
Dr Ruth Riley
Academic and research departments
Workforce, Organisation and Wellbeing (WOW) research cluster, School of Health Sciences.About
Biography
I am an applied medical sociologist and qualitative methodologist. My research uses inter-disciplinary approaches to investigate the contexts/causes of occupational distress, including working conditions and cultures, experienced by healthcare professionals, and approaches to preventing it.
My previous research explored occupational sources of distress experienced by GPs and junior doctors; my current research explores the impact of NHS staff suicide on their colleagues and teams to develop postvention guidance for the NHS. My future research will look to other NHS staff and public sector workers to examine work-related distress and approaches to improving access to support.
My PhD employed a mixed-method approach to understand the ways in which GPs, nurses and pharmacist prescribers manage patients' emotional cues and concerns in consultations about medicines.
Areas of specialism
Previous roles
ResearchResearch interests
My research uses inter-disciplinary approaches to investigate the causes of occupational distress and barriers and facilitators to help-seeking. My research examines mental health stigma, vicarious trauma, emotional labour, moral distress, working conditions and cultures and their impact on the psychological and emotional health of NHS staff. I also collaborate with theatre and film-makers to maximise the impact of my research and for public engagement purposes.
My future research will explore the workplace challenges and occupational stressors experienced by international medical graduates, nurses and other public sector workers.
Research interests
My research uses inter-disciplinary approaches to investigate the causes of occupational distress and barriers and facilitators to help-seeking. My research examines mental health stigma, vicarious trauma, emotional labour, moral distress, working conditions and cultures and their impact on the psychological and emotional health of NHS staff. I also collaborate with theatre and film-makers to maximise the impact of my research and for public engagement purposes.
My future research will explore the workplace challenges and occupational stressors experienced by international medical graduates, nurses and other public sector workers.
Publications
Almost half of NHS doctors are junior doctors, while high proportions are women and/or Black, Asian, and Minority Ethnic (BAME) individuals. Discrimination against this population is associated with poorer career-related outcomes and unequal representation. We aimed to qualitatively explore junior doctors’ experience of workplace racial and gender-based discrimination, and its impact on their psychological distress (PD). In this study, we carried out a secondary analysis of data from a UK-based parent study about junior doctors’ working cultures and conditions. Interview data was examined using thematic analysis. Transcripts (n = 14) documenting experiences of race and/or gender-based discrimination were sampled and analysed from 21 in-depth interviews conducted with UK junior doctors. Four themes were generated about the experiences and perpetrators of discrimination, the psychological impact of discrimination, and organisational interventions that tackle discrimination. Discrimination in various forms was reported, from racially charged threats to subtle microaggressions. Participants experienced profoundly elevated levels of PD, feeling fearful, undermined, and under-confident. Discrimination is associated with elevated levels of PD, whilst negatively impacting workforce sustainability and retention. This reduces the opportunity for more diversity in NHS medical leadership. We encourage NHS hospitals to review their policies about discrimination and develop in-person workshops that focus on recognising, challenging, and reporting workplace discrimination.
Background: Doctors, including junior doctors, are vulnerable to greater levels of distress and mental health difficulties than the public. This is exacerbated by their working conditions and cultures. While this vulnerability has been known for many years, little action has been taken to protect and support junior doctors working in the NHS. As such, we present a series of recommendations from the perspective of junior doctors and other relevant stakeholders, designed to improve junior doctors’ working conditions and, thus, their mental health. Methods: We interviewed 36 junior doctors, asking them for recommendations for improving their working conditions and culture. Additionally, we held an online stakeholder meeting with a variety of healthcare professionals (including junior doctors), undergraduate medical school leads, postgraduate speciality school leads and NHS policymakers where we asked what could be done to improve junior doctors’ working conditions. We combined interview data with notes from the stakeholder discussions to produce this set of recommendations. Results: Junior doctor participants and stakeholders made organisational and interpersonal recommendations. Organisational recommendations include the need for more environmental, staff and educational resources as well as changes to rotas. Interpersonal recommendations include changes to communication and recommendations for better support and teamwork. Conclusion: We suggest that NHS policymakers, employers and managers consider and hopefully implement the recommendations set out by the study participants and stakeholders as reported in this paper and that the gold standards of practice which are reported here (such as examples of positive learning environments and supportive supervision) are showcased so that others can learn from them.
Additional publications
Ibrahim, Darya, and Ruth Riley. 2023. "Female Medical Students’ Experiences of Sexism during Clinical Placements: A Qualitative Study" Healthcare 11, no. 7: 1002. https://doi.org/10.3390/healthcare11071002
Ridge, D., Bullock, L., Causer, H., Fisher, T., Hider, S., Kingstone, T., Gray, L., Riley, R., Smyth, N., Silverwood, V., Spiers, J. and Southam, J. (2023), ‘Imposter participants’ in online qualitative research, a new and increasing threat to data integrity?. Health Expectations. https://doi.org/10.1111/hex.13724
Hodkinson, A., Zhou, A., Johnson, J., Geraghty, K., Riley, R., Zhou, A., ... & Panagioti, M. (2022). Associations of physician burnout with career engagement and quality of patient care: systematic review and meta-analysis. BMJ, 378. doi: 10.1136/bmj-2022-070442
Causer, Hilary, Johanna Spiers, Nikolaos Efstathiou, Stephanie Aston, Carolyn A. Chew-Graham, Anya Gopfert, Kathryn Grayling, Jill Maben, Maria van Hove, and Ruth Riley. (2022). "The Impact of Colleague Suicide and the Current State of Postvention Guidance for Affected Co-Workers: A Critical Integrative Review" International Journal of Environmental Research and Public Health 19, no. 18: 11565. https://doi.org/10.3390/ijerph191811565
Dunning A, Teoh K, Martin J,... Riley, R (2022). Relationship between working conditions and psychological distress experienced by junior doctors in the UK during the COVID-19 pandemic: a cross-sectional survey study. BMJ Open 2022;12:e061331. doi: 10.1136/bmjopen-2022-061331
Griffin L, Riley R. (2022). Exploring the psychological impact of working during COVID-19 on medical and nursing students: a qualitative study. BMJ Open;12:e055804. doi: 10.1136/bmjopen-2021-055804
Auth NM, Booker MJ, Wild J, Riley, R (2022). Mental health and help seeking among trauma-exposed emergency service staff: a qualitative evidence synthesis. BMJ Open 2022;12:e047814. doi: 10.1136/bmjopen-2020-047814
Spiers J, Buszewicz M, Chew-Graham C, Riley, R et al. (2021) What challenges did junior doctors face while working during the COVID-19 pandemic? A qualitative study BMJ Open 2021;11:e056122. doi: 10.1136/bmjopen-2021-056122
Kenway, S & Riley, R (2021). An Integrative Review of User-Focused Methodologies with Deaf Participants to Inform a Culturally-Sensitive Research Checklist. International Journal on Mental Health and Deafness 2021 Volume 5 Issue 1 ISSN: 2226-3462
Ruth Riley, Marta Buszewicz, Farina Kokab, Kevin Rui-Han Teoh, Anya Gopfert, Anna K. Taylor, Maria van Hove, James Martin, Louis Appleby, Carolyn A. Chew-Graham (2021). The sources of work related psychological distress experienced by England-wide foundation and junior doctors: a qualitative study. BMJ Open Vol 11:6
Ruth Riley, Farina Kokab, Marta Buszewicz, Anya Gopfert Maria van Hove, Anna K. Taylor Kevin Rui-Han Teoh, James Martin, Louis Appleby, Carolyn A. Chew-Graham (2021). Protective factors and sources of support in the workplace as experienced by England-wide foundation and junior doctors: a qualitative study. BMJ Open. Vol 11:6
Ruth Riley, Johanna Spiers, Viv Gordon (2021). PreScribed (A Life Written for Me): A Theatrical Qualitative Research-Based Performance Script Informed by General Practitioners’ Experiences of Emotional Distress. International Journal of Qualitative Research, Vol 20
Caroline Morgan, Gilles de Wildt, Renata Billion Ruiz Prado, Nisha Thanikachalam, Marcos Virmond, Ruth Riley (2020). Views and Experiences of Overweight and Obese Adults on the Barriers and Facilitators to Weight Loss in Southeast Brazil: A Qualitative Study. International Journal of Qualitative Studies on Health & Well-being.
Riley, R, Spiers, J,Chew-Graham, C, Taylor, A.K., Thornton,G, Buszewicz,M, (2018). Treading water but drowning slowly’: What are GPs’ experiences of living and working with mental illness and distress in England? A qualitative study. BMJ Open; 8:e018620.
Riley, R, Spiers, J, Buszewicz,M, Taylor, A.K., Thornton,G, Chew-Graham, C (2018). What are the Sources of Stress and Distress for General Practitioners Working in England? A Qualitative Study. BMJ Open, 8 (1)
Spiers, J., & Riley, R (2018). Analysing one dataset with two qualitative methods: the distress of general practitioners, a thematic and interpretative phenomenological analysis. Qualitative Research in Psychology. 16:2, 276-290
*Spiers, J., M. Buszewicz, C. A. Chew-Graham and R. Riley (2018). "The experiences of general practitioner partners living with distress: An interpretative phenomenological analysis." J Health Psychology: 1359105318758860.
Johanna Spiers, Marta Buszewicz, Carolyn Chew-Graham, Clare Gerada, David Kessler, Nick Leggett, Chris Manning, Anna Taylor, Gail Thornton, and Ruth Riley (2017). What are the barriers, facilitators and survival strategies for GPs seeking treatment for distress? A qualitative study. British Journal of General Practice 67(663):e700-e708
Johanna Spiers, Marta Buszewicz, Carolyn Chew-Graham, Clare Gerada, David Kessler, Nick Leggett, Chris Manning, Anna Taylor, Gail Thornton, and Ruth Riley (2016). Who cares for the clinicians? The mental health crisis in the GP workforce. British Journal of General Practice Jul;66(648):344-5
Curtis, P., G. Taylor, R. Riley, T. Pelly and M. Harris (2017). "Written reflection in assessment and appraisal: GP and GP trainee views." Educ Prim Care 28(3): 141-149.
Mamunur R. Malik, Zaeem Ul Haq, Quaid Saeed, Ruth Riley, Wasiq M. Khan, Distressed setting and profound challenges: Pandemic influenza preparedness plans in the Eastern Mediterranean Region, Journal of Infection and Public Health
Thorn, J., Brookes, S., Ridyard, C. H., Riley, R., Hughes, D. A., Wordsworth, S., Noble, S., Thornton, G. & Hollingworth, W. (2017). Core items for a standardized resource-use measure (ISRUM): expert Delphi consensus survey. Value in Health
Ruth Riley and Marjorie Weiss (2016). A Qualitative Thematic Review: Emotional Labour in Healthcare Settings. Journal of Advanced Nursing Vol 72:1, 6-17; epub Jul 2015
Weiss, M., Platt, J., Riley, R., & Horrocks, S. (2016). GPs, Nurses and Pharmacists as Prescribers in Primary Care: An exploration using the Social Identity Approach. International Journal of Health Professions. 3, 2, 12.
Ruth Riley, Nikki Coghill, Alan A Montgomery, Gene Feder and Jeremy Horwood (2015). The Provision of NHS Health Checks in a Community Setting: an Ethnographic Account. BMC Health Services Research 15:546
Riley, R., Coghill, N., Montgomery, A., Feder, G., & Horwood, J (2015). Experiences of Patients and Health Care Professionals of NHS Cardiovascular Health Checks: a Qualitative Study. Journal of Public Health doi: 10.1093/pubmed/fdv121
Thorn, J., Ridyard, C., Riley, R., Brookes, S., Hughes, D., Wordsworth, S., Hollingworth, W. (2015). Identification of items for a standardised resource-use measure: review of current instruments. Trials, 16 (Suppl 2), O26
Marjorie C Weiss, Joanne Platt, Ruth Riley, Betty Chewning, Gordon Taylor, Susan Horrocks, Andrea Taylor (2014). Prescribing Decision Making and Patient Outcomes in GP, Nurse and Pharmacist Prescriber Consultations. Primary Health Care Research & Development.
Weiss, Marjorie; Platt, Jo; Riley, Ruth; Taylor, Gordon; Horrocks, Susan; Taylor, Andrea (2013). Solicitations in GP, Nurse and Pharmacist Prescriber Consultations: An observational study. Journal of Family Practice.
Ruth Riley, Marjorie C Weiss, Joanne Platt, Gordon Taylor, Susan Horrocks, Andrea Taylor (2013). A Comparison of GP, Pharmacist and Nurse Prescriber Responses to Patients’ Emotional Cues and Concerns in Primary Care Consultations. Patient Education and Counseling 91(1):65-71
Britten, N., Riley, R., & Morgan, M (2010). Resisting psychotropic medicines: a synthesis of qualitative studies of medicine - taking. Advances in Psychiatric Treatment 16: 207-218