Purpose – The purpose of this paper is to present information from the Joint Health and Social Care Self-Assessment Framework (JHSCSAF) on reported rates of cervical cancer, breast cancer and bowel cancer screening for eligible people with learning disabilities in England in 2012/2013 compared to screening rates for the general population. Design/methodology/approach – Between 94 and 101 Learning Disability Partnership Boards, as part of the JHSCSAF, provided information to allow the calculation of rates of cervical cancer, breast cancer and bowel cancer screening in their locality, for eligible people with learning disabilities and for the population as a whole. Findings – At a national level, reported cancer screening coverage for eligible people with learning disabilities was substantially lower than for the population as a whole (cervical cancer screening 27.6 per cent of people with learning disabilities vs 70 per cent of total population; breast cancer screening 36.8 per cent of people with learning disabilities vs 57.8 per cent of total population; bowel cancer screening 28.1 per cent of people with learning disabilities vs 40.5 per cent of the general population). There were considerable geographical variations in reported coverage for all three screening programmes. Originality/value – Consistent with previous research, localities in England report cancer screening rates for eligible people with learning disabilities considerably below those of the general population. There is an urgent need to address data availability and quality issues, as well as reasonable adjustments to cancer screening programmes to ensure uniformly high rates of cancer screening for people with learning disabilities across England.

Transitioning is described as a complex and highly stressful process wherein a nurse goes through a lateral movement from one setting to another, with changes in goals, roles and responsibilities (Chicca & Bindon, 2019). All nurses inevitably undergo at least one transition during their professional careers, with many making multiple transitions for a range of personal, professional and organizational reasons (Chicca & Bindon, 2019). In recent years, the strategic global shift of health service provisions from acute to primary care accentuated this transition. Such changes to the healthcare landscape were warranted to meet the demands associated with an ageing population

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Background There has been increasing research interest in the adverse effects of public health interventions; notably concern that processes in the planning or delivery of an intervention may create or exacerbate the health differences between population groups. The aim of this study was to contribute to current understanding of ‘intervention-generated inequalities’ by examining the impact of secondary and tertiary preventive interventions for Type 2 diabetes by socio-economic status (SES). Previous research has shown that Type 2 diabetes places a disproportionate health burden on individuals from more disadvantaged backgrounds. It addition, managing the condition involves multiple processes and health professionals, all of which all could potentially exacerbate existing health inequalities. Methods A secondary data analyses of patient level data collected by a hospital trust diabetes register from 1999 to 2007 was conducted to determine if receiving the same care was associated with differential health outcomes by SES. Two indicators of care were used: the number of recommended care processes (quality of care) and attendance at a hospital diabetes care clinic (shared care) each year. The Index of Multiple Deprivation 2004 was used as an indicator of patients’ SES. A series multilevel models were fitted with hbA1c, an indicator of patient’s diabetes control, as the dependent variable with interaction effects between SES and intervention indicators. Repeated measurements were nested within patients, nested within the general practice they registered with per year. Relevant socio-demographic, anthropometric, lifestyle, health and other intervention data controlled for in each model. Results The initial descriptive analyses showed that high SES was statistically significantly receive greater quality of care and less likely to receive shared care than low SES patients. Overall, in both multilevel models high SES patients were more like more favourable hbA1c rates than low SES patients. However the interaction effects suggest that amongst patients receiving high quality of care, high SES patients were significantly more likely to have poorer HbA1c compared to low SES patients. In contrast amongst patients receiving shared care, high SES patients were more likely to have more favourable HbA1c rates than low SES patients. Discussion There was evidence that low SES patients received a poor quality of care but had greater access to specialist, secondary care. In addition, there was evidence to suggest that patients receiving the same care were associated with a differential impact on patients HbA1c. More complex analyses need to be conducted to determine the direction of these associations.

Aims: The evidence on how reflection associates with clinical teaching is lacking. This study explored the reflection pattern of nursing clinical instructor trainees on their clinical teaching and its association with their teaching performance. Methods: Reflection entries on two teaching sessions and respective teaching assessment data of a cohort of Registered Nurses participating in the National Healthcare Group College Clinical Instructor program (n=28) were retrieved for this study. Reflection entries were subjected to thematic analysis. Each reflection statement was coded and scored according to topics in relevance to three clinical teaching phases -preparation, performance and evaluation. Teaching assessment scores were then used to group the participants into different performance group. Reflection patterns derived from the coding scores were compared across these groups. Results: Participants' reflections focused on the performance phase (57% of reflected items), followed by preparation (30%) and evaluation (13%) phases. To assess the reflection pattern of trainees with differing teaching performance, participants whose teaching assessment scores were already high from first teaching session were classified into Consistently High group (score>22). Remaining participants were further categorized based on their improvement in teaching assessment scores into Higher Change (score difference>1) and Lower Change (score difference≤1). Compared to Lower Change group, participants in the Consistently High and Higher Change groups had higher trend of reflection focus on performance (57% and 59% vs 48%) and evaluation phases (14% and 14% vs 8%), but lower on preparation phase (29% and 27% vs 44%). Conclusions: The finding suggests a possible role of reflection in teaching performance of nurse clinical instructors, warranting further investigation.