Protecting or improving the efficiency and effectiveness of services while reducing costs in response to public sector funding reductions is a significant challenge for all public service organisations. Preventing falls in older people is a major public health objective. We propose here an innovative model of community partnership with Fire and Rescue Services assisting falls prevention services to enhance the safety and well-being of older people in local communities through early identification of those who are at risk of injury from a fall or accidental domestic fire.

The focus of this paper is on health inequalities at a local level and the implications for community-based practice. This paper describes the development of a small multiagency project supporting families in a disadvantaged urban neighbourhood within the UK. A baseline assessment enabled primary and secondary data to be collected to inform project development and identify priorities for action. Findings revealed the scale of health need and helped focus the direction of the project. Several issues affecting implementation were identified, including the importance of good liaison between services and adopting a community development approach. This paper discusses the wider implications for the planning, delivery and evaluation of community-based initiatives addressing health inequalities. Despite the scale of need, there appears to be good potential for practitioners working in disadvantaged neighbourhoods to achieve some positive changes. Key points of learning are identified.

The PATCH project was an intersectoral initiative between health, social and education services in Lanarkshire, Scotland which provided support at home from two experienced children's nurses for parents of children with complex disability. The project was funded by the Scottish Executive Health Department Innovations Fund for Children's Services for two years from April 2000. This article reports results of an external independent evaluation of parents' and agency members' perceptions of the PATCH service. Audiorecorded interviews were obtained from members of eight families and eight agencies. Issues related to the two key aspects of support addressed in the project, carer training and partnership working, are presented. The skilled approach to training adopted was successful in creating a network of carers, both lay and professional, which resulted in improved respite and rest for parents. Effective partnership working resulted in improved communication, the development of an innovative child record, effective help in crises and improved service co-ordination. Together, the training and partnership elements of the PATCH service addressed practical, emotional and social dif. culties experienced by families. The freedom to work flexibly and to approach agencies directly and the ability to cut across established organizational structures were significant factors in improving support for families. A number of key aspects of nursing expertise and possible outcome indicators for such a service are presented.

This article reports on findings from a one-year national evaluation of the Primary School/Primary Care Health Links (PS/PC HL) initiative, commissioned in 2003 by the National Drug Prevention Development Team, on behalf of the Department of Health (DH). The primary aim of the PS/PC HL initiative was to develop links between primary and community health care professionals and primary school children in order to increase the children’s knowledge and understanding of a range of health issues. This involved developing innovative ways in which parents could engage in the health education of their children at primary school level. As part of the evaluation, a questionnaire was sent to parents (n = 69) and children (n = 464) to discover to what extent discussions about health issues, in particular substance misuse, were held at home and what messages children were receiving. In this context, substance misuse includes drugs, alcohol and tobacco. This article also examines children’s attitudes towards smoking and alcohol, and considers how parental influence affects children’s ideas about the acceptability of these substances. The findings indicated that whilst over 65% of parents thought that their children knew a lot about exercise and healthy eating, only 20% thought that their children were well informed about alcohol and drug misuse. Despite 80% of children in our survey reporting that they would prefer to discuss health problems with their parents, substance misuse appeared to be a topic rarely discussed at home. The findings confirm, (i) the need for family and community cohesiveness and (ii) reinforces the need for an increase in parents’ knowledge and motivation in order to (iii) raise their confidence in their conversations with their children about substance misuse. Partnership working between teachers, health professionals and parents would appear to be the ideal in effectively reinforcing health messages to children; however, the authors suggest that the culture of accountability both in the teaching and health professions often hinders this process.