Louise Isham

Background: This article is by lived experience co-researchers and an academic research team. Co-research involves those with lived experience of a topic under investigation. It is an increasingly popular participatory, beneficial form of co-production that improves the integrity and quality of research, and bridges gaps between academics and participants. Co-researchers can conduct interviews, analyse data and disseminate findings which contributes to meaningful, rich data. However, co-research can engender risk. Co-researchers may lack full integration, leading to isolation and exacerbation of power differentials. Risks are heightened when researching sensitive topics, due to exposure to the narratives of participants and potential re-traumatisation. Our approach: The aim of this article is to share our experiences of co-produced research on a multi-method study of specialist sexual violence services in England. Five co-researchers with lived experience of sexual violence (SV) interviewed victim-survivor participants, conducted data analysis, and were pivotal in dissemination. As part of a novel design, we employed a specialist, lived experience facilitator to support the co-researchers, which complemented that offered by the academic team. Our learning: By evaluating our experience, we highlight the benefits and challenges of co-research. The discussion considers four areas of learning: safety and self-care; empowerment and amplification of voice; accountability and transparency; creativity and joyfulness. Future co-research studies can utilise learning to avoid potential pitfalls and create success. Conclusions: By sharing unique evaluation experiences, this article might benefit academic research teams and lived experience co-researchers considering co-research, particularly on sensitive topics. Key to achieving improvements is the linchpin of a facilitator role.

The specialist voluntary sector (SVS) provides distinctive and much-valued support to victim-survivors of sexual violence. Nevertheless, in England as in other countries, the funding and commissioning landscape in which SVS services are situated is complex and frequently characterised as fragmented and uncertain. In turn, this context unsettles, and sometimes threatens, SVS services’ unique ways of working and their long-term sustainability. Drawing on the concept of boundary spanning, this article reports an interview study with 16 commissioners who had responsibility to commission sexual violence services. We found that commissioners saw themselves as promoting and protecting SVS services, for example through the development of local partnerships, adaptation of commissioning requirements and conventions, and building professional alliances with service leaders. We also found that commissioners worked to broker strategic partnerships with commissioners in other public sector organisations; however, this work was often time-consuming, deeply political and uncertain in its outcomes. This article contributes to the sparse academic literature on the experiences and views of commissioners of SVS sexual violence services. By drawing on the theory of boundary spanning, the article offers a novel way of conceptualising the sophisticated and sometime precarious nature of commissioning practices, including the emotional and political labour required to bring about changes to the commissioning status quo.

Summary: There is growing recognition that older adults may be affected by violence, abuse and harmful behavior within intimate and family relationships and that people who work with affected families play an important role fostering (or inhibiting) older adults’ processes of disclosure or help-seeking. This article reports a scoping review of empirical studies that investigated how social workers experience their work with older adults affected by abuse and harm. Findings: The review found that social work with older adults affected by abuse is characterized as distinctive, requiring a need to maintain hope in situations of adversity and to value incremental, sometimes imperceptible, change. Practitioners draw on and appear to value “creative approaches” which are often synonymous with the use of professional discretion and autonomy. This is in the context of carrying out emotionally “heavy” work that has personal and professional impacts. Finally, we found that practitioners work with “complex” family dynamics and situations and see the preservation of (safe) relationships as a critical part of their role. Applications: The review highlights the need to develop knowledge and understanding about how social workers cope, survive and thrive when working with older adults affected by violence and abuse. There is also a requirement for a more critical engagement with the concept of creative practice and the distinctly social dimensions of social work with older adults, including greater engagement with gender-sensitive and feminist responses.

Background: There is increasing recognition in England that voluntary sector specialist sexual violence services are essential in providing crisis and longer-term support to victim-survivors. However, there is limited empirical evidence about the scope, range and effectiveness of voluntary sector specialist provision and commissioning, or what victim-survivors want from services. Objectives: Explore victim-survivors’ experiences of accessing and using voluntary sector specialist services. Analyse the range, scope and funding of voluntary sector specialist services and how demand is managed. Explore the usefulness of different approaches to service delivery and different therapy models. Explore how different principles underlying service provision influence service delivery. Investigate referral patterns and pathways, and how voluntary sector specialist services fit with each other and link to the wider network of services for victim-survivors. Explore how arrangements for commissioning and funding services for victim-survivors across health, local authorities and criminal justice have evolved. Develop a taxonomy of the voluntary sector specialist services/service models being commissioned and provided. Make recommendations for the commissioning and provision of voluntary sector specialist services at practice and policy levels. Data sources: Interviews with key stakeholders, focus groups with victim-survivors; a national survey of key stakeholders. Methods: This multimethod study comprised five sequential work packages: work package 1: exploratory interviews with commissioners and providers and focus groups with victim-survivors; work package 2: national survey of service providers and commissioners; work package 3: in-depth case studies in four areas of England; work package 4: co-research with victim-survivors; work package 5: data integration. Co-production was built into the study from its inception through robust patient and public involvement and engagement activities. These included a co-applicant who is a survivor of sexual violence, plus the appointment of five expert-by-experience co-researchers. Results: We captured the combined findings conceptually and diagrammatically into a new model comprising six themes: the complex and precarious funding landscape; the challenge of competition for funding and contracts; the importance and success of partnership working with organisations; the pressured environments within which voluntary sector specialist services work; different roles, scope and eligibility of voluntary and statutory services within an area; and the ways services are organised and delivered, underpinned by services’ values and philosophies. Limitations: The COVID-19 pandemic meant that we were unable to use the proposed methods of data collection for the qualitative components. Mitigation was through developing online modes of data collection. Recruitment to the case study phase did not reach intended thresholds, but rich insights were drawn from earlier phases of the study. Conclusions: The PROSPER study has provided hitherto missing evidence regarding the funding and commissioning of sexual violence services in England. The findings are likely to be useful in informing future commissioning of such services. The PROSPER study has also presented some unexpected opportunities for learning, particularly regarding co-research in the field of sexual violence. We also claim a contribution to theory development through the expansion of a current theoretical framework that may be of use to others working in the specialist voluntary sector. Future work: The model will require development and testing to assess its usefulness as a resource for training and education or as an aid to communications in any interactions that are concerned with the delivery, funding and commissioning of voluntary sector specialist services. Study registration: This study is registered as Research Registry researchregistry5144. Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: 18/02/27) and is published in full in Health and Social Care Delivery Research; Vol. 13, No. 10. See the NIHR Funding and Awards website for further award information.

Sexual violence is a global problem with significant individual and societal health and social costs. Services that support victim‐survivors of sexual violence across a range of sectors are crucial. This study investigated the scope, range, funding and commissioning of voluntary sector specialist (VSS) sexual violence services in England and victim‐survivors’ experiences of using such services. The specialist voluntary sector plays a pivotal role in providing crisis and longer‐term support to victim‐survivors. However, there is limited empirical evidence about the scope, range and use of VSS provision, or what victim‐survivors value and want from services. The aim of the study was to address this gap and provide much‐needed evidence to inform the VSS sector nationally. This co‐produced study included five co‐researchers and one co‐applicant with lived experience of sexual violence. There were three empirical phases: (1) exploratory interviews with commissioners and service providers and focus groups with victim‐survivors; (2) national survey of service providers and commissioners; (3) in‐depth case study analysis in four areas of England. The purpose of this paper is to synthesise the findings from each of these phases and map them onto a conceptual model, encompassing six themes: the complex and precarious funding landscape; the challenge of competition for funding and contracts; the role of partnership working; the pressured environments within which VSS services work; the different roles, scope and eligibility of voluntary and statutory services within an area; the ways services are delivered, underpinned by services’ values and philosophies. The study provides new, empirical insights into how these arrangements affect those connected with the services—namely, staff, volunteers and victim‐survivors. The paper sets out 14 recommendations for all parties involved in the funding and commissioning of specialist services, including commissioners, grant funders and VSS organisations in England.

Background: In England, voluntary sector specialist (VSS) services are central to supporting victim-survivors of sexual violence (SV). However, empirical evidence is lacking about the scope, range and effectiveness of VSS provision for SV in England. Objectives: To undertake national surveys to map SV VSS service provision and describe arrangements for funding and commissioning. Design: Cross-sectional surveys. Setting: VSS services for SV and commissioners from multiple organisations across England (January–June 2021). Methods: Senior staff working in VSS services and commissioners from multiple organisations were surveyed electronically. Surveys explored SV service commissioning, funding and delivery, partnerships between organisations, perceived unmet need for services, and views about facilitators and challenges. Data were analysed descriptively to characterise VSS service provision for SV and commissioning across England. Results: 54 responses were received from VSS providers and 34 from commissioners. Data demonstrated a complex and evolving funding and commissioning landscape in which providers typically secured funding from multiple sources, impacting consistency and scope of service provision. It was common for multiple organisations to co-commission services, demonstrating trends towards larger contracts that may disadvantage smaller specialist providers. Numerous examples of partnership working between organisations were identified, although developing partnerships was noted as challenging, particularly between VSS organisations. There was clear evidence of unmet need for services, with some groups of victim-survivors such as those from black and minority ethnic groups, often underserved by specialist services. However, there was also evidence of innovative service development and commissioning approaches to meet the needs of victim-survivors who face challenges accessing services. Conclusions: This study provides novel insights into SV service provision and commissioning in England, including unmet needs among victim-survivors.

This report outlines an exploratory study that investigated whether the “Never Events” system – first used in healthcare contexts to identify and investigate preventable incidents that cause serious harm or death as a result of human error – could be adapted in the context of UK multi-agency child protection. Using a sequential design, two online surveys were carried out that explored practitioners’ (n = 46) views about the feasibility of adopting the Never Events model and what, if any, incidents or events could be investigated plausibly using such a model. Practitioners were drawn from a purposive sample. An inter-disciplinary panel of senior practitioners - drawn from nursing, public health, social work and child mental health services- discussed the surveys’ findings and the list of proposed child protection Never Events. The findings indicate that the complex, judgment-based nature of child protection contributes to difficulties creating shared understandings about what constitutes harm and the extent to which multi-agency systems can share decision-making and responsibility for the way they identify and support families. Thinking through and discussing the relative strengths and limitations of the Never Events model may nevertheless be a valuable exercise in interprofessional training and the design of highly localized review and reporting systems.