Delegation of clinical tasks from physiotherapists to physiotherapy support workers varies considerably in musculoskeletal outpatient physiotherapy services leading to variation in patient care. This study aimed to develop consensus amongst physiotherapists, support workers and managers about what components should be included in a future framework to guide effective and safe delegation of clinical tasks to physiotherapy support workers in United Kingdom\'s National Health Service musculoskeletal outpatient physiotherapy services.
A consensus study was carried out, using Nominal Group Technique. Seven physiotherapists, ten physiotherapy support workers and ten physiotherapy operational/clinical leads from 13 musculoskeletal physiotherapy services within United Kingdom\'s National Health Service were recruited through the Chartered Society of Physiotherapy\'s professional networks and social media. Three separate, role-specific consensus groups were convened, involving participants generating, discussing and rating on a Likert scale, components for inclusion in a future delegation framework.
32 out of 38 generated items reached consensus of ≥70%, i.e. a mean of ≥4.9 on a 7-point Likert scale, across the three groups. Items were grouped under five main categories: 1) training/Continuous Professional Development for physiotherapists and support workers; 2) need for a clear delegation process; 3) competencies 4) defining the role of support workers and 5) safety net.
Key stakeholder groups were able to reach consensus on five priority areas which will be developed into a best practice framework to standardise delegation and guide physiotherapists when delegating clinical tasks to support workers.

BACKGROUND: Understanding the cognitive processes of individuals with intellectual disabilities in financially abusive situations is critical to develop effective prevention strategies.
OBJECTIVE: This study investigated how persons with intellectual disabilities define and analyse financially abusive situations, and how they would feel and act in situations that they consider abusive.
METHODS: Twelve participants with intellectual disabilities participated in a semi-structured interview where they were asked to reflect on three vignettes illustrating financial abuse. We analysed the interviews using thematic analysis.
RESULTS: The findings revealed that individuals with intellectual disabilities considered the type of relationship between the victims and the perpetrators, the behavioural patterns of the perpetrators, and their own experiences when interpreting the situation. Furthermore, they discussed their emotional and behavioural reactions to the vignettes.
CONCLUSIONS: This study has important implications in supporting the autonomy and decision-making rights of persons with intellectual disabilities regarding their finances and developing effective preventions against financial abuse among this population.

BACKGROUND: People with intellectual disability have a poorer health status than the general population. In The Netherlands, support workers play a key role in meeting health support needs of people with intellectual disability. Research on how people with intellectual disability and their support workers experience the support worker\'s role in preventing, identifying, and following up health needs of people with intellectual disability is scarce. To enhance health support of people with intellectual disability it is crucial that we understand how health support is delivered in everyday practice. Therefore, this study investigated experiences of people with intellectual disability and support workers with the health support of people with intellectual disability.
METHODS: Data collection consisted of six focus group (FG) discussions with between four and six participants (N = 27). The FGs consisted of three groups with support workers (n = 15), two groups with participants with mild to moderate intellectual disability (n = 8), and one group with family members as proxy informants who represented their relative with severe to profound intellectual disability (n = 4). The data was analysed thematically on aspects relating to health support.
RESULTS: We identified three main themes relevant to the health support of people with intellectual disability: 1) dependence on health support, 2) communication practices in health support, and 3) organizational context of health support. Dependence on health support adresses the way in which support workers meet a need that people with intellectual disability cannot meet themselves, and communication practices and organizational context are identified as systems in which health support takes place.
CONCLUSIONS: This study investigated experiences with the health support of people with intellectual disability from the perspectives of people with intellectual disability and support workers. We discuss the dependence of people with intellectual disability and the complexity of health support in everyday practice. We provide practical implications that can strengthen support workers in the provision of health support for people with intellectual disability in everyday practice. The findings of this study emphasize the need for intellectual disability care-provider organizations to establish policies around consistency in support staff to make it easier to identify and follow up health needs, and an environment where support staff can develop their expertise concerning communication practices, lifestyle choices, and identifying and following up health needs.

individuals who are homeless encounter extreme health inequalities and as a result often suffer poor health. This study aims to explore ways in which access to healthcare could be improved for individuals who are homeless in Gateshead, UK.
twelve semi-structured interviews were conducted with people working with the homeless community in a non-clinical setting. Transcripts were analysed using thematic analysis.
six themes were identified under the broad category of \'what does good look like\', in terms of improving access to healthcare. These were: facilitating GP registration; training to reduce stigma and to provide more holistic care; joined-up working in which existing services communicate rather than work in isolation; utilising the voluntary sector as support workers could actively support access to healthcare and provide advocacy; specialised roles such as specialised clinicians, mental health workers or link workers; and specialised bespoke services for the homeless community.
the study revealed issues locally for the homeless community accessing healthcare. Many of the proposed actions to facilitate access to healthcare involved building upon good practice and enhancing existing services. The feasibility and cost-effectiveness of interventions suggested requires further assessment.

Achieving high levels of vaccination among disability support workers (DSWs) is critical to protecting people with disability from COVID-19 and other vaccine-preventable diseases.
To identify how demographic factors, risk perceptions of COVID-19 and the COVID-19 vaccine, and views about COVID-19 vaccination are associated with COVID-19 vaccine hesitancy among DSWs.
Survey of 252 Australian DSWs conducted in March and early April 2021. Participants were classified as vaccine hesitant if they had not been vaccinated and would not have the vaccine when offered it. Logistic regression analysis was used to control for confounders.
52.4% of DSWs were hesitant with females being more likely to be hesitant than males (58.2% female, 38.1% male). Hesitancy was more frequent among DSWs who were not worried about COVID-19 for themselves or their family (adjusted odds ratio (AOR) 1.86, 95% CI 1.0-3.45); did not agree they were at more risk than the rest of the community (AOR 2.29, 95% 1.25-4.20); were concerned about vaccine safety (AOR 22.86, 95% CI 10.59-49.13) and were not confident the vaccine would protect them (AOR 6.06, 95% CI 3.21-11.41) or the clients from COVID-19 (AOR 6.03, 95% CI 3.19-11.41). DSWs who thought vaccination was a personal choice were more likely to be hesitant (82.1%) than those who thought it was a community responsibility (27.6%).
The study shows that increasing vaccination rates among DSWs requires targeted strategies that emphasise the seriousness of the infection; the potential for vaccines to reduce transmission; and vaccine safety and efficacy.

Support workers are an underrepresented profession that receives less attention with a high degree of responsibilities. The aim of this study was to explore the lived experiences of healthcare support workers within the care sector during the COVID-19 pandemic. This is a qualitative semi-structured interview study using an interpretative phenomenology (IP) framework. Fifteen (15) support workers were interviewed while all COVID-19 restrictions from the government were still in place. We identified five main themes: (1) challenging experiences; (2) coping mechanisms; (3) emotions and behaviors arising from the COVID-19 pandemic; (4) external interest on support worker\'s health; (5) take-home message from the COVID-19 pandemic. The organization selected for the research is a good representative of how care organizations operate within the UK both in terms of policies and staff selection.

This paper describes the development and preliminary evaluation of a novel participant-led video (PLV) intervention to support people with disability (PWD) and cognitive and communication impairments to communicate their needs and preferences to their disability support workers. The PLV intervention was designed following a scoping literature review and workshop with PWD and close others. Subsequently, it was piloted with five primary participants with acquired brain injury and cognitive and communication impairments, five close other supporters and five facilitators. An independent mixed methods evaluation of the pilot was conducted with participants, close others and facilitators. All pilot evaluation participants reported high levels of satisfaction with the PLV intervention (mean ratings: primary participants 4.5/5.0; supporters 5.0/5.0; facilitators 4.8/5.0). When primary participants and their supporters were asked to rate how likely they were to recommend the PLV intervention, responses were extremely positive with the mean rating exceeding eight on a 10-point scale. Qualitative analysis of interview data revealed the PLV to be a person-centred experience for primary participants that was structured around sense of self and included having a voice and taking control in directing their lives, personal growth through participation and feeling validated through the experience. The production and use of PLV training resources has much potential to improve the delivery of support and maximise support outcomes by enabling people with cognitive and communication impairments to have choice and control, set their own goals and direct their supports. Further research is required with a larger sample size and longitudinal evaluation of participant outcomes.

Support workers are an \"invisible\" part of the health sector often working during pandemics to support clients. This meta-ethnography screened 167 articles out of 211 results identifying 4 qualitative studies that explored the support worker\'s experiences during the COVID-19 pandemic. \"Redundancy approach\" was used to map non-essential criteria and the analysis was informed by the interpretative meta-ethnography method. Eight key themes identified from studies in UK and USA. The themes identified are: (1) job role; (2) marginalized profession; (3) impact of work; (4) concerns surrounding PPE; (5) transportation challenges; (6) level of support and guidance; (7) a higher calling and self sacrifice; (8) adaptation strategies. Adaptation strategies include purchasing their own masks, to policy and agency adaptation, cleaning, talk walks, meetings with colleagues or within the company. The adaptation strategies aim at tackling emotional distress and raise the level of appreciation that society or organizations show to the support workers.

It is increasingly common for domestic and family violence to have an element of technology-facilitated abuse (TFA). As a result, technology-based responses have emerged to address TFA. Using observations from several empirical research projects into TFA, it will be shown that technology-based responses are necessary without being sufficient, and that they have persistent limitations that need to be recognized. Relatedly, it will be argued that there should be an ongoing emphasis on the development of human resources as a support for those experiencing TFA, particularly the use of professional DV support workers.

The first objective was to assess the feasibility of training on hearing aids and communication strategies by support workers in residential care via a cascade training model using two different training packages. The second was to identify key elements of these packages to inform the design of a multimedia training package.
Quantitative and qualitative methodologies were used. A pre-post feasibility design assessed the questionnaire data from residential care support workers to measure knowledge and confidence at three stages during the training. Semi-structured interviews explored the support workers\' experiences and adherence to cascading the training packages.
Fourteen support workers employed by Sense (charity for deafblind people) were trained to become \"Hearing Champions\" and cascaded their learning to 117 support colleagues.
Hearing Champions gained knowledge, skills and confidence, which were subsequently enhanced by sharing their learning with others. Despite individual and organisational barriers, they reported examples of improved practice and feelings of empowerment.
It is feasible to deliver training to support workers in residential homes using the face-to-face \"Hearing Champions\" and multimedia C2Hear training methods by cascading training to their colleagues. Support workers expressed a preference for training that is portable, adaptable and interactive.