Decisions about distributing health resources between different people and medical needs are difficult and controversial. In this project we propose to investigate how healthcare resources should be distributed across the lifespan and across different age groups. This investigation, relatively unexamined within healthcare policy research and ethics, is particularly timely. Shifting demographics, resource constraints, and exacerbated by the pandemic inequalities, pose significant challenges for the NHS and highlight the pressing need to ensure fair treatment for all age groups in healthcare services. In healthcare decision-making, connections between age and resource allocation have predominantly focused on adhering to the apparent requirement that we do not discriminate based on age. This often leads to a simplistic approach that people of all ages should be treated the same in order to be treated fairly. Regrettably, despite best intentions, this approach cannot consistently achieve fairness. Instead, it gives rise to new forms of injustice by obscuring underlying realities and needs. Currently, distinctive needs across the lifespan and the unique ways in which individuals at various life stages are impacted by healthcare are not properly considered in decision-making processes. Important challenges are often overlooked. These, for instance, include transitional phases; the specific requirements on individuals dealing with conditions at atypical ages; and the complex interplay between vulnerabilities associated with different life-stages and socio-economic factors. These omissions contribute to and exacerbate existing inequalities. Many older individuals, lacking post-operative support, experience isolation and diminished well-being. Children with complex medical conditions, waiting on backlogged lists, often miss out on time-critical developmental treatments constraining their life opportunities. Women experiencing menopause and adolescents battling mental health challenges frequently encounter suboptimal care, exacerbating health and social issues that could otherwise be alleviated. Children within palliative care services, which are generally tailored and funded for older patients, may not receive the emotional and physical support they require. This project will illuminate these currently overlooked inequalities. By exploring the critical intersection between age and healthcare justice, this work will help determine how to allocate resources in order to avoid unfair discrimination against different population groups. The study will proceed, first, to identify and analyse age-related assumptions in healthcare resource allocation in order to understand their impact on healthcare access from early life to late adulthood. Second, it will explore the legal and ethical dimensions of healthcare inequalities among age groups in order to identify overlooked injustices. Finally, collaborating with commissioners, providers, patient and policy organisations, it will develop and test the applicability of a 'stage-of-life sensitive' approach for decision-making. This approach will be more responsive to healthcare needs across the lifespan and will be adaptable to different processes and regional policy contexts. Findings will raise awareness of overlooked healthcare injustices among decision-makers, academics, and the public, aiming to prompt policymakers to revise existing guidelines. This will lead to tangible healthcare access benefits for individuals of all ages and needs. We will also establish networks among ethicists, lawyers, healthcare providers, policymakers, and other stakeholders, fostering continued dialogue to facilitate societal change.

The Media and the Inner World research network set out to bring together psychoanalysts and psychotherapists, academics and media practitioners to explore the role of emotion and therapy in popular culture and the media through the lens of object relations psychoanalytic theory. The aim was to create a dialogue between these different constituent groups to enable knowledge exchange and create further opportunities for its development. To this end, we held a series of two symposia and nine public round table discussion events in public venues at no charge to participants. The network successfully fulfilled its objectives, attracting a broad range of audiences from a range of different backgrounds. The influence of therapy culture and its meanings were widely debated and both academic and clinical perspectives formed the basis for a number of publications. Perspectives on images of psychotherapy in the popular imagination were successfully explored at a number of events. Similarly processes of media production, ethics and values were interrogated in relation to print media, celebrity culture and documentary filmmaking. As a result of these network activities, we established some fruitful links with a range of external organisations and we are now setting out to develop these. In particular, we aim to develop training opportunities and to further knowledge exchange between academic researchers, psychotherapists and media professionals. A number of potential links have been fostered with a view to enabling this, and the proposed activities will help to consolidate the outcomes of the network in relation to the needs of the therapeutic and media professional communities. In addition, we plan to extend the remit of our work by exploring the potential to influence policy. There is particular scope to do this in relation to media policy, especially with regard to documentary media formats and questions of best ethical practice in relation to the representation of emotional experience. As mentioned above, the success of the network has resulted in several opportunities for future development. Links with institutions such as the Tavistock and Portman NHS Trust, the Freud Museum and Mosaic Networking, will be developed through a programme of collaborative provision to provide CPD courses for professionals and general interest courses for the public, grounded in the intellectual foundations of our project. Our links will also be used in the joint organisation of a number of public events.For example, we have been invited to organise further round table events for the Royal Academy of Dramatic Arts and the Royal Academy of Music. We are also planning to arrange a number of film screenings in collaboration with the Freud Museum and are intending to bid for a programme strand at the East London Film Festival. The scholarly aspects of the project will be further developed through a number of additional publication opportunities, all of which go beyond the original schedule of planned outcomes and this will help to reinforce the academic impact of the work that has been undertaken.