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The purpose of this paper is to outline how personal health budgets and a universal, integrated model of support, can positively transform the way in which individuals with a learning disability experience their health and support needs.

The review recognises that Integrated Personal Commissioning, as a policy approach, provides the framework to offer personalised care, and enables people to live an independent, happy, healthy and meaningful life.

Evidence suggests that a personalised and integrated approach to both health and social care not only offers better outcomes on all levels for the individual, but also benefits the system as a whole.

The study reveals that a personalised care leads to people to have choices and control over decisions that affect in better health and wellbeing outcomes for people.

The organisational and service delivery landscape of the emergency services in the UK has been rapidly changing and is facing further change in the foreseeable future. The purpose of this paper is to examine recent and ongoing organisational changes in the policy development, service delivery and regulatory landscape of the emergency services, in order to capture the overall picture and potential opportunities for improvement or further investigation.

This general review utilises the characteristics of the three domains of a national framework, namely, policy development, service delivery and public assurance, and uses these characteristics as lenses to examine the three main blue light emergency services of police, fire and ambulances.

What emerges in the organisational landscape and conceptual maps for the police and even more so for the Fire and Rescue Service, is the immaturity of many of the organisations in the policy and the public assurance domains while the service delivery organisations have remained relatively stable. In the relatively neglected ambulance services, we find the NHS’s recent Ambulance Response Programme has considerable potential to improve parts of all three domains.

The review is limited to the UK and primarily focussed on England.

The review identifies opportunities for improvement, potential improvement and further research.

Although the National Audit Office has attempted in the past to provide organisational landscape reviews of individual emergency services, this contemporary comparative review of all three services using a common model is unique. It provides considerable new insights for policy makers, service delivers and regulators.

The purpose of this article is to report the findings from research into the governance of adult safeguarding policy and practice in England, with particular focus on interagency partnership arrangements expressed through Safeguarding Adults Boards.

The study comprised a systematic search and thematic analysis of English‐language literature on adult safeguarding governance, a survey of Safeguarding Adults Board documentation, and key informant interviews and workshops with professionals involved in adult protection.

The effectiveness of adult safeguarding governance arrangements has not been subject to prior formal evaluation and thus the literature provided little research‐led evidence of good practice. The survey and workshops, however, revealed a rich and complex pattern of arrangements spanning a number of dimensions – the goals and purpose of interagency working, the structures of boards, their membership, chairing and rules of engagement, their functions, and their accountabilities.

The research focus here is England, and thus does not incorporate learning from other jurisdictions. Whilst the research scrutinises the extent to which Boards practise empowerment, service users and carers are not directly involved in the fieldwork aspects of this study. In view of the absence of outcomes evidence identified, there remains a need to investigate the impacts of different forms of governance.

Drawing on this research and on governance frameworks in the context of related interagency fields, the article identifies standards to benchmark the approach to governance taken by Safeguarding Adult Boards.

The benchmarking framework will enable Safeguarding Adults Boards to audit, evaluate, and further develop a range of robust governance arrangements.

The purpose of this paper is to update the core data set of self-neglect safeguarding adult reviews (SARs) and accompanying thematic analysis and explore the degree to which SARs draw upon available research and learning from other completed reviews.

Further published reviews are added to the core data set, mainly drawn from the websites of Safeguarding Adults Boards (SABs). Thematic analysis is updated using the four domains used previously. The four domains and the thematic analysis are rounded in the evidence-based model of good practice, reported in this journal previously. Multiple exclusion homelessness and alcohol misuse are prominent in this sample of reviews.

Familiar findings emerge from the thematic analysis and reinforce the evidence-base of good practice with individuals who self-neglect and for policies and procedures with which to support those practitioners working with such cases. Multiple exclusion homelessness emerges as a subset within this sample, demonstrating that SABs are engaging in reviews of people who die on the streets or in temporary accommodation.

The national database of reviews commissioned by SABs remains incomplete and does not contain many of the SARs reported in this evolving data set. The Care Act 2014 does not require publication of reports but only a summary of findings and recommendations in SAB annual reports. NHS Digital annual data sets do not enable identification of reviews by types of abuse and neglect. It is possible, therefore, that this data set is also incomplete. Drawing together the findings from the reviews nonetheless builds on what is known about the components of effective practice, and effective policy and organisational arrangements for practice.

Answering the question “why” remains a significant challenge for safeguarding adult reviews. The findings confirm the relevance of the evidence-base for effective practice but SARs are limited in their analysis of what enables and what obstructs the components of best practice. Greater explicit use of research and other published SARs might assist with answering the “why” question, drawing attention where appropriate to policies being pursued by the central government that undermine any initiative to end rough sleeping.

This paper extends the thematic analysis of available reviews that focus on work with adults who self-neglect, further reinforcing the evidence-base for practice. The evidence-base also supports practice with individuals who experience multiple exclusion homelessness. Policymakers and practitioners have an approach to follow in this complex, challenging and demanding area of practice.

Serious case reviews (SCRs) are one means of learning the lessons arising from adverse, salient incidents and tragedies. Adult Safeguarding Boards in England are expected to have an SCR policy and procedure, to commission SCRs, to abstract and act on the learning, and to monitor the resulting action plans.

Since SCRs reflect a wide range of processes, the authors undertook a general review, drawing on their experiences of conducting and contributing to SCRs. They chose to pose sets of question‐prompts regarding the commissioning process, the management of the process, the appointment of a chair and author, the terms of reference, information‐sharing, confidentiality, involving relatives and making findings public. The compliance of the process with human rights legislation is also considered.

Whilst the authors acknowledge the responsibility of organisations to promote continuous and cumulative professional learning, they do not promote SCRs as the sole means of learning about the ways in which professionals and agencies work together to safeguard adults at risk of abuse.

The paper challenges the perception that SCR can be streamlined, structured, codified, and constrained.

Nine councils in the Innovation Forum for high‐performing local authorities voluntarily set a target of reducing hospital bed days for people aged 75+ by 20% over the three years to 2006/07. This kind of objective was new for the NHS, as much as for local government. It was motivated by a concern among the councils that hospital admission exposed residents to risks to their independence and well‐being which should be avoided wherever possible. They wished to demonstrate the value of the local authority community leadership or, as it has since become known, ‘place making’ role. Their success in meeting this target supports the new NHS White Paper's proposed transfer of functions and responsibilities from PCTs to councils. It suggests that councils can successfully adopt, in appropriate circumstances, the lead responsibility for ensuring strategic co‐ordination of place‐based commissioning in health and well‐being.

This paper explores the potential application of public value management theory to the practice of UK healthcare procurement. By conducting a literature review, key elements of public value theory and practice that can be applied to healthcare procurement are identified together with mechanisms that can be used in procurement to protect public values and enhance the creation of public value. These are formed into a Public Value Healthcare Procurement Framework which represents a fresh normative approach to healthcare procurement by focussing on a broader, societal view of value; by providing a blue print for procurement leaders centred around Moore's vision of “exploring” and “moral” public managers; and by promoting a public service ethos amongst all providers including the private sector.

This conceptually‐focused paper looks at particular changes implemented in the UK National Health Service. The specific context is the creation of a new organisational form: the primary care group, which brings together general practitioners and other primary care staff in a given locality. The paper attempts to examine the consequences, for the development of these groups, of the shift from competition (in the internal market) to relationships based on collaboration and partnership. The broad policy objectives envisage much greater emphasis on working in partnership, participating in strategy and planning (via new health improvement programmes), developing joint working, and promoting the integration of service delivery. A relationship marketing perspective is explored as one way of conceptualising the development of new relationships between primary care groups, health authorities, local authorities, trusts and other agencies and the paper suggests that relationship marketing offers a way of facilitating policy change.

Using a complexity-informed approach, we aim to understand why introduction of a mobile service delivery model for osteoporosis across diverse organisational and country contexts in the UK National Health Service (NHS) met with variable success.

Six comparative case studies; three prospectively in Scotland using an action research-informed approach; and three retrospectively in England with variable degrees of success. The Non-adoption, Abandonment, Scale-up, Spread and Sustainability framework explored interactions between multi-level contextual factors and their influence on efforts to introduce and sustain services.

Cross-boundary service development was a continuous process of adaptation and evolution in rapidly shifting healthcare context. Whilst the outer healthcare policy context differed significantly across cases, inner contextual features predominated in shaping the success or otherwise of service innovations. Technical and logistical issues, organisational resources, patient and staff actions combined in unpredictable ways to shape the lifecycle of service change. Patient and staff thoughts about place and access to services actively shaped service development. The use of tacit “soft intelligence” and a sense of “chronic unease” emerged as important in successfully navigating around awkward people and places.

“Chronic unease” and “soft intelligence” can be used to help individuals and organisations “tame” complexity, identify hidden threats and opportunities to achieving change in a particular context, and anticipate how these may change over time. Understanding how patients think and feel about where, when and how care is delivered provides unique insights into previously unseen aspects of context, and can usefully inform development and sustainability of patient-centred healthcare services.

This study has uniquely traced the fortunes of a single service innovation across diverse organisational and country contexts. Novel application of the NASSS framework enabled comparative analysis across real-time service change and historical failures. This study also adds to theories of context and complexity by surfacing the neglected role of patients in shaping healthcare context.