This article presents what we regard as the primary topics of concern for a feminist policy on ageing (including care and caring), derived from the results of a collaborative study undertaken in the Basque Country. The data were gathered through meetings with eight equality specialists from Women’s Houses in the region and interviews with a total of 42 older women. Our analysis shows that one of the biggest challenges is identifying strategies for articulating these topics, making them more visible and increasing societal awareness. To that end, it is necessary to analyse the intersections between age and gender.
This article compares community services provided to older adults living in Bergen, Norway, and Toronto, Canada. We investigate the gaps that are left unattended in the respective jurisdictions and consequently maintained by the organizations. Our findings reveal the importance of community organizations in positively influencing the initial transition from independence to needing more supports. Our findings show differences between the jurisdictions in the experiences of care gaps for diverse groups of providers and clients, while the overall importance of community organizations for older adults is shared in both jurisdictions, particularly by filling gaps between the formal and informal care systems.
This chapter presents a doctrinal analysis of the issue of capacity to consent to sexual relations at the intersection of the civil and criminal law, exploring the various aspects of the Mental Capacity Act 2005 and the Sexual Offences Act 2003. The chapter starts with the position outlined by the Supreme Court in A Local Authority v JB, with which the authors agree, to argue that ‘consent’ as a concept ought to be part of the information relevant to a decision to engage in sex. It then goes on to explore the various boundaries between the civil and criminal legal frameworks regarding capacity to consent to sex, justifying the differences in approach through analysing their differing theoretical and policy functions. Furthermore, the chapter considers whether it is right to view the boundaries between the civil and criminal law here as fixed or unchangeable, and whether, instead, we might usefully learn from a hybrid approach to dealing with the problem of sexual offending towards vulnerable adults.
This chapter examines the approaches and enablers for health and social care service design. It begins by discussing the steps in service design, the scale and circumstances that can affect approaches, and the key phases. The chapter then considers the impact of incumbent services and limited finance on design processes. Co-production is essential for effective design, and the success factors and approaches for implementing co-production with a range of groups, including people in communities and the voluntary, community and social enterprise (VCSE) sector, are explored. The importance of the VCSE alliance model is considered. To capture the efforts involved in the design process, the service specification is described and writing tips are provided. Finally, some of the key issues facing those designing services are examined, including capacity and demand, integrated services, workforce, and shared care records.
There are number of challenges facing health and social care in the future, but this chapter examines those that are key for future planning and readiness. The first challenge discussed is understanding the ageing population and how to plan and design services for the growing demand. The second is the technology revolution, and this covers the priorities of the NHS in the Long Term Plan, examples of change, and future planning. The third is the global pandemic, and the chapter unpicks some of the lasting impacts and how the NHS can ready itself for similar events with actions such as promoting flexibility in delivery and supporting communities to be self-sufficient. Finally, the environmental crisis is discussed in terms of its impact on the NHS, but also the impact of the NHS as deliverers of care services with a large carbon footprint. There is examination of the NHS commitment to sustainability along with suggested local actions and examples of change.
As shown throughout this edited collection, not only has the law around capacity, consent and sexual relationships recently undergone shifts in the form of the Supreme Court case of A Local Authority v JB [2021] UKSC 52, but it is an area of increasing importance for professionals and practitioners working in areas such as social work, health or supporting victims of sexual abuse. The aim of this collection has not been to resolve legal or practical issues, but to re/open some of the existing discussions and debates on mental capacity and sex, as well as offering new perspectives. In doing so, this collection has shown that such conversations and debates must not focus solely on the doctrinal questions which have historically tended to preoccupy lawyers but must also consider the challenges and opportunities the legal framework poses for disabled adults, and for professionals working in health, social care and sectors beyond. It is undoubtedly the case that A Local Authority v JB (JB), as well as many of the other decisions from the lower courts outlined in the Introduction and throughout the chapters, have precipitated a renewed focus on mental capacity and sex, often driven by legally and factually complex cases where there may be concerns about sexual abuse. The clarification offered by the Supreme Court in JB as to what is considered relevant information under the Mental Capacity Act 2005, as well as the relationship between the civil and criminal law frameworks, is – in many ways – to be welcomed.
The NHS standard contract is a key tool for commissioners and this chapter looks at the components and schedules of this document. The discussion includes the parties involved, how to monitor the contract, adjusting a contract, implementing levers and incentives, determining length of contract term, and decommissioning. The other key contract arrangements used in health and care settings are discussed, including primary care contracts, grants, and social care frameworks.
This chapter moves from theory to the current commissioning models. It explores the reforms for health and social care in the Health and Care Act 2022 and outlines the tiers of the NHS and the integrated care systems established legally in 2022. It also covers those working in this relatively new structure, including commissioners and key partners. The chapter then guides the reader through stakeholder analysis and involving multiple voices – including people in communities – in commissioning. Finally, there is a brief examination of the differences between health and care systems in England and those in the other countries of the UK and in some other countries.
This chapter opens with why we need to measure and evaluate in commissioning. It outlines the types of evaluation measures and provides examples for a service. The next steps take the reader through how to design evaluation, including the benefits realisation process. This is inclusive of data collection, triangulation, presenting evaluation findings, and dealing with poor performance. Finally, the commissioner is encouraged to evaluate themselves.
