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177 TEN Combating malnutrition in hospitals Paula Moynihan, Lisa Methven, Gemma Teal, Claire Bamford and Alastair S. Macdonald Introduction According to Age UK, over 3 million people across the UK are either malnourished or at risk of malnourishment, of which over 1 million are over the age of 65 (Age UK, 2017). Over 30 per cent of adults are malnourished on admission to hospital, increasing hospital stay, risk of complications and likelihood of being discharged into care (BAPEN, 2003; Stratton et al, 2004; Age Concern, 2006; Brotherton et al, 2010; Elia

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Key messages A supportive hospital organisational response to survivor staff has three main components: (1) awareness-raising and understanding that domestic and family violence (DFV) affects staff at hospitals, not just their patients; (2) multifaceted support that is not disclosure dependent; and (3) promotion of staff safety. Developing a trauma and violence informed culture towards both hospital patients and staff could provide the infrastructure for a safe and supportive workplace response to staff DFV. Background Prevalence and impact of

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33 THREE ‘The corruption of care’ The Ely Hospital Inquiry 1969 Introduction There is no doubt that the occasional scandal does an enormous amount for a social service. (Sir Keith Joseph, House of Commons 12 July 1971) The newspaper story that broke with The Times letter quoted at the end of Chapter Two contained many of the ingredients from which scandals are constructed. One of the signatories, Barbara Robb, was a claims-maker of the first rank. Founder of AEGIS (Aid for Elderly in Government Institutions), Mrs Robb was the mobilising spirit behind the

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137 NINE From hospital to community Alison Petch introduction Effective discharge planning is a highly skilled and difficult task, for it requires assessment, intervention, monitoring and evaluation to be completed in a very short time. (Rachman, 1993, p 111) Hospital discharge is a common experience for many individuals in the course of their lifetime. The circumstances can vary widely: from the child with complex disabilities returning to the family home to the older person of 90 years old returning home after a fall; from the individual with mental

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133 Part 3 Chapter TwoThe hospital and its patients In depth and range of complexity, the hospital as a social institution has few rivals today. In a study of the hospital, Edward Churchill (1949), writing from the famous Massachusetts General Hospital, said: “The hospital is one of the most complex and dynamic instruments of contemporary society”. In Britain, we need to view the hospital in a similar sense – operating within the additional complexities of a nationwide government-financed, centrally- regulated system of administration. No community could hope

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61 Andrew’s story: hospital discharge FOUR Andrew’s story: hospital discharge For service users and professionals alike, the ability of health and social services to ensure the efficient and effective discharge of patients from hospital is often an acid test of how well these two agencies are working together. More than any other issue, that of hospital discharge is fundamental to the experience of working at the interface between health and social services and to the quality of care provided. After a review of recent research findings, this chapter tells the

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76 7 The Hospital and Its Patients1 In depth and range of complexity, the hospital as a social insti tution has few rivals today. In a recent study of the hospital, Dr Edward Churchill, writing from the famous Massachusetts General Hospital, said: ‘The hospital is one of the most complex and dynamic instruments of contemporary society’.2 In Britain, we need to view the hospital in a similar sense operating within the additional complexities of a nationwide Government-financed, centrally regulated system of administration. No com munity could hope to

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65 Towards a national hospital service The direct and indirect consequences of war have profoundly influenced the development of the nation’s medical services. War in general has provided clinical and surgical material for experimentation on a grand scale and has imbued society upon each outbreak with a fresh interest in health. Because war means the organisation of killing and wounding, it must also mean the organisation of services to repair and heal. The Crimean War [1853-56] led, through the work of Florence Nightingale, to the creation of a nursing

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6LET THE MENTAL HOSPITALS CLOSE ... ' Dylan Tomlinson This paper considers theories of social pOlicy implementation in the light of an empirical study of psychiatric hospital closure. Five ideal types of local state are hypothesised, ranged along a continuum of discretion. At one end of the continuum are those authorities whose policies and organ- isational structures are determined by the 'centre'. At the other are those able to make discrete policies and to develop organisational structures to implement them. It is argued that the degree to which authorities

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supported decision-making leads to better outcomes ( Stacey et al, 2017 ). Advocacy, empowerment, upholding human rights and social justice are fundamental to social work, arguably placing the values and principles of assisted decision-making strongly aligned with the ethos of the profession ( Donnelly, 2021 ). The original impetus for family meetings arose from policy drivers that, over the last two decades, have become increasingly focused on human rights, autonomy, self-determination, independence, patient participation and discharge planning, particularly for hospital

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