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There have been few economic evaluations of joint working between social and health care. This paper focuses on collaboration between professionals providing care for people aged 75 and over, and examines the economic costs of contacts made by social workers with community nurses, GPs and older people or their carers. Two areas were studied, one where social care and primary care services were co‐located, and the other with social work teams located separately from local health services. The two forms of social care location had an impact on contacts and costs but overall it was fairly small. Contact costs made up only a small amount of the overall costs of care These findings suggest that altering the organisational arrangements for care delivery may improve the process of care delivery, but result in only minor changes to the proportion of overall resources directed to older service users.

The purpose of this paper is to describe the delivery of the first clinically led, inter-professional Pathway Homeless team in a mental health trust, within the King’s Health Partners hospitals in South London. The Kings Health Partners Pathway Homeless teams have been operating since January 2014 at Guy’s and St Thomas’ (GStT) and Kings College Hospital and expanded to the South London and Maudsley in 2015 as a charitable pilot, now continuing with short-term funding.

This paper outlines how the team delivered its key aim of improving health and housing outcomes for inpatients. It details the service development and integration within a mental health trust incorporating the experience of its sister teams at Kings and GStT. It goes on to show how the service works across multiple hospital sites and is embedded within the Trust’s management structures.

Innovations including the transitional arrangements for patients’ post-discharge are described. In the first three years of operation the team saw 237 patients. Improved housing status was achieved in 74 per cent of patients with reduced use of unscheduled care after discharge. Early analysis suggests a statistically significant reduction in bed days and reduced use of unscheduled care.

The paper suggests that this model serves as an example of person centred, value-based health that is focused on improving care and outcomes for homeless inpatients in mental health settings, with the potential to be rolled-out nationally to other mental health Trusts.

The cardinal point to note here is that the development (and unfortunately the likely potential) of area policy is intimately related to the actual character of British social policy. Whilst area policy has been strongly influenced by Pigou's welfare economics, by the rise of scientific management in the delivery of social services (cf Jaques 1976; Whittington and Bellamy 1979), by the accompanying development of operational analyses and by the creation of social economics (see Pigou 1938; Sandford 1977), social policy continues to be enmeshed with the flavours of Benthamite utilitatianism and Social Darwinism (see, above all, the Beveridge Report 1942; Booth 1889; Rowntree 1922, 1946; Webb 1926). Consequently, for their entire history area policies have been coloured by the principles of a national minimum for the many and giving poorer areas a hand up, rather than a hand out. The preceived need to save money (C.S.E. State Apparatus and Expenditure Group 1979; Klein 1974) and the (supposed) ennobling effects of self help have been the twin marching orders for area policy for decades. Private industry is inadvertently called upon to plug the resulting gaps in public provision. The conjunction of a reluctant state and a meandering private sector has fashioned the decaying urban areas of today. Whilst a large degree of party politics and commitment has characterised the general debate over the removal of poverty (Holman 1973; MacGregor 1981), this has for the most part bypassed the ‘marginal’ poorer areas (cf Green forthcoming). Their inhabitants are not usually numerically significant enough to sway general, party policies (cf Boulding 1967) and the problems of most notably the inner cities has been underplayed.

A co-produced clinical practice that aims to improve outcomes through a partnership with service users is becoming increasingly important in intellectual disability (ID) services, yet these approaches are under-evaluated in forensic settings. This study aims to explore and compare the feasibility of two approaches to co-production in the completion of dynamic risk assessments and management plans in a secure setting.

A convenience sample of adults admitted to a secure specialist forensic ID service (N = 54) completed the short dynamic risk scale (SDRS) and drafted risk management plans under one of two conditions. In the first condition, participants rated the SDRS and risk management plan first, separately from the multidisciplinary team (MDT). In the second condition, participants and MDTs rated the SDRS and risk management plan together.

In total, 35 (65%) participants rated their risk assessments and 25 (47%) completed their risk management plans. Participants who rated their risk assessments separately from the MDT were significantly more likely to complete the SDRS (p = 0.025) and draft their risk management plans (p = 0.003). When rated separately, MDT scorers recorded significantly higher total SDRS scores compared to participants (p = 0.009). A series of Mann-Whitney U tests revealed significant differences between MDT and participant ratings on questions that required greater skills in abstraction and social reasoning, as well as sexual behaviour and self-harm.

Detained participants with an ID will engage in their dynamic risk assessment and management plan processes. The study demonstrates the impact of different co-production methodologies on engagement and highlights areas for future research pertaining to co-production.

This article addresses the question of the determinants of public policy at the local level. It is particularly concerned with local political leaders' interpretations of given socioeconomic environments, and the bearing these have on public policy formation.

These notes on Sir Walter Scott by John Galt, here published for the first time, have been transcribed by Dr Hamilton B. Timothy, Associate Professor in the Department of Classical Studies and Galt Scholar at the University of Western Ontario, from a manuscript among the material given him by Henry Gordon Harvey Smith, Q.C., a great‐grandson of John Galt, and his sister, Mrs Muriel Harvey Turner, of Winnipeg. John Galt's youngest son, Alexander, with whom Galt's widow made her home after the novelist's death in 1839, became the Hon. Sir Alexander Galt and Canada's first Federal Finance Minister; from him John Galt's library and miscellaneous papers passed to his youngest daughter, Annie Prince Galt, who married Dr W. Harvey Smith, a distinguished opthalmologist. (In 1930 he had the rare honour of holding at the same time presidency of both the British Medical Association and the Canadian.) His carefully augmented collection of Galt family papers, inherited by his son and daughter, has now been passed to Dr Timothy for use in connexion with his study, The Galts: a Canadian Odyssey. At the same time the family collection of John Galt's writings—in sixty‐eight volumes, many from the novelist's own library—was presented to the library of the University of Western Ontario. For permission to print these interesting notes we are indebted to Mr Harvey Smith and Mrs Turner. The annotations initialled C are by Dr Robert Hay Carnie of the University of Calgary.