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Patron banning is widely used in response to disorderly behaviours in/around licensed venues, but there has been limited analysis of specific policies. This paper explores key findings in relation to police-imposed barring notices in Western Australia (WA).

WA Police provided de-identified data for 4,023 barring notices imposed between 2011 and 2020 and offender records for each recipient, to 30 June 2020. The data were analysed to identify patterns and trends in relation to ban length, recipient type and associated offending.

Mean ban lengths increased across the period (from 4.46 months in 2015 to 6.82 months in 2019). Longer initial bans (of 6–12 months) were associated with a lower likelihood of a subsequent ban – with each additional month associated with an 11.4% increase in the likelihood of not receiving a second ban. Across the dataset, some notable anomalies were identified for individuals categorised as prolific offenders.

Research examining the effects of patron banning is limited but, to date, has generally not supported presumptions of improved patron behaviour. WA adopts an individualised approach to barring notice lengths, following review of the incident and offender. The findings suggest that, while barring policy is appropriate, a number of operational refinements can help WA Police to optimise their behavioural effect/s.

To investigate the association between implementation of clinical governance and patient safety.

A pre-post study was conducted in an Australian health service following the implementation of clinical governance systems (CGS) in the inpatient wards in 2016. Health service audit data from 2017 on CGS implementation and the rate of adverse patient safety events (PSE) for 2015 (pre-implementation) and 2017 (post-implementation), across 45 wards in six hospitals were collected. CGS examined compliance with 108 variables, based on the Australian National Safety and Quality Health Service standards. Patient safety was measured as PSE per 100 bed days. Data were analysed using odds ratios to explore the association between patient safety and CGS percentage compliance score.

There was no change in PSE between 2015 and 2017 (MD 0.04 events/100 bed days, 95% CI -0.11 to 0.21). There were higher odds that wards with a CGS score >90% reported reduced PSE, compared to wards with lower compliance. The domains of leadership and culture, risk management and clinical practice had the strongest association with the reduction in PSE.

Given that wards with a CGS score >90% showed increased odds of reduced PSE health service boards need to put in place strategies that engage frontline managers and staff to facilitate full implementation of clinical governance systems for patient safety.

The findings provide evidence that implementation of all facets of CGS in a large public health service is associated with improved patient safety.

Interventions that improve timely access to outpatient health services are essential in managing demand. This process evaluation aimed to describe the implementation, mechanism of impact and context of an intervention to reduce waiting for first appointments in an outpatient epilepsy clinic.

The UK Medical Research Council framework was used as the theoretical basis for a process evaluation alongside an intervention trial. The intervention, Specific Timely Appointments for Triage (STAT), is a data-driven approach that combines a one-off backlog reduction strategy with methods to balance supply and demand. A mixed methods process evaluation synthesised routinely collected quantitative and qualitative data, which were mapped to the domains of implementation, mechanisms of impact and contextual elements.

The principles of the STAT model were implemented as intended without adaptation. The STAT model reached all patients referred, including long waiters and was likely generalisable to other medical outpatient clinics. Mechanisms of impact were increased clinic capacity and elimination of unwanted variation. Contextual elements included the complexity of healthcare systems and the two-tier triage practice that contributes to prolonged waiting for patients classified as non-urgent.

This process evaluation shows how a data-driven strategy was applied in a medical outpatient setting to manage demand. Improving patient flow by reducing waiting in non-urgent, outpatient care is a complex problem. Understanding how and why interventions work is important for improved timeliness of care, and sustainability of public health services.

Long waitlists in outpatient clinics are a widely recognised problem. The purpose of this paper is to describe and report the impact of a waitlist reduction strategy for an epilepsy clinic.

This observational study described the local impact of a methodical approach to tackling a long waiting list, using targeted strategies supported by a modest additional budget. The interventions were described using the template for intervention description and replication (TIDieR).

Over an eight-month period, the waitlist for the epilepsy clinic was reduced from 599 to 24 patients without increasing the number of days until the next available appointment. Most referrals were removed from the waitlist without an appointment. Auditing revealed a high proportion of patients no longer required the service or referrals remained on the waitlist due to administration error. A short-term increase in clinic capacity of 51 extra appointments met the needs of the remaining waiting patients. The additional project funding invested in this process was AUD $10,500 and a time-limited amount of extra work was absorbed by using existing clinic resources.

This waitlist reduction strategy resulted in a very small waitlist for the epilepsy clinic, which is now well placed to trial further interventions with the aim of sustaining the service with minimal waiting times. Not every referral on the waitlist, particularly the very long waiters, required an appointment. Other outpatient clinics may be able to apply this process to reduce their waitlists using a modest budget.

Although there are reports of successful waitlist reduction, few report the intervention in detail. Use of the TIDieR in reporting enables the intervention to be appraised or adapted to other settings where long waitlists are problematic. Considerations related to implementation of policy are discussed and in this case, a locally led and executed change management strategy was a key to achieving the result.

The authors explored clinical staff perceptions of their interactions with middle management and their experiences of the uncongeniality of their working environment.

Semi-structured interviews of clinical staff from an Australian public health service's Emergency, Surgery and Psychiatry departments. Volunteer interview transcripts were inductively coded using a reflexive thematic content analysis.

Of 73 interviews, 66 participants discussed their interactions with management. Most clinicians considered their interactions with middle management to be negative based on a violation of their expectations of support in the workplace. Collectively, these interactions formed the basis of clinical staff perceptions of management's lack of capacity and fit for the needs of staff to perform their roles.

Strategies to improve management's fit with clinicians' needs may be beneficial for reducing uncongenial workplaces for healthcare staff and enhanced patient care.

This article is among the few papers that discuss interactions with management from the perspective of clinical staff in healthcare. How these perspectives inform the perception of workplace uncongeniality for clinicians contributes greater understanding of the factors contributing to adversarial relationships between clinicians and managers.

Looks at the response of local authorities to the 1987 Town & Country Planning Use Classes Order. Reviews the response of the Department of the Environment (DoE) to planning appeals. Concludes that the DoE have upheld most appeals where local authorities have attempted to restrict the effects of the Order.

This article seeks to explore the role of the mental health professional when involved with assessment and management of individuals with a history of online sexual activity. This is a relatively new area for many professionals, who are often unaware of the novel and expanding theoretical base for work in this area. A review is provided of the aetiological theories relating to online sexual activity.

The purpose of this paper was to evaluate a pilot training programme run by Health Education North West to promote clinical leadership amongst general dental practitioners (GDPs). New powers and responsibilities for clinicians have caused a fundamental shift in the way that local services are planned and delivered in England. GDPs are being appointed onto the boards of local professional networks (LPNs) to influence the way that services are delivered at a local level. Analogous to clinical commissioning groups in medicine, the role of LPNs is to ensure that GDPs lead change and drive up the quality of service provision. Clinical leadership has been argued to be fundamentally important in these new structures, but has received little attention in the dental literature.

Semi-structured interviews and a focus group were held with participants of the pilot to explore their understanding and experience of clinical leadership. These were recorded, transcribed verbatim and underwent thematic analysis.

Nineteen codes were identified and organized into four themes: nature of clinical leadership, challenges for clinical leaders in dentistry, Leadership Exploration and Discovery programme evaluation and future direction.

The research provides an understanding of how GDPs conceptualise clinical leadership and provides recommendations for future leadership training programmes.

This is the first evaluation of a leadership programme for GDPs and so helps address the paucity of evidence in the dental literature.