Lay perceptions of the desired role and type of user involvement in clinical governance.

Objective: The aim of this paper is to explore variations in lay perceptions of user involvement in clinical governance.

Context: The English National Health Service has sought to build a dependable health service through enhanced effectiveness, responsiveness and consistency. Clinical governance, a policy for improving service quality, is a key pillar of these reforms.

Exploring barriers to teaching behavioural and social sciences in medical education.

Context: Tomorrow's Doctors provides guidance about what is considered core knowledge for medical graduates. One core area of knowledge identified is the individual in society: graduates are required to understand the social and cultural environments in which medicine is practised in the UK. Yet, despite the presence of the behavioural and social sciences (B&SS) in medical curricula in the UK for the past 30 years, barriers to their implementation in medical education remain.

Doctors' understanding of palliative care.

Palliative care has been challenged to share its message with a wider audience, and for many years it has been articulating an approach that is suitable for all patients. However, it is not clear how widely this message has been accepted. As part of a study into end-of-life care for heart failure, we conducted seven focus groups with doctors in general practice, palliative medicine, cardiology, geriatrics and general medicine.

The social impact of land contamination: reflections on the development of a community advocacy and counselling service following the Weston village incident.

Five years ago the village of Weston in Cheshire was affected by one of Britain's largest community-based land contamination incidents. The need for some form of community-based service incorporating social support and advocacy was identified and North Cheshire Health Authority in collaboration with the local community trust developed an advocacy and counselling service within the village. This article presents reflections on this highly complex service by reviewing the Weston incident, its management and possible lessons for public health practitioners dealing with similar incidents.

Negotiating palliative care expertise in the medical world.

This paper explores the relationship between palliative medicine and the wider medical world. It draws on data from a focus group study in which doctors from a range of specialties talked about developing palliative care for patients with heart failure. In outlining views of the organisation of care, participants engaged in a process of negotiation about the roles and expertise of their own, and other, specialties.

The social and psychological impact of the chemical contamination incident in Weston Village, UK: a qualitative analysis.

This paper contributes to the literature on community response to the announcement of well-established chemical contamination close to their homes. It describes a study of residents' views of chemical contamination on a close and long-standing community in the context of impacts on everyday life. This followed the discovery early in 2000 that houses in Weston Village, in the County of Cheshire, England, were contaminated by the chemical hexachlorobutadiene which was seeping from a sealed chemical waste quarry owned by Imperial Chemical Industries, one of the world's largest chemical companies.

Doctors' perceptions of palliative care for heart failure: focus group study.

Objectives: To identify doctors' perceptions of the need for palliative care for heart failure and barriers to change.

Design: Qualitative study with focus groups.

Setting: North west England.

"If there were a war tomorrow, we'd find the money": contrasting perspectives on the rationing of health care.

In spite of the substantial academic effort being devoted to the subject of health care rationing, there is little clarity about the views of those working in health care who have to implement rationing nor about the views of citizens who are (potentially) affected by the rationing of care. This paper reports the findings of a study conducted using focus groups and semi-structured interviews to explore and compare beliefs about rationing among citizens and those with a role in the health service (service informants) within the context of health care provision in the UK. Citizen and service informants both identified external pressures on the resources available for health care including technological improvement, the ageing population and increasing public expectations.

'The public is too subjective': public involvement at different levels of health-care decision making.

There are a number of impulses towards public participation in health care decision making including instrumentalist, communitarian, educative and expressive impulses and the desire for increased accountability. There has, however, been little research looking systematically at the public's preferences for being involved in particular types of rationing decisions, nor indeed, has there been a critical examination of the degree of involvement desired by the public. The research reported here uses findings from focus groups and in-depth interviews to explore these questions.