejected by all APs. The perspectives of APs and non-APs demonstrate how progress in SRA has gained pragmatic legitimacy with noticeable gaps that serve to undermine attainment of moral legitimacy.

SRA is a developing practice that will adopt changes as it continues to mature; some of these changes could impact findings in this research. General perspectives on SRA were sought from interviewees, this affected the ability for an in-depth focus on any of the range of interesting SRA issues that arose over the course of the research. Interviews were conducted with relevant parties in the SRA space that operate in the UK. Perspectives from parties outside the UK were not solicited.

Companies make an important decision to commission SRA. Findings in this research have highlighted specific non-APs issues of concern that can be useful in structuring operations and reporting regimes to facilitate assurance procedures. The findings will also be helpful to APs as they can direct more emphasis on stakeholder concerns towards demonstrating greater stakeholder accountability. Regulatory and standard setters can enact appropriate policies that can potentially drive the practice forward for assessment of cognitive legitimacy.

The findings provide relevant account of stakeholder voices on the quality of corporate disclosures that has a direct effect on the wellbeing of communities and sustainability of societies. Collective stakeholder input on expectations can shape sustainability discourse.

This research demonstrates the applicability of financial audit quality indicators in SRA processes, extends the debate around the effectiveness of new audit fields and highlights the challenges of maintaining legitimacy with different audiences.