I am a Research Fellow in the Workforce Organisation and Wellbeing team and have been working in the School of Health Sciences on projects relating to health and social care since 2015. With an academic background in Sociology and Social Policy my research interests include the social and organisational aspects of health, wellbeing and care. I am particularly interested in developing research into the wellbeing and job satisfaction of healthcare staff employed by public sector mutuals and social enterprises.
I am currently working on a project which aims to identify the organisational factors that contribute towards differences in care for patients with Early Inflammatory Arthritis between departments with the purpose of produce guidance on best practice.
This research set out to understand the context and explore the reasons for the disproportionate number of complaints raised against
paramedics to the United Kingdom professional regulator ? the Health and Care Professions Council ? relative to other health
This paper reports on qualitative findings from one aspect of a mixed-methods study which included a case analysis, Delphi study
and literature review. One-to-one semi-structured interviews conducted with 15 stakeholders drawn from practitioners, educators,
representatives and regulators, and three focus groups held with 16 practitioners and service users were used to gain an in-depth
understanding of the possible reasons for complaints about paramedic practice.
Five themes were generated from a thematic analysis of the data: the impact of public perceptions and expectations; the challenges of
day-to-day practice; the effect of increasingly pressurised services; the organisational and cultural climate which impacts paramedics?
work; and the evolving nature of the profession.
This study highlights the complex and changing nature of paramedic practice. It provides an insight into the ways in which the
character, practice and environment of the profession contribute to a disproportionate number of complaints.
in regulation ? that is, using the right amount and right types of regulatory interventions to achieve the
primary mandate of the regulatory community in order to serve and to protect. The Health and Care
Professions Council (HCPC) in the United Kingdom, one of the largest health-care regulatory bodies in
the world, recently commissioned a study examining the disproportionately large number of complaints
against paramedics in the UK and social workers in England. The objective of the study was to examine
the nature of, and to better understand the reasons behind, this disproportionality, and to identify options
and opportunities from a regulatory perspective that could be taken to address this issue. The study
involved a systematic multi-methods research approach involving four key interrelated research elements:
" A systematic literature review
" A Delphi consultation with international experts
" Interviews (n=26) and four focus groups (n=23) with UK experts, including service users and caregivers
" A review of a random sample (n=284) of fitness-to-practice cases over two years across the three stages
of the process (initial complaint, Investigating Committee Panel, and final hearing)
Findings from this study highlight the evolving nature of both professions and the influence of a binary
model of complaints adjudication that may not be sufficiently nuanced to balance public protection with
practitioners? learning needs. A non-binary option for understanding complaints against practitioners is
suggested in this paper, offering a process that involves and engages both employers and practitioners
in a more meaningful manner.
Cancer is diagnosed and managed by multidisciplinary teams (MDTs) in the UK and worldwide, these meet regularly in multidisciplinary team meetings (MDMs) to discuss individual patient treatment options. Rising cancer incidence and increasing case complexity has increased pressure on MDMs. Streamlining discussions has been suggested as a way to enhance efficiency and ensure high quality discussion of complex cases.
Secondary analysis of quantitative and qualitative data from a national survey of 1,220 MDT members regarding their views about streamlining MDM discussions.
The majority of participants agreed that streamlining discussions may be beneficial although variable interpretations of ?streamlining? were apparent. Agreement levels varied significantly by tumour type and occupational group. The main reason for opposing streamlining were concerns about the possible impact on the quality and safety of patient care. Participants suggested a range of alternative approaches for improving efficiency in MDMs in addition to the use of treatment protocols and pre-MDT meetings.
This work complements previous analyses in supporting the development of tumour specific guidance for streamlining MDM discussions considering a range of approaches. The information provided about the variation in opinions between MDT for different tumour types will inform the development of these guidelines. The evidence for variation in opinions between those in different occupational groups and the reasons underlying these opinions will facilitate their implementation. The impact of any changes in MDM practices on the quality and safety of patient care requires evaluation.
To assess feasibility of a future randomised controlled trial (RCT) of clinical and cost?effectiveness of lifestyle information and commercial weight management groups to support postnatal weight management to 12 months post?birth.
Two?arm feasibility trial, with nested mixed?methods process evaluation.
Inner?city unit, south England.
Women with body mass indices (BMIs) e25 kg/m2 at pregnancy booking or normal BMIs (18.5?24.9 kg/m2) identified with excessive gestational weight gain at 36 weeks of gestation.
Randomised to standard care plus commercial weight management sessions commencing 8?16 weeks postnatally or standard care only.
Feasibility outcomes included assessment of recruitment, retention, acceptability and economic data collation. Primary and secondary end points included difference between groups in weight 12 months postnatally compared with booking (proposed primary outcome for a future trial), diet, physical activity, smoking, alcohol, mental health, infant feeding, NHS resource use.
In all, 193 women were randomised: 98 intervention and 95 control; only four women had excessive gestational weight gain. A slightly greater weight change was found among intervention women at 12 months, with greatest benefit. Among women attending ten or more weight management sessions. There was >80% follow up to 12 months, low risk of contamination and no group differences in trial completion.
It was feasible to recruit and retain women with BMIs e25 kg/m2 to an intervention to support postnatal weight management; identification of excessive gestational weight gain requires consideration. Economic modelling could inform out?of?trial costs and benefits in a future trial. A definitive trial is an important next step.
A feasibility RCT of postnatal weight support showed women with BMIs e25 kg/m2 can be recruited and followed to 12 months postnatally.
Drawing on published statistics and unique analysis of a sample of 232 case files undertaken as part of a research project in 2016-17, the article highlights relatively high rates of inappropriate referrals from ?members of the public? (mainly service users) particularly in relation to child placements and contact. A detailed picture is offered of the variety of referrals dealt with at each stage of the fitness to practice process (from initial triage to final hearings), with recommendations for how to prevent inappropriate referrals, whilst focusing concern on the most serious cases of incompetence and misconduct.
This research is of significance at a time of increasing pressure for social workers, social services and service users under conditions of austerity and managerialism; on-going concerns about standards in social work; and recent changes in social work regulation.
Design: Concurrent mixed methods (qualitative dominant) process evaluation nested within a feasibility randomised controlled trial, comprising questionnaires and interviews at six and 12 months post-birth.
Setting: One National Health Service maternity unit in an inner city area in the south of England.
Participants: 98 postnatal women with BMIs>25kg/m2 (overweight/obese) at pregnancy commencement.
Intervention: Twelve week Slimming World® (SW) commercial group weight management programme, commencing anytime from 8 to 16 weeks postnatally.
Primary and secondary outcome measures: Data regarding uptake and retention from questionnaires and interviews conducted six and 12 months post birth, analysed thematically and mapped to the COM-B model.
Results: Barriers to SW uptake mostly concerned opportunity issues (e.g., lack of time or childcare support) though some women also lacked motivation, not feeling that weight reduction was a priority, and a few cited capability issues such as lacking confidence. Weight loss aspirations were also a key factor explaining retention, as were social opportunity issues, particularly in relation to factors such as the extent of group identity and relationship with the group consultant; and physical opportunity such as perceived support from and fit with family lifestyle. In addition, barriers relating to beliefs and expectations about the SW programme were identified, including concerns regarding compatibility with breastfeeding and importance of exercise. Women?s understanding of the SW approach, and capability to implement into their lifestyles, appeared related to level of attendance (dose-response effect).
Conclusions: Uptake and retention in commercial weight management programmes may be enhanced by applying behaviour change techniques to address the barriers impacting on women?s perceived capability, motivation and opportunity to participate.