Integrating Health and Social Care Services.

Background: A recent UK Government draft Heath White Paper follows the NHS England long term plan when it states that NHS England requires "a new framework that builds on changes already being made as well as building in the flexibility to support the system to tackle challenges of the future". At present the structure of Health and Social Care Services UK reporting to Government seems unhelpfully complex and opaque. Objective: The purpose of this paper is to contribute to the building of a new framework using a generic approach to identify and use 'systemic processes' to facilitate the integration of Health and Social Care services in NHS England and elsewhere. Methods: We highlight some of the critical issues that are currently hindering integration and set out a new way of understanding the structure of NHS England through an 'inside-out' analysis of systemic processes. Results: We describe and give three examples of existing systemic processes as 'Consulting a patient', 'Enhancing a Single point of access' - to mental health services and 'Delivering health and social care services England'. Conclusions: Rethinking the interactions between existing organisations could arguably bring considerable benefits including cost savings, better co-ordination, less 'admin' stress on staff where the work is done and provide more organisational adaptability in an uncertain future. Ultimately our suggestions are aimed at helping people to deliver better patient care - the impelling purpose of all health and social care services.

Biodiversity data and new species descriptions of polychaetes from offshore waters of the Falkland Islands, an area undergoing hydrocarbon exploration.

Benthic environmental impact assessments and monitoring programs accompanying offshore hydrocarbon industry activities result in large collections of benthic organisms. Such collections offer great potential for systematics, biodiversity and biogeography research, but these opportunities are only rarely realised. In recent decades, the hydrocarbon industry has started exploration activities in offshore waters off the Falkland Islands. A large collection of ca. 25,000 polychaete (Annelida) specimens, representing some 233 morphological species was processed at the Natural History Museum, London. Taxonomic assessment led to recognition of many polychaete species that are new to science. The existing taxonomic literature for the region is outdated and many species in existing literature are likely misidentifications. Initially, an online taxonomic guide (http://falklands.myspecies.info) was created, to provide a single taxonomic source for 191 polychaete species to standardise identification across different environmental contractors working in Falkland Islands. Here, this effort is continued to make data available for 18,015 specimens through publication of raw biodiversity data, checklist with links to online taxonomic information and formal descriptions of five new species. New species were chosen across different families to highlight the taxonomic novelty of this area: Apistobranchus jasoni Neal & Paterson, sp. nov. (Apistobranchidae), Leitoscoloplos olei Neal & Paterson, sp. nov. (Orbiniidae), Prosphaerosyllis modinouae Neal & Paterson, sp. nov. (Syllidae) and Aphelochaeta falklandica Paterson & Neal, sp. nov., and Dodecaceria saeria Paterson & Neal, sp. nov. (both Cirratulidae). The potential of the Falkland Islands material to provide up to date informationfor known species described in the literature is also highlighted by publishing images and redescription of Harmothoe anderssoni Bergström, 1916 and Aphelochaeta longisetosa (Hartmann-Schröder, 1965). Biodiversity and abundance data are made available through a DarwinCore database, including material collected from 83 stations at Sea Lion developmental oil field in North Falklands Basin and voucher specimens' data collected from exploratory oil wells in East Falklands Basin.

A comparison of sampling methods for seawater microplastics and a first report of the microplastic litter in coastal waters of Ascension and Falkland Islands.

To date there is no gold standard for sampling microplastics. Zooplankton sampling methods, such as plankton and Neuston nets, are commonly used to estimate the concentrations of microplastics in seawater, but their ability to detect microplastics is limited by their mesh size. We compared different net-based sampling methods with different mesh sizes including bongo nets (>500 µm), manta nets (>300 µm) and plankton nets (>200 µm and >400 µm) to 1 litre bottle grabbed, filtered (0.45 µm) samples. Concentrations of microplastics estimated using net-based methods were ~3 orders of magnitude less than those estimated by 1 litre grab samples. Some parts of the world with low human populations, such as Ascension Island and the Falkland Islands, lack baseline data on microplastics. Using the bottle grab sampling method we found that microplastic litter was present at these remote locations and was comparable to levels of contamination in more populated coastal regions, such as the United Kingdom.

Impacts of discarded plastic bags on marine assemblages and ecosystem functioning.

The accumulation of plastic debris is a global environmental problem due to its durability, persistence, and abundance. Although effects of plastic debris on individual marine organisms, particularly mammals and birds, have been extensively documented (e.g., entanglement and choking), very little is known about effects on assemblages and consequences for ecosystem functioning. In Europe, around 40% of the plastic items produced are utilized as single-use packaging, which rapidly accumulate in waste management facilities and as litter in the environment. A range of biodegradable plastics have been developed with the aspiration of reducing the persistence of litter; however, their impacts on marine assemblages or ecosystem functioning have never been evaluated. A field experiment was conducted to assess the impact of conventional and biodegradable plastic carrier bags as litter on benthic macro- and meio-faunal assemblages and biogeochemical processes (primary productivity, redox condition, organic matter content, and pore-water nutrients) on an intertidal shore near Dublin, Ireland. After 9 weeks, the presence of either type of bag created anoxic conditions within the sediment along with reduced primary productivity and organic matter and significantly lower abundances of infaunal invertebrates. This indicates that both conventional and biodegradable bags can rapidly alter marine assemblages and the ecosystem services they provide.

Effect of wharves on intertidal assemblages on seawalls in Sydney Harbour, Australia.

Worldwide, urbanisation has resulted in extensive replacement of natural habitats with man-made habitats. In Sydney Harbour, Australia, approximately half of the natural foreshore has been replaced by seawalls. Many of these have wharves built over part of their length, which could affect intertidal assemblages on seawalls beneath the wharves. This was tested by sampling and comparing assemblages under and not under wharves in Sydney Harbour. Assemblages differed between the two habitats, with greater cover of macro-algae and abundance of grazing molluscs on seawalls without a wharf and, to a lesser extent, greater cover of sessile invertebrates on seawalls under a wharf. There was, however, considerable spatial variability among locations in composition of assemblages and the species dominating differences between the two habitats. The impact of multiple artificial structures in close proximity and the variability among apparently homogeneous artificial habitats must be considered for the management of urbanised estuaries.