Q: How did you become involved in this area of work?
Like many women I suspect, I picked up research and teaching alongside looking after children and worked part-time for many years; often on very short-term contracts. I have also worked in the voluntary sector and been a trustee of several voluntary groups which have been great ways of learning about organisations and communities. More closely to ARC interests I have been a non-executive director of three NHS trusts, one in secondary mental health and the other two providing primary care. I have always worked in multidisciplinary teams, which is a great advantage when thinking about systems and different perspectives.
Q: You are leading the ARC’s social care research theme. What research will the theme be working on?
Those of us who have argued that social care needs to be part of NIHR activity are greatly encouraged by the requirement for ARCs to embrace social care. This change is happening across the whole NIHR and we hope that this will enrich research across systems and promote mutual learning. Funding for social care research has been rather threadbare and often has just enabled us to conduct short interview-based studies; we are looking forward to further enlarging the methodological ‘gene pool’. Our ARC work in south London builds on a scoping review of evidence undertaken for Age UK. This found that day services were an important part of social care support but often under-recognised.
We have widened our interest in this subject to construct a project that will initially map South London’s day services (for adults) – we don’t know what is out there, so practitioners and commissioners make referrals or decisions in the dark and we hope to build a picture of provision with the co-operation of the sector so that they can describe in NHS and local authority language what they do and their impact. We are fortunate that the postdoctoral researcher just starting on this work recently completed her PhD on day services.
Q: Can you tell us a bit about how the theme’s research is addressing local needs and priorities?
In addition to the day services work we will be working with the social care sector in south London to help develop its research priorities. We have been very influenced by the James Lind Research Prioritisation approach (and took part in the one on dementia and on adult social work). This involves people at the frontline in thinking about what they want to know and what would be useful. We have good contacts with the local authorities in south London though our Making Research Count network and with social care providers – running care homes, home care agencies, and so on. We will be keen to learn what they want to know and how they might want to use research-based tools in their own practice and decision-making.
Q: What do you see as the value of this type of collaborative organisation?
The value of the ARC in south London is likely to be increased co-operation between researchers and the communities they serve. It is easy to get a bit distant from localities when your focus is national or policy orientated. I am looking forward to renewing connections forged over the years in community development work in Peckham and East Dulwich and further links with organisations such as Lewisham Pensioners’ Forum. South London has such a rich history of social care development, ranging from Clubland in Walworth, Hestia in Wandsworth, Royal Star and Garter home in Surbiton, to Age Exchange in Blackheath (among countless others). I hope that celebrations of the NHS will increasingly refer to community agencies.
Q: Much of your work is about influencing policy and practice. How do you ensure that your research does this? Do you approach your research differently with policymakers in mind?
Policymakers and practitioners have a lot in common; both often need quick answers and don’t like to be told that more research is needed. Probably I don’t make much of a distinction between the two; they both want crisp answers and usually don’t mind being told that what they are seeking is a question of values or political judgement. And both find stories easier to remember than facts. Researchers can help in alerting both to connections, to underlying concepts or models, to debates about effectiveness, and in clarifying what could be a system problem rather than an individual failing. We are also quite good at spotting salespeople trying to promote ‘promising’ initiatives.
Q: Congratulations on your appointment to the NIHR strategy board. Can you tell us a bit about what this role involves?
Thanks for that, I will let you know the answer when I have been to a few meetings! It is a great honour to be there – there has been no social care presence before me. I hope to also wave the flag for thinking about workforce matters, which sometimes can get overlooked. I am very conscious of the esteem in which the NIHR is held and how other countries look on us with envy. We have a great deal of taxpayers’ money to spend wisely and must make sure that this is done well.
Q: There is a lot being said currently about the need for greater integration between social care and health services. Why do you think this is? And how do you think it can be achieved?
Working in a research unit that is both health and social care focused, I am always keen to hear what is meant by integration but not to get bogged down with definitions. There is a legal basis to integration of course and I find this a helpful way of cutting though language that can be a little overwhelming.
Social care is one area of practice where I think the law is more often discussed than in many parts of the NHS: for example, what are our responsibilities under the Care Act 2014; what will be the impact of the Mental Capacity Act changes; what is the legal basis of health and wellbeing boards? This can help cut through debates over whether we mean integration or are referring to co-operation, collaboration, capitulation… I am also interested in the outcomes of integration which must, like all things, have advantages and disadvantages.
South London is a great place to explore these questions with its strong legacy of local government changes and multiple providers of social care to diverse communities. As someone who spends a lot of time on south London’s buses, I am lucky to have ample opportunity to see such changes and hear from people being affected.