Many national policies propose integration between primary and specialist care to improve the care of people with long-term conditions. There is an increasing need to understand how to practically implement such service redesign. This paper reviews the literature on the barriers to, and facilitators of, integrating primary and specialist healthcare for people with long-term conditions in the UK, with the aim of informing the development and implementation of similar initiatives in integration. MEDLINE and CINAHL databases were searched and 14 articles discussing factors hindering or enabling integration were identified. The factors were extracted and synthesised and key lessons were tabulated. Successful integration of care requires synchronised changes on different levels, a well-resourced team, a well-defined and evidence-based service, agreed and articulated new roles and responsibilities, and a willingness among healthcare professionals to co-work and co-learn. Barriers to successful implementation of integrated care include a lack of commitment across organisations, limited resources, poorly functioning information technology (IT), poor coordination of finances and care pathways, conflicting objectives, and conflict within teams. The examples of integrated working provide insights into problems and solutions around interorganisational and interprofessional working that will guide those planning integration in the future.

<!----> <!----> This chapter focuses on the construction of the idea of a normal life in the discourses of Polish post-2004 migrants. Complementary to other methodological approaches adopted in earlier studies on contemporary Polish migrants to the UK. The other project from which the chapter draws is based on Internet data which was collected from an Internet discussion forum attached to the influential Polish daily Gazeta Wyborcza. The ethos valued by communist propaganda was marked with a strong anti-materialistic tendency, aiming to promote post-materialistic values and an aversion towards growing rich and also towards rich people. Ultimately, one issue has emerged as dominant in this research; both groups of researched post-enlargement migrants used linguistic resources rooted and embedded in the same discourse of normality', which connects closely to conceptualizations of moderation which were prevalent in Poland before 1989. It is one more example that post-communist transformations, although translocal in this case, can only be fully understood in their historical context. <!----> <!---->

The article focuses on informants’ interaction with questionnaires as a method of collecting data and analyzes how the informants struggle with the reality imposed on them by the instruments’ items. Focusing on a social psychological questionnaire used to explore experience, the authors challenge the link between the data that are collected and what is concluded from them, and particularly the notion that such conclusions offer insight into informants’ experiences. The data the article is based on come from a session in which informants were asked to complete a questionnaire designed to examine feelings and behaviors after a job loss and to “think aloud” while doing it. The authors describe three strategies of dealing with the questionnaire frame: rejecting it, constructing experience in a way that matches the instrument, and, finally, reformulating the questionnaire’s questions. The article concludes by arguing that the process of filling in a questionnaire results in the experiences that the instrument is designed to examine being made irrelevant and their complexity far too great for a-contextual quantification.

Purpose: The purpose of this paper is to examine how faculty staff on health and social care programmes support students with mental health issues.Design/methodology/approach: The study used a qualitative survey design to gain in-depth information on faculty staff experiences. Seventy-one faculty staff at two universities in the South East of England out of an eligible population of 115 staff responded to an anonymous online questionnaire which were thematically analysed.Findings: The findings indicated that faculty staff faced uncertainties in providing support to students with mental health needs. They reported tensions between their academic, professional and pastoral roles. There was a wide recognition that supporting students was physically and emotionally demanding for faculty staff and especially challenging when their roles and expectations were unclear. This was compounded by lack of explicit guidelines and an apparent severed connection between faculty staff and student support services.Practical implications: A need for clearly defined roles and responsibilities for faculty staff in supporting students with mental health needs including a review of their pastoral role were identified. The study reinforces the need for effective collaborative arrangements and collective decision making and clearer procedures in the planning and implementation of students' personal support plans. A concerted effort into adopting a transpersonal approach which incorporates mental health staff awareness training, restorative spaces for reflection and supportive pathways for faculty staff are recommended.Originality/value: This paper provides rare empirical evidence of faculty staff views on their role in supporting students with mental health needs on health and social care programmes.

Background: People with intellectual disabilities are more likely to have diabetes and develop complications from it. Diabetes management is complex and insulin treatment in particular, people with intellectual disabilities may require additional support that is not always available. This review aimed to identify barriers and facilitators to managing diabetes with insulin in adults with intellectual disabilities.Method: Patient and public involvement (PPI) was integral to the development of the research question. A systemised review was conducted across CINAHL, the British Nursing Index and MEDLINE. PRISMA guidelines were followed. Narrative synthesis of the evidence was undertaken.Results: Barriers and facilitators to managing diabetes with insulin in people with intellectual disabilities were identified related to the individual, other people participating in their care, and broader environmental and social factors.Conclusions: People with intellectual disabilities who use insulin, require reasonable adjustments to education, support, and a person‐centred approach to facilitate supported self‐management. More training for their supporters is needed and further inclusive research with PPI is recommended.

People with diabetes are vulnerable to comorbid mental illness. The burdens and worries of accepting the diagnosis, living with diabetes, adherence to treatment, fear of complications, and fear of hypoglycaemia can result in considerable distress, making diabetes difficult to self-manage.1 As a result, rates of depression and anxiety are higher.2,3 Other mental health problems linked to diabetes include delirium, substance use disorders, psychotic disorders, and eating disorders.4 Comorbidity of diabetes and mental illness is complex and can present as: The combination of mental illness and diabetes is related to worse health outcomes.1–4 Caring for patients with diabetes requires considering emotional and psychological needs together with physical health needs. Management of mental health should be a regular part of diabetes care and be delivered with the same commitment as attending to blood glucose values. Early identification of potential risks and subclinical distress is preferable to waiting for a patient’s mental health or physical health (due to poor mental health) to deteriorate before action is taken. On the other hand, caring for patients with psychosocial issues requires addressing their physical health. A major problem in looking after people with mental illness and diabetes …