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This study aims to explore the experiences of living through the COVID-19 pandemic for people who faced homelessness and dealt with mental health and/or substance use challenges.

This qualitative study was comprised of 26 1:1 interviews (16 men and 10 women), conducted between February and May 2021 with people who experienced homelessness in North East England during the COVID-19 pandemic. An inductive reflexive thematic analysis was undertaken, with input from individuals with lived experience who were involved throughout the study.

Four themes were developed. The first theme, lack of support and exacerbation of mental health and substance use difficulties, highlighted how the lack of in-person support and increased isolation and loneliness led to relapses or new challenges for many people’s mental health and substance use. The second theme, uncertainty and fear during the pandemic, explored how the “surreal” experience of the pandemic led to many people feeling uncertain about the future and when things would return to normal. The third theme, isolation and impacts on social networks, discussed how isolation and changes to relationships also played a role in mental health and substance use. Finally, opportunity for reflection and self-improvement for mental health and substance use, explored how some people used the isolated time to re-evaluate their recovery journey and focus on self-improvement.

The experiences shared within this study have important implications for planning the future delivery and commissioning of health and social care services for people facing homelessness, such as sharing information accessibly through clear, consistent and simple language.

As one of the few papers to involve people with lived experience as part of the research, the findings reflect the unique narratives of this population with a focus on improving services.

This paper aims to explore the development of the accountability ideals and practices of Quaker industrialists during the period 1840–1914.

The research employs a case study approach and draws on the extensive archives of Quaker industrialists in the Richardson family networks, British Parliamentary Papers and the Religious Society of Friends together with relevant contemporary and current literature.

Friends shed their position as Enemies of the State and obtained status and accountabilities undifferentiated from those of non-Quakers. The reciprocal influences of an increasingly complex business environment and radical changes in religious beliefs and practices combined to shift accountabilities from the Quaker Meeting House to newly established legal accountability mechanisms. Static Quaker organisation structures and accountability processes were ineffective in a rapidly changing world. Decision-making was susceptible to the domination of the large Richardson family networks in the Newcastle Meeting House. This research found no evidence of Quaker corporate social accountability through action in the Richardson family networks and it questions the validity of this concept. The motivations underlying Quakers’ personal philanthropy and social activism were multiple and complex, extending far beyond accountabilities driven by religious belief.

This research has originality and value as a study of continuity and change in Quaker accountability regimes during a period that encompassed fundamental changes in Quakerism and its orthopraxy, and their business, social and political environments.

The purpose of this paper is to evaluate pre- and post-formulation findings with multi-disciplinary staff within two secure children’s homes (SCHs) in the North East of England.

Multi-disciplinary staff teams involved in formulation across two SCHs were administered pre- and post-formulation questionnaires. The pre- and post-formulation questionnaires focused on five domains: knowledge; confidence; motivation; understanding; and satisfaction with treatment plan.

A total of 338 pre- and post-formulation questionnaires were administered across 43 formulation meetings. The highest proportion of formulation attendees were: residential staff (44%); mental health staff (17%); case managers (12%); and education staff (9%). Paired samples t-tests showed significant post-formulation improvements across all domains including: knowledge [t(337) = 22.65, p < 0.001]; confidence [t(337) = 15.12, p < 0.001]; motivation [t(337) = 8.27, p < 0.001]; understanding [t(337) = 19.13, p < 0.001]; and satisfaction [t(337) = 18.81, p < 0.001].

The SECURE STAIRS framework has supported formulation developments across the Children and Young People’s Secure Estate. Preliminary findings within two SCHs suggest multi-disciplinary staff teams find psychologically informed formulation beneficial. Future directions are considered including future evaluation of young person involvement in formulation meetings.

There is a notable lack of existing research within the child and young people secure estate evaluating the impact of SECURE STAIRS trauma-informed care developments including the impact of team formulation. This paper adds to the evidence base.

A biopsychosocial case formulation is an important tool for understanding complexity and guiding treatment for people with intellectual disabilities. It has been suggested that formulation meetings develop staff understanding of individuals they support. This study aims to explore the change processes that occur as a result of professional team formulation meetings, and the mechanisms that facilitate and hinder these events.

Eight clinicians who took part in multi-disciplinary team-based formulations in an inpatient mental health service for adults with intellectual disabilities were interviewed. Interviews were examined using thematic analysis.

The key themes identified were: “gaining information”, “altered thoughts” and “focused goals”. These themes were supported by “collaborative working” and “time for reflection” and were hindered by “poor communication and interaction” and inconsistent “staff attendance”.

Multi-disciplinary team formulation meetings may have a number of change processes that affect staff knowledge and perception of the people that they support. The facilitation of these processes should be a focus for further development.

The purpose of this paper is to evaluate the effectiveness of using several commercial tools in science, technology, engineering and maths (STEM) subjects for enterprise education at Newcastle University, UK.

The paper provides an overview of existing toolkit use in higher education, before reviewing where and how tools are used across science and engineering disciplines. Feedback was collated from Newcastle educators and students to determine whether the projected enterprise learning outcomes were achieved. STEM learning outcomes were also mapped to the NCEE entrepreneurship learning outcomes framework.

The paper investigated the use of three key enterprise toolkits across the Faculty of Science, Agriculture and Engineering and the Faculty of Medical Sciences, where the focus is on innovation and product/service development, rather than on the desire to “be an entrepreneur”. This reflection on practice evaluates the benefits and student perceptions of workshop tools for enterprise, decision making and teamwork. It makes comparison between the perceived employability needs of these students, and addresses the intended and actual outcomes of these tools.

Evaluating toolkit use within a single university is constrained by common internal workings, however as exemplars of good practice this is of value to other UK higher education institutions.

Consideration is given to entrepreneurial support and development, and whether using existing tools should be used for summative or for formative assessment. It also questions whether tools are fit for purpose.

This paper reveals patterns of tool use and their effectiveness across science and engineering.

The purpose of this paper is to examine a bold and ambitious scheme known as the North East transformation system (NETS). The principal aim of the NETS is the achievement of a step-change in the quality of health services delivered to people living in the North East region of England. The paper charts the origins of the NETS and its early journey before describing what happened to it when the UK coalition government published its proposals for unexpected major structural change in the NHS. This had a profound impact on the leadership and direction of the NETS and resulted in it taking a different direction from that intended.

The research design took the form of a mixed methods, longitudinal 3.5-year study aimed at exploring transformational change in terms of content, context, process and outcomes. The sample of study sites comprised 14 NHS trusts in the North East region chosen to provide geographical coverage of the area and to reflect the scale, scope and variety of the bodies that formed part of the NETS programme. The qualitative component of the research, which the paper draws upon, included 68 semi-structured interviews, observational studies and focus groups. Data analysis made use of both deductive and inductive frameworks. The deductive framework adopted was Pettigrew et al.’s “receptive contexts for change” and four of the eight factors stood out as especially important and form the basis of the paper.

The fate of the NETS was shaped and influenced by the eight factors comprising the Pettigrew et al. receptive contexts for change framework but four factors in particular stood out as being especially significant: environmental pressure, quality and coherence of policy, key people leading change, supportive organisational culture. Perhaps the most significant lesson from the NETS is that achieving whole systems change is particularly vulnerable to the vicissitudes of politics especially where that system, like the UK NHS, is itself subject to those very same pressures. Yet, despite having an enormous influence on health policy, the political context is frequently avoided in research or not regarded as instrumental in determining the outcomes in respect of transformational change.

The chief limitation is the credibility and authenticity of the interviews captured at particular points in time. These formed the datebase for subsequent analysis. The authors sought to guard against possible bias by supplementing interviews with observational studies and focus groups as well as running two dissemination events at which emerging findings from the study were subjected to independent external scrutiny and comment. These events provided a form of validation for the key study findings.

The research findings demonstrate the importance of context for the likely outcome and success of complex transformational change initiatives. These require time to become embedded and demonstrate results especially when focused on changing culture and behaviour. But, in practice, allowing sufficient time during which the organisation may remain sufficiently stable to allow the change intervention to run its course and become embedded and sustainable is highly problematic. The consequence is that bold and ambitious efforts like the NETS are not given the space and stability to prove themselves. Too often, politics and external environmental pressures intrude in ways that may prove dysfunctional and negative.

Unless a different approach to transformational change and its leadership and management is adopted, then changing the NHS to enable it to appear more responsive to changing health care needs and expectations will remain a cause for concern. Ultimately the public will be the losers if the NHS remains insensitive to changing needs and expectations. The patient experience was at the centre of the NETS programme.

The study is original insofar as no other has sought to evaluate the NETS independently and over a reasonable time period. The research design, based on a mixed-methods approach, is unusual in evaluations of this nature. The study’s conclusions are not so original but their value lies in largely confirming and reinforcing the findings from other studies. It perhaps goes further in stressing the impact of politics on health policy and the negative consequences of constant organisational change on attempts to achieve deep change in the way the NHS is organised and led.

Quality, accessible and appropriate housing is key to older people’s ability to live independently. The purpose of this paper is to understand older people’s housing aspirations and whether these are currently being met. Evidence suggests one in five households occupied by older people in England does not meet the standard of a decent home. The Building Research Establishment has calculated that poor housing costs the English National Health Service £1,4bn annually (Roys et al., 2016).

This paper reports on the findings of a participatory theatre approach to engaging with those not often heard from – notably, those ageing without children and older people with primary responsibility for ageing relatives – about planning for housing decisions in later life. The project was led by an older people’s forum, Elders Council, with Skimstone Arts organisation and Northumbria University, in the north east of England.

Findings suggest there is an urgent need to listen to and engage with people about their later life housing aspirations. There is also a need to use this evidence to inform housing, health and social care policy makers, practitioners, service commissioners and providers and product and service designers, to encourage older people to become informed and plan ahead.

Use of a participatory theatre approach facilitated people to explore their own decision making and identify the types of information and support they need to make critical decisions about their housing in later life. Such insights can generate evidence for future housing, social care and health needs. Findings endorse the recent Communities and Local Government (2018) Select Committee Inquiry and report on Housing for Older People and the need for a national strategy for older people’s housing.

Although this call is evidenced through an English national case study, from within the context of global population ageing, it has international relevance.

The coronavirus disease 2019 (COVID-19) pandemic has had a big impact on organisations globally, leaving organisations with no choice but to adapt to the new reality of remote work to ensure business continuity. Such an unexpected reality created the conditions for testing new applications of smart home technology whilst working from home. Given the potential implications of such applications to improve the working environment, and a lack of research on that front, this paper pursued two objectives. First, the paper explored the impact of smart home applications by examining the factors that could contribute to perceived productivity and well-being whilst working from home. Second, the study investigated the role of productivity and well-being in motivating the intention of remote workers to use smart home technologies in a home-work environment in the future.

The study adopted a cross-sectional research design. For data collection, 528 smart home users working from home during the pandemic were recruited. Collected data were analysed using a structural equation modelling approach.

The results of the research confirmed that perceived productivity is dependent on service relevance, perceived usefulness, innovativeness, hedonic beliefs and control over environmental conditions. Perceived well-being correlates with task-technology fit, service relevance, perceived usefulness, perceived ease of use, attitude to smart homes, innovativeness, hedonic beliefs and control over environmental conditions. Intention to work from a smart home-office in the future is dependent on perceived well-being.

The findings of the research contribute to the organisational and smart home literature, by providing missing evidence about the implications of the application of smart home technologies for employees' perceived productivity and well-being. The paper considers the conditions that facilitate better outcomes during remote work and could potentially be used to improve the work environment in offices after the pandemic. Also, the findings inform smart home developers about the features of technology which could improve the developers' application in contexts beyond home settings.