UK Clients Research Articles

Clinical audit of POM-V / POM prescriptions by remote consultation via a veterinary video telemedicine smartphone application

Objective: To assess outcomes of a limited period (7 months) of remote video consultation with prescribing of prescription-only (POM) or prescription-only-veterinary (POM-V) medications by Royal College of Veterinary Surgeons (RCVS) registered veterinary surgeons to UK clients via a veterinary telemedicine smartphone application.
 Background: Objective evidence is needed to inform the veterinary profession on the impact that remote prescribing, without physical examination in person, has on animal health and welfare. During the COVID-19 pandemic, the RCVS allowed remote prescribing temporarily.
 Methods: Clinical records from all veterinary video consultations from 1 April–31 October 2020 were reviewed. Details were assessed pertaining to: signalment, body system / disease categories managed, referrals into practice, medication classes prescribed and outcomes following POM-V / POM medications. Records of adverse events and antimicrobial prescribing were reviewed.
 Results: 16.6% (3,541/21,383) of video consults had a POM-V / POM prescribed; with a (mild) adverse event rate of 0.8% (30/3541). Antibacterials were prescribed in 5.88% of all consultations (1,258/21,383), 99.3% (1249/1258) being first line. Follow-up on prescribing was available in 67.7% (2,399/3541) of cases. 89% (2135/2399) of all known treatment outcomes were complete or had an expected response to treatment. Dermatological disease was the most common body system / disease category seen and prescribed for.
 Conclusion: Low prescribing rates (including antibacterials) were recorded, treatments were efficacious and no harm was done by prescribing remotely via a veterinary video consult app.
 Application: Veterinary surgeons and governing bodies are invited to use the information provided in this clinical audit to inform decisions on the suitability of remote consultations and prescribing in veterinary medicine.
 

An evaluation of Anxiety UK's psychological therapy service outcomes

BackgroundAnxiety and depression are highly prevalent. The aim was to examine the effectiveness of Anxiety UK's national psychological therapy service; benchmarking against NHS IAPT data. MethodsWe examined psychological therapy outcome data for Anxiety UK clients who completed therapy between April 2019 – March 2020 and benchmarked this against NHS Improving Access to Psychological Therapies (IAPT) outcome data for the same period. Anxiety UK clients completed validated measures of anxiety and depression at two time points: the first and last therapy session. Caseness, recovery, reliable improvement and reliable recovery rates were based on IAPT definitions. Results957 clients completed at least two psychological therapy sessions with an Anxiety UK Approved Therapist. Recovery, reliable improvement, and reliably recovered rates exceeded IAPT targets. Depression and anxiety reduced from first to last session. Cognitive behavioural therapy produced the greatest change in anxiety over time compared to counselling and hypnotherapy. The more therapy sessions attended, the greater the change in anxiety and depression scores from the first to last session. LimitationsFor some clients, anxiety and depression levels may have alleviated without therapy. No outcome data were collected following therapy cessation. Therefore, conclusions regarding maintenance and long-term effects of therapy cannot be made. ConclusionAnxiety UK provide highly effective psychological therapies for anxiety and depression. Flexibility in the number of therapy sessions provided is recommended for NHS services and those of external organisations.

Variations in investment advice provision: A study of financial advisors of millionaire investors

Vignette methodology is used to examine how the personal characteristics of investors and financial advisors contribute to portfolio recommendations, and the judgements that advisors make about investment knowledge and control of prospective millionaire UK clients. We find that advisors use investor characteristics to make recommendations broadly in line with economic theory and regulatory requirements. However, women are judged less knowledgeable and in control of their investments than equivalent men. They also receive portfolio recommendations with slightly lower risk profiles. Portfolio recommendations vary by advisor, with experienced advisors and those with wealthier clients recommending higher risk portfolios. Unmeasured advisor variables also impact on judgements and recommendations. These findings have relevance to the wealth management industry and regulators, in focusing attention on the conscious and unconscious influences on the judgements advisors make about their clients.

Death or Bust? The Risk with Post-Retirement Models: A Quantitative Evaluation

The purpose of this report is to quantitatively evaluate whether commonly used models of asset returns pose a threat to the successful retirement of retirees. In doing so, we evaluate the whether the 4% ‘safe’ withdrawal rule holds with more realistic models of market behaviour. Our approach comprises a quantitative evaluation seven of the most common portfolio simulation approaches including: Simple analytic formula; Historical backtesting; Bootstrapping; Analytic Stochastic; Simple Monte Carlo; Filtered Historical Simulation; Regime Switching Monte Carlo. Our results indicate that not all commonly used models are suitable for post-retirement pension planning. Our research shows that it is critical that portfolio frictions, like platform fees and adviser costs, are included in the modelling process as not to do so misrepresents the risks to the client substantially. Given these higher risks, we conclude that UK clients need to be supported with variable expenditure plans, and some security for both income and longevity.

Ageing opioid users’ increased risk of methadone-specific death in the UK

BackgroundThe first evidence that the hazard ratio (HR) for methadone-specific death rises more steeply with age-group than for all drug-related deaths (DRDs) came from Scotland’s cohort of 33,000 methadone-prescription clients. We aim to examine, for England, whether illicit opioid users’ risk of methadone-specific death increases with age; and to pool age-related HRs for methadone-specific deaths with those for Scotland’s methadone-prescription clients. MethodsThe setting is all services in England that provide publicly-funded, structured treatment for illicit opioid users, the methodology linkage of the English National Drug Treatment Monitoring System and mortality database, and key measurements are DRDs, methadone-specific DRDs, or heroin-specific DRDs, by age-group and gender, with proportional hazards adjustment for substances used, injecting status and periods in/out of treatment. ResultsLinkage was achieved for 129,979 adults receiving prescribing treatment modalities for opioid dependence during April 2005 to March 2009 and followed-up for 378,009 person-years (pys).There were 1,266 DRDs: 271 methadone-specific (7 per 10,000 pys: irrespective of gender) and 473 heroin-specific (15 per 10,000 pys for males, 7 for females). Methadone-specific DRD-rate per 10,000 person-years was 3.5 (95% CI: 2.7–4.4) at 18–34 years, 8.9 (CI: 7.3–10.5) at 35–44 years and 18 (CI: 13.8–21.2) at 45+ years; heroin-specific DRD-rate was unchanged with age.Relative to 25–34 years, pooled HRs for UK clients’ methadone-specific deaths were: 0.87 at <25 years (95% CI: 0.56–1.35); 2.14 at 35–44 years (95% CI: 1.76–2.60); 3.75 at 45+ years (95% CI: 2.99–4.70). ConclusionInternational testing and explanation are needed of UK’s sharp age-related increase in the risk of methadone-specific death. Clients should be alerted that their risk of methadone-specific death increases as they age.

The internal and external challenges facing clients in implementing IMC

PurposeAlthough integrated marketing communication (IMC) is generally accepted as the way forward by academics and practitioners, there is a shortage of research into the challenges that clients face in implementing the process, particularly in the UK. This paper aims to address these issues by examining how UK clients perceive the barriers to implementation, with reference to the conflict theory of decision-making and the social exchange theory from the change management literature.Design/methodology/approachThe study adopted a critical realism approach and collected data through an on-line questionnaire to an expert panel of UK clients, which generated some rich qualitative data. The experts were asked to comment on four statements developed from the literature which captured the main challenges identified in previous research.FindingsThe results indicate that UK clients are facing similar barriers to those evident in other countries more than a decade ago. Three main obstacles are identified. First, some clients still find IMC difficult to understand and therefore may avoid change because of the high level of risk involved. Second, marketing departments lack control or influence over other parts of the organisation, due in some cases to lack of representation at board level. Finally, agencies do not have a clear role in the implementation of IMC.Originality/valueThe paper is of value because it specifically investigates the UK client perspective, which is presently sparse in the literature and updates the knowledge on barriers to implementation. It underpins this discussion with reference to change management theories. The paper also examines the support being provided by industry bodies and questions their effectiveness.

Briefing: The Institution of Civil Engineers' intelligent client capability framework

Recent aspirations to transform the delivery of major capital programmes and projects in the public sector are focusing on the achievement of value for money, whole-life asset management and sustainable procurement, embodied in the principles of the intelligent client. However, there is little support offered to those working in client functions to promote the development of the skills and behaviours that underpin effective client decision-making. In line with the relaunch of Infrastructure UK's Project Initiation Routemap, the capacity building panel at the Institution of Civil Engineers has taken the first step in providing individuals with client capability development guidance. The intelligent client capability framework translates the principles of the intelligent client into a self-assessment with big potential, not just for building the capacity of civil engineers as intelligent clients, but for UK clients in general.

Liechtenstein and United Kingdom Sign Agreement to Ensure Tax Compliance of UK Clients

In this note the author describes in detail the Liechtenstein–UK Tax Information Exchange Agreement, as well as the accompanying Liechtenstein–UK Memorandum of Understanding on cooperation in tax matters, which were signed on 11 August 2009 following Liechtenstein’s declaration on 12 March 2009 that it is committed to and will implement the OECD standards of transparency and exchange of information.

Modelling the satisfaction of contractors: the impact of client performance

An assessment of the performance of UK clients on 55 ‘case projects’ as considered by contractors is presented and used to develop models of contractors' satisfaction. Principal component analysis (PCA) reveals five dimensions to contractor satisfaction, classified in this research as (i) support provided to contractors, (ii) clients' attitude, (iii) clients' understanding of their own needs, (iv) quality of clients' brief, and (v) financial aspects of performance. Knowledge of these models should enable clients to perform better, which is conducive towards satisfactory participant performance and overall project performance. The models identify three key aspects of client performance that are found to significantly influence contractors' satisfaction levels, namely, (i) the capability of the client's representative, (ii) the client's past performance and project management experience and (iii) the financial soundness and reputation of the client. Additionally, the nature of the project and certain characteristics of contractors also influence satisfaction levels. The models demonstrated accurate predictive power and were found to be valid and robust. Clients could use the models to help improve their performance, leading to more successful project implementation. This will also promote the development of harmonious working relationships within the construction project coalition (PC).

Structural surveys in Europe

Discusses structural surveying in Europe pre‐1992 and the opportunities for UK firms to exploit the market afterwards. Outlines the expectations of the French client and the services available, the role of UK Building Societies in promoting UK techniques in Spain and the current advantages open to UK surveyors to profit from the local systems in Portugal and Germany. Suggests that the future will see an increase in continental professionals considering acquisitions, mergers and associations with UK firms of chartered surveyors and argues that opportunities for expansion will arise through work on new construction commissioned by UK clients in Europe, rather than on existing buildings.

Advertising Assessment—Myth or Reality?

In this paper the topic of advertising assessment is revisited, given the widespread availability of low-cost microcomputer modelling developments. It is recognised that when regression analysis became popular in the 1970s with the advent of the mainframe computer, much hype and little marketing benefit ensued. It is argued that simply speeding up the old practices of the 1970s, which rightly fell from favour, will provide no benefit to the advertising industry. ‘What is new’, the ‘benefits’ of advertising assessment, and where it is applicable are described. It is suggested that not only does technology facilitate data analysis, but also, critically, modelling methodology itself has changed, with a greater ability to remain close to one's data. As a consequence, it is argued that improved advertising decisions can only be made when the other elements of the marketing mix are formally taken into account. The methodology described in the paper has been developed and successfully applied in a number of sectors for different UK clients of Coopers and Lybrand, and Collett Dickenson and Pearce.

Films

A substantial library of film and video based training programmes has been established by CST Training Services, the specialist training division of Cygnet Guild Communications Ltd. With 35 titles initially, the material covers management, supervisory, sales, marketing, customer relations and financial subjects and emanates from two major US producers, Roundtable Films and Salenger Educational Media, plus CST's own productions for UK clients such as Cranfield School of Management and Structured Training Ltd.