The association between presenteeism and engagement of National Health Service staff

Objective: Although several studies have demonstrated a relationship between staff engagement and health and wellbeing, none has analysed the association with presenteeism in the National Health Service (NHS) context. Our aim is to determine whether there is a relationship between presenteeism and staff engagement. Methods: A hierarchical logistic multilevel modelling of cross-sectional data from the NHS staff survey (2009) was conducted. We controlled for a range of demographic and socioeconomic background variables, including ethnic group, gender, age and occupational group. The sample was 156,951 respondents across all 390 English NHS trusts, each providing a random sample of employees. Engagement was measured using three facets: motivation, advocacy and involvement, which were also used in a composite score. Results: Therewas a low-to-moderate negative correlation between presenteeismand staff engagement: odds ratio 0.42 (95% confidence interval [CI] 0.42-0.43) for overall staff engagement and 0.53 (95% CI 0.52-0.54) for staff advocacy of the trust; 0.53 (95% CI 0.52-0.54) for motivation and 0.50 (95% CI 0.49-0.51) for involvement. Conclusions: Putting pressure on health-care staff to come to work when unwell is associated with poorer staff engagement with their jobs. © The Royal Society of Medicine Press Ltd 2011.

Co-owners and severance - determining beneficial entitlement after Stack

The article seeks to examine the effect of a severance of a joint beneficial title following the House of Lords' ruling in Stack v Dowden [2007] 2 AC 432. If, under Stack, the parties' beneficial interests fall to be treated as identical to their legal interests (in effect, giving rise to a joint tenancy both at law and in equity), how does the mechanism of severance of a joint beneficial tenancy actually operate so as to give rise to separate and unequal shares where the parties' common intention has changed by virtue of post-acquisition events? The question is examined by reference to an ambulatory and new constructive trust, as well as where the parties have entered into an express declaration of trust of their beneficial interests.

Patients' and health professionals' views on primary care for people with serious mental illness:focus group study

Objective: To explore the experience of providing and receiving primary care from the perspectives of primary care health professionals and patients with serious mental illness respectively. Design: Qualitative study consisting of six patient groups, six health professional groups, and six combined focus groups. Setting: Six primary care trusts in the West Midlands. Participants: Forty five patients with serious mental illness, 39 general practitioners (GPs), and eight practice nurses. Results: Most health professionals felt that the care of people with serious mental illness was too specialised for primary care. However, most patients viewed primary care as the cornerstone of their health care and preferred to consult their own GP, who listened and was willing to learn, rather than be referred to a different GP with specific mental health knowledge. Swift access was important to patients, with barriers created by the effects of the illness and the noisy or crowded waiting area. Some patients described how they exaggerated symptoms ("acted up") to negotiate an urgent appointment, a strategy that was also employed by some GPs to facilitate admission to secondary care. Most participants felt that structured reviews of care had value. However, whereas health professionals perceived serious mental illness as a lifelong condition, patients emphasised the importance of optimism in treatment and hope for recovery. Conclusions: Primary care is of central importance to people with serious mental illness. The challenge for health professionals and patients is to create a system in which patients can see a health professional when they want to without needing to exaggerate their symptoms. The importance that patients attach to optimism in treatment, continuity of care, and listening skills compared with specific mental health knowledge should encourage health professionals in primary care to play a greater role in the care of patients with serious mental illness.

The public benefit requirement for charities in England and Wales:a qualitative study of its impact

The Charities Act 2006 introduced at least three changes leading to renewed emphasis on the public benefit requirement for charities in England and Wales: changes which have the potential to alter substantially society’s understanding of what it means for a body to be a charity. There has been a great deal of technical discussion of the changes, but against that background, this article presents a qualitative assessment of perceptions of the practical impact. The changes made by the 2006 Act took effect in 2008, and by 2012 four years had elapsed for the impact to settle down. We assessed the perceived impact of the renewed public benefit emphasis, using in depth interviews with a number of major stakeholders and open workshops with charity staff, trustees and advisers. We found that most study participants valued public benefit as a central concept distinguishing charitable and non-charitable organisations, although for many charities the impact is experienced mainly at the time of registration and when producing their annual reports.

Co-ownership and severance after Stack

Considers if and how a beneficial joint tenancy arising under the presumption of joint beneficial entitlement following the Supreme Court rulings in Stack v Dowden and Jones v Kernott can come to be severed.

Case Comment : Challenging the validity of leasehold guarantees:undue influence, non-est factum and formality issues

Case: Beardsley Theobalds Retirement Benefit Scheme Trustees v Yardley [2011] EWHC 1380 (QB) (QBD). The recent case of Beardsley Theobalds Retirement Benefit Scheme Trustees v Yardley, nicely illustrates, inter alia, the impact of the contractual defences of undue influence and the plea of non est factum in the context of avoiding liability under leasehold guarantees, within the setting of the landlord and tenant relationship. Additionally, the case also gives us an insight into the possible application of other technical defences relating to the law of formalities for leases. Judgment in this case was handed down on September 30, 2011.

Joint purchasers and the presumption of joint beneficial ownership:a matter of informed choice?

This paper examines the ruling of Jones v Kernott and shows the results of an empirical survey of conveyancing solicitors and their practices where so affected by the ruling. In particular the paper considers how conveyancing practitioners deal with the issue of organising trusts of land and giving advice to clients in relation to the co-purchase of land.

Certainty of subject matter in the law of trusts

This piece argued that the accepted orthodoxy concerning the requirement that each individual piece of property is individually segregated for a valid trust to exist is unsupported by the case law, and that there is nothing wrong in principle or theory with a trust that exists for unsegregated property.

What makes an effective PCT pharmacist? A study of training and development needs

This research was commissioned by the Shropshire and Staffordshire Workforce Development Confederation, to undertake a review of the education and training needs of pharmacists working at a strategic level within primary care trusts.

A comparison of antibiotic prescribing indicators and medicines management scoring in secondary care

Poster: - Robust prescribing indicators analogous to those used in primary care are not available currently in NHS hospital trusts - The Department of Health has recently implemented a scheme for self-assessment scoring medicines management processes (maximum 23) in NHS hospitals - There is no clear relationship between average values for two antibiotic prescribing indicators obtained in ten NHS hospital trusts in the West Midlands - There is no clear relationship between either indicator value and the corresponding self-assessment medicines management score - This study highlights the difficulties involved in assessing the medicines management processes in NHS hospitals; better medicines management evaluation systems are needed

Investigating mental health risk assessment in primary care and the potential role of a structured decision support tool, GRiST

Aim: To explore current risk assessment processes in general practice and Improving Access to Psychological Therapies (IAPT) services, and to consider whether the Galatean Risk and Safety Tool (GRiST) can help support improved patient care. Background: Much has been written about risk assessment practice in secondary mental health care, but little is known about how it is undertaken at the beginning of patients' care pathways, within general practice and IAPT services. Methods: Interviews with eight general practice and eight IAPT clinicians from two primary care trusts in the West Midlands, UK, and eight service users from the same region. Interviews explored current practice and participants' views and experiences of mental health risk assessment. Two focus groups were also carried out, one with general practice and one with IAPT clinicians, to review interview findings and to elicit views about GRiST from a demonstration of its functionality. Data were analysed using thematic analysis. Findings Variable approaches to mental health risk assessment were observed. Clinicians were anxious that important risk information was being missed, and risk communication was undermined. Patients felt uninvolved in the process, and both clinicians and patients expressed anxiety about risk assessment skills. Clinicians were positive about the potential for GRiST to provide solutions to these problems. Conclusions: A more structured and systematic approach to risk assessment in general practice and IAPT services is needed, to ensure important risk information is captured and communicated across the care pathway. GRiST has the functionality to support this aspect of practice.

Development and psychometric evaluation of a new team effectiveness scale for all types of community adult mental health teams:a mixed-methods approach

Defining 'effectiveness' in the context of community mental health teams (CMHTs) has become increasingly difficult under the current pattern of provision required in National Health Service mental health services in England. The aim of this study was to establish the characteristics of multi-professional team working effectiveness in adult CMHTs to develop a new measure of CMHT effectiveness. The study was conducted between May and November 2010 and comprised two stages. Stage 1 used a formative evaluative approach based on the Productivity Measurement and Enhancement System to develop the scale with multiple stakeholder groups over a series of qualitative workshops held in various locations across England. Stage 2 analysed responses from a cross-sectional survey of 1500 members in 135 CMHTs from 11 Mental Health Trusts in England to determine the scale's psychometric properties. Based on an analysis of its structural validity and reliability, the resultant 20-item scale demonstrated good psychometric properties and captured one overall latent factor of CMHT effectiveness comprising seven dimensions: improved service user well-being, creative problem-solving, continuous care, inter-team working, respect between professionals, engagement with carers and therapeutic relationships with service users. The scale will be of significant value to CMHTs and healthcare commissioners both nationally and internationally for monitoring, evaluating and improving team functioning in practice.

How trust affects the use of information obtained through intra- and extraorganizational relationships?

We have limited knowledge on the potential pattern similarities/differences of trust’s role that may exist in information use obtained through intra- and extra-organizational relationships. This study addresses this question by investigating how trust leads to information use. Data from 338 intra-organizational and a sub-ample of 158 interorganizational dyadic information exchange-relationships showed that trust is an important driver of the utilization of market information in both cases. Trust has no direct relationship to information use, instead has a strong indirect effect through a mediator, perceived quality of information. The effects of trust on the use of information obtained through inter- and extra-organizational dyadic relationships proved to be similar.

Bizalom és vállalati teljesítmény. A bizalom szerepe az aszimmetrikus információk minőségének vállalati észlelésében és azok vezetői döntéshozatalban való felhasználásában = Trust and corporate performance

A kutatás azt a kérdéskört vizsgálja, hogyan járul hozzá a bizalom a vállalatok piaci teljesítményéhez. A vállalatok azon képessége, hogy felhasználják a rendelkezésükre álló piaci információkat nehezen másolható, tartós versenyelőnyt biztosít. A marketingmenedzserek a piaci információk hitelességét nehezen tudják objektív módon megítélni, mivel azokat jellemzően mások gyűjtik és rendszerezik számukra. A szerző kutatásában a menedzserek vállalaton belüli és vállalaton kívüli piaci informálódást célzó kapcsolatai esetén modellezte és empirikusan tesztelte a bizalom hatásait. Eredményei szerint a bizalom a vállalaton belüli és vállalaton kívüli kapcsolatok esetében is fontos mozgatórugója az információfelhasználásnak, jóllehet közvetlenül nincs hatással arra. Minél jobban bízik a döntéshozó az információ forrásában, annál jobb minőségűnek fogja észlelni a tőle származó információt. Az információ észlelt minősége meghatározza, hogy arra támaszkodnak-e a vezetők a döntések meghozatalánál. Azok a marketingmenedzserek, akik képesek bizalmi kapcsolatok kiépítésére, szélesebb körű, hiteles piaci információkra támaszkodhatnak a döntéshozatal során, amely hozzájárul a vállalat piaci teljesítményéhez. ____ We have limited knowledge on the potential pattern similarities/differences of trust’s role that may exist in information use obtained through intra- and extra-organizational relationships. This study addresses this question by investigating how trust leads to information use. Data from 338 intra-organizational and a sub-ample of 158 inter-organizationaldyadic information exchange relationships showed that trust is an important driver of the utilization of market information in both cases. Trust has no direct relationship to information use, instead has a strong indirect effect through a mediator, perceived quality of information. The effects of trustontheuse of information obtained throughinter- and extra-organizational dyadic relationships proved to be similar.