Westminster City Council

Family and Group Conferencing (FGC) is a relatively new strengths-based approach applied to adults needing social care and mental health support in the UK. Although the approach is well established in children's services in the UK, few services currently offer FGCs to adults; therefore, there is limited evidence regarding FGCs in the adult services context in the UK. This study aims to fill this gap by examining how FGCs work and what differences they can make in people's lives. This paper (Part 1) addresses the first of two related research questions, aiming to characterize the practice model(s) that pertain to the context of adults' FGCs as currently offered. We employed a mixed methods research design drawing on data from both, previous literature as well as current practice by undertaking a comprehensive literature review, national survey and stakeholder interviews with current services and a deliberative forum involving a range of stakeholders pertaining to adult FGCs. Although there is some variation in the practice model(s) offered by services, the overall approach is underpinned by a relatively consistent set of values and principles, although these are often implicit. The FGC offers a staged approach that enables people and their networks to take greater control over their support arrangements. It is seen as an appropriate service offer across all adults and mental health services with the potential to result in a range of positive outcomes (as will be discussed in Part 2). Central to achieving this is flexibility within the service offer to accommodate the social and cultural needs of the individual and their network, the independence of the FGC coordinator, the necessity of sufficient preparation for all participants, and rapport building in advance of the Conference.

Background:Current evidence suggests that autistic individuals are at high risk for becoming and remaining in a cycle of homelessness. Key risk factors for homelessness disproportionately affect autistic people; however, we have limited understanding of how to best support autistic individuals accessing services. This gap in the evidence base is particularly acute for autistic women.Objective:As a first step to address this gap, we aimed to (1) map gaps in knowledge and practice; (2) identify priority areas for research and (3) develop recommendations for how to implement novel research and practice in this area.Methods:We conducted a collaborative workshop with an interdisciplinary group of 26 stakeholders to address our aims. Stakeholders included autistic women with experience of homelessness, researchers, health professionals, NGO representatives, and service providers.Results and recommendations:Two research priority areas were identified to map the prevalence and demographics of autistic women experiencing homelessness, and to delineate risk and protective factors for homelessness. Priority areas for improving provision of support included staff training to improve communication, awareness of autism and building trust with service providers, and recommendations for practical provision of support by services.Conclusions:Future research is critical to increase our knowledge of the pathways leading to homelessness for autistic women, and barriers to engaging with homelessness and social services. We need to use this knowledge to develop new ways of delivering targeted and inclusive support for autistic women, which could prevent or shorten periods of homelessness.

BackgroundGo-Golborne was a three-year pilot programme to test an innovative, community-based ‘whole system’ approach to preventing overweight in children in Golborne ward, London. Whilst there is a growing interest in local whole systems approaches to obesity, understandings of what they look like in practice are newly emerging. Go-Golborne was designed, implemented and evaluated within this context.MethodsThe evaluation used a case-study design and theory of change approach to assess the effectiveness of the intervention. Height/weight measurements of children in the six participating primary schools were recorded annually for 4 years. For behavioural outcomes, children aged six-11 completed four annual on-line surveys (total 4331 responses). Parents were surveyed in year one and year four (177 responses). Three focus group discussions were held with children aged 10–11 (N = 21); interviews were conducted with parents (N = 11), and school representatives (N = 4). Stakeholders were surveyed twice (37 responses), and interviews were conducted with key stakeholders (N = 11). An extensive range of programme documents were reviewed and additional process data was collected from the programme team. The RE-AIM framework was used to synthesise findings and examine public health impact.ResultsGo-Golborne reached a diverse range of partners across Golborne. Events were attended by over 3360 local children and families and all six primary schools in the ward actively engaged in activities. The proportion of children in the above healthy weight categories remained stable over time. A number of changes in home, school and neighbourhood environments to support healthy behaviour change were evidenced. There was some qualitative evidence of positive changes in children’s behaviours, though significant or sustained changes were not evidenced by the quantitative data.ConclusionsGo-Golborne helped stakeholders and parents to develop a shared commitment to improving healthy weight in children, to identify barriers to a healthy lifestyle, and to start to make changes in their services/behaviours. The campaigns and changes made at micro-level appeared to be insufficient, in the face of counteracting forces and personal factors, to achieve significant behaviour change within 3 years. This highlights the need for local initiatives to be reinforced by supporting action at regional, national and global levels.

ObjectivesTo investigate the responses to public consultation on draft guidance on interventional procedures (IP) for the UK National Health Services, and the changes made as a result of consultation.DesignRetrospective review of responses received during public consultation for 183 pieces of draft guidance, and subsequent changes made.SettingThe National Institute for Health and Care Excellence in the UK. Guidance produced December 2009–December 2014.Main outcome measuresNumbers (%) of public consultations receiving responses, and resulting changes made to draft guidance.ResultsResponses were received during 159 (86.9%) periods of public consultation, from a total of 853 people or organizations (median number per consultation 3; range 0–82; interquartile range 1–5). Changes were made to draft guidance following 136 (74.3%) consultations. These changes were to the category (2.7%) or wording (8.7%) of the main recommendation; to other recommendations (about consent, patient selection, training and future research) (31.1%); and to other sections of guidance (description of the procedure and of the evidence on its efficacy and safety) (70.5%). Additional published evidence was proffered for 22.4%. Health‐care professionals or their specialist societies were the most frequent responders to consultation (68.8%), patients or patient organizations accounted for 22.4% and medical device companies accounted for 8.8%.ConclusionsThis study shows substantial engagement with public consultation and frequent changes made to draft guidance as a result. These findings are likely to be relevant to other areas of health‐care and national policymaking that seek to be responsive to their stakeholders.

The ease of opening up a small food business in the UK, combined with training regulations for food handlers, together with the requirement to demonstrate food safety management systems may be an indication that managers need management training in addition to food hygiene training. Enforcement agencies, examination bodies and trainers could play a key part in helping managers to develop effective food safety cultures. They could encourage management, and food hygiene training and development, for small food business bosses, owners and proprietors. Some of the skills that are missing are identified and suggestions put forward that will benefit those who run small food businesses in the UK.