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This chapter is based on compulsory school experiences of students diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and their parents in the educational context of Finland. Located in the theoretical framework of Disability Studies, the chapter aims to contribute to theory of inclusive education by initiating a new dialogue on conceptual foundations of inclusive schooling. In this regard, the chapter first deconstructs the concept of educational need that stems from the field of traditional special education as contradictory to the original ideals of inclusive education. It then moves on to reconstruct the concept of educational need in accordance with the foundational values of inclusion, that is celebration of human diversity and resistance to dichotomies of ab-/normality and dis-/ability and proposes an approach for future implementation of inclusive education.

Special Needs Assessment Procedures (SNAPs) are procedures which evaluate children who have diverged from – implicitly implied and/or explicitly stated – norms. In the course of such a SNAP, the child is evaluated by a diverging set of experts who ultimately determine the place and mode of schooling. As such, SNAPs can be read as manifestations of potentially excluding practices but also as temporal and cultural configurations concerning the very topic. By considering these (ever changing) temporal, cultural and geographical influences and understandings, SNAPs – as one aspect regarding inclusion and exclusion – can be read divergently. This chapter takes a closer look at SNAPs by firstly outlining their very structure and then presenting theoretical as well as empirical instances in which SNAPs violated their own logic or, in other words: SNAPs, as a mechanism of producing inclusion/exclusion, became divergently. Based on these incoherencies, the chapter later outlines potentially fruitful paths of future research.

Changes in demographics and disease patterns are challenging health and care systems across the world. In England, national policies have reset the direction of travel for the NHS. Collaboration, integration and personalisation are intended to become prime principles and drivers for new models of care. Central to this is the concept of population health management. This has emerged, internationally, as a method to improve population health. Fundamental for population health management to succeed is the use of integrated data, analytics combined with professional insight and the adoption of a learning health system culture. This agenda reaches beyond the NHS in England and the public health profession to embrace a broad range of stakeholders. By drawing on international experience and early experience of implementation in the United Kingdom, the potential for health and care systems in England to become world leading in population health management is explored.

A viewpoint paper.

Population health management is a major change in the way health and care systems look at the challenges they are facing. It makes what is happening to individuals, across the continuum of care, the essence for insight and action. The NHS has the components for success and the potential to become world leading in delivery of population health management as part of its integrated care agenda.

This is the first viewpoint paper to set out how population health management contributes to the integrated care agenda in the NHS.

This paper aims to address problems in patient flow and identify the reasons behind extensive wait time at a public liver transplant outpatient clinic in an education and research hospital through the use of Lean health-care theories.

This paper opted for the application of Lean thinking and action research strategy. Data were collected through personal observations, interviews with users and team brainstorming. A value stream map was developed, improvement possibilities were identified and non-value-added activities were attempted to be eliminated.

Significant problems were identified and improvements were implemented and measured. The major remedial measures were: change the scheduling pattern, create a flow chart and a Kanban visual guide for medical students. In addition, an institutional change in the medical appointment scheduling software collaborated in the reduction of time and in the patient’s displacement. The waiting time was reduced by 4.5 h, and the per cent complete and accurate increased by 50 per cent.

The flow was redesigned, and a culture of continuous improvement was introduced. Visiting the place where work was being done, leaders identified and created more value to the process without significant costs. The Gemba Walk was a powerful tool, interacting with people and processes in a Kaizen spirit.

Public health services in developing countries are one of the most deprived social needs of good practice. It will be useful for those who need examples about how to apply Lean tools in health care.

Diagnosing psychiatric disorders (PD) in adults with Intellectual Disability (ID) presents several issues and need specific skills and tools. The purpose of this paper is to provide a detailed description of the current status of art through a systematic mapping of the literature.

The authors reviewed the international literature on the basis of the following questions: what are the issues in the psychiatric diagnostic process for adults with ID? What methods and procedures have been used for psychiatric assessment in ID? To date, is it possible to identify some most effective procedures?

The analysis of the literature indicates that main issues of the psychiatric diagnostic process in adults with ID are the following: identification of psychiatric symptoms, behavioural equivalents, diagnostic criteria, setting, source of information, screening, and diagnostic tools. The evidence base is only emerging and although many relevant achievements have been reached in the last two decades, no definitive guideline has been produced. Most recent acquisition also allowed to identify some assessment procedures that are currently considered the most effective. Individualised assessment remains the best way to meet the needs of this heterogeneous and variable patient group.

This paper offers a comprehensive and updated description of current achievements and issues towards the assessment of PD in people with ID.

Records of violent incidents were retrospectively analysed to identify trends associated with violent incidents within an NHS medium secure psychiatric unit. Over a 12‐month period, 116 incident forms related to 112 incidents. These incidents were compared with a study from the previous 12 months within the same unit. Both studies were based upon work from within a high‐security setting (Caldwell and Naismith, 1989). There was a significant reduction in the overall number of violent incidents.The majority of incidents continued to occur within the intensive care admission unit. There continued to be a higher incidence of assaultive behaviour throughout the afternoon and evening. Seasonal variations demonstrates a reduction of incidents throughout the autumn and winter months compared with the previous year, and a significant change in the number of incidents that occurred during the summer.There remain opportunities for comparison with other secure units and further refinement of the methodology.

This paper describes a recent study which investigated the research culture of 21 nurses, midwives and health visitors and their nine managers in three Trusts in England. Data were collected through in‐depth interviews and analysed using an adaptation of Colaizzi's framework. The results presented in this paper describe the opportunities for, and barriers to, research‐based practice within the three cultures. These findings emphasize the complexity of creating and sustaining a research culture within NHS Trusts.

Payments to healthcare providers create incentives that can influence provider behaviour. Research on unit-level incentives in primary care is, however, scarce. This paper examines how managers and salaried physicians at Swedish primary healthcare centres perceive that payment incentives directed towards the healthcare centre affect their work.

An interview study was conducted with 24 respondents at 13 primary healthcare centres in two cities, located in regions with different payment systems. One had a mixed system comprised of fee-for-service and risk-adjusted capitation payments, and the other a mainly risk-adjusted capitation system.

Findings suggested that both managers and salaried physicians were aware of and adapted to unit-level payment incentives, albeit the latter sometimes to a lesser extent. Respondents perceived fee-for-service payments to stimulate production of shorter visits, up-coding of visits and skimming of healthier patients. Results also suggested that differentiated rates for patient visits affected horizontal prioritisations between physician and nurse visits. Respondents perceived that risk-adjustments for diagnoses led to a focus on registering diagnosis codes, and to some extent, also up-coding of secondary diagnoses.

Policymakers and responsible authorities need to design payment systems carefully, balancing different incentives and considering how and from where data used to calculate payments are retrieved, not relying too heavily on data supplied by providers.

This study contributes evidence on unit-level payment incentives in primary care, a scarcely researched topic, especially using qualitative methods.

In a collective effort to build a patient-centered and coordinated health care system, social workers and psychologists are being progressively introduced to primary health care (PHC) settings worldwide. The present study aims to explore the current status of integration through the narrative of social workers and psychologists in PHC settings in Kazakhstan.

In this paper purposive snowball sampling was utilized to recruit social workers and psychologists who work, or used to work, in PHC settings since the onset of integration in Nur-Sultan for participation in an in-depth interview. A semistructured interview guide was based on normalization process theory (NPT). Interviews were conducted via video conference, in Russian language, lasted no more than 50 min, and transcribed verbatim. Cross-case analysis of eight cases was performed using NPT constructs.

Cross-case analysis included findings from the interviews from five social workers and three psychologists. Four major constructs of implementation process from NPT were reflected in the findings: coherence (believes integration improves patient care, functions within integrated care), cognitive participation (individual changes to role performance, mechanisms of work), collective action (status of support from stakeholders, cooperation within a multidisciplinary team) and reflective monitoring (existing mechanisms for monitoring the integration).

Despite organizational integration, there is a lack of successful clinical integration of social workers and psychologists in PHC settings of Kazakhstan, which is manifested by a lack of understanding of responsibilities and functions of these mental health care specialists. Consensus was reached by all participants that both social workers and psychologists are valuable assets in a multidisciplinary team.

The present study contributes to the current knowledge of integrated PHC service delivery by addressing the status of integrated care in Kazakhstan from interviews with key stakeholders in social work and mental health. Moving forward, improvements are needed to (1) establish the monitoring mechanism to evaluate the status of integration, (2) enhance effective collaboration within multidisciplinary teams in PHC settings and (3) increase awareness among medical workers and community members on mental health issues and the available support offered by social workers and psychologists to promote quality of life in a holistic, integrated manner.