Over recent years there have been several political imperatives in the UK directed toward children's palliative care and ensuring that services are high-quality, coordinated, family-centred, and able to meet the needs of children with complex disabilities. In addition, in 2010 the health and social care regulation authority in England-the Care Quality Commission (CQC)-aligned hospices with regulation and inspection requirements. This context has acted as a driver for the creation of effective education and training to ensure a skilled and expert workforce. Against this backdrop, this paper describes a project to develop a learning and development strategy for Children's Hospices across London (CHaL). CHaL educators worked with a research team to develop a unified strategy that was based on evidence of good practice, embedded in required CQC outcomes, and validated with a wider audience. The resultant strategy contains a set of four key leaming and development principles that are applicable and transferable across different hospices.

Background: Standards, benchmarking, and audits are integral to quality monitoring in health and social service provision. Recent policy in the UK National Health Service dictating the need for increased consumer involvement necessitates that service users have significant input into the composition of standards for quality of care. Objective: To report the authors' recent involvement in research towards developing a set of agreed, measureable statements regarding quality in the provision of continence services using the views of older service users. Methods: This article focuses on the third of a three-stage project to involve, identify, and incorporate the views of older continence service users in the development of standards of care in continence services. Whereas stage 1 developed a questionnaire with the assistance of service users, and stage 2 piloted this as a postal survey in two contrasting areas, stage 3 applied the tool in the context of face-to-face interviews with more vulnerable older people. The approach also included open-ended questions to elicit qualitative data around experiences of continence service provision. Results: Earlier stages of the project involved the relatively unproblematic construction of standards based on views given by experts and focus groups of older people. However, more in-depth, semi-structured interviews with service users brought to light the holistic, complex, and subjective way in which the sample viewed their experiences. Conclusions: This study raises a number of questions over the efficacy of simple statements in capturing what is important to service users. If such standards are to empower patients usefully and assist professionals informatively in their provision of high-quality care, greater effort and sophistication is needed to truly reflect the needs and interests of service users. Alongside these concerns, however, there are potential ways of bridging the gap between standard setting and the lived patient experience.

This article describes health promotion for older people in the Czech Republic from the European perspective. It is based on findings from the European project healthPROelderly. Implemention of health promotion in the Czech Republic as a new public health concept is outlined from the historical point of view. Structures and processes of health promotion in the Czech Republic are described in the context of social policy, demography and health. The European project healthPROelderly is presenting and the outcomes of an international literature search statisicallyanalysed. Participating coutries were devided into three macro-regions according to their geographical location and political and historical tradition - Mediterranean, West-European and formerly East-European macro-regions. The outcome orf correspondence analysis partially confirms the hypothesis on the cultural background of the health promotion activities and strategies. Concerning themes addressed by health promotion projects most countries belonging to the Mediterranean or 'Western European' macro-regions have concentrated on similar themes whereas this is not valid for the countries of the 'Former Eastern European' macro-region. The hypothesis on macro-regional similarities in relation to settings of health promotion projects was not confirmed. In the conclusions the location of the Czech Republic in an international perspective is discussed and three Czech selected best practice projects are evaluated in relation to the statistical findings.

This study was undertaken in response to the audit requirements for the National Service Framework for Older People Standard 1 "Rooting our Ageism". The aim of this study was to identify and describe the nature of any age-discriminatory practice in the clinical setting through the perceptions and experiences of staff working with older people. The study adopted a qualitative approach using focus group design. Six focus groups were conducted 57 members of staff. An aim of the study method was to isolate consensus areas of ageist practice that would facilitate targeted intervention. To assist this statements relating to common practice experiences were developed following the first two focus groups. This was used as a discussion tool for the subsequent groups. Perceived ageist practice could be grouped under the following themes; access to services, communications and attitudes, treatment and care, the role of relatives, resources. On the basis of the findings greater choice and control for older people need to be key features of the recommendations, through the development of a co-ordinated development programme involving all stakeholders.