This article discusses the energy and aggressiveness of the campaigns against mitigating transmission of Covid-19 during the pandemic, and especially against vaccination. These campaigns have brought anti-vaxx sentiments into the limelight with a vengeance. The aim of the article is to seek a better understanding of the forms that the contemporary anti-vaxx movements can take and what is fuelling them. It has three parts. The first describes recent anti-vaxxer actions in the UK, France, Austria and Canada, highlighting the siege of Ottawa. The second part draws on the history of anti-vaxx movements in the UK and the USA for insights into their militancy; and in the third part there is an exploration of ideas about what makes anti-vaxx platforms so attractive and who is drawn towards them. Countering anti-vaxxer propaganda requires an understanding of the pathways by which the information spreads. False narratives will move from anti-vaccine echo chambers to mass audiences via social-media sharing, as well as coverage in local and mainstream media. Countering this misinformation all along the pathway requires a whole-of–society effort that is multifaceted, tolerant of short-term setbacks, and persistent even in challenging conditions. The NHS faces the whole of society. Could it, in its present state, be the vehicle for engaging the anti-vaxxer movements?
AbstractThe implementation in England of a Social Care Workforce Race Equality Standard (SCWRES), initially confined to social work, started with a first set of eighteen volunteer local authorities (LAs) in 2021. This article discusses a rapid evaluation of the SCWRES during its first year. We used Normalization Process Theory (NPT) to better understand the implementation process of this initiative. Thirty-one interviews were undertaken in 2021. Transcripts were analysed using the constant comparative approach and emerging themes were then mapped onto the NPT framework and its four main constructs. Using these we found some lack of clarity over the aims and data demands of the SCWRES (coherence), but generally substantial personal and employer investment in the intervention (cognitive participation); implementation was assisted by personal support to the LAs from senior managers at national level (collective action); and there was general constructive reflection and positive feedback about the SCWRES (reflexive monitoring). Barriers to implementation of new initiatives might be expected during a global pandemic. However, support for the SCWRES was generally high and participants considered they had learned much in its first six months despite pandemic pressures. This article highlights aspects of implementation to be addressed in any further SCWRES rollout.
Drawing on insights from psychology, psychoanalysis, cultural studies, health economics and medical ethics, this article explores two linked aspects of the management of the Covid-19 pandemic during its first and second waves in the UK. The first aspect is the range of cognitive and emotional responses to the imminent collapse of authority early in the crisis, and how these played out in public and private. Ultimately, the NHS fallback response was the 'Rule of Rescue', the requirement to rescue identifiable individuals in immediate peril, regardless of the cost. The second aspect is the meaning of heroism in the context of this pandemic. This includes the Clap for Carers initiative - and its function as an endorsement of others' deeds; the use of war imagery and war resources in mobilising against the infection; and the possibilities for different objects of applause to appear when seen from different standpoints. Linking these two aspects together we argue that the potential collapse of authority helps explain responses that seek heroes in the war against the virus and see war strategy and tactics as deserving of our support. We also ask what will remain of the pandemic in public memory.
In: Child abuse & neglect: the international journal ; official journal of the International Society for the Prevention of Child Abuse and Neglect, Band 116, S. 104739
Purpose The COVID-19 pandemic has shone a light on long-standing, structural race inequality in Britain. This paper aims to review historic patterns of ethnic diversity among the workforce employed in services for older people to present some of the lessons that can be learned from the pandemic.
Design/methodology/approach A historical overview was undertaken of research about ethnic diversity in the social care workforce.
Findings Too often, the ethnic diversity of the social care workforce has been taken as evidence that structural racial inequalities do not exist. Early evidence about the impact of coronavirus on workers from black and minority ethnic groups has led to initiatives aimed at reducing risk among social care employers in the independent sector and in local government. This offers a blueprint for further initiatives aimed at reducing ethnic inequalities and promoting ethnic diversity among the workforce supporting older people.
Research limitations/implications The increasing ethnic diversity of the older population and the UK labour force highlights the importance of efforts to address what is effective in reducing ethnic inequalities and what works in improving ethnic diversity within the social care workforce and among those using social care services for older people.
Originality/value The ethnic makeup of the workforce reflects a complex reality based on multiple factors, including historical patterns of migration and gender and ethnic inequalities in the UK labour market.
Purpose The purpose of this paper is to explore how any proposed Women's Health Strategy could address the needs of women affected by dementia in England.
Design/methodology/approach The authors take the following three perspectives: women living with dementia, female carers and female practitioners supporting people with dementia.
Findings In this paper, the authors explore the current evidence about dementia and female gender under three main strands relating to policy and practise.
Originality/value There is worldwide interest amongst policy communities in gender inequalities.
PurposeThis purpose of this paper is to review evidence about the barriers and facilitators to ex-service personnel obtaining employment within social care roles. Social care has long-standing, well-recognised problems of staff recruitment and retention. Policymakers and employers are exploring if there are untapped sources of potential employees. Some ex-service personnel may be interested in exploring a move to social care work with older people but may face barriers to such a move which may need to be addressed.Design/methodology/approachDatabases and grey literature were searched systematically to provide an overview of evidence on this topic. In total, 23 articles were included in the review.FindingsA narrative analysis revealed barriers to ex-service personnel obtaining employment within social care not only related to their previous occupation, health status and identity but also facilitators related to the sector's severe recruitment challenges and the transferable skills of ex-service personnel. Evidence suggests that learning from health services may be highly relevant and transferable.Research limitations/implicationsThis review was confined to English language studies published between 2008 and 2018. Few mentioned specific user or client groups.Originality/valueThis review identified evidence suggesting that learning from health services may be highly relevant and transferable to the social care sector so as to facilitate the transition of more ex-service personnel into social care work with older people.
Purpose This paper presents the results of a thematic analysis of safeguarding adults reviews (SARs) where homelessness was a factor to illuminate and improve safeguarding practice and the support of adults who are homeless in England.
Design/methodology/approach SARs were identified from a variety of sources and a thematic analysis was undertaken using data extraction tables.
Findings In addition to identifying shortcomings in inter-agency co-operation, SARs highlighted a failure to recognize care needs and self-neglect among people with experience of homelessness and evidenced difficulties in engagement between professionals and people with experience of homelessness.
Research limitations/implications The authors may have failed to find some SARs in this category (there is no central registry). SARs vary in quality and in detail; some were not full reports. The approach to people's experience of homelessness was broad and covered more than the circumstances of people who were rough sleeping or living on the streets.
Originality/value This paper contributes to the current practice debates and policy initiatives in respect of homelessness and safeguarding in England. It may have wider relevance in the rest of the UK and internationally.
Purpose Advanced care planning (ACP) involves the discussion of preferences relevant to a possible future time when one's ability to make decisions may be compromised. ACP is considered as having potential to enhance choice and control and thereby to improve the experience of care for people with dementia and their carers. Care coordinators have been highlighted as possibly playing a central role in facilitating these discussions among people with long-term care needs. However, there is limited evidence of how ACP is facilitated by community mental health professionals who may be supporting people with dementia and carers. The paper aims to discuss this issue.
Design/methodology/approach This exploratory study took the form of qualitative semi-structured interviews to explore the views and experiences of community mental health professionals when discussing ACP with people with dementia and/or their carers. A convenience sample of 14 participants working in community mental health services in one NHS Mental Health Trust in London, England, was recruited and interview data were analysed using a framework approach.
Findings Five themes emerged from the interviews – knowledge and experience, use of ACP, inhibitors of discussion, service influences and the future. The depth of ACP facilitation appeared dependent on the knowledge, confidence and skills of the individual professional. Limited resources leading to service rationing were cited as a major barrier to ACP engagement. Helping people with dementia and their carers with ACP was not viewed as a priority in the face of competing and increasing demands. A further organisational barrier was whether ACP was viewed by service managers as "core business". Findings indicate that practice was generally to refer people with dementia to other agencies for ACP discussions. However, pockets of ACP practice were reported, such as explaining proxy decision making options for finances.
Research limitations/implications This exploratory study took place in the community mental health services in one NHS Mental Health Trust that may not be representative of other such teams. Case records were not scrutinised or clinical conversations with people with dementia or carers.
Practical implications Barriers to initiating ACP discussions were cited, such as limited resources, lack of time and knowledge; unclear role remit, uncertain service direction and poor documentation sharing processes. However, participants held a common belief that ACP for people with dementia is potentially important and were interested in training, a greater team focus on ACP and pathway development. This indicates the potential for staff development and continuing professional development.
Originality/value Few studies have asked a wide range of members of community mental health services about their knowledge, skills and confidence in ACP and this study suggests the value of taking a team-wide approach rather than uni-professional initiatives.
Purpose The purpose of this paper is to review evidence about the role of education in supporting ex-service personnel to move to social care work with older people. Social care has long-standing, well-recognised problems of staff recruitment and retention in many jurisdictions. Within ageing societies, the need for more social care staff is predicted to rise. Therefore, policy makers and employers are exploring if there are untapped sources of potential employees. Some ex-service personnel may be interested in exploring a move to social care work with older people but may need to gain additional qualifications.
Design/methodology/approach Databases and grey literature were searched systematically to provide an overview of the evidence on this topic. Six articles were included in the review.
Findings A narrative analysis revealed two themes: preparing ex-service personnel for enrolment onto health and social care programmes, and supporting ex-service personnel during health and social care programmes.
Research limitations/implications This review was confined to English language studies published between 2008 and 2018. Few mentioned specific user or client groups.
Originality/value This review identified evidence gaps relating to whether the skills, education, training and experience gained in the armed services are transferable to civilian social care work with older people; the types of support which are offered to ex-service personnel who are interested in completing qualifications necessary for social care roles and the views of ex-service personnel about their experiences of completing educational courses to facilitate a transition into social care work with older people.
Purpose The Cameos of Care Homes project is an opportunity to use the medium of film to showcase the experiences and reflections of frontline care home staff whose employers participated in the National Health Service (NHS) England Vanguard programme. Reflecting on their involvement in one of the Enhanced Health in Care Homes Vanguards, 12 staff describe, in front of the camera, the impact on themselves and their colleagues, on their care for their older residents, and on the wider culture of the care home. The paper aims to discuss this initiative.
Design/methodology/approach The paper reports the experiences of care home staff that were purposefully recorded on film about their participation in a care home Vanguard. The recruitment of the care homes and staff is described, as are the development of interview questions and approaches needed when filming is considered as a research method.
Findings Participating care home staff reported that their involvement in the Vanguard programme had improved knowledge, confidence, morale, communication skills and the homes' learning cultures. They were enthusiastic about reporting their experiences on film. Examples were given of proactive early support from local NHS staff leading to improvements in care, thereby reducing demand on the NHS. However, participation was resource intensive for care homes. Care home staff hoped the support that accompanied the Vanguard programme would continue but were uncertain to what degree this would happen once the Vanguard programme ceased.
Research limitations/implications The interviews were undertaken with a self-selecting group of care home staff from two care homes operating in one of the six Vanguard sites in England. By their very nature, interviews for a public film cannot provide anonymity.
Practical implications Researchers seeking the views of care home staff may wish to consider filming interviews and presenting the film as a research output that is engaging and informative for care home and wider audiences.
Originality/value The paper presents an analysis of filmed interviews with care home managers and care workers working with older people. Their views on the Vanguard initiative have not been widely considered, in contrast to the sizeable literature relating to NHS activity and expenditure.
Purpose The purpose of this paper is to examine safeguarding adults reviews (SARs) that refer to mental health legislation in order to contribute to the review of English mental health law (2018).
Design/methodology/approach Searches of a variety of sources were conducted to compile a list of relevant SARs. These are summarised and their contexts assessed for what they reveal about the use and coherence of mental health legislation.
Findings The interaction of the statutes under consideration, in particular the Mental Health Act (MHA) 1983, the Mental Capacity Act (MCA) 2005, together with the Care Act 2014, presents challenges to practitioners and the efficacy of their application is variable.
Research limitations/implications In light of the absence of a duty to report SARs to a national register, it is possible that relevant SARs were missed in the search phase of this research, meaning that the results do not present a complete picture.
Practical implications Examining cases where use of legislative provisions in mental health has been found wanting or legislation may not be easily implemented may inform initiatives to increase understanding of the law in this area.
Originality/value This paper's originality and value lie in its focus on mental health legislation as discussed in SARs at a time when both the MHA 1983 and the MCA 2005 are the focus of attention for reform.
