Devon County Council

Flooding remains the most frequent and damaging natural hazard globally, causing significant loss of life and socio-economic disruption each year. In response, flood risk management policies have increasingly embraced nature-based solutions, particularly Natural Flood Management strategies (NFMs), which seek to preserve, restore, or mimic natural hydrological and geomorphological processes across catchments as interconnected systems. While growing evidence supports the hydrological implications of individual NFM interventions (Bagheri et al., 2025), comparative assessments of multiple NFM strategies in rapid-response catchments remain limited. This study, led by Devon County Council in partnership with 19 organisations and aiming to enhance community flood resilience through NFMs, evaluates the hydrological effectiveness of multi-intervention NFM approaches across five fast-responding catchments in Devon, UK. Utilising a robust Before-After-Control-Impact (BACI) experimental design, we collected high-resolution hydrological data at five-minute intervals using water level loggers, rain gauges, soil moisture probes, and time-lapse cameras. 545 flood events were identified and analysed. Preliminary results from the completed catchments confirm that NFMs collectively contribute to reductions in flood peak magnitude and increases in flow travel time, with the magnitude of effect varying by intervention type and catchment characteristics.ReferenceBagheri‐Gavkosh, M., Panici, D., Puttock, A., Dauben, T., & Brazier, R. E. (2025). Hydrological Analysis and Impacts of Natural Flood Management Strategies: A Systematic Review. Journal of Flood Risk Management, 18(3), e70112.

Fabricated or induced illness is a rare form of child abuse and school nurses are well placed in the community to identify potential cases. They can interact with school age children over a long period of time and can more easily identify patterns and trends, or inconsistencies in a child's health. School nurses can be key to initiating a multi-agency approach, bringing relevant professionals together and helping to safeguard the child through early recognition of this condition. The aim of this article is to provide an overview of fabricated or induced illness and outline the importance of documentation and in particular the use of health chronologies to identify this rare form of child abuse.

AimsPUPS are common, reported by 10–25% of CYP.1 Symptoms can lead to poor function, overuse of medical resource and reduced school attendance. Co-morbid mental health problems often go unrecognised. Longer term outcomes include adult chronic physical/mental ill-health, reduced employment, high health/welfare costs.2 3We established a pilot multi professional assessment/support service to meet the needs of these CYP.MethodsWeekly multiprofessional meetings including paediatrician, psychiatrist, CAMHS worker, psychologist and education wellbeing advisor (EWA) to discuss cases referred by health professionals. Patient/parent consent given. Outcomes included holistic paediatric assessment, joint appointments (paediatrician and CAMHS worker/psychologist), advice and guidance (A&G) to referrer such as signposting/facilitated referral to community services. Some were offered short-term therapeutic intervention with CAMHS worker/psychologist and/or psychiatric assessment. In all cases clear communication with school was facilitated by EWA who supported school attendance; assisting re-integration and improved attendance/wellbeing at school.ResultsOver 18 months we discussed 180 patients: 74 male, 104 female, 2 transgender. Average age 14 years. Common PUPS were musculoskeletal pain, fatigue, headaches, abdominal pain and unexplained episodes. All had reduced school attendance. 111 cases referred by Paediatricians/Allied Health professionals, 56 new GP referrals, 13 presented acutely. 106 were offered paediatric appointments. >50% were discharged with recommendations/advice to primary care/education. 25 had joint appointments. 38 were seen by psychiatrist/CAMHS worker/psychologist for assessment/therapeutic intervention. Remainder received A&G and EWA support.Cost analysis demonstrated average savings of £2600/patient in secondary care. School attendance improved for the majority with reintegration plans and reduction in use of out of school provision with associated cost savings. Referrals to tertiary services for chronic pain/fatigue were reduced and joint working with these services was developed. Linked case examples show significant improvement.ConclusionMultiprofessional assessment using a biopsychosocial approach to CYP with PUPS leads to better recognition of underlying mental illness, improved short-term functional outcomes, reduced medical costs and improved school attendance. The challenge is securing longer term funding.ReferencesHinton D, & Kirk S. Families’and Healthcare Professionals’ perceptions of healthcare services for children and young people with medically unexplained symptoms: a narrative review of the literature. Health & social care in the community 2016(1);24;12–26.Campo JV. Annual Research Review: Functional somatic symptoms and associated anxiety and depression – developmental psychopathology in pediatric practice. Journal of Child Psychology and Psychiatry 2012;53;575–592.Bermingham SL, Cohen A, Hague J & Parsonage P.. The cost of somatisation among the working-age population in England for the year 2008–2009. Mental Health in Family Medicine 2010;7:71–84.

SummaryBackgroundAlthough childhood overweight and obesity prevalence has increased substantially worldwide in the past three decades, scarce evidence exists for effective preventive strategies. We aimed to establish whether a school-based intervention for children aged 9–10 years would prevent excessive weight gain after 24 months.MethodsThis pragmatic cluster randomised controlled trial of the Healthy Lifestyles Programme (HeLP), a school-based obesity prevention intervention, was done in 32 schools in southwest England. All state-run primary and junior schools in Devon and Plymouth (UK) with enough pupils for at least one year-5 class were eligible. Schools were assigned (1:1) using a computer-generated sequence to either intervention or control, stratified by the number of year-5 classes (one vs more than one) and the proportion of children eligible for free school meals (<19% [the national average] vs ≥19%). HeLP was delivered to year-5 children (ages 9–10 years) over 1 year, and included dynamic and interactive activities such as physical activity workshops, education sessions delivered by teachers with short homework tasks, drama sessions, and setting goals to modify behaviour (with parental support and one-to-one discussions with HeLP coordinators). The primary outcome was change in body-mass index (BMI) standard deviation score (SDS) between baseline and 24 months, analysed in children with BMI data available for both timepoints. This study is registered with the International Standard Randomised Controlled Trial register, number ISRCTN15811706, and the trial status is complete.FindingsBetween March 21, 2012, and Sept 30, 2013, 32 eligible schools with 1324 children were recruited, of which 16 schools (676 children) were randomly assigned to the HeLP intervention and 16 schools (648 children) to control. All schools that began the trial completed the intervention, and 1244 children (628 in intervention group and 616 in control group) had BMI data at both baseline and 24 months for the primary outcome analysis. Mean BMI SDS was 0·32 (SD 1·16) at baseline and 0·35 (1·25) at 24 months in the intervention group, and 0·18 (1·14) at baseline and 0·22 (1·22) at 24 months in the control group. With adjustment for school-level clustering, baseline BMI scores, sex, cohort, and number of year-5 classes and socioeconomic status of each school, the mean difference in BMI SDS score (intervention–control) at 24 months was −0·02 (95% CI −0·09 to 0·05), p=0·57. One parent reported an adverse event related to their child's eating and activity behaviours, but agreed for the child to continue trial participation after discussion with the chief investigator.InterpretationDespite a theoretically informed and extensively piloted intervention that achieved high levels of engagement, follow-up, and fidelity of delivery, we found no effect of the intervention on preventing overweight or obesity. Although schools are an ideal setting in which to deliver population-based interventions, school-based interventions might not be sufficiently intense to affect both the school and the family environment, and hence the weight status of children. Future research should focus on more upstream determinants of obesity and use whole-systems approaches.FundingUK National Institute for Health Research, Public Health Research Programme.

The Exe Estuary Trail is a 25 km long sustainable cycling and walking route on the south coast of Devon, UK. The largely off-road facility links Exeter city centre to the coastal towns of Exmouth and Dawlish on either side of the Exe Estuary. The route mainly runs parallel to existing railway lines, and allows public access to the unique European environment and wildlife site. This paper describes the design and construction of the route. Designed for both leisure and commuter use, sustainable development was a key driver of this project. Delivery was led by Devon County Council working in close partnership with Parsons Brinckerhoff and key statutory authorities. The social and health benefits of this green infrastructure project are mirrored by the economic gains of new and existing businesses around the River Exe.

Abstract The Future Search process in principle appears relevant for promoting participatory approaches to rural regeneration, offering a forum for stakeholders to conduct dialogue and find a common sense of direction. Consequently, a Future Search conference was organized in Devon, England, to encourage community‐led rural regeneration, and this paper reflects on that experience. It highlights achievements but focuses on difficulties encountered in using Future Search where democratic processes are a key issue. The carefully planned structures of Future Search and the intensity of the conference process were found in some respects to be incongruous with the needs and expectations of the participants. The conference also revealed that action planning can be problematic when participants belong to different organizations. Therefore, the value of Future Search for rural regeneration would seem to be primarily in creating dialogues and establishing networks, with more limited scope for action planning. Copyright © 2002 John Wiley &amp; Sons, Ltd.

This study explores the differing perceptions of patients, carers, and professional staff in relation to psychiatric admission. There is poor to moderate agreement between lay people and professional beliefs about diagnosis or purpose of admission, although good agreement about the necessity of admission. The chronicity of symptoms in admitted patients and a rural-urban divide in rates of admissions are also noted.

A major source of the annual income of local authorities in Great Britain is the set of grants and subsidies distributed to them by central government. Perhaps the easiest way to grasp the nature and nomenclature of these grants is to begin with a consideration of the way they are set down, at Great Britain aggregate level, in volume II of the Annual White Paper The Governments’ Expenditure Plans [QRL.27] and at England, Wales and Scotland levels in respectively, Rate Support Grant Report (England) [QRL.60], Rate Support Grant (Wales) [QRL.61] and Report on Rate Support Grant (Scotland) Order [QRL.72]. See also Guide to Local Authority Finance [B.23]. In these publications, Aggregate Exchequer Grant (Aggregate Exchequer Assistance in Scotland) is identified. These are (almost) the total amounts which central government intends to disburse to authorities in Great Britain in the course of the following financial year; the grants not included are dealt with in paragraph 6.1.2. These aggregates, which are subject to modification in Supplementary Reports are subdivided in [QRL.60], [QRL.61] and [QRL.72] into their various “regional” components. In the case of England and Wales these are: (a) Specific and Supplementary Grants; (b) Rate Support Grant (further subdivided into block grant and domestic rate relief grant). As to Scotland, the components are: (a) Specific Grants and (b) Rate Support Grant (further subdivided into domestic, resources and needs elements).