Purpose Carers of people with mental health problems present with high levels of burden, poor mental well-being and feelings of disempowerment by mental health services. The purpose of this paper is to establish whether providing a psychoeducation skill programme for carers would lead to an improvement of mental well-being, reduce the levels of burden that carers sometimes feel while caring for someone with mental illness and also to increase empowerment. This paper provides a service evaluation study of an innovative carer-led psychoeducational intervention that was undertaken. Design/methodology/approach This programme was initiated and led by a carer who had experienced a lack of service provision to support carers and families in understanding and caring for a relative with severe and enduring mental health diagnoses. A model of co-production was adopted with the carer who led this initiative working closely with an occupational therapist and consultant psychologist in its development and delivery. Data were collected to measure the impact of the training at five different time points. The measures employed to measure outcomes were the Warwick-Edinburgh Mental Well-being Scale, the Burden Assessment Scale and Family Empowerment Scale. Findings Results indicated improved well-being, reduced burden and increased family empowerment in carers who completed this peer-led carer initiative psychoeducational programme. Research limitations/implications This service evaluation study was conducted in a single site and in the site in which it was developed. The carer consultant who led this evaluation and development of the intervention was also the peer worker who delivered the interventions. Hence, the authors are unable to ascertain if the results reported are unique to the individual peer worker. The transferability of this programme and generalisability of the result should therefore be treated with caution and further replication of this model and research is required. This would be beneficial to be conducted in an alternative site from where it was developed, delivered by different facilitators and include a control group. Practical implications The evidence from this study indicates that carers are able and willing to attend a group psychoeducational programme. A high number of referrals to the programme in a relatively short timeframe indicates that there is significant demand for such a service. The implementation of the programme is relatively straightforward. The key challenges for practical implementation are to have the right carer to lead and deliver the programme and the right support system in place for them (financial and supervision). Co-production also is not without challenges, the peer worker and occupational staff need to ensure that mutually valued and respected working relationship should develop. Originality/value This is the first evaluation of the impact of a carer-led psychoeducation intervention for carers of people with mental health difficulties in secondary mental health services.

ObjectiveTo better understand the factors that facilitate and hinder a positive experience of paediatric outpatient parenteral antimicrobial therapy (OPAT).DesignQualitative study using semistructured interviews.SettingA dedicated paediatric consultant-led hospital-based, outreach OPAT service in England.ParticipantsParticipants were primarily parents of children who had received OPAT; one child participated.MethodsChildren and parents of children who received OPAT and who had participated in the survey phase of the larger study were invited to be interviewed.Results12 parents (10 mothers and 2 fathers) of 10 children participated; one child (aged 15 years). Data analysis resulted in one meta-theme, ‘At-homeness’ with OPAT, this reflected the overall sense of home being a place in which the children and their parents could be where they wanted to be. Four key themes were identified that reflect the ways in which parents and children experienced being at-home on OPAT: ‘Comfort, security, freedom, and control’; ‘Faith, trust and confidence’; ‘Explanations and communication’ and ‘Concerns, restrictions and inconveniences’.ConclusionsDespite feeling anxious at times, parents reported that they and their children generally had a positive experience of OPAT; being at-home brought many benefits compared with in-patient care. Recommendations arising from the study include a ‘whole-system’ approach to discharge home that includes support related to return to school/nursery, reduction in disruptions to home-based routines, more clarity on choice and preparation for managing potential anxiety, better consideration of dose timing and enhanced preparation and information.

BackgroundThere has been little detailed systematic consideration of the delivery, setting and outcomes of paediatric Outpatient Parenteral Antimicrobial Therapy (OPAT), although individual studies report that it is a safe and effective treatment.ObjectiveThis scoping review aimed to examine what is known about the delivery, settings and outcomes of paediatric OPAT and to identify key knowledge deficits.DesignA scoping review using Arksey and O’Malley’s framework was undertaken.Data sourcesKeywords were identified and used to search MEDLINE and CINAHL.Study appraisal methodsPrimary research studies were included if samples comprised children and young people 21 or under, who had received OPAT at home or in a day treatment centre. The Mixed Methods Appraisal Tool was used to review the methodological quality of the studiesMain findingsFrom a preliminary pool of 157 articles, 51 papers were selected for full review. 19 studies fitted the inclusion criteria. Factors influencing delivery of OPAT were diverse and included child’s condition, home environment, child-related factors, parental compliance, training and monitoring. There is little consensus as to what constitutes success of and adverse events in OPAT.ConclusionsFuture studies need to clearly define and use success indicators and adverse events in order to provide evidence that paediatric OPAT is safe and effective.ImplicationsConsensus outcomes that include child and parent perspectives need to be developed to allow a clearer appreciation of a successful paediatric OPAT service.

Background Little evidence exists about parental satisfaction and their influence on referral to paediatric Outpatient Parenteral Antimicrobial Therapy (OPAT). Aim This study aimed to examine the experiences of parents, children and clinicians of OPAT at a large tertiary children’s hospital. Method A prospective e-survey, using closed and open questions, of parents (n = 33) of 33 children who had received OPAT (3 children completed a survey), and clinicians (n = 31) involved in OPAT at a tertiary hospital. Data were collected September 2016 to July 2018. Results Data were analysed using simple descriptive statistics. The results show that OPAT offered benefits (less stress, re-establishment of family life) compared to hospital-based treatment for parents and children, although some were anxious. Clinicians’ referral judgements were based on child, home, and clinical factors. Some clinicians found the process of referral complex. Conclusion Most parents and children were satisfied with the OPAT service and preferred the option of home-based treatment as it promoted the child’s comfort and recovery and supported family routines.

Objectives To understand severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission risks, perceived risks and the feasibility of risk mitigations from experimental mass cultural events before coronavirus disease 2019 (COVID-19) restrictions were lifted. Design Prospective, population-wide observational study. Setting Four events (two nightclubs, an outdoor music festival and a business conference) open to Liverpool City Region UK residents, requiring a negative lateral flow test (LFT) within the 36 h before the event, but not requiring social distancing or face-coverings. Participants A total of 12,256 individuals attending one or more events between 28 April and 2 May 2021. Main outcome measures SARS-CoV-2 infections detected using audience self-swabbed (5–7 days post-event) polymerase chain reaction (PCR) tests, with viral genomic analysis of cases, plus linked National Health Service COVID-19 testing data. Audience experiences were gathered via questionnaires, focus groups and social media. Indoor CO2 concentrations were monitored. Results A total of 12 PCR-positive cases (likely 4 index, 8 primary or secondary), 10 from the nightclubs. Two further cases had positive LFTs but no PCR. A total of 11,896 (97.1%) participants with scanned tickets were matched to a negative pre-event LFT: 4972 (40.6%) returned a PCR within a week. CO2 concentrations showed areas for improving ventilation at the nightclubs. Population infection rates were low, yet with a concurrent outbreak of >50 linked cases around a local swimming pool without equivalent risk mitigations. Audience anxiety was low and enjoyment high. Conclusions We observed minor SARS-CoV-2 transmission and low perceived risks around events when prevalence was low and risk mitigations prominent. Partnership between audiences, event organisers and public health services, supported by information systems with real-time linked data, can improve health security for mass cultural events.

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Child death overview panels (CDOPs) were set up in the United Kingdom following the confidential enquiry into maternal and child health. Their scope is to identify learning points and modifiable factors that focus on improving services and prevent further deaths. In the light of UK national review and subsequent legislative changes to local safeguarding arrangements, we wanted to share the lessons learnt from our local network study during this time of transition. At times of system change, organizational memory can be eroded, which results in lost opportunities to further strengthen multi-agency working in practice. Overall, our local study highlighted key learning points which could be of use in emergent safeguarding partnerships. Professionals need to continue to actively pursue and create opportunities to collect and collate comprehensive data and promote collaborative multi-agency arrangements. Panels need to be responsive to all partners involved in the safeguarding process, which includes parents. A level of reciprocity needs to be nurtured for safeguarding panel members and acute care providers to work in ways which promote learning, consider emotional support systems and explore ways to define and mobilize knowledge that can inform the safeguarding process and prevent future avoidable child deaths.