scholarly journals Impact of austerity on prison health in England: a qualitative study involving national policymakers

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
N Ismail
Keyword(s):  
Political Ideology ◽  
Constructivist Grounded Theory ◽  
Structured Interviews ◽  
Healthcare Provision ◽  
Narrative Texts ◽  
Female Prisoners ◽  
Prison Health ◽  
Long Term Impact ◽  
The Uk ◽  
The Impact

Abstract Prisons offer states access to a population that is at high risk of morbidity. The UK austerity policy adopted in 2010 led to a 22% reduction (-£2.71bn) in prison spending by 2017. Whilst the number of prison officers dropped by 30%, the long-term impact of austerity on prison health in England has not been systematically contextualised. This research seeks to articulate the impact of austerity on prison health in England from the perspective of national policymakers. Semi-structured interviews (X: 66 min) were conducted with 30 key prison policymakers. Constructivist grounded theory was used to assess the impact of austerity on prisoner health in England. Transcripts of 195,680 narrative texts were analysed using NVivo 11 until data saturation was achieved. As a stealthy political ideology, austerity has caused societal disruption, which disproportionately affects prisons. The lack of access to services offered by the welfare state, including health-related provisions, precipitates societal unrest, increases prisoner numbers, and encourages harsher and longer sentences. The prolonged constrained funding and the burgeoning population widen health inequalities in prisons. Healthcare provisions become increasingly limited, which unduly affects older and female prisoners who require more complex support. The degrading living conditions and lack of purposeful activities contribute to the increasing violence, self-harm and suicides in prisons, and reorient the healthcare provision from planned services to health emergencies. The excessive focus on Brexit and the perpetual changing political direction imposed on prisons reinforce the system’s instability. Despite having the fifth largest economy in the world, England’s poorest population continues to bear the brunt of austerity. Initiating a more informed economic recovery policy and considering alternatives to imprisonment would help to ensure that England lives up to its view of itself as a progressive society.

scholarly journals The impact of COVID-19 on self-management behaviours and healthcare access for people with inflammatory arthritis

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Emma Caton ◽  
Hema Chaplin ◽  
Lewis Carpenter ◽  
Melissa Sweeney ◽  
Hsiu Yen Tung ◽  
...  
Keyword(s):  
Inflammatory Arthritis ◽  
Healthcare Access ◽  
Self Management ◽  
Severe Illness ◽  
Structured Interviews ◽  
Healthcare Provision ◽  
June July ◽  
The Uk ◽  
The Impact

Abstract Background Inflammatory arthritis (IA) patients have been identified as at greater risk of severe illness from COVID-19. It is likely that lockdown restrictions (enforced by the UK government in response to the COVID-19 pandemic) and subsequent changes made to healthcare provision could impact patients’ abilities to effectively manage their condition. The aim of this study was to qualitatively explore the impact of COVID-19 on self-management behaviours and healthcare access for people with IA. Methods Semi-structured interviews were conducted with 21 IA patients in June-July 2020, with nine follow-up interviews in November 2020. Interview schedules were developed with a Patient Research Partner and explored participants’ experiences of the COVID-19 pandemic. Interviews were conducted via telephone and analysed using inductive thematic analysis. Results Participants were aged between 24 and 79 years (mean = 50.1, SD = 15.8), largely female (71%) and White British (86%). Four initial themes were identified: (1) Impact of COVID-19 on medication adherence, (2) Impact of COVID-19 on physical activity, (3) Impact of COVID-19 on diet, and (4) Impact of COVID-19 on healthcare access and delivery. Subthemes focused on positive and negative changes made to these areas, as well as behaviours which remained consistent. Follow-up interviews highlighted differences in participants’ experiences during the two lockdown periods. Conclusion COVID-19 has affected patients’ abilities to manage their IA. Healthcare professionals need to recognise the ongoing impact of COVID-19 on patient self-management and healthcare access to ensure that adequate understanding and support is available to patients who may have inadequate disease control as a result.

scholarly journals Impact of COVID-19 pandemic social restriction measures on people with rheumatic and musculoskeletal diseases in the UK: a mixed-methods study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e048772
Author(s):  
Toby O Smith ◽  
Pippa Belderson ◽  
Jack R Dainty ◽  
Linda Birt ◽  
Karen Durrant ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Qualitative Study ◽  
Online Survey ◽  
Musculoskeletal Diseases ◽  
Community Dwelling ◽  
Secondary Outcome ◽  
Healthcare Provision ◽  
Social Restriction ◽  
The Uk ◽  
The Impact

ObjectivesTo determine the impact of COVID-19 pandemic social restriction measures on people with rheumatic and musculoskeletal diseases (RMDs) and to explore how people adapted to these measures over time.DesignMixed-methods investigation comprising a national online longitudinal survey and embedded qualitative study.SettingUK online survey and interviews with community-dwelling individuals in the East of England.ParticipantsPeople in the UK with RMDs were invited to participate in an online survey. A subsection of respondents were invited to participate in the embedded qualitative study.Primary and secondary outcome measuresThe online survey, completed fortnightly over 10 weeks from April 2020 to August 2020, investigated changes in symptoms, social isolation and loneliness, resilience and optimism. Qualitative interviews were undertaken assessing participant’s perspectives on changes in symptoms, exercising, managing instrumental tasks such a shopping, medication and treatment regimens and how they experienced changes in their social networks.Results703 people with RMDs completed the online survey. These people frequently reported a deterioration in symptoms as a result of COVID-19 pandemic social restrictions (52% reported increase vs 6% reported a decrease). This was significantly worse for those aged 18–60 years compared with older participants (p=0.017). The qualitative findings from 26 individuals with RMDs suggest that the greatest change in daily life was experienced by those in employment. Although some retired people reported reduced opportunity for exercise outside their homes, they did not face the many competing demands experienced by employed people and people with children at home.ConclusionsPeople with RMDs reported a deterioration in symptoms when COVID-19 pandemic social restriction measures were enforced. This was worse for working-aged people. Consideration of this at-risk group, specifically for the promotion of physical activity, changing home-working practices and awareness of healthcare provision is important, as social restrictions continue in the UK.

“There is still a perception that homelessness is a housing problem”: devolution, homelessness and health in the UK

2016 ◽  
Vol 19 (2) ◽  
pp. 33-44 ◽  
Author(s):  
Martin Whiteford ◽  
Glenn Simpson
Keyword(s):  
Qualitative Interviews ◽  
Homeless People ◽  
Small Sample ◽  
Issue Salience ◽  
Structured Interviews ◽  
Healthcare Provision ◽  
Policy And Practice ◽  
Content Type ◽  
The Uk ◽  
Comparative Policy

Purpose The purpose of this paper is to provide an exploratory account of the links between devolution, homelessness and health in the UK. Specifically, it focusses on the policy context and governance structures that shape the systems of healthcare for homeless people in London, Scotland, Wales and Northern Ireland. Design/methodology/approach Empirically the paper draws on semi-structured interviews with a small sample of policy and practice actors from the devolved territories. Qualitative interviews were supplemented by a comparative policy analysis of the homelessness and health agenda within the devolved regions. Theoretically, it takes inspiration from Chaney’s concept of the “issue salience of homelessness” and explores the comparative character of healthcare as pertains to homeless people across the devolved territories. Findings The paper provides clear evidence of areas of divergence and convergence in policy and practice between the devolved regions. These features are shown to be strongly mediated by the interplay of two factors: first, the scope and scale of national and local homelessness prevention strategies; and second, intra-national variation in public health responses to homelessness. Originality/value The paper offers considerable insight from a comparative policy perspective into the nature of healthcare provision for homeless people in the devolved regions.

scholarly journals How are patients with rare diseases and their carers in the UK impacted by the way care is coordinated? An exploratory qualitative interview study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Amy Simpson ◽  
Lara Bloom ◽  
Naomi J. Fulop ◽  
Emma Hudson ◽  
Kerry Leeson-Beevers ◽  
...  
Keyword(s):  
Care Coordination ◽  
Structured Interviews ◽  
School Work ◽  
Travel Costs ◽  
Care Plans ◽  
Use Of Technology ◽  
Number Of Factors ◽  
Qualitative Interview Study ◽  
The Uk ◽  
The Impact

Abstract Background Care coordination is considered important for patients with rare conditions, yet research addressing the impact of care coordination is limited. This study aimed to explore how care coordination (or lack of) impacts on patients and carers. Semi-structured interviews were conducted with 15 patients and carers/parents in the UK, representing a range of rare conditions (including undiagnosed conditions). Transcripts were analysed thematically in an iterative process. Results Participants described a range of experiences and views in relation to care coordination. Reports of uncoordinated care emerged: appointments were uncoordinated, communication between key stakeholders was ineffective, patients and carers were required to coordinate their own care, and care was not coordinated to meet the changing needs of patients in different scenarios. As a result, participants experienced an additional burden and barriers/delays to accessing care. The impacts described by patients and carers, either attributed to or exacerbated by uncoordinated care, included: impact on physical health (including fatigue), financial impact (including loss of earnings and travel costs), and psychosocial impact (including disruption to school, work and emotional burden). Overall data highlight the importance of flexible care, which meets individual needs throughout patients’/carers’ journeys. Specifically, study participants suggested that the impacts may be addressed by: having support from a professional to coordinate care, changing the approach of clinics and appointments (where they take place, which professionals/services are available and how they are scheduled), and improving communication through the use of technology, care plans, accessible points of contact and multi-disciplinary team working. Conclusion This study provides further evidence of impacts of uncoordinated care; these may be complex and influenced by a number of factors. Approaches to coordination which improve access to care and lessen the time and burden placed on patients and carers may be particularly beneficial. Findings should influence future service developments (and the evaluation of such developments). This will be achieved, in the first instance, by informing the CONCORD Study in the UK.

scholarly journals Plan for the worst, hope for the best? Exploring major events related terrorism and future challenges for UK event professionals

2018 ◽  
Vol 4 (4) ◽  
pp. 513-526 ◽  
Author(s):  
Daniel Baxter ◽  
Jenny Flinn ◽  
Lucrezia Flurina Picco
Keyword(s):  
Marketing Strategy ◽  
Significant Rise ◽  
Destination Marketing ◽  
Major Event ◽  
Structured Interviews ◽  
Content Type ◽  
Future Challenges ◽  
Research Findings ◽  
The Uk ◽  
The Impact

Purpose The purpose of this paper is to investigate major event related terrorism and the resulting challenges that event professionals may face when hosting major events in cities as part of a destination marketing strategy. Design/methodology/approach The research was based in the UK due to the significant rise in terrorist activities that have taken place in its urban cities in recent years. The exploratory nature of this study utilised semi-structured interviews with UK event professionals, enabling a preliminary, in-depth investigation of the challenges that events professionals face as a result of major event related terrorism. Findings The research findings identify three challenges faced by event professionals when organising major events: knowledge and understanding in relation to major event related terrorism; the impact of major event related terrorism in terms of responsibility and accountability; and managing for major event related terrorism in budgetary terms. Research limitations/implications The research is limited to the UK, other destinations will pose their own unique challenges when hosting and managing events. It is suggested that this research be evaluated against similar studies in other destinations. This is a preliminary study and each of the topics identified within the findings warrant further exploration in their own right. Originality/value The paper offers an insight into the challenges faced by event professionals in the UK when delivering major events as part of a destination marketing strategy. With the increase in major event related terrorism in cities the findings of this research are of relevance not only to event professionals but anyone with a role in destination and tourism development.

scholarly journals How fast should social restrictions be eased  in England as COVID-19 vaccinations are rolled out?

2021 ◽  
Author(s):  
David Miles ◽  
Adrian Heald ◽  
Mike Stedman
Keyword(s):  
Healthcare Services ◽  
Key Factors ◽  
Healthcare Provision ◽  
Factors Affecting ◽  
Education Outcomes ◽  
Trade Offs ◽  
Standards Of Living ◽  
Life Years ◽  
The Uk ◽  
The Impact

Vaccination against the COVID-19 virus began in December 2020 in the UK and is now running at 5% population/week. High Levels of social restrictions were implemented for the third time in January 2021 to control the second wave and resulting increases in hospitalisations and deaths. Easing those restrictions must balance multiple challenging priorities, weighing the risk of more deaths and hospitalisations against damage done to mental health, incomes and standards of living, education outcomes and provision of non-Covid-19 healthcare. Weekly and monthly officially published values in 2020/21 were used to estimate the impact of seasonality and social restrictions on the spread of COVID-19 by age group, on the economy and healthcare services. These factors were combined with the estimated impact of vaccinations and immunity from past infections into a model that retrospectively reflected the actual numbers of reported deaths closely both in 2020 and early 2021. It was applied prospectively to the next 6 months to evaluate the impact of different speeds of easing social restrictions. The results show vaccinations are significantly reducing the number of hospitalisations and deaths. The central estimate is that relative to a rapid easing, the avoided loss of 57,000 life years from a strategy of relatively slow easing over the next 4 months comes at a cost in terms of GDP reduction of around £0.4 million/life-year loss avoided. This is over 10 times higher than the usual limit the NHS uses for spending against Quality Adjusted Life Years (QALYs) saved. Alternative assumptions for key factors affecting give significantly different trade-offs between costs and benefits of different speeds of easing. Disruption of non-Covid-19 Healthcare provision also increases in times of higher levels of social restrictions. In most cases, the results favour a somewhat faster easing of restrictions in England than current policy implies.

How did Autistic Children, and their Parents, Experience School Transition during the COVID-19 Pandemic?

2021 ◽  
Author(s):  
Aimee Code ◽  
Umar Toseeb ◽  
Kathryn Asbury ◽  
Laura Fox
Keyword(s):  
School Transition ◽  
School Closure ◽  
School Transitions ◽  
Autistic Children ◽  
Structured Interviews ◽  
School Closures ◽  
Social Distancing ◽  
New School ◽  
The Uk ◽  
The Impact

Due to the COVID-19 pandemic and resultant school closures, social distancing measures, and restrictions placed on routine activities, the start of the academic year in September 2020 was a unique time for those transitioning to a new school. This study aimed to explore the experiences of parents who supported autistic children making a school transition in 2020, and to examine what impact parents perceived the COVID-19 pandemic had on their child’s school transition. Emphasis was placed on identifying facilitating factors that had benefitted school transitions, and barriers, which had negatively impacted these experiences. Semi-structured interviews were carried out with 13 parents of autistic children in the UK. Reflexive thematic analysis was carried out to identify themes in interview data. Parents reported a variety of experiences, and factors that were perceived as facilitatory to some were observed to be barriers by others. For some parents, the COVID-19 pandemic negatively impacted aspects of school transitions. For example, school closure in March 2020, being unable to visit their child’s new school, and social distancing measures were discussed as being barriers to an easy transition. However, other parents identified these factors as being facilitatory for their child or reported that these circumstances created opportunities to approach the school transition in a unique, improved manner. This paper sheds light on the heterogeneity of experiences and perceptions of parents of autistic children, and highlights the need to examine the impact of COVID-19 on school transitions, including practices which may be advantageous to retain.

scholarly journals The impact of the COVID-19 lockdown on orthopaedic emergency presentations in a remote and rural population

2020 ◽  
Vol 1 (10) ◽  
pp. 621-627
Author(s):  
Ahmed S. Elhalawany ◽  
James Beastall ◽  
Gerard Cousins
Keyword(s):  
Healthcare Providers ◽  
Local Area ◽  
Time Frame ◽  
Healthcare Provision ◽  
Proportional Increase ◽  
Minor Injuries ◽  
The Uk ◽  
A Minor ◽  
The Impact ◽  
Second Wave

Aims COVID-19 remains the major focus of healthcare provision. Managing orthopaedic emergencies effectively, while at the same time protecting patients and staff, remains a challenge. We explore how the UK lockdown affected the rate, distribution, and type of orthopaedic emergency department (ED) presentations, using the same period in 2019 as reference. This article discusses considerations for the ED and trauma wards to help to maintain the safety of patients and healthcare providers with an emphasis on more remote geography. Methods The study was conducted from 23 March 2020 to 5 May 2020 during the full lockdown period (2020 group) and compared to the same time frame in 2019 (2019 group). Included are all patients who attended the ED at Raigmore Hospital during this period from both the local area and tertiary referral from throughout the UK Highlands. Data was collected and analyzed through the ED Information System (EDIS) as well as ward and theatre records. Results A total of 1,978 patients presented to the ED during the lockdown period, compared to 4,777 patients in the same timeframe in 2019; a reduction of 58.6%. Orthopaedic presentations in 2020 and 2019 were 736 (37.2%) and 1,729 (36.2%) respectively, representing a 57.4% reduction. During the lockdown, 43.6% of operations were major procedures (n = 48) and 56.4% were minor procedures (n = 62), representing a significant proportional shift. Conclusion During the COVID- 19 lockdown period there was a significant reduction in ED attendances and orthopaedic presentations compared to 2019. We also observed that there was a proportional increase in fractures in elderly patients and in minor injuries requiring surgery. These represented the majority of the orthopaedic workload during the lockdown period of 2020. Given this shift towards smaller surgical procedures, we suggest that access to a minor operating theatre in or close to ED would be desirable in the event of a second wave or future crisis.

scholarly journals Implementing and measuring person-centredness using an APP for knowledge transfer: the iMPAKT app

2020 ◽  
Vol 32 (4) ◽  
pp. 251-258 ◽  
Author(s):  
Tanya McCance ◽  
Brighide M Lynch ◽  
Christine Boomer ◽  
Donna Brown ◽  
Christopher Nugent ◽  
...  
Keyword(s):  
Knowledge Transfer ◽  
Patient Experience ◽  
Performance Indicators ◽  
Key Performance Indicators ◽  
Structured Interviews ◽  
Evaluation Approach ◽  
Experience Of Care ◽  
Measurement Framework ◽  
The Uk ◽  
The Impact

Abstract Objective The aim of the study was to evaluate a technological solution in the form of an App to implement and measure person-centredness in nursing. The focus was to enhance the knowledge transfer of a set of person-centred key performance indicators and the corresponding measurement framework used to inform improvements in the experience of care. Design The study used an evaluation approach derived from the work of the Medical Research Council to assess the feasibility of the App and establish the degree to which the App was meeting the aims set out in the development phase. Evaluation data were collected using focus groups (n = 7) and semi-structured interviews (n = 7) to capture the impact of processes experienced by participating sites. Setting The study was conducted in the UK and Australia in two organizations, across 11 participating sites. Participants 22 nurses from 11 sites in two large health care organizations were recruited on a voluntary basis. Intervention Implementing the KPIs and measurement framework via the APP through two cycles of data collection. Main Outcome Measures The main outcome was to establish feasibility in the use of the App. Results The majority of nurse/midwife participants found the App easy to use. There was broad consensus that the App was an effective method to measure the patient experience and generated clear, concise reports in real time. Conclusions The implementation of the person-centred key performance indicators using the App enhanced the generation of meaningful data to evidence patient experience across a range of different clinical settings.

Taught resilience programmes: a case study from the perspective of employees of a large pharmaceutical company based in the UK

2020 ◽  
Vol 2 (2) ◽  
pp. 111-129
Author(s):  
Frances Costello
Keyword(s):  
Lived Experience ◽  
Interpretative Phenomenological Analysis ◽  
Structured Interviews ◽  
Content Type ◽  
Individual Resilience ◽  
Personal Resilience ◽  
The Uk ◽  
Almost All ◽  
The Impact

PurposeResearch was undertaken to understand whether taught resilience programmes which highlight the protective factors of resilience would impact individual resilience outcomes. The research focussed on specific resilience dimensions, change agility, physical, emotional and mental resilience, purpose in life and recovery; in an attempt to bridge the gap in understanding whether it is possible through taught programmes to improve resilience through the creation of new habits.Design/methodology/approachThe research was conducted using interpretative phenomenological analysis methods and used semi-structured interviews with 12 participants to understand participants lived experience of a one-day personal resilience programme, conducted within a private global manufacturing organisation.FindingsThe research found that all 12 participants interviewed 12–18 months post-programme made sustainable habits changes increasing personal resilience levels. Participants built new habits into their everyday lives, in the physical dimension exercising more regularly, taking breaks, changes in nutrition and creating better sleep patterns. Through increased understanding of emotional intelligence participants were able to react more favourably to adverse situations and through mental increased resilience focus achieve work and home priorities. In understanding the change journey participants found that they were able to move more quickly through the change cycle. Almost all participants found understanding their life purpose difficult and were not able to give a conclusive answer to what this might be, they found that attending the programme helped reflection in this dimension.Originality/valueThe paper includes an overview of previous resilience research but differs in its examination of the impact of a specific taught resilience programme in a large private sector organisation using IPA methodology.

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