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Background: Intraoperative neurophysiological monitoring (IOM) is a valuable adjunct for neurosurgical operative techniques, and has been shown to improve clinical outcomes in cranial and spinal surgery. It is not necessarily provided by NHS hospitals so may be outsourced to private companies, which are expensive and at cost to the NHS trusts. We discuss the benefits and challenges of developing an in-house service. Methods: We surveyed NHS neurosurgical departments across England regarding their expenditure on IOM over the period January 2018 – December 2022 on cranial neurosurgery and spinal surgery. Out of 24 units, all responded to our Freedom of Information requests and 21 provided data. The standard NHS England salary of NHS staff who would normally be involved in IOM, including physiologists and doctors, was also compiled for comparison. Results: The total spend on outsourced IOM, across the units who responded, was over £8 million in total for the four years. The annual total increased, between 2018 and 2022, from £1.1 to £3.5 million. The highest single unit yearly spend was £568,462. This is in addition to salaries for staff in neurophysiology departments. The mean NHS salaries for staff is also presented. Conclusion: IOM is valuable in surgical decision-making, planning, and technique, having been shown to lead to fewer patient complications and shorter length of stay. Current demand for IOM outstrips the internal NHS provision in many trusts across England, leading to outsourcing to private companies. This is at significant cost to the NHS. Although there is a learning curve, there are many benefits to in-house provision, such as stable working relationships, consistent methods, training of the future IOM workforce, and reduced long-term costs, which planned expansion of NHS services may provide. [ABSTRACT FROM AUTHOR]

Policy integration is considered an essential condition for constructing a more sustainable society, but proponents of sustainable development differ in their views about what is to be integrated, what is to be developed, how to link environment and development, and for how long a time. Regional spatial planning has been a locus of attempts to resolve these differences and realise policy integration, but its mechanisms to achieve this remain less explored. This study sets out to meet three objectives as follows: (1) to identify, through a systematic literature review, a broad set of mechanisms by which (regional) spatial planning realises joined-up policy making; (2) to illustrate the identified mechanisms in two distinct spatial planning systems, Germany and England; and (3) to generate insights into factors that contribute to, and confine, the identified mechanisms. The findings identify five integrating mechanisms of spatial planning that could inform plan making, analysis and monitoring and provide lessons about the potential and constraints of these mechanisms in different social, institutional and political contexts. [ABSTRACT FROM AUTHOR]

The Regional Authority Index emphasizes the emergence of sub-national regions in Europe at the expense of central government but this does not chime with dynamics of regional governance in England. Seeing governance as a construct of the central state for masked steering of sub-national democratic establishments whose 'side-effects' (new political identities) are then addressed by the central state through a cyclical rescaling of governance, we explore this inconsistency. Our centennial review of sub-national governance in England challenges the concept of networked polity whereby the unconditional role of the state is to empower stakeholders and facilitate cooperation amongst them. Although sub-regional governance currently seems to have become a cross-party approach to local management, the central state may continue to promote alternative governance scales in the future to (I) break down resultant sub-regional political identities threatening central policy; and (II) maintain its influence on local governments in relation to economic objectives. [ABSTRACT FROM AUTHOR]

The most common type of pancreatic cancer is pancreatic adenocarcinoma, which affects the exocrine ducts. There are many risk factors associated with pancreatic cancer, including smoking, obesity, poor diet, diabetes, inactivity and genetics. In the UK, pancreatic cancer is the 10th most common cancer with a poor prognosis, with only 24% of people surviving the first year after diagnosis and 7% surviving for 5 years. The lives of those with the condition are impacted in a number of ways. This case study of a patient with pancreatic cancer explores the nursing assessment, management and evaluation of care provided from a student nurse perspective under the supervision of a qualified nurse. [ABSTRACT FROM AUTHOR]

This study questions if abstract regional planning strategies are fit to respond to changing societal and political conditions. We compare regional planning strategy making in North West England. Findings suggest that abstract strategies are more effective in building than managing transformative discourses. Results show that: (I) transformative discourses need to be built around manageable regional socio-spatial and spatial-economic disparities; (II) policy entrepreneurs should be targeted with equal consideration for power and counterpower; and (III) the regional planning authority should have access to specific funding schemes. It is our ultimate aim to re-energize strategic regional planning debates in England and beyond. [ABSTRACT FROM AUTHOR]

In the UK, the Labour government (1997–2010) introduced various experiments to uplift English regional and sub-regional spatial strategy to a more prominent position in sub-national governance but much of this has been subsequently guillotined by the incoming Coalition government in May 2010. This paper assesses the prospect for the survival of strategic spatial thinking under the Coalition government's ethos of ‘localism’. It first considers some of the broad conceptual issues relating to strategic spatial planning, identifying three key conundrums around flexibility of scaling, institutional structures and capacity, and core values and forms of knowledge. It then provides one of the first comprehensive accounts of what was achieved during the outgoing Labour administration, and what ultimately went wrong with the English regional planning project. Finally, an initial assessment is made of the future prospects for strategic planning in England to survive in new spatial contexts, despite the hostile conditions associated with the Coalition government. [ABSTRACT FROM AUTHOR]

This article examines the experience of operationalising the housing market area (HMA) framework in England and reflects on the value of adopting HMAs in strategic planning of housing. The paper argues that the operationalisation of HMAs in the English regions has been a challenging exercise, but that HMAs have the potential to frame the development of housing market intelligence and to underpin the analysis of housing market functionality at sub-national level. The challenge for policy and practice lies in harnessing this evidence-framing and analytical potential more effectively than has been the case to date. [ABSTRACT FROM AUTHOR]

The adoption of administrative boundaries as approximations of housing markets has long restricted the scope for housing market analysis and planning policy development to be undertaken within a functional housing market framework in England. This has prompted consideration of the value of deriving housing market areas (HMAs) to underpin the development of housing market intelligence for planning and policy purposes. Drawing on a case study of North West England, this paper critically reviews alternative approaches that have been used to define HMAs. The review highlights that in practice technical and methodological constraints have restricted the operationalisation of an idealised conceptualisation of HMAs. [ABSTRACT FROM AUTHOR]

The authors discuss aspects of plan making for local and regional spatial strategies in England which gained distinction as the most downloaded paper for 2010-2011. They focus on the issues relating to participation and involvement of stakeholders in plan making in line with the coalition government and neighborhood plans. The authors hope that their finding can assist in the decision-making and planning of practitioners in the government.

In 2004 the English planning system was subject to extensive reforms which introduced a 'spatial planning' approach that goes beyond traditional land-use planning in integrating policies for the development and use of land with other policies and programmes which influence the nature of places. At the regional level, regional planning guidance was replaced by regional spatial strategies (RSSs) and, at the local level, existing local land-use planning documents were replaced with a portfolio of documents that make up the new local development framework (LDF). Together, the LDF and RSS make up the statutory development plan for an area. At the heart of the new spatial planning reforms is a heightened emphasis on stakeholder and community involvement. This paper brings together research at two different spatial scales. The 'Spatial Plans in Practice' study examined stakeholder involvement in LDF preparation across England. Parallel research examined the experience of stakeholders in the formation of the North West RSS. Drawing on this empirical base, we examine experiences of stakeholder involvement in the reformed spatial planning system and discuss the implications for the future. [ABSTRACT FROM AUTHOR]

This paper examines the delivery of infrastructure requirements related to the plan-making (LDF) process in England introduced as part of the 2004 planning system reforms. Success or otherwise in terms of plan implementation and infrastructure delivery is crucial if the reformed spatial planning system is to be successful. The paper draws on research undertaken as part of a government-sponsored research project into the operation of the new LDF process. The research reveals a significant gap between government expectations and current practice. It suggests that longer-term commitments by central government, alongside improved understanding of the spatial planning process and the role of local government as part of a continued drive for 'culture change' among local planning authorities and delivery partners, will be required if the current barriers to the delivery of infrastructure are to be overcome. Otherwise, the new-style LDFs are as likely to be plagued by implementation gaps as were their predecessors. [ABSTRACT FROM AUTHOR]

Set within a general discussion of the characteristics of sub-regional planning and development, this paper reports the results of recent research on the proposed arrangements for strategic planning at regional and sub-regional levels in the English regions. It also examines the characteristics of strategic planning at regional and sub-regional levels in Scotland and Wales. Specific consideration is given to the advantages and disadvantages associated with sub-regional strategic planning and to a number of key issues, including — the scope and coverage of sub-regional planning; the appropriate spatial scale for sub-regional planning; the coordination or integration of and use, economic development, environmental management and ot her issues at sub-regional level; the institutional and organisational dimensions of sub-regional planning, management and governance; the remits, roles and methods of collaboration between the various bodies involved in sub-regional planning; and the issues of accountability, participation and stakeholder engagement. A final section of the paper briefly considers the lessons that can be used to help to introduce a more efficient and effective system of sub-regional planning in the English regions. [ABSTRACT FROM AUTHOR]

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Structure Plan appraisal reports provide valuable insights into the appraisal practices of English county councils. This paper presents the findings of an examination of evidence of the inclusion of a number of key good practice appraisal elements within 40 Structure Plan appraisal reports. The results are used to provide an assessment of the 'process quality' of Structure Plan appraisal practice since 1995. The methodological requirements of the European SEA Directive, which will soon apply to Structure Plans, provide a useful context for discussing the results of this study. The perspectives of relevant experts concerning good practice appraisal techniques are used as a further benchmark from which to draw conclusions. The results of the examination suggest that the process quality of Structure Plan appraisals falls short of meeting the methodological requirements of the Directive, and of experts, perspectives of good practice appraisal procedures. Several reasons are proposed to explain this situation, centring on the political nature of decision making in this sector. Although based around an examination of Structure Plan appraisal reports, the results of this study provide insights relevant to the appraisal of strategic planning documents more generally. [ABSTRACT FROM AUTHOR]

This paper examines the process of establishing a coastal forum in the North West region of England. The North West Coastal Forum is one of the first attempts at the establishment of a regional forum in England and is especially notable for the role played by the Government Office for the North West in its formation. The paper examines the relationships between the key agencies involved and, in particular, the key role played by the Government Office for the North West in promoting and establishing the forum and how this has influenced its organization, structure and composition. It provides a critical analysis of the apparent and potential strengths and weaknesses of the forum as an example of a partnership approach to the planning and management of coastal issues in the North West. The conclusions are not only of relevance to the future development of the forum within the North West of England, and to the potential establishment of similar coastal fora elsewhere, but are also of much broader interest as a case example of the development of institutional capacities and collaborative partnership approaches to planning issues at the regional level in the wider context of the changing nature of regional governance in the UK and the enhanced 'regional partnership' role being embraced by the government offices for the regions. [ABSTRACT FROM AUTHOR]

Presents information on a study reviewing the Regional Planning Guidance (RPG) by the Secretary of State of England. Details on the position of English RPG; Discussion on the re-emergence of regional planning in England; Trends in regional planning.

This study identifies three types of legitimation from the literature that can be applied within metropolitan governance in the contested sphere of spatial planning: input legitimation, throughput legitimation, and output legitimation. The reason for discussing different forms of legitimation within metropolitan governance is that, globally, only a relatively few metropolitan regions are governed directly through a single elected tier of government such as a regional council. Thus, governance mechanisms in most metropolitan regions involve some form of joint working or cross border governance initiatives that have to be legitimized in the absence of a single overarching elected council covering the whole metropolitan area. The main question discussed in this paper is, therefore, whether all three types of legitimation identified are utilized to legitimize governance mechanisms at the metropolitan scale with a specific focus—as a core part of metropolitan governance—on spatial planning processes and projects. In conceptual terms, our typology structures fuzzy lines of legitimation across the three (the "how", "who" and "what") suggested aspects of metropolitan governance in the literature. From this point, we draw on cross-case reviews of variables involved in the design, application, and outcome of input, throughput, and output legitimation in Germany and England, chosen because neither has a formal tier of metropolitan-wide government despite their differences in terms of their highly regionalised and highly centralised national government contexts respectively. This relational methodology helps us to learn about the contextual dynamics of how the three types of legitimation might reinforce one another in different international settings, leading to the overall conclusion that they will work best in combination, although output legitimation has a distinctive capacity to work in less formal settings. [ABSTRACT FROM AUTHOR]

This study of central government intervention within the statutory plan-making process in six English regions reveals a range of mechanisms through which this takes place. Such intervention has become much more rigorous since the introduction of the plan-led system in the early 1990s and has tended to become embroiled in matters of detail. Departures from national policy principles are almost always resolved without having to use reserve powers of direction and call-in. This raises questions over the purpose of development plans and suggests that the inherent centralisation of the planning system, witnessed in the 1980s, may still be strong today. [ABSTRACT FROM AUTHOR]

In September 1997 the European Centre for Medium Range Weather Forecasting in Reading, England held a workshop on Seamless Computing. Attending the workshop were more than fifty pre-eminent researchers and developers of systems and applications that required the use of high-performance distributed systems. The problem was, and is, how we integrate resources of widely varying capabilities connected by potentially unreliable networks and often located in different administrative domains. It became apparent at the workshop that there was a need to look at extensible frameworks that could be used to define the interfaces and interoperability layers between the disparate services available within such a wide-area environment.