Aims: To examine frontline staff acceptance of telehealth and identify barriers to and enablers of successful adoption of remote monitoring for patients with Chronic Obstructive Pulmonary Disease and Chronic Heart Failure.Background: The use of telehealth in the UK has not developed at the pace and scale anticipated by policy. Many existing studies report frontline staff acceptance as a key barrier, however data are limited and there is little evidence of the adoption of telehealth in routine practice.Design: Case studies of four community health services in England that use telehealth to monitor patients with Chronic Obstructive Pulmonary Disease and Chronic Heart Failure.Methods: Thematic analysis of qualitative interviews with 84 nursing and other frontline staff; and 21 managers and key stakeholders; data collected May 2012–June 2013.Findings: Staff attitudes ranged from resistance to enthusiasm, with varied opinions about the motives for investing in telehealth and the potential impact on nursing roles. Having reliable and flexible technology and dedicated resources for telehealth work were identified as essential in helping to overcome early barriers to acceptance, along with appropriate staff training and a partnership approach to implementation. Early successes were also important, encouraging staff to use telehealth and facilitating clinical learning and increased adoption.Conclusions: The mainstreaming of telehealth hinges on clinical ‘buy‐in’. Where barriers to successful implementation exist, clinicians can lose faith in using technology to perform tasks traditionally delivered in person. Addressing barriers is therefore crucial if clinicians are to adopt telehealth into routine practice.

University student wellbeing is increasingly seen as a concern, and as demands on university staff time for research, teaching, leadership and pastoral support also increase, this is mirrored in concerns about staff wellbeing. Dominant sectoral narratives frame student and staff wellbeing as oppositional, with initiatives to support student wellbeing positioned as creating additional practical and emotional demands on staff time and resources. Using a large qualitative dataset collected in the UK, including staff and students, this paper argues that that this does not have to be the case. Instead, there is a need to look beyond the provision of reactive services or isolated individual interventions, to proactively and cohesively embed cultural and structural change across the whole institution to support positive wellbeing outcomes for the whole university community. We report on the intrinsic interconnection between staff and student wellbeing; the importance of formal institutional policies in supporting or impeding staff and student wellbeing; access to training interventions to support staff and student wellbeing as a practical manifestation of these policies; and the impact of workplace culture and the centrality of compassion and community. The paper finds that it is important that institutions within higher education acknowledge and respond proactively to both staff and student wellbeing issues. To do so, institutions should seek to foster a sustainable and effective academic environment with a whole university approach.

This paper draws on staff and student consultations conducted during the development of Student Minds’ University Mental Health Charter to identify five key tensions which can arise in assessment design and strategy when seeking to balance the wellbeing of students with pedagogical, practical and policy considerations. It highlights the need to acknowledge the pressures of assessment on staff wellbeing as well as students. The particular tensions explored include the need to balance challenge against the psychological threats this can entail; the varying impacts of traditional and novel forms of assessment; the differing demands of collaborative and individual work; the tensions between ideal strategies and those which are practically feasible; and the ways in which feedback is given (as a constructive learning tool) and received (often as a psychological threat). These tensions can provide a valuable point of reflection for educators who need to critically and proactively navigate these conflicts within their own assessment design and practices, as part of a wider whole university approach to promoting student wellbeing.

Introduction Workforce issues prevail across healthcare; in emergency medicine (EM), previous work improved retention, but the staffing problem changed rather than improved. More experienced doctors provide higher quality and more cost-effective care, and turnover of these physicians is expensive. Research focusing on staff retention is an urgent priority. Methods This study is a scoping review of the academic literature relating to the retention of doctors in EM and describes current evidence about sustainable careers (focusing on factors influencing retention), as well as interventions to improve retention. The established and rigorous JBI scoping review methodology was followed. The data sources searched were MEDLINE, Embase, Cochrane, HMIC and PsycINFO, with papers published up to April 2020 included. Broad eligibility criteria were used to identify papers about retention or related terms, including turnover, sustainability, exodus, intention to quit and attrition, whose population included emergency physicians within the setting of the ED. Papers which solely measured the rate of one of these concepts were excluded. Results Eighteen papers met the inclusion criteria. Multiple factors were identified as linked with retention, including perceptions about teamwork, excessive workloads, working conditions, errors, teaching and education, portfolio careers, physical and emotional strain, stress, burnout, debt, income, work–life balance and antisocial working patterns. Definitions of key terms were used inconsistently. No factors clearly dominated; studies of correlation between factors were common. There were minimal research reporting interventions. Conclusion Many factors have been linked to retention of doctors in EM, but the research lacks an appreciation of the complexity inherent in career decision-making. A broad approach, addressing multiple factors rather than focusing on single factors, may prove more informative.