Yes / On the 8th of June 2017 the United Kingdom will go the polls. The NHS will be central to the campaign. This will not just be a campaign concerned about NHS funding it never really is, there are always so many other issues. However, it will be either be consciously or subconsciously about the nature of the NHS in the immediate foreseeable future.

No / Dementia is a global concern. Although effort is being put toward finding a cure, many advances have been made in ensuring excellence in dementia care. In the United Kingdom, the concept of person-centered dementia care has transformed what is expected for individuals with dementia. Now embraced in national policy in the United Kingdom, it was pioneered by Thomas Kitwood and Kathleen Bredin and driven by a con-cern for the quality of care for indi-viduals with dementia in care homes. The purpose of the current article is to describe key concepts of Kitwood’s pioneering work in person-centered dementia care and to use them to inform current community-based supports and services for individuals with dementia in their own homes, whether alone or with family carers. / Full text is unavailable due to publisher copyright restrictions.

No / Carers make a considerable contribution to the health and social care of sick or disabled people, reducing the strain on health and social care systems. This has been recognised through support mechanisms, including (in the UK) a payment for caring (Carer’s Allowance – CA). This article draws upon data from a study of carers receiving CA. Utilising a citizenship perspective, it examines respondents’ perspectives on their role in the UK and shows how CA provides not only financial support but also contributes to normative conceptualisations of citizenship. The data highlight the primacy of paid work in UK citizenship, as well as the stigma associated with receiving welfare benefits. The article concludes by claiming that changes to the UK benefit system need to take into account a ‘recognition’ aspect, reformulating what is considered a worthwhile contribution to society.

Yes / The purpose of this paper is to identify current UK screening practices prior to contrast-enhanced CT. To determine the patient management strategies to minimize the risk of contrast-induced acute kidney injury (CI-AKI) risk in outpatients. An invitation to complete an electronic survey was distributed to the CT managers of 174 UK adult National Health Service hospital trusts. The survey included questions related to local protocols and national guidance on which these are based. Details of the assessment of renal function prior to imaging and thresholds for contrast contraindication and patient management were also sought. A response rate of 47.1% was received. Almost all sites had a policy in place for contrast administration (n = 80/82; 97.6%). The majority of sites require a blood test on outpatients undergoing a contrast-enhanced CT scan (n = 75/82; 91.5%); however, some (15/75; 20.0%) sites only check the result in patients at high risk and a small number (7/82; 8.5%) of sites indicated that it was a referrer responsibility. The estimated glomerular filtration rate (eGFR) or serum creatinine (SCr) result threshold at which i.v. contrast was contraindicated varied and 19 different threshold levels of eGFR or SCr were identified, each leading to different prophylactic strategies. Inconsistency was noted in the provision of follow-up blood tests after contrast administration. The wide variation in practice reflects inconsistencies in published guidance. Evidence-based consensuses of which patients to test and subsequent risk thresholds will aid clinicians identify those patients in which the risk of CI-AKI is clinically significant but manageable. There is also a need to determine the value of the various prophylactic strategies, follow-up regimen and efficient service delivery pathways. This survey has identified that further work is required to define which patients are high risk, confirm those which require renal function testing prior to contrast administration and how best to manage patients at risk of CI-AKI. The role of new technologies within this service delivery pathway requires further investigation.

Yes / The UK Palliative Medicine Syllabus is critically evaluated to assess its relationship and relevance to contemporary palliative care policy and direction. Three criteria are employed for this review: (1) relevance to non-cancer dying, ageing, caregivers, and bereaved populations; (2) uptake and adoption of well-being models of public health alongside traditional illness and disease models of clinical understanding; and (3) uptake and integration of public health insights and methodologies for social support. We conclude that the current syllabus falls dramatically short on all 3 criteria. Suggestions are made for future consultation and revision.

Yes / To survey the diagnostic radiography workforce in the United Kingdom (UK) at an organisational level to ascertain the scope of advanced practice and compliance with Health Education England standards for multiprofessional advanced clinical practice (ACP). 174 diagnostic imaging departments were invited to participate in a cross-sectional electronic survey focused upon advanced level practice and their educational and accreditation expectations (October-December 2019). Breast imaging, computed tomography, fluoroscopy, interventional radiology, lithotripsy, magnetic resonance imaging and projectional radiography were included. A total of 97 responses were received, of which 79 were eligible for inclusion (45%). Respondents reported advanced-level practice roles across all imaging modalities, which included clinical reporting, procedural-based and combined roles. Radiograph and mammogram reporting were most prevalent (95 and 67% of Trusts), with fluoroscopy the most frequent procedure-only role (25%). Only 39% of trusts required adherence to the four pillars of ACP within job descriptions, and only 12% requiring a full Masters qualification. Diagnostic radiographer reporting and procedure-based roles in the NHS are varied and widespread. However, inconsistencies in fulfilment against the expected standards for advanced practice exist. Realignment of advanced-level roles to delineate enhanced and advanced clinical practice may ensure consistency between roles and professions. A requirement for accreditation as an advanced (clinical) practitioner with adherence to advanced practice requirements could therefore provide value to accreditation for both individual practitioners and Trusts. Within the UK, diagnostic radiographer roles previously self-identified as advanced-level practice may be termed enhanced practice when not adhering to expected ACP standards.

Yes / Rationale and Perceptions of frailty can influence how families cope, quality of life and access to support services. Yet little is known of how lay members of the UK general public perceive frailty. This scoping review aimed to explore how frailty is perceived among the lay public in the United Kingdom. Methods: The established scoping review methodology by Arksey and O’Malley was followed and searches were conducted across eight electronic databases and grey literature websites for articles published between 1990 and August 2022. In total, 6,705 articles were identified, of which six were included in the review. Data were analysed using Braun and Clarke’s thematic analysis framework. Results: Three key themes were identified; frailty as a normal part of ageing, perceived consequences of frailty and coping with frailty. Overall, frailty has negative connotations and is perceived as linked to a natural part of the ageing process, increased dependency, loss of identity and social exclusion and stigma. However, it is unclear whether these perceptions have a direct bearing on access to support services for communities. Conclusion and implications: This review identifies that it is imperative for health and social care service providers to consider the individual meaning of frailty for older people and families, to understand and integrate their particular needs and preferences when planning and delivering person centred frailty care and support. There is also a need for development of interventions that focus on increasing education and reducing stigma around frailty in order to change frailty perceptions in the UK. / This report is independent research funded by the National Institute for Health and Care Research, Yorkshire and Humber Applied Research Collaborations NIHR200166.

No / Notions of leadership change over time. The last two decades have been dominated by US models of ¿heroic¿ leadership, based largely on predominately male-biased samples, which have been focused on studies of ¿distant¿ leaders, but these are being challenged by the findings from more recent studies which question the potential dangers of adulating the few ¿gifted¿ ¿charismatic¿ individuals, not least of which because of the disasters they may cause. In addition, there is a growing interest by organisations of identifying how they can increase ¿engagement¿ amongst their employees, since this process appears to contribute significantly to organisational success. This study seeks to replicate an earlier study of ¿nearby¿ leadership in UK public sector organisations.

No / The authors present findings from the initial phase of an ongoing externally funded research project into senior executive perceptions of the impact of capital taxation upon unquoted companies incorporated in the United Kingdom. Open-ended interviews were conducted with the senior executives of six unquoted companies which are also multigenerational family businesses. The interviews guided the executives to explore the history of their company; the values and aspirations of the founding or owning family(ies); the impact of capital taxation regimes, previous and current, both on ownership and on management succession; and strategies being pursued. Using content analysis to identify key themes, the authors suggest that their findings indicate that capital taxation may have a major impact both on ownership and on management succession as well as on succession planning. However, the current capital tax regime in the United Kingdom is perceived to be more favourable than that of previous regimes and vis-aé-vis the regimes currently operating in most European countries. Capital taxation is not thought to influence strategic or operational decisions either positively or negatively. Companies use taxation-planning devices, frequently involving trusts, in order to reduce the actual burden of capital taxation falling upon individual shareholders at ownership succession. The present capital taxation regime, which includes gift relief and business asset taper relief within capital gains tax, and 100% business property relief within inheritance tax, eases succession planning. Business asset taper relief also facilitates shareholder exit strategies.

Yes / This article evaluates the British system of NVQs, focusing on their capacity to increase skill levels. It reviews the way NVQs were designed and argues that they are ill-equipped to encourage knowledge and skills, partly because they simply replicate the weaknesses which currently exist in the labour market and partly because of the focus on observed workplace behaviours. NVQs were intended to be 'employer-led' and the assumptions underpinning their design are unitarist. In contrast, the German apprenticeship system is developed and implemented by pluralist consortia and results in qualifications that are far better equipped to support skill levels.