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Horses in Great Britain are living into increasingly older age and are often regarded as friends or family members by their owner. The horse is reliant on their owner to meet their needs and this paper discusses how horse owners frame an issue that becomes a matter of veterinary concern within the context of the older horse. Qualitative methods were used to explore the experiences of owners and veterinarians. Data were collected and analysed using a grounded theory approach during the period 2019-2022. Analysis identified that owners undertook an ongoing and iterative process of assessment, monitoring and decision making in relation to the animal and any changes they observed. Matters that became a veterinary concern required the owner to formulate the issue as something that fell within the knowledge domain of the veterinarian. Veterinarians had a medicalised view of older horse health and their perspectives on socially acceptable care were shaped by their understanding of speciesspecific needs, and whether owners were providing appropriately for those needs. The formulation of a matter of veterinary concern was itself shaped by an owner's experiential knowledge of both veterinary matters and their horse. The extent to which owners felt like they and their individual horse mattered during interactions with veterinarians affected whether they adopted veterinary advice and the nature of future veterinary employment. Findings demonstrate how matters of health, disease, and the role of professionalised forms of medical knowledge, are not static but constantly changing and interacting over time. An issue that became a matter of veterinary concern was contextual, and rooted in individual relationships. The significance of veterinarian-owner interactions in shaping future consumption of veterinary health care may be underestimated. [ABSTRACT FROM AUTHOR]

Introduction: To meet the ambition of the UK becoming the global leader in health technology, the future workforce needs to have a developed digital literacy. The influence of the COVID-19 pandemic on the move to online learning has also increased the requirement for a reinvention of traditional teaching methodologies (Sá & Serpa, 2020). Methodology: A systematic review was conducted using a mix of Boolean search terms in twelve education and health journal databases to discover the extent of current international research of digital literacy in health programmes. Papers were selected for their specificity to digital literacy in health education pre-registration professional programmes. Results: The initial search included 5359 papers, 3925 after duplicates removed, 134 remained after title review which were then input into Covidence for full reading, finally 47 papers being included for thematic analysis. This thematic analysis identified a number of key themes within these papers: digital literacy of the educator, digital literate workforce, technical skills limit adoption, information literacy, a curriculum requirement in education, institutional infrastructure or personal access, preparedness for entering academia, concerns over the use of digital skills, personalised digital literacy experience, increased communication skills with digital literacies, competency frameworks, COVID-19 and social media in education. Conclusion: This research identifies areas of good practice and areas that need to be considered in higher education programmes and by academics to ensure the digital literacy of the future healthcare workforce. [ABSTRACT FROM AUTHOR]

People with intellectual disabilities face health disparities, including in high‐income countries such as the United Kingdom, despite publicly funded healthcare. This paper describes the healthcare system in England (a nation of the United Kingdom) for the general population, and more specifically for people with intellectual disabilities. Key legislation that impacts the lives of people with intellectual disabilities, such as the UK Equality Act 2010 (https://www.legislation.gov.uk/ukpga/2010/15/contents), the Mental Capacity Act 2005 (https://www.legislation.gov.uk/ukpga/2005/9/contents), and the UN Convention on the Rights of Persons with Disabilities, and its implementation in the United Kingdom, is discussed. The role of deinstitutionalization and the shift to living in the community for people with intellectual disabilities is also discussed. Programmes that have been implemented to address the health disparities experienced by people with intellectual disabilities are reviewed. Finally, the recent changes to healthcare organization in the UK, the COVID‐19 pandemic, and the implementation of the Valuing People white paper are discussed. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to report on research undertaken in an National Health Service (NHS) emergency department in the north of England, UK, to identify which patients, with which clinical conditions are returning to the emergency department with an unscheduled return visit (URV) within seven days. This paper analyses the data in relation to the newly introduced Integrated Care Boards (ICBs). The continued upward increase in demand for emergency care services requires a new type of "upstreamist", health system leader from the emergency department, who can report on URV data to influence the development of integrated care services to reduce further demand on the emergency department. Design/methodology/approach: Patients were identified through the emergency department symphony data base and included patients with at least one return visit to emergency department (ED) within seven days. A sample of 1,000 index visits between 1 January 2019–31 October 2019 was chosen by simple random sampling technique through Excel. Out of 1,000, only 761 entries had complete data in all variables. A statistical analysis was undertaken using Poisson regression using NCSS statistical software. A review of the literature on integrated health care and its relationship with health systems leadership was undertaken to conceptualise a new type of "upstreamist" system leadership to advance the integration of health care. Findings: Out of all 83 variables regressed with statistical analysis, only 12 variables were statistically significant on multi-variable regression. The most statistically important factor were patients presenting with gynaecological disorders, whose relative rate ratio (RR) for early-URV was 43% holding the other variables constant. Eye problems were also statistically highly significant (RR = 41%) however, clinically both accounted for just 1% and 2% of the URV, respectively. The URV data combined with "upstreamist" system leadership from the ED is required as a critical mechanism to identify gaps and inform a rationale for integrated care models to lessen further demand on emergency services in the ED. Research limitations/implications: At a time of significant pressure for emergency departments, there needs to be a move towards more collaborative health system leadership with support from statistical analyses of the URV rate, which will continue to provide critical information to influence the development of integrated health and care services. This study identifies areas for further research, particularly for mixed methods studies to ascertain why patients with specific complaints return to the emergency department and if alternative pathways could be developed. The success of the Esther model in Sweden gives hope that patient-centred service development could create meaningful integrated health and care services. Practical implications: This research was a large-scale quantitative study drawing upon data from one hospital in the UK to identify risk factors for URV. This quality metric can generate important data to inform the development of integrated health and care services. Further research is required to review URV data for the whole of the NHS and with the new Integrated Health and Care Boards, there is a new impetus to push for this metric to provide robust data to prioritise the need to develop integrated services where there are gaps. Originality/value: To the best of the authors' knowledge, this is the first large-scale study of its kind to generate whole hospital data on risk factors for URVs to the emergency department. The URV is an important global quality metric and will continue to generate important data on those patients with specific complaints who return back to the emergency department. This is a critical time for the NHS and at the same time an important opportunity to develop "Esther" patient-centred approaches in the design of integrated health and care services. [ABSTRACT FROM AUTHOR]

Background: Over half the population (51%) of England and Wales is female, most of whom will experience menopause, either as a result of endocrine ageing or medical treatment. Aim: The project aimed to undertake a review of the literature to determine the level of knowledge about menopause that healthcare students are exposed to, and to highlight why it is important for them to have an understanding of this subject both for their own clinical practice and for supporting colleagues in the workplace. Method: A literature review was conducted by the project team. Findings: There is a lack of education for healthcare students, who will go on to care for those affected by menopause, and will also work with colleagues experiencing menopause. Conclusion: Educational programmes should include menopause as a component, which will allow for a breaking down of barriers on a subject that is still generally considered taboo. Recommendations: A national audit should be conducted on menopause coverage in UK pre-registration nursing. The addition of menopause to the Liverpool John Moores University pre-registration nursing curriculum is also recommended based on agreed competencies. [ABSTRACT FROM AUTHOR]

Objective: To understand the impact of the UK Clinical Librarian (CL) workforce and benchmark the results against a study undertaken in the North West region of the English National Health Service (NHS). Methods: An online survey was distributed by CLs to their service users regarding literature searches that had been carried out on their behalf in the 6 months from April to October 2017. Interviews were later carried out in person with selected respondents to the questionnaires. Results: CLs across the UK contribute to a wide range of outcomes, with 41% of search requests contributing to the choice of intervention, and 41% also to the advice offered by the clinician requester to a patient or their carer. These results are in line with the previous work undertaken in the North West. Discussion: CLs provide diverse services to clinical teams. They support the continuing professional development and personal research needs of team members, service development needs of organisations, and the information provided contributes to improved quality and safety of patient care. Conclusion: The survey confirms the findings of the earlier NW study. It demonstrates the impact of services based around literature searching on patient care. [ABSTRACT FROM AUTHOR]