Good decision-making in adult social care

[Intro] 

This is a Research in Practice Podcast, supporting evidence-informed practice with children and families, young people and adults.  

Ofelia: Welcome to this Research in Practice Podcast. My name's Ofelia Torres and I'm a Research and Development Officer with Research in Practice, where we champion evidence-informed practice in children's, families', and adult services. I'm delighted to be joined by Gerry Nosowska and people with lived experience, and practitioners who help develop a good decision making resource. Today, we are going to have a conversation about good decision making. Making decisions is something we do every day without realising. But when it comes to social care, decision making takes a new level of complexity. It no longer becomes about just making decisions, and it becomes about making informed and collaborative decisions that impact people's lives in meaningful ways.

In today's podcast, we'll be exploring good decision making. And at the end, we'll discuss an exciting announcement about the launch of our updated Good Decision Making resource. Research in Practice first developed the Good Decision Making Handbook in 2013, which was written by Gerry. But in 2025, we will be launching an updated version. It's primarily written for adult social care practitioners with the aim of enabling them to improve the quality of their judgement and decision making so that experiences and outcomes are improved for people who draw on care and support. So, I'm just going to start by saying welcome and thank you to everyone joining us. I'm going to go ahead and give everyone a chance to introduce themselves. Gerry, if you can please introduce yourself.  

Gerry: Thanks. Ofelia. I'm Gerry Nosowska. I'm an independent social worker and an associate for Research in Practice. Really pleased to be here today.

Susan: My name is Susan, Susan Gruss. My mother had vascular dementia. She died in 2018 and it was really the toughest part of my life. But now that I am retired, I am dedicating my life basically to getting everything as it should be. But it is not easy out there in the social care world, not easy at all.  

Victoria: Hi, everyone. I'm Victoria Grimwood. My pronouns are she or they. I've been a qualified social worker for 20 years now. I work mainly in adult social care. And before I was a social worker, I worked in other kinds of care and support roles in social care. I work for a local authority and I'm also a postgraduate researcher at King's College London in the Health and Social Care Workforce Research Unit.  

Elaine: Hi, I'm Elaine James, I'm a social worker. I'm a head of service for a team in West Yorkshire. We support young people transitioning from children's services and adults with disabilities under the age of 65. And I'm also an honorary fellow of the research team up at Manchester Met University, focusing on learning disabilities and autism. It's a real honour to be here this morning, and really looking forward to the conversation.  

Bob: My name's Bob Jones. I became involved in care when I took early retirement to look after my mother. And like many people whose first contact with social services is in a time of crisis, and you don't know as a, sort of, recipient what your rights are, you don't know who these people are. Sometimes they are different each time you meet them. I remember when my mum was being discharged from hospital, no less than sixteen different people were involved in the simple act of discharging her and getting her a residential home place. So, I suppose technically what I'd be called is an expert by experience, but I think what I'd prefer to be called is somebody who's still learning through experience and wanting to improve that experience for others. 

[Why is decision making important?] 

Ofelia: I'm just going to invite you all around a discussion around good decision making. So, to kick off this podcast, I just want to start off with discussing, why is decision making important? So, I'm just going to start off with Susan.  

Susan: Well, as Ofelia said in her introduction, we do make decisions every day. And decision making underpins absolutely everything we do in our day-to-day lives, but particularly when we are talking about social care. And of course, now I'm thinking about vascular dementia. A good company, a good organisation, knows how to make these decisions. They know that they must be made. A good decision in the outside world is always underpinned with the law. And then you start, because that is, I think, the most important decision that you've got to remember is that it is the law which shows us the way to go. Without good decision making, without any reference to the law, then that's it, you're not a good provider, you're not a good company, you're not anything. You have to get the decision making in, otherwise you lose yourself and you leave yourself open to challenges. You leave yourself open to, at best, not being perceived as a good company, but at worst, up for challenge for mistakes you have made. It is one of those things that it is fundamental. Without good decision making, you can't do your job. It's as simple as that. You cannot do your job and look after those people who you care for.  

Ofelia: Bob, from your point of view, why is decision making important?  

Bob: I think the most important decision is how you make decisions. Because do you make decisions because that's the way we've always done things around here? Do you make decisions because of a personal bias in a particular area? So, that's one thing that I think, I hope that practitioners will start to reflect on. Is it decision making by consensus? Is it decision making from top-down decisions made by a senior manager of the team? Is it a decision that actually is a decision that is needed? And the reason I say that is that sometimes doing nothing may be the right decision as well, you know. But what I hope will come out from this is that practitioners start to reflect a bit more. They don't just make decisions because they're under time pressure, which I know they are, or under resource pressure, because I know they are. But what they try and do is involve the person who's affected by the decision in that actual decision. So, that's why decision making is important. This is an important message to practitioners, and it's about understanding, maybe in the past, making decisions because that's the way we do things around here, is not the right way forward. That's my point on decisions.

[What goes wrong with decision making, and what helps?] 

Ofelia: Great. Thank you both. So, in our decision making resource, it aims to enable practitioners to improve the quality of their judgement and decision making so that experiences and outcomes can be improved for the people that draw on care and support. So, this question is for Gerry and Elaine. What goes wrong with decision making, and what helps? I'll go ahead and start with Gerry.  

Gerry: Thanks, Ofelia. I think the fundamental thing to bear in mind here is that there's real potential in decision making in adult social care, but that potential can either be realised, or, you know, it can be under realised. Good things can happen, positive impact can occur, wellbeing can be promoted, or we miss that opportunity. And fundamentally, decision making in adult social care is going to be tricky because we're making decisions that are about someone else's life. And in an ideal world, people will be making those decisions about their own life, they'd have the capability and the resources to do that. Those, kind of, struggles, and need some support to come in to assist you with that decision making, to be alongside you. And there's a public service element to that, then the decision making is automatically going to be complicated because it's the local authority in this case making a decision with someone which is about their life. So, I mean, in terms of what helps, the fundamental thing that is necessary is to get as close to co-production as you possibly can so that those decisions are as good as they can be. Things can go wrong, or opportunities can be missed because it's such a complex context that we're working in. I think there are difficulties with decision making and complexity anyway because of human fallibility and, you know, things that can affect our judgement. And there are constraints, as Bob talked about, around time and resources. There's an emotional impact, an emotional component of decision making. So, it is going to be complicated always. And I think that what we have to do and what we need to try to do is be as conscious as possible about those decisions and critically reflect on them and seek support. One of the things that I tend to say to social workers is that social work isn't a solo activity. You shouldn't be out there making decisions on your own. You need to look at the people around you and draw on that support.  

Ofelia: Elaine, what goes wrong with decision making and what helps?  

Elaine: Yes, it's a really good question, Ofelia. So, the, sort of, decisions where I see practitioners facing really ethical dilemmas are struggling with the conflict. And I really would want social workers to embrace that. The social workers who worry me are the ones who are really definite and clear. The ones who are struggling with the ethics of it are the ones I'm drawn to, and I feel are really in the right space with this. They're usually about where there are disagreements about the person wanting to live a life involving risk that worries others. And for example, a person wanted to move away from their family and live more independently with different views about what independence means. Our young adults leaving children's services are adults with disabilities who, for the first time, are exploring adult relationships. We're really comfortable talking about friendship, but adult relationships involve sexual relationships, they involve thinking about having children, starting families. All those areas of practice are areas that are really common everyday ethical dilemma conversations in the offices and in the teams with social workers that I'm involved with. Any decision really where the family or the professionals are worried that the person might experience harm and they want to protect them from that harm. And I absolutely understand that. I feel like that about my own family members, that I don't want any harm to come to them, so I'm not in any way being critical of families about that space.

But all life involves risk. And I think, as Bob said earlier on, sometimes the hardest decision is not acting, standing still, taking a breath, thinking before you act. We're activist in nature by profession. We want to help, we want to do something. For me, that's where the guide comes in. I think it's a really helpful guide for practitioners. It signs you right back to a defensible framework to support thinking in action and thinking on your actions, that being The Mental Capacity Act. Can the person understand why others are worried? Can they use them where there are worries about risk? Can they communicate their decisions and retain it over time? To move away from a, kind of, medical model, remember your social model of disability and your professional education. I see decision making go wrong when practitioners rush past the statutory principles around taking all practical steps to support and enable somebody to really understand what others are worried about and move into making decisions on behalf of the person, ostensibly in their best interests. That's usually where people react to it and situations can escalate.

[Important messages for practitioners]

Ofelia: Thank you both. So, I'm not going to, kind of, pass it over to Susan and Bob. So, from your view, what are the most important messages for practitioners about decision making?  

Bob: I think one of the best outcomes is to help somebody live a life without fear by making sure that their needs are met. And it reduces their anxieties and it helps their family members, or it might be an advocate, which we haven't discussed yet, or it might be somebody holding an LPA license, legal power of attorney. I think that's really what we're hoping for. And I think one thing that's been missed so far is that these decisions that affect the person making the decision as well as the receiver of the outcome of that decision, you know, you've got to look at it as a system, a systemic way - that both parties are involved, and it's the extent to which the needs of both parties are met. Because I think one thing that's been missing a bit from this debate is what do social workers want from it? I think the most important message is to listen and then reflect, rather than going in with a set of questions that they think are the right questions to ask. It may be that the person who they're meeting with has got questions that aren't on your right list of questions to ask. So, listen, take your time. And I know time's a finite resource and it's the most precious one, but you can take time mentally, you know, by not immediately thinking of an answer, but just considering what that answer will be. So, that's my short answer to the most important message. I love the idea good decision making helps both parties to live a life without fear or worry.  

Ofelia: Susan? From your point of view, what is the most important message for practitioners about decision making?  

Susan: Never guess. Never rush into a decision. Never shrug your shoulders when somebody's asking you what they should do. Because if you do any of this, I've said it before and I'll say it again, you will bring yourself and your organisation into disrepute. You must know not to jump into a decision, 'Oh, this person, well, we'll just to blah, blah, because we've done it blah, blah before.' All of that, no. No. And I think Bob said, stand back, take your time, reflect. But never shoot from the hip. Never. Because it's going to go wrong if you do. And again, it's somebody's life and their happiness and wellbeing will be affected by the decision you make. You make it without thinking, and yes, you will have a difficult time on your hands. So, please think before you speak, before you advise, and don't shoot from the hip.

[How can decision making be supported?]

Ofelia: How can decision making be supported? So, I'll go ahead and pass it onto Gerry first.  

Gerry: Thanks, Ofelia. So, in the decision making resource, I think there are three elements that help us think about what supports good decision making. The first one is an understanding of the basics of decision making, the context of decision making. What kind of decisions are we making? Who's making them? What are our roles? What is this for? What's the purpose of decision making? And having that purpose as being about enabling people to lead the lives that they want to lead. The second, kind of, element of it is really good well-evidenced approaches to decision making. So, ways that we can go about making decisions that, kind of, keep us on the firm ground and help us from wandering off into really messy territory, or maybe rushing into things, or doing things by habit or by process. So, some of the approaches that we talk about, the fundamental one, the main one is co-production, getting as close to that as we can. We also talk about legal literacy and using the law well, using evidence, positive risk enablement. So, what Elaine was talking about around not being risk averse, but thinking about how we're achieving outcomes and managing risk. And also, we talk about intersectionality and being aware of people's identity and experiences, and how, if we want to be person-centred, that's got to be part of our decision making. That's all well and good, and that's, kind of, very focused on, I say my practice, but it's got to be supported then by the culture of the organisation and the structures and systems that are wrapped around it.

And Bob's already mentioned how constrained those systems can be, how they might not be, kind of, what we need. And, you know, it's clear from what we've been saying so far that a culture which is supportive of these ways of making decisions, of taking time and stepping back, will make it much more possible for people to make good decisions than one in which it's all about getting things done, getting things done, being busy. And so, I think I would probably want to highlight that element as the most important one. The environment in which we're making decisions has got to be as conducive as possible to critically reflective co-productive decision making. And that requires an organisational commitment and things like good supervision, good peer support. Yes, support for people's wellbeing.  

Ofelia: Great. Thanks, Gerry. Victoria, how can decision making be supported?

Victoria: Yes. As other people have said, I think that it's firstly important to understand the context for the decision making and the basis for decision making. When is it required that a decision is made and why? Whose decision is it and what information is important to draw on? How the problem, or the decision that needs to be made is being represented is very important, because this can guide how the decision is made, what approach is taken, what information is drawn upon, and what options are available and what the implications are for people when decisions are taken. As Gerry said, it's important that we foster the conditions that support good decision making co-productively and within our organisations. To do that, we really need psychological safety so that there can be robust critical reflection, and if there are barriers to decision making, that these can be properly explored so that they can be addressed. And there are, you know, things that we can do to improve our working conditions and to foreground mindful practice approaches that can support with that. There are also, you know, lots of resources. We have the law, we have guidance, we have checklists, tools, techniques, and ethical and professional guidelines that we can draw on. But I think the important thing is that we are looking to enhance people's agency and empower people, and what when we use any of these tools, or law, or guidance, that we have easier information and visualisations and that we're genuinely co-productive. And I think, as Bob said earlier, sometimes that is about taking a stance of radical non-intervention for a period and slowing down and asking the question, 'Do I need to make the decision or not? Is it my decision? Is the context conducive to the decision being made?'

[What are your hopes for people using this handbook?] 

Ofelia: Thank you both. So, now reflecting on our discussions and thinking about our good decision making resource, what are your hopes for people using this handbook? So, I'm just going to open this up to everyone on our panel. So, I'll go ahead and start with Gerry.  

Gerry: My hope's really simple actually. It's in two parts. The first is for people to be more conscious of their decision making, and the second is with that consciousness and the awareness of complexity, to give them some things to, kind of, hold onto as they go about decision making.

Ofelia: Right, thanks. Elaine?  

Elaine: Yes, I just hope that practitioners find this a really useful reference guide. It reminds us the real impact of ethical trespass when you get this wrong. And…but you really can't go far wrong when you stand in solidarity with the person, you take a breath, and you really listen to what their wish is, their feelings, their beliefs are. And work with that as your starting point for any intervention.  

Ofelia: Right, thanks. Susan?  

Susan: That people realise that good decision making is not just an abstract concept and not just another thing that you think you know what to do. That you actually understand what goes on behind every decision and why you have to make it correctly. I've just got a picture in my head of an organisation where nobody knows how to make a decision, and because they don't know how to make a decision, they don't know the people concerned and they don't know their organisation. It's got to be appreciated, and it is not boring. I'm sorry, I've said this before, I'm going to say it again, it underpins absolutely everything that you do when you are in the field that you're in.  

Ofelia: Bob, what are your hopes for people using this handbook?  

Bob: I want to go back to some of the things that have been mentioned so far, and people come into contact with social services usually as a result of a crisis. What also is happening at that point is unequal power, that they feel, and this is all covered in the Research in Practice Future of Social Care section which features me, that they have that unequal power. I think that we haven't looked at the role of lasting power of attorney or advocates because you may actually be dealing with the person who is affected by the result of that person being in between the individual and the system. And so, that's something to consider for the future maybe. I also felt that initial decisions may well be altered later. If somebody's in crisis and you need to find, say, for example, a refuge for a victim of domestic violence, then obviously the first decision is the immediate and urgent one. But there may be other decisions that follow on from that. So, just don't think that the first decision is going to last in every instance. And I want to come back to something that Gerry said, and it's a phrase that is familiar to me, and it's that of legal literacy. If people don't know what powers the social worker has, or what powers they have, then it's going to be a very poor place to start making decisions. And my solution to this is why not have something like a rights card for legal literacy? That on one said, it says, 'These are you rights as a client.' Might not use the word client, it's as an individual. 'And these are our rights which we have to work within, which are the legal barriers to our job here.' On a simple card, one side of the individual and one side for the social side. That might be a really good way of helping the decision to be made appropriately.  

Victoria: My hope is that the resource will support a more open dialogue about good decision making within organisations and with people who draw on services so that there can be more engagement with wider processes that foster the conditions required for good decision making. So that practitioners can advocate for the right kinds of resources and the approaches needed to work to empower and enhance people's agency and to have the right kind of education and continued professional development. We work in large organisations where there is, kind of, a lot of design thinking. I hope to create feedback loops to continually improve and innovate, and to co-produce where people are, you know, not just subjects, but genuine stakeholders. So, I think that this handbook can support good practice, but it can actually be on that support being a good citizen within wider organisations and systems as well. 

[Who is the handbook designed for?]

Ofelia: We're going to be shifting the conversation to discuss a little bit more about the resource and discuss some new updates and changes. So, I just want to start off with thinking about, kind of, the background. So, Gerry, for anyone that's new to the resource, who is it designed for and who would find it useful?  

Gerry: The original handbook, which came out in 2013, was very squarely aimed at the practitioners. And back then, it was actually a physical object that you could get off the printer and use. This one is an online resource, so it's much more accessible and it's much more simple to, kind of, dip in and out and find things in it. And that's the recognition that still the major audience will be adult social care practitioners and that they're very constrained for time and there'll be particular things that they want to go find. And so, we've tried to, kind of, really make that work for them. We've also been really conscious and supported by experts by experience in making it a resource that's understandable to anyone. So, that's good practice anyway, but it also means that we'd hope people who draw on social care, or people who are, kind of, approaching social care, or are trying to find out more about it, could find it helpful as well. Which is why it has the, kind of, context and basics of decision making in there. And there's also a summary for people who use services and for carers. So, I think really those are two main audiences, but hopefully it's also going to have transferable messages for people making decisions in these, kind of, complex systems around adult services, and potentially in children's services as well.  

Ofelia: Right, thanks, Gerry. So, as Gerry has just shared, the handbook was first written in 2013. And since then, there have been significant changes in adult social care, as mentioned in the beginning. So, Elaine, from your point of view, what are the main changes that have been made in practice?  

Elaine:: Yes, so, since 2013, I think we've had a much deeper understanding, mainly through the courts actually and emerging case law. And through family carer challenges that have been brought to practice about what the limits of our powers of intervention are. And it's been a really good wakeup call for us to reconnect with understanding relational practice, that we are the intervention sometimes. There isn't a service-, we didn't even touch on resource constraints this morning, though I'm sure it's on everybody's mind, that often the social worker is the thing that somebody has, and there isn't a secret stash of housing, or an amazing pack of jobs that I have somewhere that suddenly lives will change. It's just having somebody there to help you navigate through as best you can really. So, I think, kind of, exploring that a little bit. The agenda around adult safeguarding has changed a lot. We've had two national reviews now of learning from Safeguarding Adults Reviews. In my local area, I chair the Safeguarding Adults Review Partnership Group that reports into our Partnership Board. And the themes are really consistent there about, Bob mentioned legal literacy, people understanding rights frameworks and understanding who lawfully the decision maker is, is a really important part of any new resource toolkit for practitioners. Really understanding where there's a Mental Capacity rights card, I think Bob, kind of, put in my head the minute he suggested it. I was almost, kind of, messaging myself so I don't forget that. 

And just recognising that understanding some of those legal positions that people have taken around advance directives, we are seeing more of those in place post-COVID than perhaps ever before. Knowing if somebody has LPA, that they are the decision maker. It's not the social worker's job to decide that they are somehow going to displace the decision maker from LPA. So, there are lots of contextual issues, different understanding legally around the limits of decision making. Perhaps a more nuanced understanding of child development as well and understanding transitional safeguarding. There's a brilliant tool that Research in Practice have produced around the interfaces around different, very complex legal frameworks that I operate with all the time between The Children Act, The Care Act. The Children and Families Legislation, which is really a piece of legal framework for education, but it's a really powerful tool if it's understood and used well. All of that, keeping up to date with it, knowing what the courts are saying, knowing what research best practice is then telling us about that, a live tool like the one Gerry describes is really what we need going forward rather than a static, fixed in time publication book. 

[Key themes of this resource] 

Ofelia: Right, thanks, Elaine. So, thinking about some of the changes that have just been shared. So, Gerry, what are some key themes that have changed in this new version of the resource?  

Gerry: Yes, so, The Care Act was only just coming in, or about to come in, when this original handbook came out, and it's now embedded in practice and there's a lot of really good research around decision making under The Care Act. So, all the learning that was in the original resource about how we make decisions and some of the constraints and things that would help practitioners has been able to be built on them with the 10 years of practice of The Care Act. I think the major change in the resource is the emphasis on co-production within this version. So, in the original version, we talked a lot about partnership work and person-centred practice, and Nothing About Me Without Me. There's been so much campaigning, and so much learning, and so much good, constructive challenge from people and the development of co-productive thinking and practices that that has really shifted, I think, over the last ten years. And so, in this resource, what we're saying is get as close to co-production as possible. That's the major message of what we're trying to help people do within the resource. There's more detail around approaches and to decision making, and there's a much bigger emphasis in there on intersectionality, to build on what we've discussed before around anti-oppressive practice. And there's also a whole new section at the end which is about developments in decision making, which is recognising that we're in this really fast changing context. And that picks up on two particular developments, environmental ones around climate change and technological ones primarily around digital technology. But we could have talked about lots of different developments. And that, I think, will be the section that gets added to and evolves as we go along.

[How decision making is changing with data and technology]

Ofelia: Victoria, how is decision making changing with data and technology?  

Victoria: Well, I think, as Gerry said, there's been quite complex and rapid transformation and innovations in this area. And I think, you know, before I go on, I think it's important to say that these transformations should be undertaken in ways that suit and include people. It should be co-produced and we should all think of ourselves not just as data subjects, but as data stakeholders. And we need to find ways of doing these things that involve people who are novices, who aren't data scientists, and that we render these things of things understandable. So, there is much greater emphasis on new technologies and on the methods of data science within organisations now. And there are many benefits in terms of gathering, analysing, and presenting information more quickly and in ways that bring new insights. There are data dashboards and tools that make visualisations that more people can understand and interact with, not just data scientists. It's important to remember that data doesn't just exist, data is made through processes and practices. They're not neutral, they're earned, we have to build anti-oppression into those kinds of practices and work together with data scientists in our organisations. There are things like transcription AI that have many benefits, but might also occasion some risks and some concerns that existing inequalities are going to be built in.   

I know that Social Work England has very recently called for evidence and has commissioned research into this area. So, I think we'll be watching this space and find out what more we can do to understand how we engage in ways that support social justice and are safe and don't occasion new risks to people. So, my hope is that we are evidence-informed and we are data-led and technology-led, but not driven by those things. That we're assisted by AI and technology, but not replaced or automated by that, and that there isn't techno or data solutionism. And that means that we think about what the problems are the we wish to solve, which issues are important, rather than being told that by the companies that are producing technologies. We need to centre people and human rights and social justice concerns, not reinforce inequalities or create new risks. But within that, I think that it's very important that we work within systems that are producing these new technologies.  

Ofelia: Bob, did you want to come in?  

Bob: Yes, if I may. One of the first things that struck me of course is that I'm an expert in my life, you know. No matter who I'm talking to, they don't know what I know about me. And sometimes, I think that gets a little bit lost. I think good decisions allow good thinking. I mean, it may sound like a truism, but it's, again, that ability to think slightly more deeper. And one of things I hope would be an outcome from this is that there are enough examples in it that people could hold little training sessions at the workplace level and use the resource as a guide, or as a stimulus towards good thinking. I think one thing that's been missed when talking about co-production is that actually, what co-production requires is some people giving up their power to enable other people to be more powerful. So, there's clearly a leadership role involved in stimulating co-production thinking in organisations. And my final point, which I really like and wanted to get this one in, is that I must have told those sixteen people from different organisations who are dealing with my mother the same thing over and over and over again. The NHS is now moving towards digital records, but there isn't a digital care record. So, why on Earth can't that be an innovation to smooth the process so that you know exactly when you're attending somebody about what the previous care history or care needs are? So, I just wanted to put that plug in as well. Thank you. 

[How this resource will be structured] 

Ofelia: Right, thank you both so much for sharing your insights. And just lastly, kind of, continuing the conversation around changes, Gerry, how will this new resource be structured?  

Gerry: The resource will hopefully be structured in a way that is fairly straightforward to get into and use. It's going to be in sections, and the sections, you can work through them roughly in order. There's one about the context of decision making, one about the basics of decision making, the who, what, where, when, why. And then one about what is a good decision, how to support decisions, and current and future developments. If I was a practitioner, I'd probably want to jump more into the what's a good decision? What are my approaches to that? Let's start there. I would hope that organisations, and supervisors in particular, will be looking at the support for good decision making section. Within each section, there's an introduction that tells you what's in there. Everything is, kind of, click through links, and there are subsections so that you can get fairly concise pieces of information which you can work with. And at the end of each section, there are examples, as Bob was saying, for people to look at and think, 'Okay, how would that look in my way of working, my role, in my life?' And there are exercises that you can use, either in practice, you know, go out with these things and work through them with people, or you can use them in learning and development or in supervision to help you, again, slow down, be conscious, and think through your decisions.  

Ofelia: I just want to say, thank you all for your time and insights. We hope that you enjoyed listening to this podcast. Please let us know what you think by emailing us at ask@researchinpractice.org.uk.  

[Outro]

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