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So could you start by saying your name and saying what your current title is?

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Yes. So my name's Stephanie Chaney. I'm a department lecturer and senior researcher at the Centre for Evidence based Medicine,

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which is at the University of Oxford and in the Nuffield Department and in the Nuffield Department of Primary Care Health Sciences.

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So it's primary care health sciences, not primary health care sciences. I've always found that puzzling.

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But yes, both because we're interested in primary care as an entity, as a setting.

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And first of all, just briefly, can you tell me how you first got interested in the area that you're interested in now?

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And give me the kind of headlines for your career progression till you reached your post here.

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So I've got it's a long career history, but I've always been in academia, university settings, I've always worked as a researcher.

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My background was I did a first degree in journalism studies and enjoyed the sort of

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more qualitative bits of that where you're talking to people finding out their stories.

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Then I went on to do a master's in disability studies,

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and again I was interested in thinking about theory, but also the more applied part of that work.

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And then started working at an organisation called the Centre for Evidence based Social Services.

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Whilst there I did my practice that, that was at the University of Exeter.

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Right. And whilst there I did my PhD as well part time and just enjoyed the qualitative part of that work.

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So what was the topic of your Ph.D.? So that was, I don't know, the exact title,

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but it was something around the effectiveness of psychosocial interventions for adolescents with anorexia nervosa.

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So it's on eating disorders.

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It was a systematic review, meta analysis, then qualitative interviews with children or young people that parents and health providers as well.

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And then from that, I've done a lot of research,

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so I that was the Exeter that I worked at University of Manchester doing research there around long term conditions,

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diabetes, cystic fibrosis, heart failure, cleft lip and palate.

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So mainly qualitative research there. But the question was always about social intervention.

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Was it describing social, but not necessarily social prescribing, but the impact of social, the social environment on people who had these conditions?

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Yes, it was always more around the non-medical issue.

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So I wasn't looking at drugs and things like that.

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I was looking at heart failure or physical activity and how we encourage people to be more physically active if they've got heart failure.

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It was looking at patients with cystic fibrosis, their experiences of transitioning from paediatric care to care.

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So it was more the it was about service delivery and also about experiences of living with a condition.

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So there were with long term conditions.

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Then I moved to the University of Warwick where I was looking at compassion in health care and the meaning of compassion what that meant,

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because there was a big report that was suggesting that there was a lack of compassion in the health care at the time,

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and there was funding to do some research on compassion in healthcare.

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So I did some work with health professionals around their views of compassion,

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also supported a PhD student to do some work around self-care and self-compassion in nurses among nurses.

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And then after that, I've moved here to the University of Oxford,

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where I started doing some work on social prescribing by initially just doing a review, a realist review.

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It was a particular type of review of the literature. But from that then we've sort of done lots of work on social prescribing as an intervention.

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Let's just go into that a little bit more. So there's various terms that I would start with social prescribing.

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So what, what, how, how has social prescribing come to be a thing that people are interested in?

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What is it and what effect is it intended to have?

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So if we start with what it is, it's the idea that people's health and wellbeing is not just affected by their physical status,

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their physiology, it's affected by where they live, where they grow, where they work.

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So those non-medical issues that may come into people's lives like loneliness, like housing problems,

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like finance, these are all things that people often affect their health and wellbeing.

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But it's not the primary.

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Yeah, it's the, it's, it's not what maybe their physical issue is and not the thing that a GP would necessarily latch onto when they come to see them.

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Yeah. Or they might latch onto it, they might identify it but then not know what.

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To do to help that person because they've not got the training in those more non-medical issues or they haven't got time and resources.

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So this is where social prescribing comes in to support people with those issues that are really

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having a detrimental impact on people's lives but are solvable by a pill or some sort of procedure.

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And I suppose it's been around in the UK since probably the nineties, but in patches.

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So it depended on where you lived.

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But in 2019, in the NHS long term plan, the NHS made a commitment to employ people called link workers in primary care.

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And link workers are a we talk about the social prescribing pathway where you have a referrer usually to GP,

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you'll have the link worker who's the connecting resource and then you have what the link worker connects people to.

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So you've got these three elements and link workers are just key to social prescribing.

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So this commitment from the NHS to support social prescribing through employing

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link workers to work in primary care was sort of a big thing at the time.

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And is there one or more in every GP practice now?

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Well there should be. There's funding, NHS funding for at least one per primary care network.

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So primary care networks are often an amalgamation of two or three practices.

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Some are just one practice if it's a very big practice, but usually it's an amalgamation of.

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So the link worker might be serving more than one practice sometimes as well with other link workers who are employed through different routes.

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But some practices, though, might have one link workers as a serving to different practices who are part of that PCN Yeah.

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Yeah. So and what are the kinds of services that the link worker is linking the person to?

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I mean, that's really varied depending it's about personal health care and what that they we talk about in social prescribing,

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not what matters, what not what's the matter with me, but what matters to me.

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So what people could be referred on to is really as unique as their individual needs, but often it's to do with like it.

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So it might be referring them to bigger organisations like citizens advice, like housing trusts,

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but it could be linking them to much smaller organisations like a knitter natter group or a something at the local library that's going on.

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Could be referring them to cultural activities like go on at the Ashmolean Museum here,

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could be engaging them in some sort of we call green social prescribing.

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So doing things outdoors with nature. So it's, it's very, very diverse.

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And I think part of it depends on what the person needs, but also it depends what's available in the local area.

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Some areas like Oxford City Centre got loads going on the legwork and could refer to, whereas if you're in a more rural setting, it's more difficult.

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But also I think it's around what the link worker knows and what they've tried themselves sometimes.

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So I'll research, I'm jumping ahead here.

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But our research part of it found that if the link workers have maybe been involved in going to a museum themselves,

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they're more likely then to recommend that as an option for people that they work with.

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So the other phrase you used was a real estate review.

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What does that mean? So really research is around the idea that often what we find is it's not a case of something works or doesn't work.

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It might work for some people in some situations. So it tries to tease out that not does something work or not.

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But what works for whom, why and in what circumstances.

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So it thinks very much about what context.

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It thinks about outcomes in terms of mechanisms that have contributed caused that outcome.

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So an outcome is attached to a mechanism. And then you think about what context is needed for that mechanism to occur to then create the outcome.

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So you give an example of that to say all that again, but with a specific example.

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So it might be I should have written one down, I think one off the top of my head.

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When a link worker has time to talk to the patient, the patient doesn't feel rushed.

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That's the mechanism. So the outcome is that waiting to open up is the outcome.

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So the context is time. And having time.

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The mechanism might be not feeling pressured, not feeling rushed, and then the outcome is being able to open up and being willing to open up.

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So we think about it and we think about our data in terms of context, mechanism, outcome configurations.

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We talk about CMC context mechanism, outcome configurations.

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So we don't think about an outcome in isolation.

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It's always about what mechanism might have caused the outcome and what context is needed to trigger that mechanism to cause that outcome.

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And it's that more difficult to get across as a as something to, as it were, sell to the NHS or any other funder than something that just says.

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If you refer older people to events at museums, they feel less lonely, I think.

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I think it's becoming more well known among policy departments like the NHS.

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I think the way that we probably would disseminate it is not necessarily as CMO sees context makes the outcome configurations.

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We talk about findings in a way that would be appropriate.

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So if you want to have this outcome, this is what you might need to think about in terms of your context,

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but maybe use the word context because you need to bring about this response from the participants or the service provider or the.

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Yeah. So the way we phrased it, we wouldn't talk about context mechanisms, outcomes, but we would, but in a roundabout way, right?

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So as I say, if you want this outcome, think about this situation setting because it might lead to this mechanism.

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So yeah, we will use those terms exactly.

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But we would try and phrase it in a way that would make recommendations based on the outcome that they're interested in.

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Then they might need to think about what context is required to trigger the mechanism to bring about an outcome.

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So it's it's more complicated than just looking at the referral at one end and what the patient might do at the other end.

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It's very much looking at the process of delivery that gets from one of those.

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Yeah, yeah, yeah. So it's sort of pulling apart the black box between referral and outcome.

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It's all the bits in between. Yeah. Mm hmm. So you were you were engaged in that review or had you finished that review?

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When we got to the beginning of 2020 and you finished it said yes.

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So I finished that review. I started working here in February 2018.

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I think we finished the review about a year later,

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and then we use this review to support a application to the National Institute for Health Care Research,

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the NIH, or for some further funding to do some primary research, because obviously the review was based on other people's research.

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So this was trying to find our own data by going by,

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but it was based very much on what we found in the review and where we felt the gaps were still in knowledge based on what we done from the review.

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So that was in 2019 that I think we put that application in, we heard about it.

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I'm trying to recall probably we heard we got the funding in 2020, but I think it was.

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Around. I don't know whether COVID it was after COVID.

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I think it was because I'm I think some of the review comments were around how we deal with sort of the ongoing COVID issues.

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So that was good because there's two project we worked on one project during the pandemic itself,

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which was funded by the arts and we might as well get onto that. We'll get onto that.

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Let's don't rush me yet. So that's given that we've started talking about the pandemic.

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Can can I just ask you what if you remember when you first heard about the pandemic and

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how you came to realise that it might actually impact on the work that you were doing?

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Yes. Well, I remember having some conversations here because we've got quite a few groups who

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work here and they were sort of mentioning things around that was the January,

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you know, in the media that started talking about stuff in China.

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I remember having we organised a knowledge exchange event trying to what we were doing was bringing

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together people at St Luke's just over the way there and we were bringing people together in,

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in this building to talk about social prescribing for people with mild cognitive impairment.

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And that was an in-person event and quite a few people called off because they weren't feeling good, they had sore throats.

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So that was February 2020. And then I remember sort of by March she started to think something is happening here.

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And I remember the announcement. The 23rd of March 2020 came on my brother's 40th birthday.

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So it's sort of embedded in my head. Yeah. Yeah.

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So yes. So having got that far and you had just got this, this new funding to do your primary research,

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how was that going to be affected by the fact that there was a pandemic?

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Because I'm trying to remember, I think we hadn't quite yes, we hadn't got the funding we got we got confirmation of the funding in August 2020.

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All right. Okay. But there's a two stage process to the application.

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So I remember we had to put in stage two.

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We got asked to put in a stage one and must have been the end of 2019 and then got asked to put the stage two in by February 2020.

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And then that comes back with review further comments. So that would have been over the summer 2020.

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And I remember one of them was around the COVID situation.

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So I suppose naively I thought that it wouldn't have lasted as long as it did.

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But we we delayed the start of that project until August 2021.

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So and what was the what was the project setting out to do? What kind of primary data were you hoping to collect?

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So the idea is what we have done is to go into we worked with seven link workers, social prescribing link workers in different parts of England,

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spent three weeks with them shadowing really what they did, watching what they did, talking to people as well that they worked with.

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So the health professionals, the voluntary sector patients,

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some of the interviews with the patients and the voluntary sector and health professionals, we did remotely after that three week period,

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but it was going into surgeries for three weeks and actually being with the link worker and watching what they did,

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how they interacted with patients but with all staff,

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what meetings they went to, looking at what was in the surgery around social prescribing, if anything, whether any posters.

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So yeah, that the issue we knew that we had to physically be in spaces and this was a time when GP

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practices were closing in terms of they were doing stuff more remotely over the pandemic.

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So did you. So when did you actually start collecting?

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Is that you just I think you just told me you didn't actually start till 20, 21.

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So the actual project started in August 2021.

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Yes. By which time vaccination was in place. Yes.

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So I mean, primary care still was running during the pandemic, but it was just that people weren't going to the building as much,

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including the work as they were doing a lot of their work remotely.

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So we actually first our first set of data collection, we worked with two sites in this time last year.

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So we yeah, that was 2021 November time, November to December.

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And it was a bit of a knife edge because we were wondering are we going to be going back into a lockdown?

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Are we going to be able to do this as there was another year over the winter, wasn't it?

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Our research is going to get ill and not be able to do the data collection,

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all the surgeries going to be accommodating and want another body in the surgery.

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What guidelines do we need to follow? So there was a lot of sort of liaising with the surgeries who were great.

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They were really sort of still very open to us going down there.

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And, you know, we did it, but it was a bit anxiety provoking, sort of.

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Search team, are we going to be able to go in and do it?

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And you I mean, your research question was specifically looking at loneliness in older people.

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Is that is is that right. So this project this takes us into our was looking at the implementation of link workers in primary care.

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All right. Okay. So how are link workers being implemented in the primary care based on that idea that they've been responding in 2019?

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How are they being implemented? And obviously how they're being implemented was being affected by COVID?

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Yes, yes. Yes. Because they were either working remotely or they were getting involved,

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at least at the beginning with some of the sort of admin for the the injections

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that we're doing a lot of checking up on people that they've got medication,

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that they've got food, being able to access food, especially older people who might not be using the Internet as much.

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So it's quite interesting and we had ongoing conversations.

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I think that's one of the things that we did. Although we got the funding in August 2020 and we didn't start for a year later,

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we were constantly sort of communicating with link workers who might be involved in the project.

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And it's quite interesting over that year, although it wasn't data research,

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we were talking to them about how things were going and how they were finding that

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the pandemic and what they were doing to sort of work in these circumstances.

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Mm hmm. And were they able to deliver what they were aiming to deliver?

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Not so much. Well, I think that we're still providing a valued service to the primary care,

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but connecting people to things in the community was much harder because buildings were closed.

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A lot of voluntary sector organisations didn't run because staff were on furlough,

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so they were perhaps doing a different role at that time in terms of being the support for people,

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phoning people up once a week or every two weeks to check they were doing okay,

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as I say, checking they had their medication, checking they had access to food.

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So they were doing a slightly more holding role of the person rather than connecting

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them to things in the community that might support their non-medical needs.

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And so where where did you go from there and what findings did you have from that study that you could take on?

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Well, that study is still in progress. Yeah. So we've done we did the first two sites in the end of last year, November-December.

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Then we did another two sites in February, March 2022.

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We did another two sites in June, July 2022, and then we did the seventh and final site in September this year.

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And now what we're trying to do is to follow up patients that we talk to about nine months later.

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So we talk to them maybe this time last year. We're trying to contact them again to see how things are going.

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Have that no medical issue got better and if so, what did they do with anything that the worker did with them?

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Was it helpful or not? So yeah. So how many points of contact with a particular single patient have with a single link work?

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I mean, is it a one off try this or do they take on a kind of continuous support role?

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So it's very varied. How link workers work is not one set thing.

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So some places we've been to, it's been they've got six sessions maximum that's it usually starts with a sort of 40 to an hour,

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40 minute to an hour meeting initially with the patient to give them time to tell their story and then meetings after that as and when needed.

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Some link workers were much more transactional in terms of, okay, that's your problem.

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Here's a leaflet or a number that you might want to phone, but then we're talking to other link workers who are maybe seeing patients for two years.

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They've got them on their case loads and because they feel there's not enough support in the community,

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they are taking on a sort of holding role of that person.

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I think that's becoming more and more difficult because link workers are becoming more well-known in their area.

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More people are being referred. There's more need at the moment with the cost of living crisis and, you know, post-COVID mental health problems.

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So yeah, it does vary though in terms of how often they'll see someone.

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So yeah. So I was yes, I think I must be talking about the different study,

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which is the the one where you've written a couple of reports about the pandemic and working with cultural institutions.

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So tell me about that study. How did that come about? Yeah.

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So we've had a good working relationship with the Gardens Libraries, the museums team here at Oxford,

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and I think a call came out from the Ukri funding and this was the Arts and Humanities Research Council and.

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Yeah. We must have thought this sounds like a good chance to do a piece of work together.

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We are interested, particularly in older people and their experiences because they were perhaps more at risk of the sort of consequences of COVID.

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Not so much the disease, but the isolation yet. Well, also, I mean, they were, you know, in terms of hospitalisation.

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Oh, yes. At the beginning, yes. So we thought there'd be an interesting group to work with.

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And we know that a lot of the settings that they may get support from were closing.

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So yeah, we were interested in sort of exploring how social prescribing might work within the cultural sector during a COVID pandemic.

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But I suppose what we found, I think a lot of the findings were more generic than that and probably still apply,

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even though we're not in that time now in terms of lockdown.

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So this was a project, it was another realist review, but what we call a rapid or restrictive release review where we did it in six months.

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And then that helped to inform the next part, which were interviews with healthcare, sorry, with cultural sector providers and also with older people,

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where we explored in a bit more detail some of the things that we found in the review or where there were gaps in knowledge in the review.

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And I mean, and we also did a questionnaire.

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We sent a questionnaire to link workers, electronic online questionnaire about their use of the cultural sector as part of social prescribing.

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So do they connect people to the cultural sector? If so, what sort of organisations?

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How did they find out about what's going on in the cultural sector? Um.

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Yeah. And I think I mean, what we found was this idea of the importance of tailoring what's offered to older people to meet their needs,

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but the difficulties that could stem especially from the pandemic, when, you know, things were closing, when there was lack of resources.

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The other thing was around how you message a social prescribing offer in the cultural sector.

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So for some people, the cultural sector might be something that they have never contemplated, never set foot in.

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It's not for me, and it's a no go at the beginning.

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So link workers almost having to do some preparatory work with the person saying there's this great group going on at the museum where, you know,

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people who are in a similar situation to you might be quite isolated,

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come together to talk about things, you know, what do you think about giving that go?

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And I think it depends partly on the way that that link work a message to the person whether they would then take it up.

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Yes. There's it's I've never been to a museum before. They might just think that's not where I go.

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Yes, yes, yes. And this research talks about sort of four broad benefits that older people might get from engaging with the cultural sector,

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although I think these are benefits that would be for any age group. So one was around immersion.

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So the idea that you were distracted for a short period from your worries because you're doing something that's culturally engaging.

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The second one was around this idea of feeling psychologically safe and held in a setting.

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These settings are often, you know, like the museum. Even libraries are calm and peaceful.

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So you could get that feeling of being psychologically or emotionally held in these settings.

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Another one was connecting. So obviously connecting with the cultural providers, but also the people who are attending activities.

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And then the fourth one was this idea of transformation.

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So from engaging with cultural activities, you could increase your skills, your knowledge, your self-confidence,

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and that would transform how you saw yourself as an individual and your place in the world.

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So that was sort of the there was a continuum, I think, from immersion, which was short lived,

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but maybe some people just needed that distracting from their worries through to transformation,

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which was perhaps a longer term process, but was perhaps more sustainable in terms of benefits, health and wellbeing.

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So these are benefits that you conclude could could potentially come from these engagements.

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What what was the evidence that supported those particular four things?

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Is that what so that came from the review,

264
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but also all conversations with the link that the social the culture providers but the older people as well.

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Yes. Yes. So they articulated. Yes. Those and those benefits.

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And so did any of the the the glammed up the Oxford providers that you were working with specifically

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put on offers that could be delivered even when face to face meetings weren't possible.

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Yes. So we didn't get so involved in the in the provision of offers.

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But I know that they did. I know that a lot of stuff transferred online.

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Some of the older people we talked to mentioned that it would qualitatively different to the experiences that

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they had face to face and that if you were working with the link work and maybe they needed to prepare people.

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The other thing was they suggested that you couldn't just take what you did face to face and put it online,

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that providers needed to think carefully about how they transferred things online and how it might come across to older people.

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There was a sense that older people did use online technology, so we shouldn't just think that it's out of bounds for these individuals.

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But some older people might need encouragement and support in using online resources.

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And then some people just said, I don't want to do anything online.

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You know, I don't like the little and in well, they didn't use the term,

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but that idea of that lack of seeing the body, you know, that it felt more dispersed, more yeah.

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Less personal than face to face. So they waited until buildings became open again.

280
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And what's next? So you've written up that stage?

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Yes. So we've written up that research. I mean, all link work, a study that I mentioned at the beginning is still ongoing.

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Yeah, there's a number of areas that I think will come out of that that will be doing hopefully future research on with the gardens,

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libraries, the museums. What we're trying to do now is with the gardens,

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libraries and Museums team is looking at different programs or activities and using some of our learning to inform those activities.

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So for example, one of the things that came out was the idea of having a body to go to these.

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Things with. So, yeah, some of the programs that they're doing, they're thinking about, well, how do we introduce this idea of a body?

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Would that be another patient or a or a volunteer?

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Yeah, probably be a volunteer, I think is how it's been talked about and what training that person might need so that the patient

289
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or the individual involved in social prescribing doesn't become dependent on that individual.

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Um, and then we've also the work that I mentioned before as well about mild cognitive impairment and social prescribing is an area that,

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you know, I think all gardens, libraries and museums team are also interested in how do we support people who haven't got dementia,

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might not ever have dementia, but have some sort of impairment in their cognition, which is quite a high proportion.

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Yeah. Older population. Yeah.

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And it can make people feel, it can encourage people to socially withdraw, to feel that they've got a loss of identity and who they are.

295
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So how do we support them? Through social prescribing, also through cultural offers or provision as well.

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And what's the what's the attitude to social prescribing generally among the the general practice community, would you say?

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Is it something that they've welcomed? Or again, I mean, everybody's different, so I'm not sure it's me.

298
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Yeah, I think it's mixed. I think there is quite a lot of.

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Not respect, but people, professionals like that idea that there's somewhere that they can refer people onto if they have a non-medical issue.

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Some professionals are sceptical about the, I think, the ability of link workers to support.

301
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And that partly depends on what's available in the community, but also what background the link workers had.

302
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What kind of background do they tend to come from? It's varied often, so I'm just thinking about the link workers we've worked with.

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Some of them have a background in the voluntary sector and are very much embedded in that community

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and are concerned about making their community better and have lots of links because of that.

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In the community sector, others are more from a health backgrounds and maybe have been healthcare assistants, might have been a nurse or a midwife.

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So they focus more on maybe the health side and they understand how the health system works and what their role could be in that.

307
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And then some individuals have had very different backgrounds.

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So one person I know was an accountant and he went into social prescribing after his parent he

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found really had difficulties accessing support for his parent when his parent had dementia.

310
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So but I think that there tends to be this voluntary sector background or healthcare background.

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We've also had some younger workers who've maybe got a background in psychology and are interested in developing

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their psychology experience to then go on to train as a psychologist and to give them that experience as well.

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So very, very varied. And who were your collaborators in the study generally?

314
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And in so it's like the there are overlaps so with the one around the cultural sector and older people,

315
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it was the gardens and libraries and museums team here.

316
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We also work with somebody called Helen Chatterjee, who's based at UCL, Karyn Husk, who's based at the University of Plymouth.

317
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I'm trying to think who else work with us on that project, and I think a lot of people came from from Oxford on that project.

318
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Apologies if I've missed any, but I'm just thinking of Carmel because it's oh, well, yes, he's part of it, but he's it.

319
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But he's a GP. Yes. So he's come at it from the GP. Yes, yes.

320
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So he's an academic GP and brings that experience and knowledge also.

321
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Geoff Wong is an academic GP, has a background in GP, well being a GP and then with the link work study,

322
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the one that I mentioned at the very beginning, we have quite a few GP's in that, so we have a GP from Hull and York University, a GP from Sheffield.

323
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Carmel's involved in Geoff in that one as well. And then we've got Karen, who's on the HRC project with us.

324
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We've got somebody who's more of a sort of sociologist on that with us.

325
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A couple of people who are more sort of medical sociologists on that with us.

326
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Um, somebody from the, uh, King's Fund is involved with us.

327
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We've got a patient representative on the study team as well.

328
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So it's quite a diverse group of people.

329
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So it's, I mean, it's very multidisciplinary, but that necessarily makes it they're very collaborative.

330
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Yes. Working. And is that how you've always worked or is this more collaborative than you've been in the past?

331
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I think it's definitely more collaborative than I've been in the past, although projects that I worked on,

332
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yeah, in in Manchester were often with other departments but within the same university.

333
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So this, you know, it's quite different in terms of.

334
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Part of it is working out the bureaucracy and the, you know, you have different universities contacting you about contracts and things like that.

335
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So it's a bit more involved in that respect. But it's nice because people also have different contacts themselves.

336
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So you start to increase your sphere of contacts through having contacts in different universities,

337
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I think, which presumably leads to potential routes to new research in future.

338
00:36:00,110 --> 00:36:07,220
Yeah. And they know if research that's going on that you don't know about, that's maybe not directly the same but is linked to what you're doing.

339
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So that can be helpful to sort of put your research in context.

340
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So I found that quite useful and things like having access to link workers in different parts of the country,

341
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having collaborators in different parts of the country means they can reach out to link workers in their area who they might already know,

342
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and then they call up people they know. So again, helping with finding not collaborators in terms of the research day to day work,

343
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but people who we might need to access to be involved in the study or to help us disseminate the findings.

344
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It can be helpful having people in different parts of the country, in different universities.

345
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Mm hmm. Yeah, that all sounds very good. Okay, so I'm just going to turn a bit more to your own personal experience of the.

346
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Of the pandemic. Um, how did it change the way you worked then, when the lockdown started, particularly?

347
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Yeah. I mean, I remember having a conversation in one of these rooms downstairs and one of the GP, um, you know, was saying take stuff with,

348
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you know, sort of any things that you think you're going to need to work on because we might not be coming back into the office for a while.

349
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I was like, No, I will be back in a couple of weeks.

350
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Little did I know. So I think it did come as a shock for how long it took and I teach as well.

351
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So I think that was a bigger issue, um, teaching because we still had to do it, but it will have to go online.

352
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And although I had some meetings online, I wasn't used to teaching online.

353
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So it's changed. It changed teaching. It sort of made us have to learn how to do teaching online.

354
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There were lots of courses suddenly set up for us to to work out how to do it in an interactive way with students.

355
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And I did quite a few bits of teaching online life, as it were.

356
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I mean, you didn't just record a lecture, it was mixed. So some were recorded and some were live teaching sessions as well.

357
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And are your students medical students or are they in social science departments?

358
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Most they are postgraduates. They come from medical disciplines.

359
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They're not necessarily just medics, but you might have allied health professionals, nurses, physios.

360
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You then also get some people who are more of a policy background in health, or they might have a medical sociology.

361
00:38:38,150 --> 00:38:48,200
So it is varied, but I'd say a lot of them have a sort of medical background, maybe not, as I say, as a doctor, but other disciplines as well.

362
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But the postgraduate school tended to be teaching in small groups.

363
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So 1 to 1. Yes, yes, yes. So that was a big change.

364
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Changes in terms of not just being able to pop into somebody's room and say, oh,

365
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if you've got 5 minutes having to arrange every meeting a bit more, you know,

366
00:39:07,940 --> 00:39:14,509
it wasn't a spontaneous getting used to presenting online at meetings,

367
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not necessarily teaching, but I remember the first presentation that I had to do online.

368
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I was terrified because is the technology going to work?

369
00:39:21,590 --> 00:39:28,579
And to show my slides, you're talking to a screen so you don't get any feedback, but it's amazing how quickly you just get used to doing that.

370
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And actually, now I don't mind doing that. And it's. Easier in some respects because you don't have to travel somewhere to present.

371
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So yeah, that was in areas that remained part markets remote working remained part of what you do.

372
00:39:42,260 --> 00:39:46,310
Yeah, well, I actually live in Birmingham. Oh, right. I don't come in that much.

373
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Probably three or four times a month maximum.

374
00:39:51,020 --> 00:39:57,350
Um, so I moved to Birmingham during the pandemic to be nearer my family.

375
00:39:57,860 --> 00:40:05,780
Um, so, yeah, it's. Yeah, it definitely changed and given me that bit more flexibility to be able to do that.

376
00:40:06,280 --> 00:40:12,680
Um, and I feel that sometimes, I don't know, we have more meetings,

377
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I feel possibly sometimes more online meetings than we would because you can't have those informal conversations.

378
00:40:19,850 --> 00:40:25,010
So it does feel definitely the beginning. It felt really teams meeting, having.

379
00:40:25,100 --> 00:40:28,220
Yes. Lots of meals your calendar was full of. Yeah. Yes. Yes.

380
00:40:28,970 --> 00:40:37,150
Um, I'm trying to now block out a Friday for just thinking of writing and things that I don't want to be disrupted by.

381
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Meetings doesn't always happen. But yeah, I've tried to do that a bit more as well.

382
00:40:41,750 --> 00:40:46,310
And how threatened did you feel by the infection itself, by the possibility that you might catch it?

383
00:40:47,090 --> 00:40:55,280
I think, oh, I personally didn't feel too anxious because I was not in the I don't know,

384
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I didn't feel that I came into a bracket that put me at great risk.

385
00:40:58,970 --> 00:41:01,580
But I actually during the lockdown,

386
00:41:01,730 --> 00:41:09,470
I lived on my own and I moved back with my parents so that I was not on my own for three months and I was more worried about them.

387
00:41:09,890 --> 00:41:17,810
So I made sure I did all the shopping. I, you know, I constantly not about, you know, washing hands and all that stuff.

388
00:41:17,810 --> 00:41:24,620
I became a bit like a parent, I think in that respect. I mean, they were fine and yeah.

389
00:41:24,620 --> 00:41:31,370
So I think I was more worried about them and their wellbeing rather than my own.

390
00:41:32,700 --> 00:41:40,849
And I actually didn't get COVID until this summer, August 20, 22, when I went to the Edinburgh Festival and picked it up there.

391
00:41:40,850 --> 00:41:47,810
So that was the first time I'd had it. Um, I won't want it again necessarily, but I'd had my injection.

392
00:41:47,840 --> 00:41:54,110
So I think once the injections, once vaccinations came in, I felt much more confident.

393
00:41:54,110 --> 00:42:00,409
Yeah. Um, but yeah, I think, I think myself was quite physically resilient.

394
00:42:00,410 --> 00:42:05,600
I don't, I should say that we don't get colds and things like that very much.

395
00:42:05,600 --> 00:42:10,669
I use public transport all the time, so I don't know whether I've just developed a good immune system.

396
00:42:10,670 --> 00:42:13,790
I assertion to say that. But, um. Okay,

397
00:42:14,000 --> 00:42:17,540
so I suppose the only reason that I didn't want to get it was because I don't like not

398
00:42:17,540 --> 00:42:22,399
being able to have plans for work each day and I've not being able to carry that out.

399
00:42:22,400 --> 00:42:28,430
So, um, but yeah, personally I, yeah, I was more worried about other people than myself.

400
00:42:30,590 --> 00:42:35,809
I think we've more or less got to the end. Um, yeah.

401
00:42:35,810 --> 00:42:46,410
And, and, I mean, did you, did you find having to work remotely and psychologically difficult, was that, was that stressful for you?

402
00:42:46,710 --> 00:42:55,610
Um, not desperately, because I worked two days a week from home anyway, even before the pandemic.

403
00:42:55,610 --> 00:43:02,120
So I've always had a bit of home working. I didn't have kids, so I didn't have to worry about them as a parents.

404
00:43:02,120 --> 00:43:07,820
So you had some company? Yeah, I had some company. I didn't have to do any washing did that for me, so that was quite nice.

405
00:43:08,390 --> 00:43:15,020
Um, I don't think I coped if I'd have been living on my own, and I think that would have been really, really hard.

406
00:43:15,860 --> 00:43:20,240
But because I had, I think I made very clear distinctions in the day.

407
00:43:20,660 --> 00:43:24,620
So I'd always go for a walk in the morning, like, as if I'm going to work.

408
00:43:24,980 --> 00:43:29,960
I'd have break, 11 break from a lunch break about 3:00.

409
00:43:30,440 --> 00:43:39,020
I probably worked much longer though. Our boys, I definitely work much longer than I would necessarily.

410
00:43:39,800 --> 00:43:47,090
Um, sometimes it was a bit difficult to switch off because you haven't got that commute home or that walk home.

411
00:43:47,570 --> 00:43:51,950
Um, but I think I managed relatively okay.

412
00:43:52,190 --> 00:43:57,350
I just missed seeing people in person and you know, you do that.

413
00:43:57,380 --> 00:44:04,459
Yeah, you do miss that sort of. It's really nice now that we are able to have meetings face to face and to have that mixture.

414
00:44:04,460 --> 00:44:06,740
So not every meeting has to be face to face,

415
00:44:06,740 --> 00:44:12,440
but it's nice to have some and especially when we're doing more sort of in-depth analysis, I think it's really good.

416
00:44:12,440 --> 00:44:18,770
We've got a meeting next month where we're all coming together in one of these rooms for the day to talk about the data and a bit more detail.

417
00:44:19,250 --> 00:44:25,250
Um, so I think sometimes we do need those face to face meetings and has the experience of,

418
00:44:25,250 --> 00:44:30,530
of working through COVID changed your attitude or approach to your work?

419
00:44:32,460 --> 00:44:36,540
Um. I'm sure it's changed my approach to work. Um.

420
00:44:40,730 --> 00:44:52,549
It's just made me realise that you can't, you don't know what's around the corner, so you have to be a bit more circumspect about things.

421
00:44:52,550 --> 00:44:57,980
And you know, um, I realised that some things can happen more efficiently,

422
00:44:57,980 --> 00:45:05,320
like having meetings online when you don't need to go up north or down south for a meeting, you can just do it online.

423
00:45:05,330 --> 00:45:10,330
So I suppose that's been the main thing for me is it's been quite good to be out.

424
00:45:10,370 --> 00:45:14,099
People have got so much more used to doing stuff online meeting wise.

425
00:45:14,100 --> 00:45:20,330
So although I said it's nice to meet in person and it is it's given that sort of flexibility to be able to,

426
00:45:20,870 --> 00:45:24,529
you know, just put in a meeting with somebody from up in Scotland,

427
00:45:24,530 --> 00:45:30,469
you know, and it might just be an informal conversation, which you probably wouldn't have done as much prior to the pandemic.

428
00:45:30,470 --> 00:45:33,830
I have a teams meeting with them, so she might have had a phone meeting,

429
00:45:33,830 --> 00:45:38,120
but do much more meetings where I can actually see the person as well, which is quite nice.

430
00:45:38,990 --> 00:45:42,330
Um. Yeah, good. Right. Thank you very much.