A Service Model For Delivering Care Closer to Home.

Upton Surgery (Worcestershire) has developed a flexible and responsive service model that facilitates multi-agency support for adult patients with complex care needs experiencing an acute health crisis. The purpose of this service is to provide appropriate interventions that avoid unnecessary hospital admissions or, alternatively, provide support to facilitate early discharge from secondary care. Key aspects of this service are the collaborative and proactive identification of patients at risk, rapid creation and deployment of a reactive multi-agency team and follow-up of patients with an appropriate long-term care plan. A small team of dedicated staff (the Complex Care Team) are pivotal to coordinating and delivering this service. Key skills are sophisticated leadership and project management skills, and these have been used sensitively to challenge some traditional roles and boundaries in the interests of providing effective, holistic care for the patient. This is a practical example of early implementation of the principles underlying the Department of Health’s (DH) recent Best Practice Guidance, ‘Delivering Care Closer to Home’ (DH, July 2008) and may provide useful learning points for other general practice surgeries considering implementing similar models. This integrated case management approach has had enthusiastic endorsement from patients and carers. In addition to the enhanced quality of care and experience for the patient, this approach has delivered value for money. Secondary care costs have been reduced by preventing admissions and also by reducing excess bed-days. The savings achieved have justified the ongoing commitment to the service and the staff employed in the Complex Care Team. The success of this service model has been endorsed recently by the ‘Customer Care’ award by ‘Management in Practice’. The Surgery was also awarded the ‘Practice of the Year’ award for this and a number of other customer-focussed projects.

Higher education, professionalism and skills in the built environment: the impact of the new urban agenda on teaching and learning

In the mid-to-late 1990s, the New Urban Agenda initiated a rethinking of urban development strategies placing a greater focus on regeneration of central urban spaces. The skills and competencies required by urban planners and built environment professionals to successfully implement regeneration schemes tend to differ from those required for greenfield development. The working paper summarises skills and competencies required by urban regeneration practitioners and how they are delivered through public and/or private sector providers at present. The role of the newly established regional Centres of Excellence and the professional bodies of the Built Environment professions in defining skills and educational requirements and providing training are explored. An analysis of supply and demand of skills training reveals that there is a mismatch rather than a lack of provision. The report draws on a conference where research findings were presented and discussed. It concludes with suggestions for improving the skills provision at the local government as well as community level. Skills audits were found useful tools in defining training needs. A set of sample workshop programmes outline flexible, tailor-made approaches guaranteed to address specific and identified needs.

The Use of Touch Screen Technology by People with Dementia and Their Carers in Care Home Settings.

Dominic Upton, Jennifer Bray, Tim Jones and Penney Upton report on research that confirms that touchscreen devices can be of great benefit in engaging and supporting people with dementia.

Professionalism and skills enhancement in the built environment: the role of higher education in a changing policy context in England

Since the election of the Labour Government in 1997 there have been a series of policy initiatives emphasising the importance of co-ordinated and integrated approaches to the delivery of urban regeneration and in particular Sustainable Communities. This changing policy context has given rise to a shortage of practitioners with both the technical skills to deliver specific programmes, and more especially the generic skills to work in multi-disciplinary teams in conjunction with partnership-based management boards. This paper discusses the origins of the debate about skills shortages and deficiencies and reviews the main government reports which have advocated a new approach to the provision of skills for community regeneration. It focuses particularly on the work of the Planning Network which was funded by the Centre for Education in the Built Environment (CEBE) to examine the contribution of higher education to the wider skills debate. It concludes by arguing that higher education has an important part to play in the provision of a more appropriate skills set for professional practice within a broader and more inclusive strategy involving all key stakeholders. However, employers also have a major responsibility in ensuring that key skills are maintained and enhanced within their own organisations.

Analysing energy use in supply chains: the case of fruits & vegetables and furniture

An increasing number of producers, retailers and third-party logistics providers are interested in carrying out energy assessments of their product supply chain. This is due to sensitivity about climate change and carbon emissions, but also to high energy prices. This paper presents an analytical approach developed to measure energy use in logistics activities in product supply chains. The approach (based on the Life Cycle Approach) quantifies energy use in transport and logistics activities at all stages of a product supply chain. The work has demonstrated that such an assessment approach based on the supply chain is useful in comparing the energy use implications of different strategies. This supply chain approach can be used to consider options such as sourcing and distribution centre locations, transport modes, road freight vehicle types and weights, vehicle load factors, empty running, transport distance and the balance between consumer shopping trips and delivery to the home.

Energy efficiency and greenhouse gas emissions of different supply chains: a comparison of French, UK and Belgian cases

Freight transportation system is critical to economic activity but it carries significant environmental costs, notably GHG emissions and climate change : energy use and corresponding CO2 emissions is increasing faster in freight transport than in other sectors and this increase is primarily the result of increased trade. This paper compares the transport activities, associated energy consumption and CO2 emissions of different supply chains for a range of products in three countries: Belgium, France and United Kingdom. Among the products considered are furniture and ‘fruits & vegetables’. For each of these products, different supply chains, involving more or less transport activity and associated energy consumption are analysed in each country. The comparison highlights some of the main factors that influence GHG emissions for different supply chains and illustrates how they vary according to product and country of final distribution. In more detail, the paper addresses the main differences between the supply chains of these products namely, the origin of their sourcing, the logistical organisation between production and retail and different types of retail outlet. The origin of the sourcing impact is mainly related to distance. The impact of the logistical organisation between raw material and retail on GHG emissions is linked to the mode and vehicle choice and to the load factor. As for retail, the consumer trip emissions, between his home and the retail outlet, are also an important part of the whole supply chain emissions. It is worthwhile to notice that our goal in this project is to consider the whole supply chain, from production to consumption. Therefore a particular focus is put on the mobility behaviours of consumers purchasing the studied products during their shopping and dropping back home activities related to these products. Especially a web based survey has been conducted and the gathered results offer an opportunity for drawing a more detailed picture of the associated CO2 emissions. This paper uses the results of an ongoing research on supply chain energy efficiency, funded by ADEME (the French Energy Agency) through the French program on transport research (PREDIT). This research is based on a comprehensive review of the various approaches to quantifying the environmental impacts of supply chains together with data collection from a range of organisations including manufacturers, retailers and transport companies. We will first present the developed methodologies, then the results corresponding to each studied product will be described. A discussion of the potential application of the research approach to the wider debate about the environmental impact of freight transport and the scope for GHG emissions reduction targets to be achieved will be included.

Survey forms used in urban freight studies

Report produced as part of the Green Logistics project (EPSRC and Department for Transport funded). This report contains examples of survey forms used in urban freight studies both in the UK and overseas. The studies from which these examples have been drawn range in data from 1970-2008. The purpose of the report is to provide insight into the types of questions used in different survey techniques and also into the design of survey forms. It is hoped that bringing together in a single document these examples of urban freight survey forms will be of use to researchers involved in such studies in future in planning and designing their survey work. Examples of several different types of survey techniques are provided including: Establishment surveys -- Commodity flow surveys -- Freight operator surveys -- Roadside interview surveys -- Driver surveys -- Vehicle observation surveys -- Parking surveys -- Vehicle trip diaries -- Service provider surveys

Energy efficiency and greenhouse gas emissions of different supply chains: a comparison of French, UK and Belgian cases

Freight transportation system is critical to economic activity but it carries significant environmental costs, notably GHG emissions and climate change : energy use and corresponding CO2 emissions is increasing faster in freight transport than in other sectors and this increase is primarily the result of increased trade. This paper compares the transport activities, associated energy consumption and CO2 emissions of different supply chains for a range of products in three countries: Belgium, France and United Kingdom. Among the products considered are furniture and fruits & vegetables. For each of these products, different supply chains, involving more or less transport activity and associated energy consumption are analysed in each country. The comparison highlights some of the main factors that influence GHG emissions for different supply chains and illustrates how they vary according to product and country of final distribution. In more detail, the paper addresses the main differences between the supply chains of these products namely, the origin of their sourcing, the logistical organisation between production and retail and different types of retail outlet. The origin of the sourcing impact is mainly related to distance. The impact of the logistical organisation between raw material and retail on GHG emissions is linked to the mode and vehicle choice and to the load factor. As for retail, the consumer trip emissions, between his home and the retail outlet, are also an important part of the whole supply chain emissions. It is worthwhile to notice that our goal in this project is to consider the whole supply chain, from production to consumption. Therefore a particular focus is put on the mobility behaviours of consumers purchasing the studied products during their shopping and dropping back home activities related to these products. Especially a web based survey has been conducted and the gathered results offer an opportunity for drawing a more detailed picture of the associated CO2 emissions. This paper uses the results of an ongoing research on supply chain energy efficiency, funded by ADEME (the French Energy Agency) through the French program on transport research (PREDIT). This research is based on a comprehensive review of the various approaches to quantifying the environmental impacts of supply chains together with data collection from a range of organisations including manufacturers, retailers and transport companies. We will first present the developed methodologies, then the results corresponding to each studied product will be described. A discussion of the potential application of the research approach to the wider debate about the environmental impact of freight transport and the scope for GHG emissions reduction targets to be achieved will be included.