London Borough Research Articles

External Peer Challenge in Local Government: The Role of Spatial Spillover and Past Performance

AbstractVoluntary assessments by a team of critical friends (external peer challenges) among local governments became established as popular complement to compulsory and centralized audits and inspections. This study empirically investigates the decision of English local authorities to have a voluntary peer challenge or not by taking advantage of an original dataset about participation in the Local Government Association’s Peer Challenge Programme (CPC) 2010–2015. We find that the LGA’s CPC programme does not carry a risk of leaving behind authorities with performance shortcomings. Councils with poor past performance scores and those with excellent ones do not differ in their tendency to invite a team of critical friends. Spatial clusters exist in the case of small district councils but not in the case of larger unitary authorities, London boroughs and metropolitan authorities. This implies that the corporate peer challenge process seems to be more suited to small authorities delivering community based services.

An innovative multi-agency consultation model for harmful sexual behaviour displayed by children and young people: practice paper

ABSTRACT Harmful Sexual Behaviour (HSB) has been regularly documented as a demanding area of practice within the United Kingdom (UK). The aim of this paper is to share a practice model developed in an under-resourced inner London borough. The HSB forum is formed of a multi-agency group of professionals and runs monthly providing a platform for practitioners to seek consultation for young people they are working with who are displaying HSB's. Initial feedback for the forum from practitioners has been consistently positive and they have valued specifically the opportunity to formulate, have clear directions, and the multi-disciplinary perspective. In addition, most reported feeling empowered to implement the recommendations suggested. Given the shared vulnerability factors between those displaying HSB's and other at-risk young people such as those who are being sexually exploited, this model provides an innovative way that practitioners can be supported by multiple agencies where there is a lack of specialist services.

Testing the feasibility of a sustainable preschool obesity prevention approach: a mixed-methods service evaluation of a volunteer-led HENRY programme

BackgroundOver the last 10 years HENRY has been working to reduce and prevent child obesity by training health and early years professionals to deliver its evidence-based programme to parents. The aim and unique contribution of this study was to evaluate whether training volunteers to deliver this programme on a one-to-one basis was feasible.MethodsMixed-methods service evaluation with parent-reported pre- and post-programme outcomes and focus groups conducted with parents and volunteer facilitators. The programme consisted of 8 one-to-one sessions delivered weekly by volunteers (n = 18) to build food and activity-related knowledge, skills, and understanding, and improve parenting efficacy, and parent and child eating and physical activity. Programmes took place at parent’s (n = 69) home or local community venues in four London boroughs, United Kingdom. Parent-reported parenting efficacy, emotional wellbeing, eating, and physical activity data were captured, alongside parent ratings of the programme and volunteer ratings of the training. Parent and volunteer focus groups explored involvement, expectations, and experiences of the programme, training and delivery, feedback, and impact.ResultsParents were mostly female, had varied ethnic backgrounds, and were often not working but well educated. There were statistically significant improvements of a medium-to-large size in parent and child emotional wellbeing, parenting efficacy, fruit and vegetable consumption, family eating and food purchasing behaviours. Parent ratings of the programme were positive and qualitative data highlighted the holistic nature of the programme, which focused on more than just food, and the relationships with volunteers as key facets. Volunteers were also mostly female, had varied ethnic backgrounds, and were often well educated, but more likely to be employed than parents. Volunteers rated the training and delivery as useful in enabling them to deliver the programme confidently and for their own wellbeing. Despite finding some sessions challenging emotionally, volunteers reported positive family lifestyle improvements by parents and children and that the experience would be useful for future employment.ConclusionsIt is feasible to recruit and train volunteers to deliver a structured preschool obesity prevention programme, which parents considered acceptable and enjoyable, with preliminary reports of parent and child benefits.

The effect of urban development on runoff volumes in the London Borough Barking and Dagenham

Estuarine and coastal areas have always had an issue with regard to an increased level of flood hazards. In addition, since urban developments have an impact on water runoff, future house building plans and new decisions to prevent flooding are essential. The peak rate of runoff is greater for a developed site than it was for the pre-development sit and flood recovery of developed sites requires more time. Therefore, it is crucial to ensure that future developments do not worsen flooding problems. The London Borough of Barking and Dagenham (LBBD) is an example of an area in the north-east corner of London, on the north bank of the River Thames which is currently undergoing major developments. The runoff coefficient as calculated by the Wallingford modified rational method, the geographic information system, and the core strategy in the LBBD illustrated that there was an increase in the peak runoff discharge by about 29.4% following developments. The use of sustainable urban drainage systems and other feasible mitigations such as drainage systems could reduce the risk of flooding as a result of surface water runoff.

Activists, Influencers, or Participants?: A Muslim Culture Forum and the London Borough of Culture 2019

Activists, Influencers, or Participants?: A Muslim Culture Forum and the London Borough of Culture 2019

Interests, Gender Differences, Impulsivity and Reflectivity among Year Three Pupils in London (U.K.) Schools

The achievement of year 3 pupils in the classroom may be influenced by how they are taught familiar topics. That is, it is suggested that pupils may develop interests such as hobbies which are related to academic studies at school. It is therefore hypothesised that the extent to which year 3 pupils are interested in school subjects is a major factor contributing to performances in terms of time taken to complete tasks, errors made during completion and the type of strategies pupils use for successful completion of tasks. The extent to which pupils make errors and the time it takes to complete matching tasks of interest, is used as an indicator of how ‘reflective or impulsive’ pupils are, and this has implications for academic achievement. Thirty girls and thirty boys, (7-8 years old) were recruited for a study across five primary schools in a London Borough (England, U.K.). Interest and lack of interest in things was elicited using an interview and simple matching tasks were used to establish performance on tasks of interest and disinterest. Boys generally made slightly more errors than girls and were quicker when making matches. Girls used ordered strategies to make matches compared with random/global strategies for boys. The implications for this research are: - training of pupils to problem-solve using appropriate strategies; establishing ways of developing students’ subject interests and encouraging teachers to find ways of using suitable styles for individual students’ needs who are either reflective or impulsive.

Major investment in active travel in Outer London: Impacts on travel behaviour, physical activity, and health

IntroductionThis paper analyses three years’ data from the People and Places longitudinal study. The study examines the travel behaviour impacts of major investments in active travel infrastructure in three Outer London boroughs (the ‘mini- Hollands programme’). MethodsThe People and Places survey, conducted annually in May-June, treats the mini-Holland interventions as a ‘natural experiment’. Participants in other Outer London boroughs form a control group. The survey had over 3,000 respondents at baseline (May-June 2016). Three follow-up waves each had over 1400 repeat respondents. A difference-in-differences analysis was used to compare changes in active travel uptake in intervention and control groups. Further analysis examines likelihood of meeting targets for past-week active travel and all physical activity. Finally, the article conducts a health economic benefit assessment based on uptake of active travel at Wave 3. ResultsAt all waves, living close to mini-Holland interventions (‘high-dose’ areas) was consistently associated with increased duration of past-week active travel, compared with the control group (44.0 extra minutes in Wave 2, 41.0 in Wave 1, and 41.5 in Wave 3). Changes in active travel behaviour were stronger in the high-dose area than in the low-dose area. Most of the increase was in walking. People living in high-dose areas were 13% more likely at Wave 3 to achieve 140 minutes active travel than people in control areas. People living in high- or low-dose areas in mini-Holland boroughs were more likely to be physically active for 5 days in the past week. The 20- year health economic benefit in high-dose areas from three years’ of interventions (costing £80 million) is £724 million. ConclusionAmbitious interventions can yield substantial health economic benefits from changes in active travel. This includes early uptake of walking as well as cycling. Most of the increase was in walking but the ratio varied by year.

Covid-19, county lines and the seriously “left behind”

Purpose The purpose of this study is to suggest how the Covid-19 lockdown may affect illicit drug users and vulnerable children and young people who become involved in County lines drug dealing. Design/methodology/approach This is an “opinion piece” based on data released by central and local government departments and voluntary sector sources concerning the impact of the Covid-19 restrictions on illicit drug users and vulnerable children and young people. The data is augmented with information from recent discussions with police officers, youth workers and social workers in a London borough. Findings It appears that the Covid-19 restrictions have had, and will continue to have, a deleterious impact upon both illicit drug users and the young people caught up in County lines drug distribution. Originality/value The study’s originality lies in its attempt to use a range of sources to anticipate the consequences of the Covid-19 restrictions on illicit drug users and vulnerable children and young people.

Highest Harm Crime “Recruiters” in a London Borough: a Case of Moving Targets

Highest Harm Crime “Recruiters” in a London Borough: a Case of Moving Targets

Point Prevalence of Gastrostomy in a Paediatric Population.

The aim of the study was to determine the prevalence of gastrostomy in a paediatric population. A population-based cross-sectional point prevalence study of paediatric gastrostomy was performed. Patients included were ages 0 to 19 years, living within 3 inner-city London boroughs; Southwark, Lambeth, and Lewisham. Patients were identified as having a gastrostomy in situ via Home Enteral Nutrition (HEN) and community nursing databases. Electronic healthcare records were scrutinised to confirm current use of a gastrostomy. The main outcome measures were the point prevalence of gastrostomy in the paediatric population (gastrostomies/100,000 children), primary diagnosis, indication underlying gastrostomy insertion, and age at insertion. The total population studied was 946,709, of whom 213,920 were of age 0 to 19 years. Of these, 179 had a gastrostomy in situ giving a point prevalence for gastrostomy in the paediatric population of 83.7 (95% confidence interval [CI]: 71.4-96.0)/100,000 children. This varied between age groups: 0 to 4 years: 79.6 (57.3-102.0)/100,000, 5 to 9 years: 116.3 (88.7-143.9)/100,000, 10 to 14: years 87.9 (61.9-113.9)/100,000 and 15 to 19: years 41.4 (22.1-60.1)/100,000. The most common primary diagnoses were neurological disorders (57.1%), and structural abnormalities (16.2%). Unsafe swallow was the most common indication (61%), followed by nutritional or fluid supplementation (28.6%), and behavioural reasons (8.7%). The majority (85.1%) of gastrostomies were inserted under the age of 2 years. This is the first UK population-based study of paediatric gastrostomy, identifying a point prevalence of 84/100,000 children. The peak prevalence is in children ages 5 to 9 years. Gastrostomy insertion after a child reaches school age is uncommon.

Novel Linkage of Administrative Health and Family Court Data to Examine Mental Health Need Among Women Whose Children Enter Care

IntroductionAn estimated 23% of children in England are exposed to maternal mental health problems, with growing concern around how maternal mental health affects parenting capacity and entries into public care for their children. There is limited evidence on the prevalence of mental health service need among women whose children enter care and on whether these needs are sufficiently met. With England’s family justice system and children’s social care sector increasingly overstretched, there is a need to identify opportunities for an improved response to maternal mental health.
 Objectives and ApproachWe linked administrative family court data for women (n = 5463) involved in public family court proceedings (care proceedings) across eight London boroughs between 2007 and 2019, with patient records from South London and Maudsley NHS mental health trust (SLaM). Work is ongoing to (1) describe the frequency, type and timing of mental health service use among women who link and (2) compare these findings to general population trends.
 Results2843 (52%) women linked to a SLaM patient record via deterministic linkage. Matches had better recording of identifiers and were more likely to have returned to court than non-matches (36% vs 26%). The majority of women (75.0%) were referred for treatment before the start of their (first) care proceeding, while 34.8% had a diagnosis recorded in a structured field. To appraise linkage quality, we manually reviewed de-identified clinician notes for 100 randomly selected women who linked; we confirmed ‘true’ match status for 95 women and found no evidence contradicting match status for the remainder.
 Conclusion / ImplicationsThis novel linkage between mental health and family court data supports growing evidence that women whose children enter care in England have high prevalence of mental health problems. Research using this linkage will help to inform strategies to improve maternal mental health and outcomes for vulnerable women and their children.

Allocating Unique Property Reference Numbers to Patient Addresses Using A Deterministic Address-Matching Algorithm: Evaluation of Accuracy, Match Rate and Bias

IntroductionRepresenting patient-registered addresses as pseudonymised Unique Property Reference Numbers (UPRNs) enables linkage of environmental and household information to electronic health records (EHRs). However, the accuracy and potential biases in address-matching algorithm results applied to patient addresses is unknown.
 Objectives and ApproachTo investigate accuracy, match rate, and biases in assigning UPRNs to general practitioner (GP)-registered patient addresses for a geographically-defined UK population, using a bespoke deterministic address-matching algorithm comprising 213 rules applied in rank order of minimising false-positives, developed for the Discovery Data Service.
 We ran this algorithm to match 906,220 adult patient GP-registered addresses (48% female, 47% non-White, 89% 20-64) sampled in mid-2018 from 159 GP practices in four London boroughs to Ordnance Survey’s AddressBase Premium database.
 We evaluated the error rates using a gold-standard dataset. We used binary logistic regression to estimate the likelihood (Odds Ratio [OR]; 95% Confidence Intervals [CI]) of no UPRN match according to and adjusting for patient age, sex, ethnic background, deprivation, residential mobility and multiple GP registrations.
 Results96% of patient addresses were successfully assigned a UPRN. Algorithm sensitivity, specificity, positive and negative predictive-values and F-measure were, respectively: 0.993, 0.019, 0.914, 0.204, and 0.9516.
 After mutual adjustment, UPRN assignment was less likely for: men (OR: 0.87; 95%CI: 0.83,0.91); adolescents and the elderly (15-19 years: 0.57;0.43,0.77; ≥90 years: 0.39;0.18,0.84); those from Chinese ethnic backgrounds (0.87;0.8,0.91), living in the least deprived areas (0.25;0.21,0.31), or with two or more distinct UPRNs across multiple registrations (0.37;0.28,0.49); and more likely for: those from Bangladeshi ethnic backgrounds (1.79;1.61,2.00), registered before 2018 (5.10;4.42,5.87), or with multiple GP registrations (2.36;1.82,3.05).
 Conclusion / ImplicationsThe Discovery open-source algorithm achieves a high accurate match rate and quantifies the demographic groups that may be under-represented among those successfully matched. This is the first time that bias in matching rates for an address-matching algorithm has been evaluated using patient-registered addresses.

Socio-economic inequalities in social network, loneliness and mental health during the COVID-19 pandemic.

Background:During the COVID-19 pandemic, a focus on isolation and loneliness is important, especially as social distancing policies (which for some groups involve self-isolation or quarantine) are likely to accentuate these experiences and affect mental health.Aims:This study focuses on socio-economic inequalities in social network, loneliness and mental health during the COVID-19 pandemic.Methods:Two-hundred and fourteen residents of Wandsworth, a South West London Borough in the United Kingdom completed an online cross-sectional survey on the impact of COVID-19 on mental health. Data were analysed using independent samples t-tests and multiple regression.Results:Middle-aged people reported a less strong social network and more loneliness, anxiety and depression than younger people. People with a long-term health condition reported a less strong social network, more loneliness, more general practitioner (GP) and hospital visits, and poorer mental health than those with no long-term health conditions. People receiving State financial benefits reported less use of public spaces, a less strong social network, more loneliness, more GP and hospital visits and poorer mental health than those not receiving benefits. Greater neighbourhood identification was associated with a stronger social network and better mental health outcomes. Multiple regression analyses showed that, over and above loneliness, perceived personal risk of COVID-19 constitutes an additional precipitant for both depression and anxiety when controlling for other variables.Conclusion:As a novel stressor associated with the pandemic, the situational and involuntary perception of being at risk of COVID-19 may be stimulating anxiety and depressive symptomatology, which will need to be managed effectively as resurgences of the disease are predicted and communicated to the general public under growing mistrust and uncertainty.

Highest Harm Crime \u201cRecruiters\u201d in a London Borough: a Case of Moving Targets

Research QuestionCan criminal recruiters be identified and ranked by crime harm levels in a London borough, and if so, how long is the predictive window of opportunity for targeting them with crime prevention efforts?DataThis study deploys 5 years of Metropolitan Police Service crime data, relating to one of the 32 London boroughs in that time period. The data structure allowed identification of all suspects linked to the same crime report and all crime reports linked to the same suspects. Identification of linked suspects and their associated crime harm was undertaken using Structured Query Language (SQL) and ColdFusion Markup Language (CFML) via a web-based application.MethodsAll offenders were ranked by the number of co-offenders they acquired, as well as the total Cambridge crime harm index weight of the detected offences associated with them.FindingsThe highest harm recruiters are shown to be up to 137 times as harmful as the average offender, with one recruiter committing the same number of crimes as another but having 97 times more crime harm. Recruiter populations are highly dynamic, with few potential targets persisting from year to year over multiple years.ConclusionsThis study suggests that criminal recruiters are readily identifiable from police data, but police would only have a short window of opportunity to use deterrent or other preventive strategies with them once they are identified.

Quality improvement project to eliminate the occurrence of never events during insertion of intrauterine contraception

AimThis project aimed to reduce the occurrence of never events during insertion of intrauterine contraception (IUC), within Central North West London NHS Foundation Trust (CNWL) clinics, to zero within 6...

Supporting youth workers: A reflective group consultation approach

Forensic child and adolescent mental health services (FCAMHS) became a service within the Tavistock and Portman NHS Foundation Trust in 2018, and since then has become a multidisciplinary expansion of the Portman Clinic’s consultation and assessment work. FCAMHS provides specialised consultation, assessment and brief interventions to professionals, families, and young people across 13 boroughs in Central, North, and East London. As a service provider we aim to support third sector service users who are working directly with some of the most vulnerable, at risk, and risky young people in our area. Through an existing contact in a local youth organisation we began to discuss the idea of creating a space where professionals could come together as a group to reflect on experiences and identify areas of difficulty in their work. Reflective practice groups offered by the Portman Clinic are often psychoanalytically-informed consultation groups which offer a way of working with professionals and young people by reflecting on the meaning, communication and experience of the young person’s behaviour, and our own responses to this. Therefore, we decided to offer a reflective practice group to third sector professionals known to FCAMHS from local youth services and other local agencies, who work with some of the most vulnerable, challenging and high risk young people in this location of London. This reflective practice group has now been running for almost two years and provides a valuable space for youth workers to process and make sense of their work with this challenging forensic population.

‘Playing the Game’: Power, Authority and Procedural Justice in Interactions Between Police and Homeless People in London

Abstract We explore the relevance of procedural justice theory for understanding the relationship between police and marginalized groups and individuals. Analysis is based on ethnographic research into the policing of the street population in an inner London borough through shadowing policing patrols and embedding observation within the homeless community. Police–street population relationships appear characterized by: (1) a structural context of extreme disempowerment; (2) a micro-sociological dimension relating to the exercise of authority and (3) a dynamic power relationship characterized by ‘the game of cat and mouse’. The nature of interactions within this context and the extreme marginality of the street population alter the weight placed on fairness perceptions and the extent to which police activity can affect legitimacy and compliance.

“No shit Sherlock”! Canine DNA and policing public space

PurposeThis paper argues that this animal surveillance has the potential for considerable function creep going far outside the scheme's original objectives and acts as a conduit for more problematic surveillance of humans. This results in social sorting of people with subsequent unforeseen consequences leading to discrimination and curtailment of freedoms for both animals and their owners. Ultimately this opens people up to further intrusive targeting by commercial interests and, more alarmingly, scrutiny from law enforcement agencies.Design/methodology/approachAn empirical study examining an initiative involving the collection of canine DNA sources data from publicly available Cabinet, Select Committee and Scrutiny Committee records from the London Borough of Barking and Dagenham (LBBD). It also draws on news media sources, publicity material from the company running the scheme and from this and other local authorities. Methods include analysis of documents, semiotic and discourse analysis.FindingsThis paper highlights the importance of animals to surveillance studies and examines the extent to which animals are a part of the surveillant assemblage in their own right. It also demonstrates how nonhuman animals extend the reach of the surveillant assemblage.Social implicationsThe scheme was called a badge of considerate dog ownership, yet it is one that can be franchised to tie up with diverse income streams being described as advantageous in the age of austerity. In 2017, it was reported that this scheme was to be rolled out in other areas and was moving from being voluntary to being mandatory with the enforcement of Public Space Protection Orders (PSPOs). These have been described as “geographically defined ASBOS” that have come into force under the Anti-social Behaviour and Policing Act (2014); they often work to criminalise activities that were not previously considered illegal.Originality/valueIn the theorising of surveillance, animals have been largely overlooked. Epidemiological studies proliferate, yet the role of animals in many aspects of everyday surveillance has been neglected.

Cross-school ‘close-to-practice’ action research, system leadership and local civic partnership re-engineering an inner-city learning community

This article presents two sequential case reports of how 60 schools in the London Borough of Camden used action research in three phases of development of their local school system reform, from a traditional council-led, top-down model of centrally based professional development and monitoring of schools, to one that is schools-led and ‘bottom-up’ in nature, but still in close partnership with its local council and community. The article uses a sociocultural lens through which to view this journey of self-reform, tracking change through three evolutions of the sociocultural model as professional learning becomes situated in classrooms and between schools in Camden, as motivations to develop and change become increasingly intrinsic and less driven by fear of failure or the consequences of failure. Of critical importance is the feedback-rich context created by adoption of enquiry- and coaching-based learning models at classroom, organizational and system levels. This both fuels and is fuelled by the strategic collaboration of head teachers and by system leadership also provided by middle leaders, whose increased cross-school agency builds improvement capacity and collaborative capital. The article does not report on the action research alone: unlike many accounts of action research for change, this account provides a narrative backdrop in which to locate both scientific and system developments. This is provided through three short vignettes that place the changes reported in a societal, political and community context, without whose energetic actors (in the form of local political and community leaders and school governors) the local ‘civic governance’ so strongly behind these reforms, would not have existed.

Cognitive Trajectories in Comorbid Dementia With Schizophrenia or Bipolar Disorder: The South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLaM BRC) Case Register

ObjectivesWe aimed to compare trajectories of cognitive performance in individuals diagnosed with dementia with and without severe mental illness (SMI). DesignRetrospective cohort study. SettingWe used data from a large longitudinal mental healthcare case register, the Clinical Record Interactive Search (CRIS), at the South London and Maudsley NHS Foundation Trust (SLaM) which provides mental health services to four south London boroughs. ParticipantsOur sample (N = 4718) consisted of any individual who had a primary or secondary diagnosis of dementia from 2007 to 2018, was 50 years old or over at first diagnosis of dementia and had at least 3 recorded Mini-Mental State Examination (MMSE) scores. MeasurementsCognitive performance was measured using MMSE. Linear mixed models were fitted to explore whether MMSE trajectories differed between individuals with or without prior/current SMI diagnoses. Models were adjusted by socio-demographics, cardiovascular risk, smoking, and medication. Results and conclusionsOur results showed differences in the rate of change, where individuals with comorbid SMI had a faster decline when compared with those that have dementia without comorbid SMI. However, this association was partially attenuated when adjusted by socio-demographics, smoking and cardiovascular risk factors; and more substantially attenuated when medication was included in models. Additional analyses showed that this accelerated decline might be more evident in individuals with bipolar disorders. Future research to detangle the potential biological underlying mechanisms of these associations is needed.