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Purpose:The purpose of this paper was to capture carers' views of a service in Bristol funded jointly by the Local Authority and the NHS Clinical Commissioning Group, which offers support to carers in the form of a one-off payment which they can use for anything they choose. Design/methodology/approach: A multi-method evaluation of this integrated service was conducted between August 2012 and October 2013 to explore its impact on carers' health and well-being. This paper presents findings from 40 interviews conducted with carers as part of the evaluation. Findings: Many carers have little respite from very stressful situations; the break enabled them to focus on their own needs. Carers' needs included actual short breaks away with or without those being cared for, as well as items like household equipment or exercise classes. Research limitations/implications: The study was centred on an innovation and integrated approach to support carers in one city and provides a snap-shot of the short-term effects. Longer lasting effects are not known. Social implications: Most carers found the support beneficial, and in some cases reported a positive effect on their own health and well-being. Effective inter-agency communication and collaboration is essential for the success of the integrated service. Originality/value: There is limited research available on the outcomes of integrated approaches to support carers. [ABSTRACT FROM AUTHOR]

A longitudinal quantitative study in an English faculty of health and social care explored the effects of a pre-qualifying interprofessional curriculum for students from 10 professional programmes. Students on the interprofessional curriculum completed questionnaires containing four attitude scales on entry to the faculty, during their second year and at the end of their final year. At qualification, 581 students (76.9% of those qualifying) completed scales concerning their communication and teamwork skills, their attitudes towards interprofessional learning, their perceptions of interaction between health and social care professionals, and their opinions about their own (inter)professional relationships. Questionnaires were completed at both entry and qualification by 526 students (69.8% of those qualifying), and at all three points by 468 students (61.9% of those qualifying). A comparison group of 250 students (67.6% of those qualifying) on the previous uniprofessional curricula also completed questionnaires at qualification. Students on the interprofessional curriculum showed no significant change in their self-assessment of their communication and teamwork skills between entering the faculty and qualification. However, there was a negative shift in their attitudes to interprofessional learning and interprofessional interaction. Nevertheless, most students were positive about their own professional relationships at qualification. Students with previous experience of higher education were comparatively positive about their communication and teamwork skills, as were female students about interprofessional learning. However, the strongest influence on students’ attitudes at qualification appeared to be professional programme. This suggests that interprofessional education does not inhibit the development of profession-specific attitudes. Students who qualified on the interprofessional curriculum were more positive about their own professional relationships than those who qualified on the previous uniprofessional curricula. These data suggest that experiencing an interprofessional curriculum has an effect on students’ attitudes at qualification, particularly with regard to their positive perception of their own professional relationships. [ABSTRACT FROM AUTHOR]

The aim of this study was to establish the extent of use of complementary therapies in the maternity services in England and to determine the views of heads of midwifery to the integration of these therapies into midwifery practice. The questionnaire was sent to 221 heads of midwifery in all NHS maternity units in England. A response rate of 75% was achieved. Sixty four percent of the maternity units who responded provided a complementary therapy service in a variety of combinations to mothers, babies and staff. However, only 9% provided a service to all three groups. The four therapies offered most widely were massage, aromatherapy, reflexology and acupuncture. Attitudes were positive with 70% of respondents convinced of the benefits and 94% believing it important for them to be available in the NHS. Respondents felt that complementary therapies had an important role, particularly in relation to increasing consumer satisfaction, promoting normal childbirth, decreasing medical intervention and increasing midwives' job satisfaction. [ABSTRACT FROM AUTHOR]

This paper presents the initial findings from a longitudinal quantitative study of two cohorts of students who entered the 10 pre-qualifying programmes of the Faculty of Health and Social Care, University of the West of England (UWE), Bristol, UK. The overall aim of the study is to explore students' attitudes to collaborative learning and collaborative working, both before and after qualification. On entry to the faculty, 852 students from all 10 programmes completed the UWE Entry Level Interprofessional Questionnaire, which gathered baseline data concerning their self-assessment of communication and teamwork skills, and their attitudes towards interprofessional learning and interprofessional interaction. Comparative analysis of these data was undertaken in terms of demographic variables such as age (i.e. older or younger than 21 years), experience of higher education, prior work experience and choice of professional programme. The results indicate that most students rated their communication and teamwork skills positively, and were favourably inclined towards interprofessional learning, but held negative opinions about interprofessional interaction. Some student groups differed in their responses to some sections of the questionnaire. Mature students, and those with experience of higher education or of working in health or social care settings, displayed relatively negative opinions about interprofessional interaction; social work and occupational therapy students were particularly negative in their responses, even after adjustment for confounding demographic variables. The paper concludes by considering the implications of the findings for interprofessional educational initiatives and for professional practice. [ABSTRACT FROM AUTHOR]

Objectives: To establish how quality indicators used in English community nursing are selected and applied, and their perceived usefulness to service users, commissioners and service providers., Methods: A qualitative multi-site case study was conducted with five commissioning organizations and their service providers. Participants included commissioners, provider organization managers, nurses and service users., Results: Indicator selection and application often entail complex processes influenced by wider health system and cross-organizational factors. All participants felt that current indicators, while useful for accountability and management purposes, fail to reflect the true quality of community nursing care and may sometimes indirectly compromise care., Conclusions: Valuable resources may be better used for comprehensive system redesign, to ensure that patient, carer and nurse priorities are given equivalence with those of other stakeholders.

It is widely assumed that interprofessional learning (IPL) impacts positively on interprofessional working (IPW) in health and social care. However, there is no clear evidence that pre-qualifying IPL improves service delivery. The direct effect of pre-qualifying IPL on IPW and service delivery is difficult to demonstrate; researchers must rely on professionals' self-report in this regard. This paper presents findings from a qualitative study in which semi-structured interviews were used to collect individuals' views and perceptions about pre-qualifying IPL as preparation for practice. Two groups of participants came from four health and social care professions: adult nursing, midwifery, physiotherapy and social work. One group had experienced a substantial pre-qualifying IPL initiative, while the other group had not. Useful insights were gained from comparing the views and perceptions of individuals from these two groups. The total sample comprised 29 practitioners: 19 were educated on interprofessional curricula and 10 on traditional uniprofessional curricula. Thematic data analysis produced findings about pre-qualifying education as preparation for IPW. These findings suggest that pre-qualifying IPL can prepare individuals to work effectively as qualified professionals with colleagues from other disciplines and that effective IPW impacts positively on service delivery.

Background: poor relationships between maternity care professionals still contribute to poor outcomes for childbearing women, although issues concerning power, gender, professionalism and the medicalisation of birth have been identified and discussed as germane to this situation for nearly three decades. Although power relationships and communication issues are known to affect the way maternity care professionals in the UK work together, there has been no study of the interplay between these factors, or of how semiotic aspects of professionals' communication relate to it., Aim: to explore how National Health Service midwives' discursive practices relate to the status quo; that is, how they contribute either to maintaining or challenging traditional discourses concerning power, gender, professionalism and the medicalisation of birth., Method: in a qualitative study within a critical discourse analysis framework, data were collected from maternity care professionals and women within one English maternity unit, through semi-structured interviews and observation of physical behaviour and naturally occurring conversation., Findings: midwives in the unit revealed an inconsistent professional identity, sometimes challenging established hierarchies and power relationships, but often reinforcing traditional notions of gender, professionalism and the medicalisation of birth through their discursive practices., Conclusions: given the known effect of wider social factors on maternity care, it is not surprising that the status quo persists, and that problems linked to these factors are still commonplace. This situation is compounded by the conflicting obligations under which UK midwives are forced to practice. These findings may have implications for midwives' capacity to respond to current challenges facing the profession., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

Health and social care students in a faculty in the United Kingdom learn together in an interprofessional module through online discussion boards. The module assessment encourages engagement with technology and with group members through peer review. An evaluation of student experience of the module gathered data from 48 students participating in 10 online groups. Analysis of contributions to discussion boards, and transcripts of interviews with 20 students revealed differing levels of participation between individuals and groups. Many students were apprehensive about the technology and there were different views about the advantages and disadvantages of online learning. Students interacted in a supportive manner. Group leadership was seen as associated with maintaining motivation to complete work on time. Students reported benefiting from the peer review process but were uncomfortable with critiquing each other's work. Sensitivity about group process may have inhibited the level of critical debate. Nevertheless the module brought together students from different professions and different sites. Examples of sharing professional knowledge demonstrated successful interprofessional collaboration online.

Racial harassment continues to be a feature of the United Kingdom (UK) National Health Service (NHS). It has serious consequences for those at the receiving end and impacts negatively on attempts by the NHS to retain and recruit a diverse workforce. The prevalence and persistence of racist views and behaviours amongst NHS staff raises questions concerning the preparation and education of practitioners. In 2004 the Faculty of Health and Social Care, University of the West of England, Bristol, piloted a training workshop to prepare students on a pre-qualifying adult nursing programme to prevent, recognise and effectively manage incidences of racial harassment in the workplace. Students found the training workshop useful to their learning. They felt more aware of racial harassment issues in the NHS and the specific actions they can take in the prevention and management of these. The findings support introduction of the training workshop as an integral component of the preparation of all students on the Faculty's pre-qualifying nursing programmes.

Objective: to gain an understanding of what midwives understand by the term 'autonomy',and to discover whether they consider themselves and their colleagues to be autonomous in practice., Participants: a snowball sample of 27 midwives working in five National Health Service (NHS) trusts within the south west of England, based in both hospitals and in the community., Method: within a qualitative research design, semi-structured interviews with participants were tape-recorded and transcribed verbatim, and analysed using thematic content analysis., Findings: most participants did not fully understand the implications of professional autonomy, particularly in terms of interprofessional collaboration and control of their own practice. There were mixed views among respondents about whether they practised autonomously. Although good relationships with medical personnel were found to facilitate midwifery autonomy, the ongoing dominance of the medical profession was still perceived as a major barrier to autonomy. Many participants did not feel that their midwifery education had equipped them for professional autonomy, although midwives educated by the direct-entry route were perceived to be more capable of exercising autonomy in practice than were nurse-trained midwives. Some participants expressed doubts about the possibility of genuine midwifery autonomy within the present system, while others felt that many midwives do not support their own or other midwives' professional autonomy., Implications for Practice: midwives need to initiate major change at a collective level, or to consider the creation of obstetric nursing posts, both to afford women the choice of genuinely autonomous midwifery care and to alleviate the stresses of practising within a system that requires the accountability and responsibility of midwifery autonomy, yet neither recognises nor supports it.