Voice and Wellbeing in the Caring Professions

Date and Time	14th and 15th September 2021 between 9am and 5pm BST. A day three had been planned for January 2022 in Glasgow but it was cancelled due to covid restrictions. We plan to organize a meeting of participants at EAWOP 2023.
Venue	Online due to covid restrictions
Organisers	Dr Sarah Brooks (Sheffield University) Dr Michael Knoll (University of Leipzig) Dr Lotta Dellve (University of Gothenberg) Professor Carolyn Axtell (Sheffield University) Professor Anthony Montgomery (Northumbria University)
Topic	Voice and Wellbeing in the Caring Professions – Linking  Research and Application
Panel speakers	Professor John Blenkinsopp (Oslo New University) Dr Lotta Dellve (University of Gothenberg) Professor Anthony Montgomery (Northumbria University) Professor Graeme Currie (Warwick Business School) Professor Carolyn Axtell (University of Sheffield) Professor Hannah Hasselgreaves (Northumbria University) Mimmi Kheddache Jendeby (Västra Götalandsregionen) Annie Sorbie  (University of Edinburgh)
Participants	There were 21 participants from across the world including India, Australia, UK, Switzerland, Germany, Sweden, Republic of Ireland, Portugal and Greece.

     

• It was an opportunity to bring together academic researchers at different stages of their career from both voice and silence fields and healthcare fields to share insights and develop opportunities for future collaborations.
• We created a good foundation for a network of researchers with an important common goal.
• We identified a number of research questions which are important next steps for the field

Two papers were published as a direct result of conversations held in the Small Group Meeting.

• Montgomery, A., Lainidi, O., Johnson, J., Creese, J., Baathe, F., Baban, A., & Vohra, V. (2022). Employee silence in health care: Charting new avenues for leadership and management. Health Care Management Review, 10-1097. Available online at:
  https://journals.lww.com/hcmrjournal/Abstract/9900/Employee_silence_in_health_care__Charting_new.9.aspx
• Montgomery, A., & Lainidi, O. (2022). Understanding the Link Between Burnout and Sub-Optimal Care: Why Should Healthcare Education Be Interested in Employee Silence? Frontiers in Psychiatry, 13. Available online at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9008194/

Given the main focus of the SGM was to facilitate collaborations, the first three hours of Day 1 were dedicated to a World Café exercise allowing everyone to share their research with each other in small groups. Following lunch, a plenary session identified some observations that had emerged during the World Café Exercise.

• That the SGM projects within the voice and silence field were multidisciplinary and offered a broad conceptual framework through which to explore research questions
• There are many different contexts in which voice and silence can be studied and each offers a unique perspective

However, what was most noticed was that clarification is required within the field to understand questions such as:

• When is voice enough?
• How do you know that voices have been heard?
• What do voice and silence look like for remote workers?
• What are the implications of voice and silence on different groups of workers (e.g., nurses, mobile care staff)?
• How are voice and silence operationalised in the workplace?
• What is the value of voice and silence in different situations?
• Who has responsibility for voicing?
• Does everyone have the right to voice or remain silent?
• What is the role of leadership (e.g., facilitator of voice or reason for silence; interpreter of silence and voice; transfer to higher level management)

Also, certain themes became apparent:

• Early socialisation of workers is likely to be important especially for temporary/casual staff, those from different cultures
• Comparing and contrasting studies from different contexts would allow identification of norms and idiosyncrasies e.g. private/public sector
• Voice is assumed to be better than silence but not enough exploration has been carried out to understand where each is most powerful
• There are a lack of interventions to understand what works in encouraging voice and reducing silence
• Methodological innovations in this field are needed
• Different types of voice are important and need to be studied independently e.g. stressor voice, prosocial voice, safety voice, moral voice.
• There is a need for studies including different samples, i.e. not traditional bureaucratic organisations

Following the plenary session, each of the SGM organisers hosted a group where participants chose to discuss particular foci in more detail:

1. Multi-disciplinary concepts of voice (Anthony Montgomery)
2. Philosophical perspectives on voice (Lotta Dellve and Carolyn Axtell)
3. Culture and context (Sarah Brooks)

Following Day 1 which was about introducing participants to each other, identifying common themes of research and generating theme groups, Day 2 provided three panel events which looked at different areas.

Panel 1

What I learned whilst doing research in healthcare. The aim of this panel event was for experienced scholars to share their insights about key areas for further development. The panel speakers were:

• Professor John Blenkinsopp (Oslo New University)
• Dr Lotta Dellve (University of Gothenberg)
• Professor Anthony Montgomery (Northumbria University)

Insights generated through this panel event included:     

• Look for other grants on which you can include your research rather than applying solely for voice and silence grants
• Working with those from different disciplines requires sharing some (limited) information about each other’s perspectives in order to generate insights independent of the respective disciplines
• Get commitment in writing where multi-disciplinary teams are delivering different outputs
• Be open to considered different types of research publications (e.g. University Press) for research which does not fit disciplinary norms

Panel 2

Grant proposals/funding opportunities. The aim of this panel was to provide advice and guidance from experienced scholars on how to advance research ideas through competitive funding. The panel speakers were:

• Professor Carolyn Axtell (University of Sheffield)
• Professor Hannah Hasselgreaves (Northumbria University)
• Professor Graeme Currie (Warwick Business School)    

Insights generated through this panel event included:

• Building an academic career is a juggling game between publications and grants. With that in mind, there is some advice:
  • Focus on generating papers initially during your career because grant wins will be easier once you have a track record of publications
  • Start gaining experiencing of winning funding for smaller grants first e.g. ESRC Seminar Series[CA1] 
  • Contribute grants and funding to your CV by getting involved in other people’s projects initially before leading your own
• Other more general advice included:
  • Writing grants is a specific skill and partnering with someone good at writing grants is advisable
  • Consider types of funding from different disciplines by focusing on perspectives that are important for them e.g journalism, medicine, gender
  • Generate impact by focusing on policy and practice
  • To win a large grant, funders are usually looking for research to address a social problem using interdisciplinary methods - emotional narratives are always the loudest
  • Ensure there is a robust methodology which generates clear impact; if this methodology is qualitative, demonstrate methods are reliable and valid.
  • Outputs should be delivered the whole way through the project, not just at the end
  • Offer funders something interesting about their policy decisions which shows how your research will contribute to further policy development
  • Ensure the research addresses the “so what” question.

Panel 3

Practitioner and policy insights: Key challenges facing care practitioners around wellbeing/voice and alignment with policy makers’ view on this. The aim of this panel event was to provide a perspective on what makes good policy and practical implications from policy maker and practitioner perspectives. The panel speakers were:

• Mimmi Kheddache Jendeby (Västra Götalandsregionen, Sweden)
• Annie Sorbie  (University of Edinburgh)
• Professor Graham Martin (THIS Institute, Cambridge University)

Insights generated through this panel event included:

• Policy can be defined a set of ideas or a plan agreed to officially by a group of people which are based on principles of importance but do not include detailed decisions.
• Policy drives goal and value-based decisions which supports experts to explore how goals can be achieved
• Trust is fundamental for voice and one of the key areas of exploration must be how can we increase trust and voice within organisations? Suggestions included:
  • Educate leaders and employees
  • Create conditions and structures which build, not undermine, psychological safety
  • Understand better how organisations can encourage leadership at all levels
• The healthcare industry is highly regulated and it is everyone’s individual duty to be open and honest in voicing when things go wrong
• Stakeholder engagement and building relationships are key within healthcare and it’s important to ask the question “who am I seeking to influence and how will I do it?” when planning research projects
• Projects generate outputs which are sometimes unplanned and it’s important to have a mechanism which allows these to be recognised
• As an academic, it’s important to consider what type of academic you want to be and what you want to achieve because this will drive your priorities.
• There is a need to support people working in the healthcare sector to speak up about problems and concerns. However, the NHS speak-up guardians found it difficult to categorise the concerns that were coming to them, highlighting that voice can take many forms, some of which are not easily recognisable.
• Voice should be rewarded and not punished
• It is very difficult to consider what might be a policy decision but some guidance includes:
  • What are politicians grappling with at that time?
  • What societal problems are important at that time?
  • How do we ensure compliance with policy?
  • Who is involved in making those decisions?
• There are laws which support voice and it is important to consider the context in which the legislation exists when researching voice in that field. e.g. Duty of Candour

The following outputs are now intended following the SGM over the next 3 years:

• Year 1
  An animation of 5 mins long to present ideas generated during the SGM about voice and silence in context. An animation that introduces the concept of silence was presented at an EAWOPii event and was well received. The new animation aims at following up on this and provide more specific information on particular contexts (e.g., health care) – due September 2023. A symposium concerning silence and voice in context(s) will be submitted for EAWOP 2023. We invite SGM-participants to submit the research they presented at the SGM – due 15 October 2022 for the event in May 2023.
• Year 2
  Hosting a launch event webinar (maybe ESRC Festival of Social Sciences) for the animation which can be subsequently added to Youtube – November 2023
  A special issue on this topic will be prepared in 2024 – publication early in 2025.
• Year 3
  The generation of policy content and a webinar to launch these – September 2025

 

Self-assessment of the SGM

What went well:

• Bringing together participants from all around the world giving an increased spectrum of perspectives
• The panel speakers contributed knowledge and thought-provoking conversations for the participants
• Frequent plenaries and breakout group opportunities meant that we kept in contact with the participant needs
• Application of online tools (e.g., coffee areas, break-out rooms) made it possible to create an atmosphere where people were able to exchange ideas virtually

Lessons learnt:

• Shorter sessions and different timings are required when working with a global audience to accommodate time zones
• Momentum was lost after the first 2 days and before Day 3 so more intervention was required following the first 2 days or the format of the SGM could have been changed to ensure a cleaner end to the SGM
• The SGM was not an effective mechanism for building collaborations

Participants’ assessment of the SGM

We had 14 out of a possible 20 responses.  Participants were asked on a scale of 1-10, where 10 is fully met and 0 is not met at all, to what extent did the SGM meet their expectations? The average response was 8 which comprised 4 responses of 10.

They were then asked if they didn't score 10, what would have made it a 10?  Their responses included:

• More specific focus on the individual projects
• Maybe it had been better if we had four short days on a spot on the day when it suited the participants from all over the world
• One idea would be to set up several panels so that the participants could participate in the ones most relevant to them. 
• A clear structuring of next steps; clarity on how visibility to other projects would be provided
• I attended the cafe and theme discussion. Loved those.
• Being able to fully participate.
• I didn't really know what to expect if I am honest so answering with a 10 would have been inaccurate. I was very pleasantly surprised and energised from the small group meeting. It was well worth staying awake until 1am for.
• Due to the time we spent online I felt very tired which had an impact in my ability to contribute more. For an online meeting I think we should have less meeting time/Screen time.

They were also asked what the key messages they were taking away from the 2 days. Responses included:

• Importance of thinking about 'pathways to impact'
• The learning from meeting you all - and through the format of the SGM
• Excellent discussions/presentations and wonderful opportunities for fruitful collaborations. Helpful tips for funding. Thanks for really good organisation and for creating a space to share :)
• New and/or deepend perspectives on voice/silence. Especially day 1 was great!
• It was really wonderful to meet people that are interested in the same research area as I am. As I am at the beginning of my research project process it was very helpful to listen to others and hear about their thoughts, ideas and challenges. I am looking forward to keeping in touch with this group going forward, to help me develop research ideas and hopefully be able to contribute myself when I have some more experience. 
• I've taken away some useful practical tips about research in healthcare which will directly impact my research. Additionally, I have got some ideas to think about in relation to operationalising and conceptualising voice in my healthcare context.
• Interesting and insightful suggestions. Enhancing the quality of work with collaborations. Amazing ideas to build up as projects for impact
• Many connections, wonderful new directions for my work, and the support and encouragement of a new-found community!
• Robustness of the Voice/Silence community and its potential for high impact research globally
• I hope for more of these types of arrangement where one can meet and discuss.
• Connections and Networking!
• Novel approaches to how I can develop my research further by using voice as a mechanism for agency to facilitate change in policy and organisational structure.
• The need for more theoretical and empirical developments around the conceptualization of  silence and voice and the challenges of studying those concepts in Healthcare contexts