Early morning training has already begun in preparation for the 5km run. I’ve been meaning to give this run a go for a while now, and strangely enough I got ‘ the final push’ after meeting a stranger with an inspirational story on a bus ride home!
If you wish to sponsor me, the link is https://www.raceforlifesponsorme.org/fatimahwobi
Following the CLAHRC Video Competition back in February of this year, I joined the new Video-Podcast team for the CLAHRC LNR’s Implementation Theme. We are currently in the process of producing a short video which will provide a concise summary of the group’s activities. Publicising and marketing any form of work to your target audience in a way that is accessible, be it an idea, a research project or the results of a health evaluation, is important in ensuring that people find out about your organisation and are provided with the opportunity to learn more about it if they so wish. As we started to create the video storyboards drafts, I began to realise the volume of high quality and potentially impactful research and collaborative work that takes place between the CLAHRC LNR and healthcare bodies, work that many outside of the projects themselves would simply be unaware of (particularly the general public, who experience the results of health research every day, knowingly or otherwise). After creating the video, I think it would be great to obtain feedback from others outside CLAHRC to see whether it was successful disseminating the group’s main aims in a clear & simple manner.
Some thoughts from my Interview Log:
During the semi-structured interviews I became aware of certain practice staff changing their opinions and style of their answers as I asked certain questions. It was almost as if they were undergoing a review of their practice’s processes in their mind as we progressed through the interview. As the researcher, I felt that my questioning was drawing their attention to an areas they had previously paid little attention to but were now discovering strong reasons why they now should (or maybe should have done in the past).
The research process itself can therefore start to spark thoughts for change even before a project is completed.
On the 5th March I attended the Society for Academics in Primary Care (SAPC) regional conference to present my work on “non-clinical patient needs: mapping diversity in primary care” a parallel session. Dr Alf Collins, Consultant in Pain Medicine at Taunton and Somerset NHS Foundation Trust, and Professor Nigel Mathers were the keynote speakers in attendance. Their talks focused on patient-centred care and, in particular, its influence in the management of long term clinical conditions. Dr Collins talked about the three principles deemed necessary for the personalisation of care: coordination of care, the engagement of patients in decision-making and thirdly, the supported self-management of care for individuals. He described how a fine balance of all three is something that the UK health system is already working towards but that it requires cultural changes within the system for it to work effectively. Following on from this, Prof. Mathers elaborated on the components needed for true patient ‘activation’; the combination of knowledge, skills and confidence which will allow patients to actively and safely manage their health.
Poster viewing sessions were scheduled throughout the day and I found one particular study’s poster quite relevant to the work that I have been doing over the past six months. It was on the feasibility and acceptability of Clinical Commissioning in general practice, drawing on evidence from interviews with GP’s, some of whom were saying that it was not their place to do so and that they had entered into the profession to help to care for people, not to ‘population-manage’ or budget for services. This was of particular interest to me as it provided a possible explanation as to why some of the practitioners I had interviewed responded apathetically to mapping out their population’s needs even though after recognising the benefits of such mapping for their patient population (i.e. informing commissioning decisions with cost implications)
Being the first presentation that I have delivered in front of an audience of health care professionals with academic interests, the planning was slightly more challenging than usual! But having the chance to run-through the presentation beforehand and to receive feedback from the SAPPHIRE group helped me to make the final adjustments. On the day it was well-received and I think it has given me the confidence to do something similar on an even bigger stage!
I presented on the topic of “non-clinical patient needs: mapping diversity in primary care”. Department of Health guidelines continue to emphasise the importance of seeing the patients as customers to a service, listening to them and catering to their requirements. For this to be done effectively within primary care organisations, they will need to have certain knowledge about their patients’ characteristics. There has been on-going interest to reduce health inequalities through using data intelligently, but less focus had been placed on non-clinical data (e.g. age, sex, spoken language, ethnicity, employment status, learning difficulties, visual impairments etc.) and the inequalities to health that arise through patient cohorts with these diversity characteristics. The annual GP surveys have reported a trend in certain patient cohorts who continually report back as being ‘underserved’. Therefore the idea of mapping out a practice’s population based on these needs may help a practice decide how best to allocate their resources (staff time and practice money) to reduce these inequalities. This could reduce inefficiencies in service provision by moving away from a ‘one size fits all’ even spread of services, or allocating services in an ad hoc fashion (as revealed through my interviews with practice staff), to making informed decisions based on real data. It is also key to think about these issues as we move to having Clinical Commissioning Groups or CCG’s nationally. Such data may lead to the smarter commissioning of services.
The Athena SWAN event took place last Wednesday at the University of Leicester. This year’s theme was ‘Breaking through the Barriers of Bias’ with an insightful keynote speech by Professor Jennifer Saul, professor of Philosophy from the University of Sheffield.
Women, across all academic fields, are underrepresented in the STEM subjects (science, technology, engineering and mathematics). The event aimed to discuss whether our hidden biases as individuals were unconsciously denying women opportunities with academia. The two main strands were concerning implicit biases and stereotypical threat. In summary, implicit biases are biases which individuals have towards certain ‘groups’ of people who they have unknowingly stigmatised within societies. I use the word groups quite loosely her, as it refers to different socially constructed groups dependent on the context; gender and race can be included within these groups but other groups do not have to be as fixed or apparent. Our instinctive reactions to different members of these groups were what Professor Saul wanted to draw attention to, and the “Project Implicit” psychological test illustrates this point in practice – https://implicit.harvard.edu/implicit/ .
Stereotypical threat was an interesting theory of how an individual may unconsciously undermine their performance do well due to an awareness of belonging to a particular group thought of as being ‘less good’ at certain tasks. The individual may begin to ‘live up’ to their group’s labelled characteristics, subsequently leading to underperformance. An example was given of a study involving children at a young age; infant school girls were told that boys were better at maths before embarking on a test and their results were compared to control groups of girls. The test was repeated with different sets of children and, consistently, those who had been told the additional information did end up doing significantly worse than the others. It did make me wonder just how early we form our biases and which elements within the environment around us influence our biases more.
Group discussions during the second half of the event brought through ideas of combating implicit bias as mentioned by Professor Saul (i.e. citing more women in papers, having a male/female balance on university students reading lists) aswell as opinions surrounding the effect of implicit bias on recruitment of academics, promotions, merit awards, pay and promotion. Comments surrounding maternity leave and the strain this causes on ‘keeping up to speed’ with developments in your academic department dominated the discussions on promotions and pay. We shall wait to see how the recent government amendments will have an effect on these views and what plays out in practice.
At the end of the session I did feel that there were a lot of problems highlighted but there were complex challenges of to making change happen. This is especially as many individuals (regardless of gender) may feel that they are immune to bias and will therefore not take the step to even recognise the effect of implicit bias in their decision-making, let alone positively work on ways to limit its hidden effect.
We are all aware of the benefits of team working – more thoughts and ideas, a chance for smaller thoughts to grow and develop into big ideas with the help contributions from others. But what does this look like in practice, and how is it acted out in the workplace? It requires mutual recognition of every team player’s opinion being as valuable as the idea you are bringing to the table. The best work is produced through many thoughtful stages of corrections, making changes each time in an attempt to add quality. At first it may seem time consuming and it may feel like there’s a lot of unnecessary shuttling taking place (going forwards and backwards refining different parts of the same idea) but the effort is definitely apparent in the end product. These processes are core to collaborative writing and I think doing so is a good way to achieve exceptional results.