Zeitschriftenartikel zum Thema „Commissioners of Charities“

When the Health and Social Care Act (2012) was passed, it was one of one of the most extensive NHS reforms ever seen in England. It gave rise to Clinical Commissioning Groups, which replaced Primary Care Trusts and larger strategic health authorities in April 2013. Commissioners identify the needs of the local population, set clinical priorities and purchase services on behalf of their community from a provider. Hospital trusts, community health groups, general practices, charities and private healthcare providers can ‘sell' services to the ‘buying' commissioner. This article will outline how services are commissioned in England, and explains how services are decommissioned when no longer required.

The Charity Commissioners have indicated that they possess a law-making role. This paper evaluates the extent to which the Commissioners have exercised this role in relation to charities for the advancement of religion, and evaluates this role in the light of the Human Rights Act 1998. The analysis draws upon both case law and decisions of the Commissioners, in particular the decision of the Commissioners to refuse status as a religious charity to the Church of Scientology.

Aim This exploratory study of commissioning third sector services for older people aimed to explore whether service data was fed back to commissioners and whether this could improve intelligence about the population and hence inform future commissioning decisions. Background Third sector services are provided through charities and non-profit community organizations, and over recent years services have developed that assess and advise people for self-management or provide wellbeing support in the community. Third sector services have an opportunity to reach vulnerable populations and to provide intelligence about them. Some third sector services are state funded (commissioned) in the United Kingdom. While evidence is available about the commissioning of statutory health and social care, as well as private providers, there is limited evidence about how third sector health services are funded. Methods Participants were recruited from commissioner organizations and third sector organizations, both with an interest in supporting the independence, self-management and wellbeing of older people. Organizations were recruited from five purposively selected sites within one region of England (East Midlands). Semi-structured interviews explored the relationships between commissioners and providers and the nature of funding arrangements, including co-production. Interviews also explored collection of data within the service and how data were fed back to commissioners. Focus groups were held with older people with the potential to benefit from wellbeing services. Results Commissioning arrangements were varied, sometimes complex, and often involved co-production with the third sector. Commissioners valued third sector organizations for their engagement with the local community, value for money, outreach services and ability to provide information about the community. Assessing the needs and outcomes of individuals was integral to delivery of support and advice to older people. Diverse approaches were used to assess an individual’s needs and outcomes, although there were concerns that some assessment questionnaires may be too complex for this vulnerable group. Assessment and outcomes data were also used to monitor the service contract and there was potential for the data to be summarized to inform commissioning strategies, but commissioners did not report using assessment data in this way, in practice. While the policy context encouraged partnerships with third sector organizations and their involvement in decision making, the relationship with third sector organizations was not valued within contract arrangements, and may have been made more difficult by the tendering process and the lack of analysis of service data. Conclusion This exploratory study has demonstrated a diversity of commissioning arrangements for third sector services across one region of England. Most commissioners invited co-production; that is, the commissioners sought input from the third sector while specifying details of the service. Service data, including assessments of needs and outcomes, were reported to commissioners, however commissioners did not appear to use this to full advantage to inform future commissioning decisions. This may indicate a need to improve measurement of needs and outcomes in order to improve the credibility of the commissioning process.

ObjectivesTo identify the shared research priorities of patients, caregivers and multidisciplinary renal health and social care professionals across Wales for integrated renal health and social care in Wales.DesignResearch priority setting exercise adapted from the James Lind Alliance national priority setting partnership framework in UK healthcare.SettingTwo workshops: one in North Wales with patients, caregivers and multidisciplinary renal health and social care professionals and one in South Wales with the Welsh Renal Clinical Network (commissioners of renal services in Wales). Additional input provided from stakeholders via email correspondence and face to face communications.ParticipantsAcademics n=14, patients n=16, family/carers n=6, multidisciplinary renal healthcare professionals n=40, local authority councils n=3, renal charities n=6 wider third sector organisations n=8, renal industries n=4, Welsh government social care n=3, renal service commissioners n=8.Results38 research priority questions grouped into 10 themes were agreed. The themes included: (1) integrating health and social care, (2) education, (3) acute kidney injury, (4) chronic kidney disease and cardiovascular disease, (5) transplantation, (6) dialysis, (7) personalised medicines, (8) cross-cutting priorities, (9) specific social contexts and (10) transitional services and children. Research questions were broad and covered a range of health and social care topics. Patient and professional perspectives broadly overlapped. Research priority setting activities revealed gaps in knowledge in overall service provision and potential areas for service improvement.ConclusionsMapping priorities in health services and social care highlighted the research needed to support renal health services delivery and commissioning in Wales.

Following a series of legislative changes around privacy over the past 25 years, this study highlights data protection regulations and the complexities of applying these frameworks. To address this, we created a privacy framework to guide organisations in what steps they need to undertake to achieve compliance with the UK GDPR, highlighting the existing privacy frameworks for best practice and the requirements from the Information Commissioners Office. We applied our framework to a UK charity sector; to account for the specific nuances that working in a charity brings, we worked closely with local charities to understand their requirements, and interviewed privacy experts to develop a framework that is readily accessible and provides genuine value. Feeding the results into our privacy framework, a decision tree artefact has been developed for compliance. The artefact has been tested against black-box tests, System Usability Tests and UX Honeycomb tests. Results show that Privacy Essentials! provides the foundation of a data protection management framework and offers organisations the catalyst to start, enhance, or even validate a solid and effective data privacy programme.

Background Homecare workers provide essential care at home for people at end-of-life but are often poorly trained and supported. Aim To explore the experiences and needs of homecare workers and the views of homecare clients and carers, and other community-based health and social care staff about the homecare worker role, including identification of good practice. Methods In this qualitative exploratory study, we will conduct 150 semi-structured interviews with homecare workers within three geographic English localities chosen for maximum socio-demographic variation. Eligible participants will be consenting adults providing care services (workers [n = 45], managers [n = 15] community practitioners [n = 30]), receiving care (clients thought to be in the last 6 months of life [n = 30], family carers [n = 15], or commissioners of homecare services supporting end-of-life care [n = 15]. Interviews may adopt a Pictor-guided or standard semi-structured approach according to their preference. Managers and commissioners can contribute to an online focus group if preferred. A range of recruitment strategies will be used, including through homecare agencies, local authorities, local NHS services, charities, voluntary sector groups and social media. Interviews and focus groups will be recorded, transcribed, anonymised, and analysed adopting a case-based approach for each geographic area within-case and then comparison across cases using reflexive thematic analysis. The design and analysis will be informed by Bronfenbrenner’s Adapted Ecological Systems theory. This study is registered on the Research Registry (No.8613). Contribution We will provide evidence on ways to improve the experiences and address the needs of homecare workers in relation to caring for people nearing end-of-life. It will offer insight into good practice around supporting homecare workers including responding to their training and development needs. Findings will inform subsequent stages of an evaluation-phase study of a training resource for homecare workers.

This article considers the public and voluntary sector relationship in housing provision from an historical and social science perspective. It pays particular attention to models based on markets, hierarchies and networks and presents an overview of voluntary action and state intervention in English housing since 1900. The article focuses on housing agencies with charitable status, and on three periods – pre-1914, the 1950s and the 1970s. For the first two periods, the emphasis is on the William Sutton Trust, England's largest house-building charity. In the latter period, attention shifts to Shelter, founded in 1967 and the most successful of the homelessness charities. In these case studies, the role of the courts, charity commissioners, government legal officers, Ministries responsible for housing, parliament and local authorities are discussed. The importance of attempts to politicise charity law and charitable status throughout the twentieth century is underlined. Central government is shown to play a significant part in this process, legitimising its preferred response from local authorities and voluntary agencies. A hierarchical interpretation of state intervention is tempered, however, by stressing the significance of unintended consequences attending central government's successive interventions in housing provision.

ObjectivesTo understand parents’ experiences of receiving care for their child with medical complexity.DesignQualitative semi-structured interviews with parents of children with medical complexities across England analysed using reflexive thematic analysis.ResultsTwenty parents from four hospital sites in England took part in the study, a total of 17 interviews were completed, 3 joint and 14 single parent interviews. Four themes were developed: parents feel abandoned; continuity of care (made up of three subthemes); equipment barriers; and charities fill the gaps.ConclusionsThe perceived quality of healthcare provided to this population was found to be inconsistent, positive examples referred to continuity of care; communication, clinical management and long-lasting relationships. However, many experienced challenges when receiving care for their children; many of these challenges have been highlighted over the past two to three decades but despite the children’s needs becoming more complex, little progress appears to have been made. Parents were seen as adopting significant additional roles beyond being a parent, but they still find themselves left without support across all areas. These families require more structured support. Policy makers and commissioners need to prioritise the needs of families to enable health and social care services to provide the support required.

BackgroundThe number of beds in care homes (with and without nurses) in the United Kingdom is three times greater than the number of beds in National Health Service (NHS) hospitals. Care homes are predominantly owned by a range of commercial, not-for-profit or charitable providers and their residents have high levels of disability, frailty and co-morbidity. NHS support for care home residents is very variable, and it is unclear what models of clinical support work and are cost-effective.ObjectivesTo critically evaluate how the NHS works with care homes.MethodsA review of surveys of NHS services provided to care homes that had been completed since 2008. It included published national surveys, local surveys commissioned by Primary Care organisations, studies from charities and academic centres, grey literature identified across the nine government regions, and information from care home, primary care and other research networks. Data extraction captured forms of NHS service provision for care homes in England in terms of frequency, location, focus and purpose.ResultsFive surveys focused primarily on general practitioner services, and 10 on specialist services to care home. Working relationships between the NHS and care homes lack structure and purpose and have generally evolved locally. There are wide variations in provision of both generalist and specialist healthcare services to care homes. Larger care home chains may take a systematic approach to both organising access to NHS generalist and specialist services, and to supplementing gaps with in-house provision. Access to dental care for care home residents appears to be particularly deficient.ConclusionsHistorical differences in innovation and provision of NHS services, the complexities of collaborating across different sectors (private and public, health and social care, general and mental health), and variable levels of organisation of care homes, all lead to persistent and embedded inequity in the distribution of NHS resources to this population. Clinical commissioners seeking to improve the quality of care of care home residents need to consider how best to provide fair access to health care for older people living in a care home, and to establish a specification for service delivery to this vulnerable population.

The article analyzes the Canadian government policy of social protection and support for soldiers’ dependents during World War I. The description of events begins when Canada entered the war (August 4, 1914) and ends when the North American Dominion switched to the system of compulsory military service (conscription) (August 29, 1917). The reconstruction of the details of the material support for soldiers’ dependents during the war helps reveal the details of the functioning of the Canadian government’s social policy in the early 20th century. The article is based on the legislative acts of the Dominion Government, official records of the debates in the Canadian parliament, and the Provincial press publications. It examines the institutional foundations of providing financial assistance to soldiers’ dependents using the example of the creation and activities of special state and non-state institutions (the Canadian Patriotic Fund, the Board of Pension Commissioners, and the Separation Allowance Board). It studies the process of forming the legislative base of social security for dependents of soldiers serving in the Canadian Expeditionary Forces and the Canadian Navy. The author traces the assignment and payment of social benefits to wives, children, parents and other dependents. The Canadian laws enacted during the war provided social assistance to military dependents in the form of state maintenance benefits and survivor’s pensions. The low rate of government benefits was offset by donations raised by charities. The process of creating special state bodies was very slow, and their activities were not always effective. Against this background, the work of the Canadian Patriotic Fund looked more fruitful.

ObjectiveTo examine the forms, scale and role of community and voluntary support for community hospitals in England.DesignA multimethods study. Quantitative analysis of Charity Commission data on levels of volunteering and voluntary income for charities supporting community hospitals. Nine qualitative case studies of community hospitals and their surrounding communities, including interviews and focus groups.SettingCommunity hospitals in England and their surrounding communities.ParticipantsCharity Commission data for 245 community hospital Leagues of Friends. Interviews with staff (89), patients (60), carers (28), volunteers (35), community representatives (20), managers and commissioners (9). Focus groups with multidisciplinary teams (8 groups across nine sites, involving 43 respondents), volunteers (6 groups, 33 respondents) and community stakeholders (8 groups, 54 respondents).ResultsCommunities support community hospitals through: human resources (average=24 volunteers a year per hospital); financial resources (median voluntary income = £15 632); practical resources through services and activities provided by voluntary and community groups; and intellectual resources (eg, consultation and coproduction). Communities provide valuable supplementary resources to the National Health Service, enhancing community hospital services, patient experience, staff morale and volunteer well-being. Such resources, however, vary in level and form from hospital to hospital and over time: voluntary income is on the decline, as is membership of League of Friends, and it can be hard to recruit regular, active volunteers.ConclusionsCommunities can be a significant resource for healthcare services, in ways which can enhance patient experience and service quality. Harnessing that resource, however, is not straight forward and there is a perception that it might be becoming more difficult questioning the extent to which it can be considered sustainable or ‘renewable’.

ObjectivesTo identify the facilitators and barriers to implementing patient-reported outcome measures (PROMs) in third sector organisations (TSOs) delivering health and well-being services.DesignA qualitative interview study. Participants were recruited using purposive, opportunistic and snowballing methods. Framework analysis was used.SettingTSOs including charities, community groups and not-for-profit organisations in England, UK.ParticipantsThirty interviewees including service users, TSO front-line workers and managers, commissioners of TSOs and other stakeholders such as academic researchers.ResultsTSOs primarily used PROMs because of pressures arising from the external funding context. However, organisations often struggled to implement PROMs, rarely getting the process right first time. Facilitators for implementation included having an implementation lead committed to making it work, investing resources in data management systems and support staff and taking a collaborative approach to designing the PROMs process. The latter helped to ensure an appropriate PROMs process for the specific TSO including choosing a suitable measure and planning how data would be collected, processed and used. There was a dilemma about whether TSOs should use standardised well-being measures (eg, the Warwick-Edinburgh Mental Well-being Scale) or design their own PROM. Not all TSOs sustained the collection and reporting of PROMs over time because this required a change in organisational culture to view PROMs as beneficial for the TSO and PROMs becoming part of front-line workers’ job specifications.ConclusionsTSOs are trying to use PROMs because they feel they have no choice but often struggle with implementation. Having an implementation lead, designing an appropriate process, investing resources, training staff and taking mitigating action to address potential barriers can facilitate implementation. Some of the findings are consistent with the experiences of more clinical services so appear relevant to the implementation of PROMs irrespective of the specific context.

IntroductionThe Pain in Older People with Frailty Study is a mixed-method, co-design study, which aims to develop the content, implementation strategies, service and professional guidance to support older adults with frailty to manage their pain.Methods and analysisThe study has four phases: Phase 1, research evidence and information synthesis from randomised controlled trials of multicomponent pain management programmes and psychological therapies for community-dwelling older adults. Phase 2, qualitative interviews with 30 community-dwelling older adults (≥75 years) living with frailty and persistent pain, including dyadic interviews with a spouse or unpaid carer. Phase 3, qualitative interviews with healthcare professionals (HCPs) working within various pain service types; 5–8 HCPs per service and up to 12 services including primary care, secondary care, tertiary centres and services with voluntary sector input. Phase 4, co-design workshops with older adults, HCPs and commissioners. Inclusion criteria (Phase 2): community-dwelling older adults (≥75 years) living with frailty and persistent pain. Exclusion criteria (Phase 2): care home residents, a dementia or cancer diagnosis. Cancer survivors, ≥5 years cancer free, and not undergoing active cancer treatment can participate. Analysis for Phase 1 will use narrative synthesis, Phase 2 will use grounded theory analysis and Phase 3 will use thematic analysis. Oversight is provided from a patient and public involvement group and an independent steering committee.Ethics and disseminationThe protocol was approved by Leeds-East Research Ethics Committee on 28 April 2022 (22/YH/0080). Consent is sought if an individual is willing to participate (Phases 2–4) and has capacity. Findings will be disseminated at conferences, in newsletters and journals and to local authorities and charities.

The Charity Commission for England and Wales published an updated list of the questions to be included in the 2018 Annual Return for registered charities. The trustees of charities excepted from registration with the Commission – which include a considerable number of church congregations – are not required to submit an annual return; but an increasing number find that they must do so because when an excepted charity's annual income exceeds £100,000 it loses its excepted status. The previously expressed intention to require every charity trustee to provide an e-mail address has been abandoned; instead, the Commission intends to ask all trustees either to supply an e-mail address or to confirm that they do not have one – which looks very like a welcome climbdown. The Commission's on-line Annual Return Service opened for submissions on 20 August.

Purpose – The purpose of this paper is to put the issue of ageing on the agenda of the English voluntary sector; to support the development of strategies about resourcing, supporting, governing and making relevant the voluntary sector for the next 20 years. Design/methodology/approach – An independent Commission hosted by New Philanthropy Capital and the International Longevity Centre, funded by the Big Lottery and the Prudential Methodology: issuing a discussion paper, created by the Commissioners and based on futures work and an evidence review; holding national and international seminars and conferences. Findings – Our ageing society has the potential to lead the voluntary sector into a viable future by building bridges between generations and communities, by expanding the resources available to it through rethinking its workforce, both paid and unpaid, by inspiring and delivering a more integrated and committed sense of social obligations and mutuality – if it embraces “The Age of Opportunity”. Research limitations/implications – This is a policy and practice led review with implications for the UK voluntary sector, its role in society and its resourcing. Practical implications – The Commission on the Voluntary Sector & Ageing takes as its basic premise that if we can grasp the potential, we can invest the skills and resources available to us to create a thriving, relevant and creative place for the voluntary sector and civil society. The Commission is setting a challenge to charities and social enterprises. The authors want them to rethink their work so that they can help make Britain a great place to grow old and one that encourages reciprocity between generations and over a lifetime. Social implications – A more integrated and mutually empowering society that builds on an asset-based model of ageing. Originality/value – The work of the Commission has never been done before and has been seen as creating an opportunity for rethinking the role, purpose and potential of the voluntary sector.

Purpose – The purpose of this paper is to establish the main causes of early failure of small recently established fundraising charities. Design/methodology/approach – Heads and ex-heads of small recently established British charities that had either shut down within two years of registration with the Charity Commission or had survived for two years following registration were surveyed to determine the sorts of issue they believed were particularly problematic at the time their charities were formed or shortly thereafter. The research combined ideas from human capital theory, organisational ecology, and the survivor principle to investigate the mortality of new charity start-ups. Information was obtained from the ex-heads of 182 charities that had been removed from the Charity Commission’s register and from 356 heads of charities that were still in operation. Findings – Participants in both groups reported that they had experienced major difficulties relating to funding, the development of plans, lack of marketing and management skills, and personal workload. Differences between the groups emerged with respect to their perceptions of problems involving competition from other charities (both for donations and for clients), internal conflict within their organisations, networking, and the need for background research. Start-ups run by people with prior experience of working in charities had a significantly better chance of survival than start-ups managed by individuals lacking such experience. Research limitations/implications – The data used in the investigation were self-reported and less than a majority of the sampling frame participated in the study. Practical implications – Prospective founders of small new charities need to recognise competitive realities and the competencies required for success before commencing operations. Government and nonprofit support organisations should arrange short work experience placements and shadowing activities for individuals contemplating starting a new charity. Originality/value – This was the first research ever to examine reasons for small enterprise collapse within the nonprofit domain.

A recent consultation by the European Commission on a draft code of conduct for the voluntary and community sector to combat illegal political activities highlights the regulation of the sector. This paper considers the European Commission’s code in light of the current regulation for charities and the wider voluntary and community sector, questioning whether sector-specific regulation of political activities is achievable and how such regulation could be best achieved.

AbstractOlder persons are among the most vulnerable of refugees seeking protection in Malaysia, yet seldom are they the focus of the work of the United Nations High Commissioner for Refugees, local charities or non-government organisations. In-depth ethnographic research with a group of older Chin women in Kuala Lumpur demonstrates both the vulnerability and resilience of older refugees in urban environments. Older refugees play a crucial role in sustaining families and communities. They provide much-needed support to refugee communities who struggle to meet the needs of everyday life in the absence of protection protocols.

The above quotation comes from the general public group discussions which were part of MORI's survey on public attitudes to mental health. This investigation was commissioned by the Mental Health Foundation as part of the events making the charity's 40th anniversary appeal.

This paper provides the reader with an insight into the legal analysis of the concept of ‘charity’ and ‘charitable purpose’. This discussion is important in light of the 2010 High Court decision in Commissioner of Taxation v Aid/Watch Incorporated. It begins with an overview of the historical development of ‘charity’ as a legal concept. It then considers how this concept has been interpreted in the context of taxation law and in particular focuses on the arguments for and against a restriction of advocacy and political lobbying by charities. It concludes with an analysis of the Aid/Watch Case and how this may be applied in the future to other charitable entities.

Cuts in the Charity Commission's budget have caused it to retrench in its regulatory activity and re-prioritise its core functions. As a consequence, the Commission has promoted greater trustee self-reliance and charity-sector provision of regulatory services. This paper analyses these regulatory developments alongside a broader analysis of self-regulation in the charity sector. This paper argues that while self-reliance and self-regulation offer opportunities to the charity sector to create nuanced, sector-sensitive regulation, they could also compromise the credibility and quality of charity regulation. This paper further argues that the charity sector needs to address as a matter of priority the drivers for regulatory reform, the purposes and priority of charity regulation, and the shift in the balance of power that results.

Three themes crucial to understanding eighteenth-century British history converge when one writes about the country attorney: the professions, which had a remarkable development in Georgian England; the rural practitioner as distinct from his urban, principally London, counterpart about whom much more has been written; and the local economy in which attorneys performed as conveyancers, money lenders, managers of landed properties, copyhold court holders, and clerks—for justices of the peace, at the assizes, on turnpike, enclosure, and drainage commissions, for charities, and for law and order associations. Popular literature notwithstanding, country attorneys were not so often knaves using their skills to cheat unwitting clients as indispensable cogs in the rural economy where they served the interests of the landholding classes.

BackgroundPatient experience surveys (PESs) often include informative free-text comments, but with no way of systematically, efficiently and usefully analysing and reporting these. The National Cancer Patient Experience Survey (CPES), used to model the approach reported here, generates > 70,000 free-text comments annually.Main aimTo improve the use and usefulness of PES free-text comments in driving health service changes that improve the patient experience.Secondary aims(1) To structure CPES free-text comments using rule-based information retrieval (IR) (‘text engineering’), drawing on health-care domain-specific gazetteers of terms, with in-built transferability to other surveys and conditions; (2) to display the results usefully for health-care professionals, in a digital toolkit dashboard display that drills down to the original free text; (3) to explore the usefulness of interdisciplinary mixed stakeholder co-design and consensus-forming approaches in technology development, ensuring that outputs have meaning for all; and (4) to explore the usefulness of Normalisation Process Theory (NPT) in structuring outputs for implementation and sustainability.DesignA scoping review, rapid review and surveys with stakeholders in health care (patients, carers, health-care providers, commissioners, policy-makers and charities) explored clinical dashboard design/patient experience themes. The findings informed the rules for the draft rule-based IR [developed using half of the 2013 Wales CPES (WCPES) data set] and prototype toolkit dashboards summarising PES data. These were refined following mixed stakeholder, concept-mapping workshops and interviews, which were structured to enable consensus-forming ‘co-design’ work. IR validation used the second half of the WCPES, with comparison against its manual analysis; transferability was tested using further health-care data sets. A discrete choice experiment (DCE) explored which toolkit features were preferred by health-care professionals, with a simple cost–benefit analysis. Structured walk-throughs with NHS managers in Wessex, London and Leeds explored usability and general implementation into practice.Key outcomesA taxonomy of ranked PES themes, a checklist of key features recommended for digital clinical toolkits, rule-based IR validation and transferability scores, usability, and goal-oriented, cost–benefit and marketability results. The secondary outputs were a survey, scoping and rapid review findings, and concordance and discordance between stakeholders and methods.Results(1) The surveys, rapid review and workshops showed that stakeholders differed in their understandings of the patient experience and priorities for change, but that they reached consensus on a shortlist of 19 themes; six were considered to be core; (2) the scoping review and one survey explored the clinical toolkit design, emphasising that such toolkits should be quick and easy to use, and embedded in workflows; the workshop discussions, the DCE and the walk-throughs confirmed this and foregrounded other features to form the toolkit design checklist; and (3) the rule-based IR, developed using noun and verb phrases and lookup gazetteers, was 86% accurate on the WCPES, but needs modification to improve this and to be accurate with other data sets. The DCE and the walk-through suggest that the toolkit would be well accepted, with a favourable cost–benefit ratio, if implemented into practice with appropriate infrastructure support.LimitationsSmall participant numbers and sampling bias across component studies. The scoping review studies mostly used top-down approaches and focused on professional dashboards. The rapid review of themes had limited scope, with no second reviewer. The IR needs further refinement, especially for transferability. New governance restrictions further limit immediate use.ConclusionsUsing a multidisciplinary, mixed stakeholder, use of co-design, proof of concept was shown for an automated display of patient experience free-text comments in a way that could drive health-care improvements in real time. The approach is easily modified for transferable application.Future workFurther exploration is needed of implementation into practice, transferable uses and technology development co-design approaches.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

Abstract Introduction HIV is now a long-term condition, presenting new challenges for primary care providers. Hospital-based specialists have traditionally provided medicine-related support to people living with HIV (PLWH) within secondary care clinics,1 but with an aging population and rising polypharmacy2 other forms of support will be needed. Although community pharmacists (CPs) are already involved in sexual and reproductive health service delivery to varying magnitudes,3 it is unknown whether PLWH want them to be involved in their HIV treatment and medicine support. Aim To understand the pReferences and perceptions of PLWH towards CP involvement in their care. Methods An online survey, promoted to UK HIV charities and activists via social media (November 2021–July 2022), asked about pReferences for medicine-related support and the involvement of CPs in PLWH’s care. Questions explored factors that would influence use of CPs for all services. Views on sharing HIV diagnoses with CPs during medicine-related consultations were also obtained. Descriptive analysis was used. Institutional ethics approval was obtained. Results Approximately half (73/144) of those who accessed the survey fully completed it: 57.5% male; age 22-80 years. Of those who provided demographic data: 88.9%(n=48/54) were white; gay/lesbian (64.8%, n=35); University-level education (57.4%, n=31) and employed (55.6%, n=30). CPs were rated among the least helpful health professionals in terms of medicine support (2.7%, n=2) compared to general practitioners (13.7%, n=10), HIV clinic-based nurses (35.6%, n=26), specialist pharmacists (42.5%, n=31) or consultants (56.2%, n=41). Over half (56.1%, n=41) were unsure or did not want their CP to be involved in their HIV care. Patient autonomy/self-efficacy, mistrust, concerns around stigma and privacy/confidentiality of information shared in community pharmacy settings, and perceived lack of HIV-related knowledge among CPs influenced participants’ pReferences: “they don’t need to know or don’t have the understanding of HIV and HIV meds to correctly use this information. I check drug and treatment interactions or complications before procedures myself.” Many participants wanted more information on HIV-related drug interactions and less judgemental attitudes: "if they could be less racist and homophobic and normalise conversations about HIV.” Some participants wanted holistic supply of all their antiretroviral and non-HIV medicines from their community pharmacies. There was equal resistance from other participants: “I certainly wouldn’t want my HIV care to be done by a chemist...” Expectedly, more participants were willing to share information about their HIV status and antiretroviral drug history during private (39.7%, n= 29) compared to over-the-counter consultations (28.8%, n= 21). Reasons for sharing information with CPs were positive: “so that they fully understand my medical circumstances and help me accordingly” and “in case of interactions”. Discussion/Conclusion Whereas some PLWH want more involvement of CPs in their care, others are sceptical of their role in HIV, similar to other primary care providers.1 This study was limited to online respondents. Future research is needed to explore how to build confidence of PLWH in CPs with regards to their changing medicine support needs. Understanding training needs of CPs and promoting HIV-friendly community pharmacies will be key in supporting medicine needs of PLWH. References 1. Rai T et al. Experience of primary care for people with HIV: a mixed-method analysis. BJGP Open, 2019;3(4):1-14 2. Baylis A et al. The future of HIV services in England -shaping the response to changing needs. Kings Fund Report. 2017;1-100 3. Public Health England (The UK Health Security Agency). The pharmacy offer for sexual health, reproductive health and HIV - a resource for commissioners and providers, 2019;1-25

AbstractSince 2001, a number of common law jurisdictions have initiated reforms to their charity law and the United Kingdom has taken the lead. This article examines what Hong Kong and Australia can learn from the United Kingdom in reforming their own outdated and fragmented charity laws. It is contended that the lessons and experiences of the United Kingdom provide good insights for Hong Kong and Australia as each jurisdiction anticipates implementing a broadly similar regime to the United Kingdom's to modernize regulation of their charity sectors. This article contends that there is no need to make a choice between retaining judicial decision-making over charities (inconsistent as it is) and establishing a type of charity commission which makes determining charitable status akin to a decision of a government department. Instead, Hong Kong and Australia can have charity commissions with missions that are sensitive to their own legal terrains but which are subject to judicial review.

This article examines the control framework for the supervision and oversight of charitable trusts in the common law world. It outlines in Section 1 the fundamental differences between private and public trusts that necessitate a separate enforcement regime for charitable trusts before exploring in Section 2 the historical and political powers and duties of the Attorney General as parens patriae of charities. In light of the limitations of the Attorney General’s effective scrutiny, Section 3 considers the emergence of alternative charity regulators – from tax authorities to independent charity commissions – comparing the relative regulatory achievements of these agencies with that of the Attorney General (AG). Section 4 turns its attention to the role of the courts and tribunals in the enforcement of the interests of donors, beneficiaries and charitable entities. The article concludes in Section 5 with a discussion of the merits and demerits of the charitable trust vis-à-vis the public benefit foundation and explores whether civil law systems intent on adopting the trust need to rethink their enforcement options when it comes to charitable trust enforcement.

IntroductionIdiopathic congenital talipes equinovarus (CTEV) is the most common congenital limb deformity. Non-operative intervention using the Ponseti method has shown to be superior to soft tissue release and has become the gold standard for first-line treatment. However, numerous deviations from the Ponseti protocol are still reported following incomplete correction or deformity relapse. Significant variation in treatment protocols and management is evident in the literature. Reducing geographical treatment variation has been identified as one of The James Lind Alliance priorities in children’s orthopaedics. For this reason, the British Society of Children’s Orthopaedic Surgery (BSCOS) commissioned a consensus document to form a benchmark for practitioners and ensure consistent high quality care for children with CTEV.Methods and analysisThe consensus will follow an established Delphi approach aiming at gaining an agreement on the items to be included in the consensus statement for the management of primary idiopathic CTEV up to walking age. The process will include the following steps: (1) establishing a steering group, (2) steering group meetings, (3) a two-round Delphi survey aimed at BSCOS members, (4) final consensus meeting and (5) dissemination of the consensus statement. Degree of agreement for each item will be predetermined. Descriptive statistics will be used for analysis of the Delphi survey results.Ethics and disseminationNo patient involvement is required for this project. Informed consent will be assumed from participants taking part in the Delphi survey. Study findings will be published in an open access journal and presented at relevant national and international conferences. Charities and associations will be engaged to promote awareness of the consensus statement.

Purpose Multiple challenges remain in achieving sustainability of digital health innovations, with many failing to realise their potential due to barriers to research, development and implementation. Finding an approach that overcomes these challenges is important if society is to derive benefit from these new approaches to healthcare. Having been commissioned by local authorities, NHS Trusts, prisons, charities, and third sector providers across the UK, Breaking Free Group, who in 2010 launched Breaking Free Online (BFO), a computer-assisted therapy programme for substance misuse, have overcome many of these challenges. This has been possible through close collaborative working with partner organisations, to overcome barriers to implementation and sustainability. The paper aims to discuss these issues. Design/methodology/approach This paper synthesises findings from a series of qualitative studies conducted by Breaking Free Group in collaboration with health and social care charity, Change, Grow, Live (CGL), which explore barriers and facilitators of implementation and sustainability of BFO at CGL. Data are analysed using thematic analyses with findings conceptualised using behavioural science theory. Findings This partnership has resulted in UK wide implementation of BFO at CGL, enhanced focus on digital technologies in substance misuse recovery, and a growing body of published collaborative research. Originality/value Valuable lessons have been learnt through the partnership between Breaking Free Group and CGL, which will be of interest to the wider digital health community. This paper outlines those lessons, in the hope that they will provide guidance to other digital health developers and their partners, to contribute to the continued evolution of a sustainable digital health sector.

Background The Efficacy and Mechanism Evaluation (EME) programme – a Medical Research Council (MRC) and National Institute for Health Research (NIHR) partnership – funds trials that evaluate the efficacy of interventions with the potential to promote health and studies that improve our understanding of the mechanisms of underlying diseases and their treatments. Objective To conduct an independent review of the EME programme’s impact and identify opportunities for future improvement. Design A mixed-methods approach, including desk research, an analysis of secondary data, stakeholder consultation and the development of impact case studies. Participants Chief investigators of EME awards, unfunded applicants to the EME programme and key opinion leaders relevant to the programme and research ecosystem. Interventions No interventions were tested, as this was a retrospective programme evaluation. Main outcome measures The evaluation was guided by a set of 15 evaluation questions. Results The EME programme bridges the gap between proof-of-concept and effectiveness studies that are located among other MRC and NIHR schemes and grants from charities in the funding landscape. Mechanistic studies alongside EME trials add value by lending confidence to trial findings and providing insights into the underlying biology. Between 2009 and September 2018, £175.7M in funding was approved for 145 EME projects. EME programme-funded research has started to deliver value to the NHS and patients by improving treatments and providing more efficient use of resources. Of the 43 completed trials, 14% (n = 6) showed that the intervention had a positive effect, whereas 74% (n = 32) of trials did not. The remaining five (12%) trials were unable to recruit participants or did not proceed to the full-trial stage. Seven projects (i.e. 16% of completed trials) have informed clinical guidelines or regulatory approval decisions and another eight projects have the potential to do so in the future, given the nature of their findings. Projects in the EME programme portfolio address a range of UK health needs and government priority areas, but they do not fully align with the level of health needs present. Commissioned calls for applications steer applicants. However, many commissioned calls do not lead to funded awards, and a better understanding of the underlying reasons for this would enable targeted supported to address key health needs. The majority of EME projects investigate existing interventions of limited commercial interest, focusing on repurposing (67/136, 49%) and informing current practice (23/136, 17%). Although there is little evidence of wider economic impact from commercial benefits, the EME programme is important in funding research in which industry is unlikely to invest. Stronger co-ordination with other funders, such as charities, could lead to synergies, enhancing the potential for health impact and influence on other funders’ agendas. The main challenges identified for EME projects were ‘complex and slow contracting processes’ (35/46, 76%), ‘setting up of study sites’ (30/46, 65%) and patient recruitment (28/46, 61%). Enablers of research included a clinical research fellow position on the project and support from Clinical Research Networks and Biomedical Research Centres. Nearly all of the chief investigators consulted had engaged in patient and public involvement at some project stage, and a lack of patient and public involvement did not emerge as a barrier to research or impact. Research ideas stemming from patients were, however, over-represented among unfunded applications, but the reason for this is unclear. Limitations Only about one-third of all studies had been completed or had published their main findings, necessitating a purposive, rather than representative, sampling of the portfolio. The COVID-19 outbreak cut short the programme of interviews, limiting the depth to which some evaluation questions could be explored. Several data sources were based on self-reporting by chief investigators; whereas key self-reported aspects were verified through desk research, this was not possible for all findings. Conclusions The EME programme plays an important role in the UK research funding landscape and has started to deliver value to the NHS and patients. Based on the evidence gathered, seven recommendations were developed to enhance the EME programme’s health and economic impact and address challenges encountered by chief investigators in implementing research projects. Funding This project was funded by the EME programme, a MRC and NIHR partnership. This will be published in full in Efficacy and Mechanism Evaluation; Vol. 8, No. 20. See the NIHR Journals Library website for further project information.

As Australia's population ages, increasing numbers of seniors move to a growing number of retirement villages. Unlike time shares, which are ‘managed investment schemes’ and therefore regulated as ‘financial products’ under corporate law administered nationally by the Australian Securities and Investments Commission (ASIC), the Commonwealth withdrew from the regulation of retirement villages in the 1980s on the basis that at that time they were local, usually run by religious bodies and charities and were not of national concern. The regulation of retirement villages was taken over by the states and territories under their non-uniform Retirement Villages Acts and the common law. Until then retirement villages, often indistinguishable from Commonwealth regulated timeshares, were regulated in the original State and Territory Uniform Companies Acts in 1961 as ‘interests’, and then in later Commonwealth legislation as ‘prescribed interests’ by the forebear of ASIC, the then National Companies and Securities Commission (NCSC) with the State and Territory Corporate Affairs Commissions as its ‘delegates’. Today retirement villages, which are largely owned and managed by the corporate sector, raise many issues of national concern such as accountability, fees and the rights of residents. Some aspects of retirement villages such as directors’ duties, fundraising, prospectuses and unregistered schemes are regulated as corporations by ASIC under the Corporations Act 2001 (Cth), but retirement villages are not regulated as ‘financial products’ under corporate law. This article challenges the effectiveness of state and territory regulation of retirement villages and calls for federal regulation of retirement villages by bringing retirement villages into the definition of ‘financial product’ in the Corporations Act 2001 (Cth) and in the Australian Securities and Investments Commission Act 2001 (Cth). As financial products, retirement villages would then be regulated by Commonwealth legislation which deals with financial services and financial markets, as regulated by ASIC. These laws include consumer protection provisions such as the prohibition of misleading or deceptive conduct, unfair contract terms, unconscionable conduct, licensing and high standards for those in the retirement village industry. This would result in a return to Commonwealth leadership of the regulation of retirement villages to harmonise and to consolidate the current mix of state and territory regulation with federal legislation including an enforceable Retirement Villages Code of Conduct.

AbstractWhat is termed the social economy in Ireland includes charities, co-operatives, voluntary associations and non-profits. However, the label is not widely used to describe them collectively so that many organisations within the wider social economy do not identify themselves with, or even fully understand, the term. The concept of social enterprise first emerged in public policy discourse in the 1990s and, since then, has been mainly viewed as a mechanism of job creation/integration and service provision in disadvantaged communities. This perspective on social enterprise has been significantly influenced by European policy. By contrast, in Irish academic discourse, the interpretation of social enterprise is more varied due to the different influences of the US and European intellectual traditions. These variations have contributed to ambiguity about the social economy as a sector, and social enterprises as distinctive forms, and this has compromised attempts to estimate the scale and potential of the sector in Ireland to date. In 2013, as part of the policy response to the unemployment crisis of the economic recession, the Irish government commissioned an examination of the job-creation potential of social enterprise. The Forfás report offered a new official definition of social enterprise, characterised by many of the features of the EMES ideal type. Furthermore, the description and examples of social enterprises included in the report confirmed the dominance of one model of social enterprise in Ireland – the Work Integration Social Enterprise or WISE. The objective of this paper is to discuss how social economy and social enterprise are understood in Ireland and to explain how WISEs have evolved as the dominant Irish social enterprise model to date. The influence of the US (Salamon and Anheier 1997; Dees 1998) and European/EMES academic traditions (Pestoff 1998; Borzaga and Defourny 2001; Nyssens 2006; Defourny and Nyssens 2010, 2012) and EU and national policy perspectives, since the early 1990s, on Irish academic and policy discourse is discussed in this paper. It is argued that the adoption by successive Irish governments of a labour market integration approach, to supporting the development of the Irish social economy, since the early 1990s, has shaped the sector and contributed to the emergence of one dominant social enterprise type, the WISE. Some of the characteristics and impacts of Irish WISE are then discussed together with the challenges they face.

Purpose The purpose of this paper is to explore the link between age discrimination and the injustices that have taken place in our care homes during the COVID-19 pandemic in this country. It seeks to show how destructive age discrimination is to those who live in our care homes and attempts to shake up our attitudes to older people, as the pandemic continues. It is hoped that shifts in attitude would lead to a societal revolution in care and support for older people as the pandemic shows us how the current system is breaking down. Design/methodology/approach This is a personal insight into the plight of the care home sector during the COVID-19 pandemic in the UK. The writer has worked in the field of social care and older people’s services for many years and felt compelled to share her learning and observations. This led to venturing more deeply into understanding why those who live, work and visit care homes have been so neglected and “cast into the shadows” in the face of such desperate danger. Whilst tracking the media narrative during the first wave, she attempts to apply her knowledge, in particular gained from working for Help the Aged (now Age UK) as a policy manager for Quality Care, but also draws on experiences as a social worker, commissioner and care provider from the 1980’s to the present. By “shining a light” on care homes, revealing that the darker practices that have taken place contravene the Human Rights Act 1998, it is hoped that the recognition of age discrimination will happen at every level and become better known in its application. The paper observes how deeply rooted it is in us all. Findings Having highlighted some shocking examples of bad practice from the authorities relating to care homes, the article concludes that Government policy on care homes from March to July 2020 was discriminatory and questions how far lessons have been learned. The legislation is in place in the form of the Human Rights Act 1998 to protect older people in care homes but is not being widely implemented at regional policy level. Government rhetoric remains far from reality Instead of redressing the gap and admitting mistakes, there is evidence at a high level of continued denial and the projection of blame on to the care homes themselves. Originality/value The author’s professional background includes meeting the founder of the Gray Panthers, Maggie Kuhn, in the United States in the 1988. This was a defining moment that gave her an original insight into age discrimination and influenced her entire career. It eventually led to her working in national policy for one of the most influential charities for older people at the turn of the millennium, Help the Aged. Here, she co-founded the My Home Life Programme (promoting quality of life in care homes). The paper offers a unique insight into why it is so challenging to achieve quality of life for older people needing care and should be of interest to policymakers, clinical commissioning groups, local authorities, older people’s care providers and carer and user organisations.

Third sector dementia support is characterised by wide variation and a heavy reliance on volunteer engagement. While there has been a growth in the reach and diversity of different schemes, their short-term funding results in a loss of networks, collaborations and local knowledge. This practice paper reflects on strengthening community-based dementia support and care via public and third sector partnerships. National and local data sources could help charities and commissioners begin to identify inequalities of provision.

Summary The Scaling-up Health-Arts Programme: Implementation and Effectiveness Research (SHAPER) project is the world's largest hybrid study on the impact of the arts on mental health embedded into a national healthcare system. This programme, funded by the Wellcome Trust, aims to study the impact and the scalability of the arts as an intervention for mental health. The programme will be delivered by a team of clinicians, research scientists, charities, artists, patients and healthcare professionals in the UK's National Health Service (NHS) and the community, spanning academia, the NHS and the charity sector. SHAPER consists of three studies – Melodies for Mums, Dance for Parkinson's, and Stroke Odysseys – which will recruit over 800 participants, deliver the interventions and draw conclusions on their clinical impact, implementation effectiveness and cost-effectiveness. We hope that this work will inspire organisations and commissioners in the NHS and around the world to expand the remit of social prescribing to include evidence-based arts interventions.

Abstract Background Two million people in the UK are living with or beyond cancer and a third of them report poor quality of life (QoL) due to problems such as fatigue, fear of cancer recurrence, and concerns about returning to work. We aimed to develop and evaluate an intervention based on acceptance and commitment therapy (ACT), suited to address the concerns of cancer survivors and in improving their QoL. We also recognise the importance of exercise and vocational activity on QoL and therefore will integrate options for physical activity and return to work/vocational support, thus ACT Plus (+). Methods We will conduct a multi-centre, pragmatic, theory driven, randomised controlled trial. We will assess whether ACT+ including usual aftercare (intervention) is more effective and cost-effective than usual aftercare alone (control). The primary outcome is QoL of participants living with or beyond cancer measured using the Functional Assessment of Cancer Therapy: General scale (FACT-G) at 52 weeks. We will recruit 344 participants identified from secondary care sites who have completed hospital-based treatment for cancer with curative intent, with low QoL (determined by the FACT-G) and randomise with an allocation ratio of 1:1 to the intervention or control. The intervention (ACT+) will be delivered by NHS Talking Therapies, specialist services, and cancer charities. The intervention consists of up to eight sessions at weekly or fortnightly intervals using different modalities of delivery to suit individual needs, i.e. face-to-face sessions, over the phone or skype. Discussion To date, there have been no robust trials reporting both clinical and cost-effectiveness of an ACT based intervention for people with low QoL after curative cancer treatment in the UK. We will provide high quality evidence of the effectiveness and cost-effectiveness of adding ACT+ to usual aftercare provided by the NHS. If shown to be effective and cost-effective then commissioners, providers and cancer charities will know how to improve QoL in cancer survivors and their families. Trial registration ISRCTN: ISRCTN67900293. Registered on 09 December 2019. All items from the World Health Organization Trial Registration Data Set for this protocol can be found in Additional file 2 Table S1.

Abstract Background Third sector organisations such as charities and community groups are using Patient Reported Outcome Measures (PROMs) at an aggregated service level to demonstrate their impact to commissioners to generate or retain funding. Despite this motivation, organisations can struggle with implementing PROMs. Previous studies have identified facilitators including organisations using an appropriate measure, co-producing the PROMs process with staff, and investing resources to support the use of measures. However, to date no studies have applied this learning to third sector organisations to evaluate whether taking an evidence-informed implementation approach improves the use of PROMs. Methods A Community-Based Participatory Research approach was used which involved university-based researchers supporting two third sector organisations to implement PROMs. The researchers provided evidence-informed advice and training. The organisations were responsible for implementing PROMs. The researchers evaluated implementation through a mixed methods approach including five key informant interviews, four evaluation groups and analysis of collected PROMs data (n = 313). Results Both third sector organisations faced considerable constraints in incorporating known facilitators and addressing barriers. The organisations involved staff in choosing an acceptable measure. However, competing priorities including external pressures to use specific PROMs, busy workloads and staff opinions created challenges to using measures. Investment of time and energy into developing an outcomes-based organisational culture was key to enable the prioritisation of PROMs. For example, discussing PROMs in supervision so that they were viewed as part of people’s job roles. Organisations found that implementation took several years and was disrupted by other pressures. Conclusions Whilst organisations were motivated to implement PROMs to obtain or retain funding, they faced considerable practical and ideological challenges. Consequently, some stakeholders felt that alternative methods to measuring impact could potentially be more feasible than PROMs.

Abstract Background Young adult offenders represent a third of the UK prison population and are at risk of poor health outcomes including drug and alcohol misuse, self-harm and suicide. Court diversion interventions aim to reduce the negative consequences of formal criminal justice sanctions and focus resources on addressing the root causes of offending. Although diversions are widely used, evidence of their effectiveness has not yet been established. Hampshire Constabulary, working together with local charities, have developed the Gateway programme, an out-of-court intervention aimed at improving the life chances of young adults. Issued as a conditional caution, participants undertake a health and social care needs assessment, attend workshops encouraging analysis of own behaviour and its consequences and agree not to re-offend during the 16-week caution. Methods This is a pragmatic, multi-site, parallel-group, superiority randomised controlled trial with a target sample size of 334. Participants are aged 18–24, reside in Hampshire and Isle of Wight and are being questioned for an eligible low-level offence. Police investigators offer potential participants a chance to receive the Gateway caution, and those interested are also invited to take part in the study. Police officers obtain Stage 1 consent and carry out an eligibility check, after which participants are randomised on a 1:1 basis either to receive Gateway or follow the usual process, such as court appearance or a different conditional caution. Researchers subsequently obtain Stage 2 consent and collect data at weeks 4 and 16, and 1 year post-randomisation. The primary outcome is the Warwick-Edinburgh Mental Well-being Scale (WEMWBS). Secondary outcomes include health status, alcohol and drug use, recidivism and resource use. The primary analysis will compare the WEMWBS score between the two groups at 12 months. Discussion This pioneering trial aims to address the evidence gap surrounding diversion in 18–24-year-olds. The findings will inform law enforcement agencies, third sector organisations, policymakers and commissioners, as well as researchers working in related fields and with vulnerable target populations. Trial registration International Standard Randomised Controlled Trial Register (ISRCTN 11888938).

AbstractThe last few decades have witnessed radical reform of charity regulation around the world. Australia has not been untouched and has developed several unique approaches. First, unlike many other federations (such as the US and Canada), Australia relies on a charities commission rather than its federal tax authority to act as the principal regulator, resulting in a very different scope of responsibility and the likelihood of greater interaction with state regulators. Second, unlike many other jurisdictions that have implemented a charities commission (such as England and Wales), the Australian commission is ultimately intended to apply to a broader pool of not-for-profits than just charities, which raises fundamental questions about the ways in which charities differ from the not-for-profit sector more broadly. This paper outlines the historical and political reasons for reform in Australia and the shape of that reform. As the reforms have now achieved broad political and sector support, the chief focus of this paper is on the out-workings of the reforms, with particular attention to the challenges and opportunities posed by Australia’s federal system of government and by the charity commission’s potential to regulate the broader not-for-profit sector.

This overview highlights the Commission’s (i) adoption of new State aid rules to support the economy in the context of Russia’s invasion of Ukraine; (ii) recommendation to EU Member States to repeal “golden passport” schemes in response to Russia’s invasion of Ukraine; (iii) position on cutting development aid to blacklisted jurisdictions; (iv) reasoned opinion regarding Malta’s investor citizenship scheme; (v) reasoned opinion concerning the German taxation of dividends and interest payments to charities; (vi) reasoned opinion on the correct application of the SEPA regulation by Spain; (vii) closing of infringement procedure against Belgium regarding the tax treatment of investment in immovable property abroad; and (viii) closing of infringement procedure against Luxembourg regarding the taxation of interest received by individuals.

Historically, the cy‐près doctrine required that, upon the substantive alteration of a charitable trust, the new purposes should be ‘as near as possible’ to the old. This is no longer the case. Subject to section 67(3) of the Charities Act 2011, the redrafting court or Charity Commission must have regard to factors other than proximity of purpose. Zedra Fiduciary Services (UK) Ltd v Attorney General is the first high‐level authority to consider the meaning of the statute, and, with it, the scope of the contemporary statutory cy‐près doctrine. This note argues that the Court of Appeal read down the statutory factors conservatively, prioritising fidelity to the original objects of the trust. The note considers the method of the Court and suggests that a more creative approach might have been taken. Finally, the note considers the impact of the authority on the Charity Commission's routine, day‐to‐day cy‐près casework .

The scenario is common: a charity, typically with a name including an emotional word like “cancer,” “children,” “veterans,” “police,” or “firefighters,” signs a contract with a professional fundraiser to organize and run a campaign to solicit charitable contributions. The charity may be legitimate or a sham. The directors of the charity may be allied or coconspirators with the fundraiser, or as likely, well-meaning but naïve individuals. The fundraiser raises millions of dollars through telemarketing, Internet, or direct mail solicitation. The charity receives but a small percentage of the amount. In some cases, at the close of the campaign, the organization owes the solicitor more than the amount raised for the charity.1Thereafter, the state attorney general investigates the charity and finds fraud in the solicitation or an improper use of the funds raised. As part of the settlement, the professional solicitor agrees to be barred from operating in that particular state. Thereafter, the fundraiser moves to a neighboring jurisdiction, opens business (perhaps under a different name), and commences the same cycle of fraudulent fundraising using another charity.2 Deception in solicitation and misuse of monies raised for charitable purposes is not only a fraud on the donor; it also can be a diversion of tax dollars from state or federal treasuries.This article examines several approaches for regulating unscrupulous professional fundraisers and preventing carpetbagging, moving from jurisdiction to jurisdiction, committing fraud, or willfully violating regulatory requirements. It examines limitations in the existing regulatory framework to prevent charity fraud and offers possible solutions to the problem. As a first solution, the Internal Revenue Service should revitalize and extend the “private benefit doctrine” as a tool of enforcement. Second, Congress and the Service should amend § 4958 to address excess benefit transactions to more clearly include unscrupulous solicitors.A third possible resolution to the problem outlined would be the expansion of the Federal Trade Commission’s enforcement authority to cover charitable solicitation generally. Currently, the FTC has authority over telemarketing by for-profit fundraisers.3 The legislation proposed would enable the creation of a self-regulatory organization under Federal Trade Commission aegis that fundraisers would be required to join. This new organization would enforce norms and rules for professional fundraisers, have the authority to discipline and, if necessary, to bar dishonest fundraisers from the fundraising industry.A final recommendation is the creation of an online, readily accessible database containing records of violations of professional fundraising companies and the individuals who own and work for them, the contracts between professional solicitors and the charities they work for, the results of fundraising campaigns listing the percentage of dollars raised that goes to the charity, and the texts of settlement agreements between state charity officials and fundraisers and the charities involved. An important issue not addressed in detail is the fiduciary responsibility of charity boards to carefully select the firms that manage their solicitation campaigns.

Objectives Improve and refine BOLD's delivery of its four pilot projects via feedback on acceptable uses and forms of analysis of shared data. Inform how BOLD communicates its aims and progress for maximum clarity and transparency. Understand the impact of BOLD's data management on the level of trust in the program. MethodsInitial workshops were conducted with expert intermediary organisations, such as charities, who have a deep understanding of each of the audiences’ attitudes and needs. This was to explain the purpose of the project to the intermediary organisations and to gain their feedback on the approach and materials. Fieldwork was undertaken with 82 participants from across the four vulnerability audiences, using a combination of methods to ensure full participation from a range of individuals with differing levels of need. Participants were presented with information about BOLD's purpose, objectives, and three example scenarios related to their respective pilot to prompt useful discussions. Results Participants in the BOLD program pilots generally support data sharing to improve public services. They view the program positively, have similar experiences across pilot areas, and reflect on its relevance to a range of audiences. However, some lack experience with issues addressed by BOLD. Concerns exist regarding negative impacts and scepticism towards government. BOLD use cases should prioritise four principles: relevance, impact, clarity, and non-stigmatisation. Intermediary organisations are crucial for engaging with pilot audiences. ConclusionBOLD is a three-year cross government pilot project that links social policy datasets to better support individuals with complex needs. It aims to improve outcomes by providing new evidence and insight into how services delivered in one part of government affect outcomes in another. This research was commissioned to inform how to take the BOLD programme forward, by engaging and consulting with relevant audiences in an ethical and transparent way. The published findings are informing the delivery of BOLD and improving and enhancing our understanding of the impact of BOLD's data management on trust.

AbstractValproate is the most effective medication for generalised epilepsies, and several specific epilepsy syndromes. For some people, it will be the only medication to establish seizure remission, and withdrawing it carries risks of seizure recurrence and Sudden Unexpected Death in Epilepsy (SUDEP). It is also of proven efficacy for bipolar disorder and migraine prevention. Guidelines based on observational and epidemiological studies stress that maternal valproate related teratogenicity and neurodevelopmental effects are significantly higher than for other antiseizure medications (ASMs). It should, therefore, only be used if other medications are ineffective and after balancing the teratogenicity risk. Regulatory restrictions have changed prescribing practices and reduced valproate use. The number of other medications that must be trialled in the different conditions for which valproate has effectiveness and the consequences of the lack of efficacy of those drugs leading to significant harm including death remains unexplored. Risk minimisation measures (RMMs) for valproate, chiefly Pregnancy Prevention practices (PPP), consider foetal risk and not risk to people living with epilepsy. In the United Kingdom (UK), limitations relating to valproate use in all people < 55 years commenced in January 2024. While the evidence in child-bearing women is not disputed, the data in males are based on animal models, case reports, and one commissioned, unpublished, non-peer reviewed report unavailable to the UK public, stakeholder charities or professionals. Evidence suggests that 30–40% of people switching from valproate have breakthrough seizures. Thus, an estimated 21,000–28000 people in the UK will imminently be exposed to the potential hazards of breakthrough seizures, including death. There is little government investment in monitoring the effects of these changes to valproate prescribing on patient health and quality of life. This review summarises the history of valproate regulation, evidence underpinning it and argues how the latest regulations in the UK do not align with the country’s medical regulatory bodies ethical principles nor with the Montgomery principles of informed patient choice and autonomy. It dissects how such regulations infringe Common Law principles, nor give due regard for patient outcomes beyond reproduction. The paper looks to provide recommendations to redress these concerns while appreciating the core need for such governance to emerge in the first place.

Zammit, Marisa, and Erica Dornbusch. A Friend In Hope: a Story About Hope's Journey with a Brain Tumour. Brain Tumor Foundation of Canada, 2008.Zammit, Marisa, Erica Dornbusch, and Carole Baillargeon. Mon amie Claire: L'histoire de Claire et de sa tumeur cérébrale. Foundation canadienne des tumeurs cérébrales, 2009.Zammit, Marisa, Erica Dornbusch, and Rocco Speranza. La mia amica Speranza : Speranza e il suo tumore cerebrale. Fondazione canadese del tumore cerebrale, 2008.In an interview with Daytime television, available on YouTube, author Marisa Zammit explains how the Brain Tumour Foundation of Canada contacted her as an established freelance copy writer to come up with a positive story of hope for and about children with brain tumours. According to Susan Marshall, executive director of the Foundation, no other storybook existed for elementary school aged children in Canada before 2008, when the book was published. It is the personal connection, having a child diagnosed with a brain tumour at the age of 4,that motivated Sharon to commission the publication of A Friend in Hope. Marisa had worked previously with illustrator Erica Dornbusch, who had published other storybooks (e.g. Finding Kate's shoes , Mrs. Goodstory) in the past. Marisa is now a school teacher librarian at Holy Cross Catholic Secondary School in Strathroy, Ontario and she has read the book to her students.A Friend in Hope has definitely accomplished its main objective of giving children, parents, and friends a positive and hopeful outlook on the brain tumour journey. Amy Mathias, the Online Community Engagement Coordinator of the Foundation, indicated that 15,000 copies of the book had been distributed in time for the organization’s 30th Anniversary in 2012. It is thanks to the Ronald McDonald House Charities that printing and distribution of the book were possible. The book addresses a very real need not only in alleviating young patients’ fears, but also in explaining brain tumours and their medical implications to children’s teachers and classmates. In turn, adults diagnosed with brain tumours may also use the storybook to approach the subject with their children.As for the translated versions of the book, Pia di Bacco helped translate from English into French by enlisting the support of youth and staff at her school in Montreal. Similarly, her godson Rocco Speranza commissioned grades 4, 5, and 6 youth and staff at the École East Hill School’s Italian program to translate the storybook from English and French into Italian. The motivation in both translation cases was a result of a family member or a student being diagnosed with a brain tumour and the belief in educating youth about brain tumours. Schools across the English Montreal School Board and beyond in Italy, Australia, Argentina, and the USA have also benefited from the storybook.The story is written from the perspective of a young brain tumour patient’s best friend, Danny, Daniel, or Daniele in English, French, and Italian respectively. Danny is trying to understand and, most of all, support his “best buddy,” Hope, who begins her brain tumour journey. As the author Marisa Zammit expressed in the Daytime interview, Hope, or in Italian Speranza, received that name because “it is hope [speranza] that buoys the character through the hardships of the story.” In French, the character’s name is Claire, whose Latin origin “clarus” means “clear, bright, celebrated” and by extension the word “clear”. The French name too, therefore, is representative of her personality and journey.Part of the story involves references to some of the medical treatments that Hope undergoes: MRI, pharmaceutical drugs, radiation therapy, a special helmet and mouthguard, a hospital’s child life centre, and the effects of various treatments on Hope. In every instance, the story uses the narrator’s voice and point of view to express Hope’s various experiences, Danny’s reactions to them, and his own fears. It is a child’s imagination which makes this topic bearable and allows the illustrations to become particularly powerful, when, for example, Danny sees Hope take some medication, which she says will help her “feel well enough to play with [him].” The illustration, in this case, represents a mountain scape and the children’s game of climbing pillows and cushions as if they were mountain climbers, because as Hope says the medication she takes is the “same medicine mountain climbers use,” (ie. dexamethasone). Another exceptional illustration is the one representing an oceanic world with an octopus and fish, which is how Hope faces the MRI machine and transforms it into a submarine. The illustrations are identical across the translations and the English source text, except for one image representing a hockey player in what appears to be Toronto Maple Leafs colours; however, in the French and Italian translations, which originated in Montreal, the team colours were changed to those of the Montreal Canadiens. Habs fans will no doubt appreciate the sensitivity of the illustrator.All in all the story is very well written and the language is suitable for children from grades 2 to 4; however the concepts that are addressed also make this book relevant to higher grade levels. That said, some grammatical inaccuracies exist within the French translation. Public and school libraries would benefit from access to this book, as would hospital library patrons and those who use Faculty of Education libraries. The health education elements of the story are presented in a very appropriate yet realistic manner for the target audience, who will appreciate having access to such a unique resource.Highly Recommended: 4 out of 4 stars Reviewer: Denis LacroixDenis Lacroix has worked at the University of Alberta Libraries since 2003. He is the romance languages and classics librarian and enjoys reading in French, Spanish, and Italian.

Introduction Since his election to the papacy in 2013, Pope Francis has garnered international headlines for his environmental activism. His decision to adopt Francis as his papal name communicated to the public how his papacy would be advocating the environmental ethics associated with his namesake Saint Francis of Assisi. As part of his environmental activism and commitment to centring the socioeconomic injustices faced by the poor in public messages, Pope Francis deliberately incorporates modest, rather bare vestments into his papal uniform. He has emerged as a men’s fashion icon primarily due to his humble institutional uniform and public critiques of the wasteful consumerism commonly associated with contemporary consumer culture and the fashion industry. Pope Francis’s individualised approach to the papal uniform is not unique to his papacy. His selection of vestments and regalia is situated within a larger visual history of pontiffs selecting their religious uniform to brand and circulate their papal persona in public discourse and popular culture, evident through the actions of Pope John Paul II and Pope Benedict XVI. As the leader of the Catholic Church, the pontiff represents the institution’s brand identity. Following Naomi Klein’s analysis of institutional branding, the characteristics associated with a pontiff’s public image provide an opportunity for the Catholic Church to revitalise its image for global audiences (Klein “How Corporate”). Through a textual analysis of select media coverage of pontiffs and their approach to the papal uniform, this article discusses how Pope Francis’s religious uniform functions as a mechanism to extend the symbolic institutional power of the Catholic Church as a brand in popular culture by negotiating ideas of austerity. The Institutional Politics of the Uniform as a Form of Communication Fashion and clothing are important modes of communication that enable an individual to nonverbally signal their identity and belonging to various social groups, causes, and institutions (Barnard; Coghlan; Craik). An understudied but widespread element of everyday life, the uniform is a powerful signifier of the ideological and discursive formations reproduced by social institutions (Craik). Uniforms played not only an essential role for social organisation within modernity, but for Jane Tynan and Lisa Godson their materiality has significantly shaped the imagery of visual culture (8). Scholars including Jennifer Craik, William Keenan, and Q. Colville have addressed how uniforms negotiate gendered politics due to the prevalence of such garments within institutional spheres such as the military, healthcare, and religion. Influenced by Foucault’s view of the uniform as a mechanism to brand the body as under the power, authority, and control of the institution, Tynan and Godson have extended this argument to identify the relationship between uniforms, social structures, and violent practices of colonisation and imperial dominance (10-15). The institutional power of the uniform also extends to the papacy and the Catholic Church. In her historical analysis of papal regalia, Maureen C. Miller argues that during the thirteenth and fourteenth centuries the uniform may not have been viewed by large audiences, but popes were beginning to understand how their vestments were a powerful communicative tool shaping their public image. Combined with the increasing theatrically of the pontiff, Miller argues that “performative uses of clothing were significant not for the complexity of the messages they conveyed but for their strategic aim to make simple points memorably and to promote their diffusion” (293). Her analysis underscores how the papal uniform – and the individual way in which different pontiffs have approached donning vestments – represents a significant visual communicative history which continues to intensify in contemporary media culture. In a retrospective discussing papal regalia, Vanity Fair alluded to this extensive history. Evoking the theatricality discussed by Miller, Vanity Fair compared previous popes’ uniform choices to rap artists and the individuality of Sex and the City characters, noting that the Catholic Church’s leaders “have historically exhibited a daring sense of style over their 2,000 years in the high office” (Miller). Following Miller’s argument, Pope Francis’s approach to his papal uniform is purposefully designed to memorably communicative his environmental message, a core aspect of his brand identity. The message of his simple approach to the papal uniform cannot be adequately addressed without placing it within the sartorial choices of his predecessors, especially Pope Benedict XVI and his preference for communicating authority and power through opulence. Approaches to the Papal Uniform since the 1960s Fashion has always played a significant role in communicating the institutional power and brand identity of the Catholic Church. Beginning in the mid-1960s with the creation of the Second Vatican Council by Pope Paul VI, the vestments comprising the papal uniform became the subject of increased media attention. Pope Paul VI’s move towards eliminating the more ostentatious robes and accessories associated with the papacy included his “dramatic gesture” to auction a papal tiara – which The New York Times estimated was worth roughly $80,000 in 1964 – with proceeds donated to charities and organisations assisting the poor (“Pope Paul Donates His Jeweled Tiara to Poor of World”). In a sociohistorical analysis of papal fashion, The Guardian argued that the decision by Pope Paul VI to auction the accessories of the papal uniform that were intended to mediate the Catholic Church’s institutional power represented his mandate to appear “more in touch with the people” (Conway). Pope Paul VI’s understanding of the communicative power of the papal uniform to symbolise the institutional values of the Catholic Church’s brand identity draws parallels to Pope Francis. The strategic curation of papal vestments and accessories demonstrates that the role of institutional uniforms for practices of brand and image management is not unique to the contemporary cultural moment. Although Pope John Paul II was known to enjoy a fondness for Rolex watches (which Teen Vogue cites as an iconic papal fashion moment), the papacy of Pope Benedict XVI coincided with a drastic resurgence in the grandiose garments neglected by his predecessors (Webster). With a preference for pre-Vatican II luxurious self, velvet, and fur pieces like the cape-style mozzetta, The Guardian contends that Pope Benedict XVI’s papal uniform represented a shift away from the communal emphasis of Pope Paul VI towards reviving the Catholic Church’s hegemonic heritage and tradition within visual culture. The Guardian argues that “at a time of global economic uncertainty, and with the Church struggling to retain its flock in an increasingly secularised world, reinforcing tradition and underlining the continuity of ritual was a bold and, Benedict felt, necessary direction” (Conway). The newspaper situates Pope Benedict XVI’s sartorial preference for his papal uniform within the larger trend of couture houses like Alexander McQueen and Chanel revisiting their archives. Pope Benedict XVI’s papacy oversaw the Catholic Church experiencing a significant decline in global authority and symbolic power due to the continued fallout from numerous scandals, including the longstanding history of sexual abuse allegations and charges of embezzlement at the Institute for the Works of Religion, the official bank of the Vatican. Combined with his highly conservative doctrinal approach and unwillingness to adapt the church’s position on key human rights and social justice issues, including LGBQT+ acceptance within the institution, Pope Benedict XVI’s conspicuous taste and approach to the papal uniform was symbolic of his leadership. His regalia and vestments mediated an undesirable brand identity as a pontiff largely disconnected from the realities of his public. Pope Benedict was also reported by the press to enjoy conspicuous designer accessories, in particular his Gucci sunglasses and, most notably, allegedly preferred to wear Prada for his papal shoes. In line with his symbolic approach to the papacy, Benedict revived the wearing of red shoes by the pope (with red a signifier of martyrs’ blood). Esquire labelled Pope Benedict XVI as their 2007 “Accessorizer of the Year”, primarily for incorporating a signature “ornate” footwear into his institutional religious uniform (“Best Dressed Men in America”). Conversely, Pope John Paul II’s papacy signified a shift away from this aspect of the papal uniform, preferring burgundy over a blood red colouring. The Vatican subsequently corrected that Pope Benedict XVI’s red papal shoes were not Prada but rather commissioned specifically for him by Italian cobblers (Fetters Maloy). However, the idea that Benedict incorporated Prada shoes into the institutional papal uniform had become repeated by numerous cultural intermediaries ranging from the Associated Press to Women’s Wear Daily,to the extent that it is now entrenched into the popular imaginary. Upon his retirement in 2013, The Cut argued Pope Benedict would be primarily remembered for the “pair of bright red Prada loafers that he almost always wore beneath his robes” (Cowles). When Pope Francis arrived in Washington, D.C. for his 2015 visit to the United States, USA Today celebrated the event with the brazen headline, “Pope Francis arrives and he’s not the ‘Prada Pope’” (Puente). Reflecting upon his divisive legacy after his death in December 2022, The Daily Beast continued circulating this narrative, writing that when Benedict XVI was elected to the papacy, he donned “Prada slippers and stumbled his way through a papacy fraught with controversy” (Latza Nadeau). It is within this context of Pope Benedict’s hegemonically ornate approach to the papal uniform that Pope Francis’s modest and humble styling of his vestments registered with the public as a mechanism for branding his public image. The Role of the Uniform for Pope Francis’s Brand Identity For his public introduction after the 2013 papal conclave to those pilgrims gathered in St. Peters Square, Pope Francis shaped the tone, narrative, and messaging of his papacy through his unique and calculated approach to the Church’s institutional uniform. His decision to appear on the balcony wearing a basic white cassock with an unadorned crucifix around his neck exemplifies Tynan and Godson’s argument that uniforms can act as a form of “self-preservation” within the context of institutional power (18). Pope Francis is not only the pontiff, but his image and persona work to maintain the institutional brand identity of the Catholic Church (Moir). His selection and wearing of a cassock demonstrate that Pope Francis is aware of how his image and persona will be critiqued by the public and cultural intermediaries. Pope Francis’s first encyclical published in 2015, Laudato Si’, argues that the environmental crisis (which he blames on wasteful consumerism) disproportionally impacts on the planet’s most socioeconomically marginalised communities. The correlation of climate change with the injustices faced by the poor is highlighted by scholars including Bruno Latour and Anne F. MacLennan for exemplifying Pope Francis’s radical approach prioritising empathy to the papacy. Pope Francis’s uniform performs his environmental activism by signifying how discourses of sustainability and ethical consumption are core social justice issues for the Church. Through rejecting the opulent vestments for a modest white cassock and wearing sandals rather than red shoes, sartorial decisions were strategically made to communicate his symbolic approach to the papacy through the power of the uniform. His sartorial approach to the papal regalia comprising his religious uniform ignited extensive public conversations concerning how Pope Francis’s image – humble, modest, advocating for the poor, environmental activist – would improve the Catholic Church’s brand identity amidst numerous scandals. Fashion critic Vanessa Friedman’s discussion of Pope Francis is a potent example of the type of public commentary from cultural intermediaries that framed the symbolic power of his papal uniform for the Church’s re-branding efforts: Pope Francis hasn’t really had a chance to do anything in terms of influencing doctrine – except appear in moments broadcast to millions … they can all make their own assumption based on how he looks. There was a very clear rationale behind his decision to eschew the more fancy, ermine-trimmed red and purple robes of Pope Benedict in favour of plain white vestments; to swap the fold cross for an iron version. The choices telegraphed the importance of humility; the importance of recognizing and working with the poor; and the need, in a time of austerity, to acknowledge the suffering and deprivations of others. It was a discreet but unmistakable announcement of a new agenda, using the tools most immediately and least aggressively available. (“Pope and Circumstance”) Friedman’s analysis is particularly noteworthy because she underlines how the papal uniform has always been subject to personal interpretation based upon the brand identity of the pontiff. More significantly, she connects Pope Francis’s selection of papal regalia to his environmental politics and social justice activism. The uniform possesses greater symbolic power than Pope Francis’s actions. His uniform emphasises the frames, narratives, and discursive schemas grounding his brand identity that is then circulated by cultural intermediaries as in the example of Friedman’s analysis. In a feature detailing the impact of Pope Francis’s papacy on the fashion industry, The New York Times highlighted the cultural impact of the pontiff’s religious uniform. Italian fashion designer Silvia Venturini Fendi is cited by The New York Times as recognising the rise of sustainability in high fashion, making a direct association to Pope Francis’s criticism of wasteful consumerism: “we have a new pope going back to real Christianity, which lately was far from the church … . People are looking for meaning, and the real meaning of fashion is as a tool to express yourself. Sometimes fashion hides your language, but we look for meaning in materials and fabrics to allow true personality to come out” (Menkes). Esquire named Pope Francis their “Best Dressed Man of 2013”, an honour bestowed upon the pontiff for how his sartorial approach to the papal uniform signified the Catholic Church’s rebranding efforts. Justifying their selection over other candidates like Bradley Cooper and Joseph Gordon-Levitt, Esquire cites New York University professor Ann Pellegrini, who situates Pope Francis’s papal uniform as a powerful signifier of his brand identity: “the humility of his garments offers a way to visibly display his theological and material concerns for the poor. This Holy Roman emperor really does have new clothes” (Berlinger). Fendi and Esquire’s positioning of Pope Francis’s papal regalia as an institutional yet personal communicative tool underscores how his religious uniform performs a critical function to reshape the public narratives and discourses shaping judgements on the Catholic Church. Pope Francis’s celebrity status and the deliberate rejection of lavish vestments helped initiate a wider discourse on the politics of the papal uniform in media and popular culture. In 2018, the Metropolitan Museum of Art’s Costume Institute debuted their annual fashion exhibit Heavenly Bodies: Fashion and the Catholic Imagination, showcasing both the influence of Catholicism for numerous designers (such as Alexander McQueen and Versace) as well as the visual politics of the Church’s institutional uniform (Bolton). The debut of Heavenly Bodies was the focus of the 2018 Costume Institute Gala, the prestigious – and highly exclusionary – annual fundraiser for the Metropolitan Museum of Art. Rihanna attended wearing a papal-inspired Margiela bejewelled minidress with a matching jacket and mitre (Syme). Proclaimed as “Pope Rihanna” by Twitter users, her choice of embodying an opulent imagination of the papal uniform received extensive attention by the press and the public on social media (“The Most Hilarious Twitter Reactions to Rihanna’s Met Gala Look”). Teen Vogue argued that Rihanna’s thematic outfit functioned as a form of activism by highlighting the gender discrimination within the organisational structure of the Catholic Church (Papisova). Despite advocating against social injustices, Pope Francis’s continued denial of women becoming priests remains one of the major criticisms of his papacy. Although Pope Francis has employed his papal vestments and regalia to perform a social justice-oriented mandate for his papacy, there are limits to the advocacy of his institutional uniform which must balance and negotiate the complex politics of the Catholic Church. Conclusion Papal vestments and regalia play an important communicative role in visual culture. Prior to 2018’s Met Gala, Vox argued that “instead of watching celebrities at the MET Gala Monday night, pay attention to what the pope wears everyday” (Burton). Vox highlights the symbolic power of the pontiff as an institutional figure to negotiate various trends and social shifts circulating in public discourse. Heavenly Bodies and the larger discussions by cultural intermediaries analysing papal fashion exemplifies how the papal uniform contributes to the symbolic power of the Catholic Church in public discourse and media culture. The papal vestments comprising the pontiff’s institutional uniform is a critical element of Pope Francis’s public persona, and his sartorial tactics signify a larger visual history of institutional branding through fashion. Pope Francis is an intriguing example of a celebrated public figure utilising the iconicity of his institutional uniform to mediate ideas about sustainability, environmental ethics, austerity, and consumption. However, cultural intermediaries focussing on the symbolism of such regalia shift attentions away from the Catholic Church’s institutional power and reduce opportunities to critique Pope Francis on key social justice issues, such as the treatment of women, the role of the Church in colonisation, and continued sexual abuse allegations. References Barnard, Malcolm. “Fashion as Communication Revisited.” Popular Communication 18.4 (2020): 259-271. Berlinger, Max. “The Best Dressed Man of 2013: Pope Francis.” Esquire, 27 Dec. 2013. 25 Jan. 2023 <https://www.esquire.com/style/mens-fashion/a26527/pope-francis-style-2013/>. “Best Dressed Men in America: The Awards.” Esquire, 20 Aug. 2007. 25 Jan. 2023 <https://www.esquire.com/style/a3312/bestdressedawards0907/>. Bolton, Andrew. Heavenly Bodies: Fashion and the Catholic Imagination. New York: Metropolitan Museum of Art, 2018. Coghlan, Jo. “Dissent Dressing: The Colour and Fabric of Political Rage.” M/C Journal 22.1 (2019). DOI: 10.5204/mcj.1497. Conway, Henry. “Pope Benedict: His True Legacy is His Fashion Sense.” The Guardian, 3 March 2013. 25 Jan. 2023 <https://www.theguardian.com/fashion/fashion-blog/2013/mar/03/pope-benedict-true-legacy-fashion-sense>. Cowles, Charlotte. “An Ode to Pope Benedict XVI’s Sassy Footwear.” The Cut, 11 Feb. 2013. 25 Jan. 2023 <https://www.thecut.com/2013/02/ode-to-pope-benedict-xvis-sassy-footwear.html>. Craik, Jennifer. “The Cultural Politics of the Uniform.” Fashion Theory: The Journal of Dress, Body and Culture 7.2 (2003): 127-147. ———. Fashion: The Key Concepts. Berg, 2009. Fetters Maloy, Ashley. “The Hidden Meanings of Pope Benedict XVI’s Ruby-Red Shoes.” The Washington Post, 31 Dec. 2022. Friedman, Vanessa. “Pope and Circumstance.” Financial Times, 20 Mar. 2013. 25 Jan. 2023 <https://www.ft.com/content/e81f0f66-9234-11e2-851f-00144feabdc0>. Keenan, William J.F. “Dissolving Vatican Uniform Hegemony: The Marist Road to Dress Freedom.” Uniform: Clothing and Discipline in the Modern World. Eds. Jane Tynan and Lisa Godson. Bloomsbury, 2019. 87-106. Klein, Naomi. “How Corporate Branding Has Taken Over America.” The Guardian, 16 Jan. 2010. 25 Jan. 2023 <https://www.theguardian.com/books/2010/jan/16/naomi-klein-branding-obama-america>. Latour, Bruno. “The Immense Cry Channeled by Pope Francis.” Environmental Humanities 8.2 (2016). 251-255. Latza Nadeau, Barbie. “Death of Pope Benedict XVI Raises Question of His Legacy as Protector of Predator Priests.” The Daily Beast, 31 Dec. 2022. 25 Jan. 2023 <https://www.thedailybeast.com/pope-benedict-xvi-will-be-remembered-as-the-enabler-and-protector-of-predator-priests>. MacLennan, Anne F. “Promoting Pity or Empathy? Poverty and Canadian Charitable Appeals.” Advertising, Consumer Culture, and Canadian Society. Ed. Kyle Asquith. Oxford: Oxford UP 2019. 225-243. Menkes, Suzy. “Fashion and the Power of the Pulpit.” The New York Times, 15 July 2013. 25 Jan. 2023 <https://www.nytimes.com/2013/07/16/fashion/16iht-frome16.html>. Miller, Julie. “From Lipstick-Red Loafers to Pontiff Bling Rings, the Most Fascinating Papal Fashion Choices.” Vanity Fair, 14 Mar. 2013. 25 Jan. 2023 <https://www.vanityfair.com/style/photos/2013/03/pope-francis-jorge-mario-bergoglio-papal-fashion>. Miller, Maureen C. “Clothing as Communication? Vestments and Views of the Papacy c. 1300.” Journal of Medieval History 44.3 (2018): 280-293. Moir, Aidan. Punk, Obamacare, and a Jesuit: Branding the Iconic Ideals of Vivienne Westwood, Barack Obama, and Pope Francis. 2021. PhD thesis. York University. 25 Jan. 2023 <https://yorkspace.library.yorku.ca/xmlui/bitstream/handle/10315/38473/Moir_Aidan_M_2021_Phd.pdf?sequence=2&isAllowed=y>. Papisova, Vera. “The Catholic Church Should Learn from Rihanna’s 2018 Met Gala Look.” Teen Vogue, 8 May 2018. 25 Jan. 2023 <https://www.teenvogue.com/story/the-catholic-church-should-learn-from-rihannas-2018-met-gala-look>. “Pope Paul Donates His Jeweled Tiara to Poor of World.” The New York Times, 14 Nov. 1964. 25 Jan. 2023 <https://www.nytimes.com/1964/11/14/archives/pope-paul-donates-his-jeweled-tiara-to-poor-of-world.html>. Puente, Maria. “Pope Francis Arrives and He’s Not the ‘Prada Pope.’” USA Today, 23 Sep. 2015. 25 Jan. 2023 <https://www.usatoday.com/story/life/people/2015/09/22/pope-francis-arrives-and-hes-not-prada-pope/72634962/>. Syme, Rachel. “Pope Rihanna and Other Revelations from the Catholic-Theme 2018 Met Gala.” The New Yorker, 8 May 2018. 25 Jan. 2023 <https://www.newyorker.com/culture/on-and-off-the-avenue/pope-rihanna-and-other-revelations-from-the-catholic-themed-2018-met-gala>. “The Most Hilarious Twitter Reactions to Rihanna’s Met Gala Look.” Harper’s Bazaar, 8 May 2018. 25 Jan. 2023 <https://www.harpersbazaar.com.sg/life/celebrities/twitter-reaction-rihanna-met-gala-look/>. Tynan, Jane, and Lisa Godson. “Understanding Uniform: An Introduction.” Uniform: Clothing and Discipline in the Modern World. Eds. Jane Tynan and Lisa Godson. Bloomsbury, 2019. 1-22. Webster, Emma Sarran. “10 Iconic Moments in Papal Fashion History to Celebrate Met Gala 2018.” Teen Vogue, 3 May 2018. 25 Jan. 2023 <https://www.teenvogue.com/gallery/pope-fashion-history-met-gala-2018>. Zargani, Luisa. “Pope Francis’ Simple Style Statement.” Women’s Wear Daily, 21 Sep. 2015. 25 Jan. 2023 <https://wwd.com/eye/people/pope-francis-simple-style-statement-10235021/>.