Prevention is becoming ever more central in UK care policy for older people, though precisely what this entails, and how it works most effectively in social care and support, remains ambiguous. Set against the “newness” of recent social care legislation in Wales, this article explores the perspectives of professionals on prevention and community development, particularly for older people. This draws on qualitative data collected from 11 Welsh local authorities, four NHS Wales health boards, and eight regional third-sector organisations, incorporating 64 interviews with directors, executives, and senior managers. Recent research has highlighted concerns over the slipperiness of prevention as a concept, resulting in multiple interpretations and activities operating under its banner. Consistent with this, our data suggested a kaleidoscopic picture of variously named community-based initiatives working to support the intricate web of connections that sustain older people, as well as provide practical or material help. Similarly, professionals highlighted varied agendas of community resilience, individual independence, and reducing the need for state-funded health and social care, as well as a range of viewpoints on the roles of the state, private sector, and the third sector. Analysis revealed fragments of familiar themes in community development; positive hopes for community initiatives, tensions between the mixed agendas of state-instigated activities, and the practical challenges arising from systems imbued with neo-liberal ideas. Realising the promise of prevention will require deft steering through these challenges.
Recently there has been a chorus of demands to “re‐imagine” social care. Community and faith‐based organisations, policy, and academic communities are engaged in discussions on issues such as human rights for older populations, the future of residential care, how to better support family/community care, and strengthen local place‐based community development. Moreover, the Covid‐19 pandemic has added new urgency to this mission, galvanizing developments for change and collective action and exposing public troubles of endemic system failings, prevailing discourses of ageism, tensions with health systems, and limitations of market models of care and support. Prevention is a central social welfare principle in many countries. It is associated with policy and practices that aim to meet social care needs early and is explored in this thematic issue.
Prevention is a core principle in social care legislation across the UK. However, history shows great variability in how a preventative social care agenda is conceptualised and implemented. We report findings from an independent evaluation of the implementation of the ‘2014 Social Services and Well-being (Wales) Act’ incorporating a document analysis of reports and plans from Wales’ twenty-two local authorities (LAs) and eighty-eight qualitative interviews from social services strategic leaders and operational managers within four Welsh LAs. Analysis highlighted multiple interpretations of national policy, with notable overlapping agendas. In Gramscian terms, there is a constant process of negotiating prevention values and agendas, with consequences for whose interests are served. This was apparent through drives towards cost-saving, financial sustainability and reduced service demand operating alongside values-based principles rooted in well-being and mutualism. Following Kenny’s work in community development, we argue a ‘fusing’ of principles whilst espousing benefits for service users, potentially blurs the aims of the legislation, with implications for practice.
Prevention has become increasingly central in social care policy and commissioning strategies within the United Kingdom (UK). Commonly there is reliance on understandings borrowed from the sphere of public health, leaning on a prevention discourse characterised by the 'upstream and downstream' metaphor. Whilst framing both structural factors and responses to individual circumstances, the public health approach nonetheless suggests linearity in a cause and effect relationship. Social care and illness follow many trajectories and this conceptualisation of prevention may limit its effectiveness and scope in social care. Undertaken as part of a commissioned evaluation of the Social Services and Wellbeing Act (2014) Wales, a systematic integrative review was conducted to establish the key current debates within prevention work, and how prevention is conceptually framed, implemented and evaluated within the social care context. The databases Scopus, ASSIA, CINAHL and Social Care Online were initially searched in September 2019 resulting in 52 documents being incorporated for analysis. A further re-run of searches was run in March 2021, identifying a further 14 documents, thereby creating a total of 66. Predominantly, these were journal articles or research reports (n = 53), with the remainder guidance or strategy documents, briefings or process evaluations (n = 13). These were categorised by their primary theme and focus, as well as document format and research method before undergoing thematic analysis. This highlighted the continued prominence of three-tiered, linear public health narratives in the framing of prevention for social care, with prevention work often categorised and enacted with inconsistency. Common drivers for prevention activity continue to be cost reduction and reduced dependence on the care system in the future. Through exploring prevention for older people and caregivers, we argue for an approach to prevention aligning with the complexities of the social world surrounding it. Building on developments in complexity theory in social science and healthcare, we offer an alternative view of social care prevention guided by principles rooted in the everyday realities of communities, service users and caregivers.
There are ongoing policy concerns surrounding the difficulty in obtaining timely appointments to primary healthcare services and the potential impact on, for example, attendance at accident and emergency services and potential health outcomes. Using the case study of potential access to primary healthcare services in Wales, Geographic Information System (GIS)-based tools that permit a consideration of population-to-provider ratios over space are used to examine variations in geographical accessibility to general practitioner (GP) surgeries offering appointment times outside of 'core' operating hours. Correlation analysis is used to explore the association of accessibility scores with potential demand for such services using UK Population Census data. Unlike the situation in England, there is a tendency for accessibility to those surgeries offering 'extended' hours of appointment times to be better for more deprived census areas in Wales. However, accessibility to surgeries offering appointments in the evening was associated with lower levels of working age population classed as 'economically active'; that is, those who could be targeted beneficiaries of policies geared towards 'extended' appointment hours provision. Such models have the potential to identify spatial mismatches of different facets of primary healthcare, such as 'extended' hours provision available at GP surgeries, and are worthy of further investigation, especially in relation to policies targeted at particular demographic groups.
Fragments of antifouling paint and environmental geosolids have been sampled from the island of Malta and analysed for total and bioaccessible metals. Total concentrations of Ba, Cd, Cu, Pb, Sn and Zn were two to three orders of magnitude higher in spent antifouling composites relative to respective values in background soils and road dusts. Paint fragments were visible in geosolids taken from the immediate vicinity of boat maintenance facilities and mass balance calculations, based on Ba as a paint tracer, suggested that the most contaminated soils, road dusts and boatyard dusts contained about 1%, 7% and 9%, respectively, of antifouling particles. Human bioaccessibilities of metals were evaluated in selected samples using a physiologically based extraction technique. Accessibilities of Cd, Cu, Pb and Zn in the most contaminated solids were sufficient to be cause for concern for individuals working in the boat repair industry and to the wider, local community.
Wild stocks of Atlantic cod (Gadus morhua) are low. With fisheries in decline, continued demand for cod has led to a fledgling aquaculture industry and current forecasts call for rapid growth. However, critics blame aquaculture of carni- vorous species for further depleting fish stocks and for its wider effects on the marine environment. We examine the activities of Johnson Seafarms, a sea-cage organic cod farming facility in the Shetland Islands, to investigate whether "organic" cod farming can be environmentally, economically, and socially sustainable. Data were collected via public questionnaires and interviews with aquaculture experts. The results show that, before it closed in 2008, Johnson Seafarms was addressing the environmental concerns traditionally associated with aquaculture of carnivorous spe- cies and that economic viability is possible as a market exists for organically farmed cod at prices higher than for wild fish. We conclude that organic cod farming, as was practiced in the Shetland Islands, is sustainable on that scale. While the industry has room for measured expansion, overexpansion would increase pressure on natural systems, undermining environmental and, ultimately, social and economic sustainability. Producers and regulators should con- sider alternative techniques, including land-based or integrated aquaculture systems. Any development should be accompanied by further research regarding the industry's sustainability.
This paper explores the perceptions of academics and students towards embedding Education for Sustainable Development (ESD) into undergraduate degree programmes in the School for Earth, Ocean and Environmental Science (SEOES) at the University of Plymouth. The main purpose of the research was to identify current ESD related teaching and learning in a science-based undergraduate programme and the opportunities for, and barriers to, further extensions of ESD. The results indicate that there is general support for the embedding of ESD in the curriculum, but there is considerable uncertainty expressed by lecturers concerning how this can best be done. There is a general concern that additional embedding into the degree programme might lead to reductions in the amount of core subject matter being taught. The programme and ESD agendas are to an extent seen by lecturers as conflicting. ESD is viewed mainly in terms of curriculum content as opposed to the pedagogy employed.
The success of a regulatory regime in decreasing point-source emissions of some harmful chemicals has highlighted the significance of other sources. A growing number of potentially harmful chemicals have been incorporated into an expanding range of domestic household products and are sold worldwide. Tighter regulation has been proposed, and the European Commission has introduced the Regulation on the Registration, Evaluation, and Authorisation of Chemicals to address this concern. However, it is clear that in addition to the regulation, there is a potential to effect change through retailer and consumer attitudes and behaviours. Interviews were conducted with 7 key stakeholder groups to identify critical issues, which were then explored using a public survey questionnaire (1,008 respondents) and 8 subsequent focus groups. The findings demonstrated that the issue of chemicals in products is of concern to consumers for reasons of personal health rather than environmental protection. Key obstacles to the wider purchase of “green-alternative” products included perceived high cost and poor performance, lack of availability of products, and poor information concerning such products. Although improved regulation was seen as part of the solution, consumers must also play a role. It was clear from this study that consumers are not currently able to make informed choices about the chemicals they use but that they would be receptive to moving toward a more sustainable use of chemicals in the future if empowered to do so.
In 2001, legislative measures were introduced in the UK to restrict usage of antifouling agents in small (<25 m) vessel paints to dichlofluanid, zinc pyrithione and zineb. This removed the previously popular booster biocides diuron and Irgarol 1051 from the market. To investigate the impact of this legislation, water samples were taken from locations where previous biocide levels were well documented. Results from analyses demonstrate a clear reduction in water concentrations of Irgarol 1051 (between 10% and 55% of that found during pre-restriction studies), indicating that legislation appears to have been effective. Although other booster biocides were screened for (chlorothalonil, dichlofluanid and Sea-Nine 211), they were below the limits of detection (<1 ng/l) in all samples. A survey of chandlers and discussions with legislative authorities supports these results and concurs the removal of Irgarol 1051 based paints from the market using simple regulations at a manufacturer level with little regulation at a retailer level.