Discharge policies for homeless people and immigrants: Compromising professional ethics

2020 ◽  
Vol 27 (5) ◽  
pp. 1355-1363
Author(s):  
Nathan Hodson ◽  
Rose Glennerster
Keyword(s):  
Best Practice ◽  
Ethical Issues ◽  
Homeless People ◽  
Social Needs ◽  
Hostile Environment ◽  
Environment Policy ◽  
The United Kingdom ◽  
Health And Social Care ◽  
Healthcare Professions

Discharging a homeless patient from hospital raises ethical issues which are compounded when the patient is from outside the United Kingdom. This article begins with an extended case study of a 30-year-old homeless man from Lithuania describing his complex medical and social needs. It is best practice for all homeless patients to have their housing needs planned for prior to discharge, but this is made more difficult by the United Kingdom’s ‘hostile environment’ policy which creates a subclass of homeless people who are not eligible for support. This means healthcare professionals discharge patients back to homelessness, even when this is likely to adversely affect their health and dignity both directly and indirectly through impairing access to care for chronic conditions. Policies in health and social care which compel professionals to treat some patients with second-class care undermine the ethics of healthcare professions.

A journey towards integrated person-centred care: a case study of a mental health perspective in the voluntary sector

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Louise Kermode
Keyword(s):  
Mental Health ◽  
Best Practice ◽  
Care Delivery ◽  
Voluntary Sector ◽  
Assessment Tools ◽  
Valuable Insight ◽  
Physical And Mental Health ◽  
Content Type ◽  
Health And Social Care

PurposePerson-centred care is a fundamental component of any service. This case study aims to explore the delivery of person-centred care in the voluntary sector, discussing how integrating support can be achieved to benefit individuals. It identifies challenges, best practice and learning that can be applied across sectors and promotes further enquiry.Design/methodology/approachThis case study is the result of a service audit at a mental health charity. The findings are a blend of reflections, observations and examples from service delivery, synthesised with national policy to provide evidence of best practice and processes that enable person-centred care.FindingsA focus on need not diagnosis, creating accessible and inclusive services, employing dual trained practitioners, having a varied skill mix along with holistic self-assessment tools are all enablers for integrated person-centred support. Multi-agency assessment frameworks, collaboration across services, cross-agency supervision and a shared vision for integration and person-centred care support services to coordinate more effectively. Barriers to integrated person-centred support include complex physical and mental health needs and harmful risk and safeguarding. The diversity of the voluntary sector, a lack of resources along with complex and competitive funding also hinder integration.Originality/valueThis case study provides a valuable insight into the voluntary sector and shares its findings to enhance best practice. It aims to promote interest and invites further research into health and social care delivery by the voluntary sector. As this delivery continues to increase, it is vital to examine the interface between the voluntary and statutory sector. Through better understanding and further research across all sectors, the author can identify how they can achieve person-centred outcomes and deliver the national policies.

Nursing associate apprenticeship – a descriptive case study narrative of impact, innovation and quality improvement

2020 ◽  
Vol 10 (5) ◽  
pp. 751-766
Author(s):  
Marion Taylor ◽  
Cariona Flaherty
Keyword(s):  
United Kingdom ◽  
Education Institution ◽  
Academic Discourse ◽  
Subject Area ◽  
Content Type ◽  
Descriptive Case Study ◽  
The United Kingdom ◽  
Health And Social Care ◽  
Is Value

PurposeThe purpose of this article is to explore how one higher education institution (HEI) has embraced the apprenticeship agenda and is successfully providing an apprenticeship programme for nursing associates (NA) a new profession within health and social care in the United Kingdom.Design/methodology/approachThis is a descriptive case study narrative about one programme from one HEI, selected for its relevance for the subject area of apprenticeships. This descriptive approach allows the provision of apprenticeships within HEI to be explored in depth by one institution.FindingsThis case study identifies the considerable value of apprenticeships within HEI for the students, the employers and the HEI. It also identifies that there are challenges within this. These findings will be of interest to those entering into the apprenticeship arena, especially within healthcare, and may inform an academic discourse in this area.Research limitations/implicationsIt is acknowledged that this case study does not seek to compare apprenticeships with other programmes. However, there is value in providing an academic narrative around the challenges of this provision which will be informative for others developing higher apprenticeships in the United Kingdom or similar delivery of apprenticeship models internationally.Practical implicationsThere is value in providing an academic narrative around the challenges of this provision which will be informative for others developing higher apprenticeships in the UK or similar delivery of apprenticeship models internationallySocial implicationsThese findings will be of interest to those entering into the apprenticeship arena, especially within healthcare, and will inform the academic discourse in this area.Originality/valueThis is original work and provides a new body of knowledge to the inform HEIs engaging with the relatively new context of higher and degree apprenticeships, as well as the new role within healthcare of the nursing associate.

scholarly journals Challenges Affecting Access to Health and Social Care Resources and Time Management among Parents of Children with Rett Syndrome: A Qualitative Case Study

2020 ◽  
Vol 17 (12) ◽  
pp. 4466 ◽  
Author(s):  
Javier Güeita-Rodriguez ◽  
Pilar Famoso-Pérez ◽  
Jaime Salom-Moreno ◽  
Pilar Carrasco-Garrido ◽  
Jorge Pérez-Corrales ◽  
...  
Keyword(s):  
Qualitative Research ◽  
Health Services ◽  
Rett Syndrome ◽  
Time Management ◽  
Social Care ◽  
Qualitative Case Study ◽  
Social Needs ◽  
Entire Family ◽  
Health And Social Care

Rare diseases face serious sustainability challenges regarding the distribution of resources geared at health and social needs. Our aim was to describe the barriers experienced by parents of children with Rett Syndrome for accessing care resources. A qualitative case study was conducted among 31 parents of children with Rett syndrome. Data were collected through in-depth interviews, focus groups, researchers’ field notes and parents’ personal documents. A thematic analysis was performed and the Standards for Reporting Qualitative Research (SRQR) guidelines were followed. Three main themes emerged from the data: (a) essential health resources; (b) bureaucracy and social care; and (c) time management constraints. Parents have difficulties accessing appropriate health services for their children. Administrative obstacles exist for accessing public health services, forcing parents to bear the financial cost of specialized care. Time is an essential factor, which conditions the organization of activities for the entire family. Qualitative research offers insight into how parents of children with Rett syndrome experience access to resources and may help improve understanding of how Rett syndrome impacts the lives of both the children and their parents.

Architectural Ethics

2005 ◽  
Vol 1 (2) ◽  
pp. 67-72 ◽  
Author(s):  
Nicholas Ray
Keyword(s):  
Ethical Decision Making ◽  
Ethical Issues ◽  
Relationship Building ◽  
First Century ◽  
Managerial Values ◽  
Architectural Practice ◽  
The United Kingdom ◽  
The Face ◽  
Twenty First Century

The practice of architecture, a discipline that is inescapably contingent on the particular, but that is also required by society in some way to represent an ideal, raises a number of specific ethical issues. Following an essay by the philosopher Thomas Nagel, this paper argues that it is intrinsic to professional judgement that this involves the prioritizing of unquantifiable ‘goods’. A twentieth-century case study is examined, which exhibits the choices made by a well-known architect. The changed nature of architectural practice in the United Kingdom in the twenty-first century is then described, whereby the privilege of making such judgements has been severely limited by the substitution of managerial values for professional values. In the face of different ethical imperatives – most obviously to design responsibly within pressing ecological concerns – it is argued that the task for architects now is to re-establish a context within which sound judgements can be made, which of course implies a degree of professional trust. Their ability to balance managerial values (technical competence for example) with ethical decision-making is what may prove to be most valuable. There are implications for architectural education, which in the past has either pretended to be a science or has retreated into aesthetic speculation, providing training in the skills of persuasion rather than relationship-building. The conclusion is that ethical thinking is inescapable for the profession of architecture in the twenty-first century.

Social and Strategic Partnership in Marketing Contexts

2020 ◽  
pp. 122-145
Author(s):  
Bruno Barbosa Sousa ◽  
Filipe Sequeira Magalhães
Keyword(s):  
Social Marketing ◽  
Best Practice ◽  
Ethical Issues ◽  
Behavioural Change ◽  
Strategic Partnership ◽  
Marketing Practice ◽  
Social Good ◽  
Non Profit ◽  
Social Marketing Campaigns

Social and strategic marketing seeks to develop systematic marketing concepts with several approaches to influence behaviours that benefit individuals and society for the greater social good. Social marketing practice is guided by ethical issues. It seeks to integrate approach, best practice, theory, audience, and partnership insight to inform the delivery of competition-sensitive and segmented social change programmes that are effective, efficient, equitable, and sustainable. This case study concerns help2kids as a young and dynamic non-profit organization operating in Africa. The case study consists of reflection and discussion of the several practices, marketing strategies, social entrepreneurship topics, and multiple projects inherent to help2kids. Help2kids strives to allow children the pursuit of a better and more sustainable future. The authors intend to present different social marketing campaigns to promote behavioural change for the benefit of society and the strategies that have been followed to achieve the desired idea or behaviour.

scholarly journals “You know, we can change the services to suit the circumstances of what is happening in the world”: a rapid case study of the COVID-19 response across city centre homelessness and health services in Edinburgh, Scotland

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Tessa Parkes ◽  
Hannah Carver ◽  
Wendy Masterton ◽  
Danilo Falzon ◽  
Joshua Dumbrell ◽  
...  
Keyword(s):  
Substance Use ◽  
Harm Reduction ◽  
Social Needs ◽  
City Centre ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Complex Needs ◽  
Health And Social Care ◽  
The Impact

Abstract Background The COVID-19 pandemic has necessitated unprecedented changes in the way that health, social, and housing services are delivered to individuals experiencing homelessness and problem substance use. Protecting those at high risk of infection/transmission, whilst addressing the multiple health and social needs of this group, is of utmost importance. This study aimed to document the impact of the COVID-19 pandemic on individuals who were experiencing homelessness in one city centre in Scotland, and how services adapted in response. Methods Semi-structured interviews were conducted with individuals with lived/living experience of homelessness (n = 10), staff within onethird sector service (n = 5), and external professionals (n = 5), during April-August 2020, using a rapid case study design. These were audio-recorded, fully transcribed, and analysed using Framework. Analysis was informed by inclusion health and equity-orientated approaches to meeting the needs of people with multiple and complex needs, and emerging literature on providing harm reduction in the context of COVID-19. Results Those with lived/living experience of homelessness and problem substance use faced a range of additional challenges during the pandemic. Mental health and use of substances were affected, influenced by social isolation and access to services. A range of supports were provided which flexed over the lockdown period, including housing, health and social care, substance use treatment, and harm reduction. As well as documenting the additional risks encountered, findings describe COVID-19 as a ‘path-breaking’ event that created opportunities to get evidence into action, increase partnership working and communication, to proactively address risks. Conclusions This rapid case study has described the significant impact of the COVID-19 pandemic on a group of people experiencing homelessness and problem substance use within one city centre in Scotland and provides a unique lens on service/professional responses. It concludes with lessons that can inform the international and ongoing response to this pandemic. It is vital to recognise the vision and leadership that has adapted organisational responses in order to reduce harms. We must learn from such successes that were motivated both by compassion and care for those vulnerable to harms and the desire to provide high-quality, evidence-based, harm reduction services.

scholarly journals Bordering Through Religion: A Case Study of Christians from the Muslim Majority World Seeking Asylum in the UK

2020 ◽  
Vol 9 (3) ◽  
pp. 47-60
Author(s):  
Roda Madziva
Keyword(s):  
Religious Discrimination ◽  
Hostile Environment ◽  
Complex Issue ◽  
Refugee Protection ◽  
Liberal Democratic ◽  
The United Kingdom ◽  
Majority World ◽  
Muslim Majority ◽  
The Uk

The current global ‘crisis’ of the refugee movement has drawn to the forefront longstanding public worries about welcoming and accommodating refugees, especially in liberal democratic States. While religion is central to refuge, very little is known about the experiences of individuals seeking refugee protection on religious grounds and even the racialisation of religious identities within the asylum adjudication system. Drawing on ethnographic research with Christians from Pakistan, who are seeking asylum in the United Kingdom (UK), this paper explores the religious discrimination that this group faces within the context of the UK’s current hostile environment. Findings reveal a complex issue of misdirected Islamophobia, along with other multi-layered forms of stereotyping. By exploring and engaging with these issues, the paper aims to highlight the complex ‘borders’ that those seeking protection on religious grounds have to negotiate as they move through the asylum adjudication system.

Impacts of Environmental Regulation on Sustainable Economic Growth

2018 ◽  
Vol 9 (9) ◽  
pp. 749-773
Author(s):  
Jonathan Fisher
Keyword(s):  
Economic Growth ◽  
Environmental Regulation ◽  
Technical Change ◽  
Best Practice ◽  
Environmental Regulations ◽  
The European Union ◽  
Porter Hypothesis ◽  
The United Kingdom ◽  
Environment Agency ◽  
Sustainable Economic Growth

There is considerable concern and debate about the economic impacts of environmental regulations. Jonathan Fisher, former Economics Manager at the Environment Agency in England and Wales, reviews the available evidence on this subject. Section 2 presents estimates of the costs and benefits of environmental regulations. Section 3 examines the impacts of environmental regulations on economic growth, innovation and technical change as well as impacts on competitiveness and any movement of businesses to less pollution havens. He questions call for greater certainty regarding future environmental regulations, whereas in fact there should be calls for less uncertainty. This section then suggests how this could be achieved. This section then finishes with an overview of the available evidence. This includes an examination of the Porter Hypothesis that environmental regulations can trigger greater innovation that may partially or more than fully offset the compliance costs. Section 4 then sets out principles for how better environmental regulation can improve its impacts on sustainable economic growth and illustrates how the European Union (EU) Water Framework Directive is a good example of the application of these principles in practice. Section 5 reviews current and recent political perspectives regarding developments in environmental regulations across the EU and shows how the United Kingdom (UK) has successfully positively managed to influence such developments so that EU environmental regulations now incorporate many of these principles to improve their impacts on economic growth. Section 5.1 then examines the implications of Brexit for UK environmental regulations. Finally, Section 6 sets out some best practice principles to improve the impacts of environmental regulation on sustainable economic growth, innovation and technical change.

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