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The prominence of the best interests principle in the Mental Capacity Act 2005 represented an important transition to a more resolutely patient-centred model regarding decision-making for incapable adults (“P”). This paper aims to examine the courts’ consideration of P’s values, wishes and beliefs in the context of medical treatment, reflect on whether this has resulted in a wide interpretation of the best interests standard and consider how this impacts clinical decision makers.

A particular focus will be on case law from the Court of Protection of England and Wales and the Supreme Court of the UK. Cases have been selected for discussion on the basis of the significance of their judgements for the field, the range of issues they illustrate and the extent of commentary and attention they have received in the literature. They are presented as a narrative review and are non-exhaustive.

With respect to values, wishes and beliefs, the best interests standard’s interpretation in the courts has been widely varied. Opposing tensions and thematic conflicts have emerged from this case law and were analysed from the perspective of the clinical decision maker.

This review illustrates the complexity and gravity of decisions of the clinical decision makers and the courts have considered in the context of best interests determinations for incapacitated adults undergoing medical treatment. Subsequent to the first such case before the Supreme Court of the UK, emerging case law trends relating to capacity legislation are considered.

Many health-care professionals leave clinical practice temporarily or permanently. Interventions designed to facilitate the return of health-care professionals fail to consider returners’ psychosocial needs despite their importance for patient care. This study aims to evaluate the efficacy of a psychoeducational intervention in improving personal skills and well-being among UK-based health-care professionals returning to clinical practice.

In total, 20 health-care professionals took part in the one-day intervention and completed measures of demographics, self-efficacy, positive attitudes towards work and perceived job resources before and after the intervention. A baseline comparison group of 18 health-care professionals was also recruited.

Significant associations were detected between return-to-work stage and study group. Following the intervention, participants reported improvements in self-efficacy and, generally, perceived more job resources, whereas positive attitudes towards work decreased. While none of these changes were significant, the intervention was deemed acceptable by participants. This study provides modest but promising evidence for the role of psychoeducation as a tool in supporting the psychosocial needs of returning health-care professionals.

Additional research is needed to clarify the reliability of intervention effects, its effectiveness compared to alternative interventions, and the impact across different subgroups of returning health-care professionals.

Return-to-practice interventions should address the psychosocial needs of health-care professionals in terms of their personal skills and well-being. Psychoeducation can increase self-efficacy and perceptions of job resources among returning health-care professionals.

This study sheds light on a relatively understudied, but fundamental area – the psychosocial challenges of health-care professionals returning to clinical practice – and further justifies the need for tailored interventions.

During COVID-19, Maudsley Simulation successfully pivoted to fully online delivery of simulation-based education (SBE) in mental health. In migrating digitally, the simulation faculty experienced a range of new phenomena and challenges. The authors’ experiences may be transferable to other specialities and for other educator groups. By sharing the authors’ experiences, this study aims to support others adapt to online SBE.

This piece represents the authors’ collective reflections on the challenges of adapting their facilitation skills to the online environment. It also offers various suggestions on how to improve the learner experience in view of these challenges.

Beyond merely platform orientation and operating procedure familiarisation, the team gained insights into ensuring optimal learning, engagement and participant experience during online deliveries. Delivery of online SBE brings several potential barriers to psychological safety and these warrant careful consideration by experienced simulationists.

Optimising participant engagement and psychological safety remain key considerations despite this novel medium. Facilitators must be willing to adapt accordingly to begin delivering high-quality online SBE.

From their experience, facilitators must reframe their debriefing expectations and adjust how they engage participants and manage group dynamics given the inherently different nature of this new learning environment.

Financial abuse can be difficult to detect, and it is deemed to have the same potential to cause distress as other forms of abuse. The delegation of financial affairs brings with it the scope for degrees of exploitation. This study aims to assess the adequacy of the statutory provisions and courts in England and Wales at protecting at risk older people from the harm of financial abuse.

This review focuses on the enduring power of attorney and the lasting power of attorney provisions. Cases discussed were selected based on their judgments’ significance in relation to these powers, the range of issues illustrated and the extent of associated commentary and attention received in the literature. This piece is presented as a narrative review, and as such, references to case law and associated commentary are non-exhaustive.

Shortcomings and vulnerabilities are identified and explored with respect to both provisions. These are contrasted and contextualised in view of the broader challenges and complexities associated with preventing financial abuse within society. Key consideration is given to powers of creation, registration, supervision, objection and revocation in addition to the role and powers of both the Office of the Public Guardian and the Court of Protection.

Given these powers of attorney are exercised during a donor’s lifetime, they will directly experience their effects. This review illustrates there remains scope for further reform to introduce new safeguards and bolster existing ones to mitigate the risk of financial exploitation and to support people to plan and safeguard their financial future with increased confidence and security.

East London NHS Foundation Trust (ELFT) is a major provider of mental healthcare and community health services. Quality improvement (QI) has become central to its organisational policy and goals for which it has received national and international attention.

This piece reflects on the Trust's transformation and its approach. It provides many examples and discusses several of the associated challenges in building and sustaining QI momentum. It is the result of a range of perspectives from staff involved in planning and building large-scale QI capability. It contextualises QI's current status in UK mental healthcare.

Several key factors were identified: board-led commitment to organisational transformation; investment in training and resources to support staff motivation; clear and realistic project goals in line with the service's over-arching strategic direction; support for service users and staff at all levels to get involved to address issues that matter to them; and, finally, placement of a high value on service user and staff qualitative feedback.

Building QI capability represents a significant challenge faced by all large healthcare providers. Sharing experiences of change can assist other organisations achieve the necessary buy-in and support the planning process.

Achieving and sustaining lasting organisational change in healthcare is challenging. This article provides a background on QI at ELFT and reflects on the pathway to its present position at the forefront of the application of QI within healthcare.

The purpose of this paper is to explore critically the potentially harmful business of professional wrestling in the USA as state-corporate crime.

This paper comprises desk-based research of secondary sources. The lack of official data on the harms experienced by professional wrestlers means that much of the data regarding this is derived from quantitative and qualitative accounts from internet sites dedicated to this issue.

A major finding is that with regard to the work-related harms experienced by professional wrestlers, the business may not be wholly to be blamed, but nor is it entirely blame free. It proposes that one way the work-related harms can be understood is via an examination of the political economic context of neo-liberalism from the 1980s onwards and subsequent state-corporate actions and inactions.

The paper raises questions about the regulation of the professional wrestling industry together with the misclassification of wrestlers’ worker status (also known as wage theft and tax fraud) and the potential role they play in the harms incurred in this industry.

The potential wider social implications of the misclassification of workers are raised.

The originality and value of this paper is the examination of work-related harms within the professional wrestling industry through the lens of state-corporate crime.

Despite recent advances, neither organizational studies nor the scholarship on economic resilience has systematically addressed how the ecologies of organizations that populate local economies can serve as infrastructures for responding proactively to economic shocks. Using county-level data, this study analyzes relationships between the prevalence of organizational alternatives to shareholder value-oriented (SVO) corporations within a particular locality and its unemployment levels during and after the Great Recession. The results support the hypothesis that the presence of such alternative organizations can enhance the capacities of local economies to resist and recover from recession shocks. Cooperative, municipal, and community-based enterprises, research universities, and nonprofits more generally were associated with greater resistance to the recession shock and stronger recoveries – specifically, lower surges in unemployment rates from 2007 to 2010 and greater reductions in unemployment rates from 2010 to 2016. By contrast, SVO corporations were associated with greater surges in unemployment and perhaps weaker recoveries. Providing a proof of concept, this study opens up new lines of inquiry for organizational studies by linking organizational ecologies to the promotion of collective efficacy and a more broadly shared prosperity in economic life.