Walking football for people with chronic breathlessness – has it got legs?

Posted by Callum Bradford, Research Associate, Teesside University

Following on from the recent success of the England Women’s football team, and with the Men’s World Cup final just around the corner, now seems like a good opportunity to talk about our walking football project, designed exclusively for people with chronic breathlessness. What is walking football you ask? Well it's football, without running (you don’t say?!), and the physical contact is a bit more restricted. Thankfully, FIFA hasn't got its hands on walking football just yet, with the World Cup being an example of why we perhaps should avoid such a thing.

 

Chronic Breathlessness is predominantly caused by pulmonary conditions, such as chronic obstructive pulmonary disease (COPD), impacting 75 million people globally. With Covid-19 and an ageing population this number is expected to rise, increasing the burden on families, carers, and health and social care services. For individuals, breathlessness is associated with a lower quality of life, decreased capacity to do exercise, and higher levels of anxiety and depression

Pulmonary rehabilitation is recommended for everyone with breathlessness. Consisting of both exercise and education, its benefits on health are unequivocal, however, any benefits gained by patients are often reduced three months after completion. This is primarily because patients go back to doing less physical activity once the programme has finished and support from healthcare professionals is removed. With this in mind, we wanted to develop an intervention that could step-in when patients finish their rehabilitation, offering a form of exercise maintenance and continued social support. Given the nation's love of football (most of the time), we believed walking football might have potential.

To develop the intervention, we initially consulted pulmonary physiotherapists, and a local walking football team. The physios were initially very sceptical, raising concerns that the pace would be too fast, and highlighting the number of people with breathlessness who required oxygen or walking-aids. Walking-aids?! Oxygen?! I hadn't even considered that. I was starting to worry that this idea might be a complete non-starter.

So next stop was to see some walking football for myself at Middlesbrough’s Herlingshaw Centre. I left the session with mixed feelings. They played three-touch, meaning everyone got the opportunity to play, forcing that one player who thinks they're Allan Saint-Maximin to pass the ball. It was also proactively refereed to the benefit of everyone, with players encouraged to talk to the ref if they felt the pace of the game was too fast. However, after giving it a go myself, the pace was still surprisingly quick, despite what Father Ted might have you believe, bringing back concerns as to whether it would be too high an intensity. What I really needed to know was what patients themselves thought of walking football.

So we linked up with Breathe Easy Darlington, a local support group for people with lung conditions. Describing the input from Breathe Easy members as invaluable to our research over the last few years would be a massive understatement. So much so that, as a small thank you, we held a fundraiser for them last month on World COPD Day, raising £1120.76.

Their opinions would be vital to walking football’s success... however, they were also dubious of the idea. Again, concerns were raised about the speed, the walking-aids, and the balance required to play. So I asked, under what circumstances – if any – would they consider giving walking football a go? They stated that if the football was exclusive to people with breathlessness like themselves, they would give it a try, as they would be able to dictate the pace of the game and not feel too self-conscious of their footballing abilities. Our original plan involved asking patients to join onto sessions at the Herlingshaw. Luckily, by consulting with Breathe Easy members, I now understand how that plan – to mix people with and without breathlessness - would have likely ended in disaster, demonstrating the importance of including end-users when designing research studies.

Twelve Breathe Easy members agreed to play and the stage was set for our walking football taster sessions, and as you can see from our video, I don't think it could have gone much better.

The players embraced the competitive aspect of football, stating that “On the pitch you forget about breathlessness”; and the concern for walking-aids was turned on its head after we agreed that hitting the ball with a walking-stick is a perfectly fine way to score a goal. Our coach, Monty Towers, was key to its success, mixing up the session with fun games, while allowing everyone to play football at their own pace. In our follow-up conversations, members also suggested implementing a buddy system, where more experienced participants take responsibility for introducing new patients to the group so they feel more welcome – a brilliant idea that we intend to implement in the future.

Throughout 2023 we will be assessing the feasibility of walking football following pulmonary rehabilitation in collaboration with both North Tees & Hartlepool and South Tees NHS Foundation Trusts, plus the North Riding FA; and I’m confident if it’s anything like our sessions with Breathe Easy members, it will be a great success.

And if you’re still upset about the World Cup, don’t worry, I’m sure our walking football team will bring it home next year.

The views and opinions expressed by the author are those of the author and do not necessarily reflect those of Teesside University or Fuse, the Centre for Translational Research in Public Health.

What support do children and young people actually want when their parents use drugs and alcohol?

Posted by Cassey Muir, Fuse & NIHR School for Public health Research (SPHR) funded PhD Researcher from Newcastle University and Kira Terry, Lived Experience Expert. 

“No-one has ever asked me about how I feel in any of this.”

I found the powerful quote above from a young person during my research exploring parent drug and alcohol (or substance) use from the young person’s perspective. Since then the question of ‘what support do children and young people ACTUALLY want?’ has remained central to my PhD research in this area.

Most schemes focus on the parents themselves, to reduce the risk to young people. While these interventions are needed it should be alongside and in addition to support for the child or young person as well. There are currently a very limited number of evidence-based interventions for young people whose parents use substances, with low quality effectiveness. The distribution of support services for children and young people whose parents use substances is also patchy across the country, with practitioners doing really great work with little funding and resources.

In a recently published review of the research in this area, I aimed to understand the experiences, perceived impacts, and coping strategies of young people whose parents used substances. The review was extensive - covering the perspective of over 700 children and young people from across twenty different countries - and I hope that it can help to inform practice and policy through illustrative cases of young people’s experiences, as well as giving insights into what support could be useful.

Feeling different and isolated

Working with PROPS Young Person’s Project, a group of young people with lived experience supported the early stages of this review to help us understand the findings. One area that the young people felt was missing and may not have been explored across the current studies was the experience of feeling different to their peers, and how they felt isolated and like they had to keep everything hidden from others. This idea, relating to the experience of stigma, helped me to explore the data from a different perspective.

Children and young people described living highly disrupted and chaotic lives, characterised by unpredictability and insecurity within their relationships. They also often experienced adversity occurring at the same time in childhood, such as parents with mental health problems, domestic violence and abuse, as well as poverty. Children and young people were impacted both emotionally and socially from their experiences of parental substance use, which often extended beyond their parents stopping use, further highlighting that child-focused support is crucial. The painful experience of shame, stigma, and discrimination due to their close association and relationship with a parent who uses substances, was often further compounded for those who had experienced poverty or lower socioeconomic status.

Resisting and coping

Most of the studies described the negative impacts of parental substance, without recognising children and young people’s agency and attempts to change, control, and resist their experiences or impacts. Children and young people tried to manage and mitigate vulnerabilities and be resilient to unpredictable, adverse, and stigmatising experiences. While it is not a child’s role to resist and cope with the negative impacts of parental substance use, they were trying to do this anyway, often without formal support in place. Formal support was often thought of as something children and young people only have at times of crisis and due to the stigma and fear of speaking out it was also difficult for young people to seek support for themselves before a crisis point.

What can we do to support?

The findings had little to say about how young people wanted to be supported following their experiences. So, as part of my PhD I have been chatting with young people, and the practitioners that support them, around what we can do to support and build on their strengths, agency, resistance, and resiliency. For instance, young people and practitioners thought it would be good to develop a digital app that teenagers and young adults can access themselves at any time of day. They can choose what topics or sessions they want to go through and hear about other young people’s stories. Such digital interventions could be used alongside in-person support with a practitioner or act as a gateway to more formal support, with the aim of helping reduce the stigma of speaking out and accessing help. Additionally, young people wanted free text support lines that they can access out of hours, usually in the evening when things may be worse at home. Text and chat-based support lines provide young people with the opportunity to safely get support without having to physically talk to somebody and gives them more flexibility. Both young people and practitioners wanted in-depth training for professionals (e.g. teachers or first responders) around the experiences and impacts of parental substance use on children and young people and how to signpost to support.

Finally, one of the main areas that the young people and practitioners wanted to focus was on the co-production of resources to be used in primary and secondary schools. Young people wanted parent drug and alcohol use to be talked about in schools, as many reflected that it had never been spoken about making them feel more alone and isolated. Having lessons around the emotional and social impacts of family substance use within secondary school, or having story books read out loud in primary school about a child whose parent drinks alcohol or uses drugs would begin to reduce the stigma and fear of speaking about such a hidden and taboo subject.

“I’ve really enjoyed that chat, thanks for reaching out to me and wanting to hear about my experiences and how to support young people.”

Young person after taking part in this study

 

“He has told us he has gotten so much out of chatting with you and is really happy to have been involved and listened to regarding what might help others.”

Practitioner on behalf of a young person 

The young person’s voice

In any decisions made throughout my PhD, I have tried to ensure that the young person’s voice is lasting and at the forefront. Young people have been involved in this project from the start, guiding the research questions, designing research materials, contributing to ethics procedures, analysing data, and presenting results to over 100 practice and policy professionals. To finish this blog post, Kira shares her thoughts on contributing to this project as a Lived Experience Research Advisor and what she thinks is needed to support young people whose parents use substances:

“It has been an absolute honour to be involved as part of this project. To use my ‘negative’ life experience and be able to turn it into a positive impact for other children like me in the future: to help speak for those who feel they don’t have a voice and aren’t seen by people around them in the position they are in. The main part of supporting young children is accessing them and communicating with them. Reaching out to young people in general about parental substance use issues, getting the knowledge out there about it is important. This in turn will help the young people experiencing parental substance use, as the subject isn’t so hidden anymore as it usually feels hidden in the home. And through that we must back up with access to different support links. Some children aren’t ready, some don’t want help, some we won’t reach, but to push and be as present for as many children as possible, as long as possible and to reduce the isolation of the stigma around it is vital.”

Find out more about this research in the first Public Health Research and Me Fuse Podcast: How can we promote resilience in children and young people affected by parental substance use?

Links:

• Cassey’s first PhD Journal Publication reviewing the existing literature around children and young peoples' experiences of parental substance use.
• Cassey’s book chapter exploring stigma experienced by young people, which they may feel about their parent’s substance use.
• Fuse/Adfam Research Event recording with young people’s perspectives.
• PROPS Young Person’s Project.
• Adfam

Image credits:

1. Photo by Polina Zimmerman from Pexels: https://www.pexels.com/photo/young-woman-talking-with-therapist-3958461/
2. PROPS Family Recovery Service logo. Copyright © 2022 - All Right Reserved - PROPS North East: https://props.org.uk/

How can we give our communities the Best Start in Life?

Posted by Liam Spencer, ARC North East & North Cumbria Mental Health Fellow, Newcastle University

Having had a background in youth and community work within a local authority, the question contained in the title of this blog is one close to my heart.

It is also the name that South Tyneside Council gave to one of their projects - the Best Start in Life (BSIL) Alliance - which really struck a chord with me, especially as my research interests focus on children and young people’s mental health.

I first learned about the project back in May 2019, when I attended an AskFuse brokering event for the Public Health Practice Evaluation Scheme (PHPES) of the NIHR School for Public Health Research. At this event Anna Christie, the Public Health Knowledge and Intelligence Lead for South Tyneside Council, presented on the BSIL Alliance, focussing on three initiatives: Locality Hubs; Mental Health Champions; and Young Health Ambassadors.

This was the beginning of a partnership between Fuse researchers and South Tyneside Council, and after successfully being shortlisted and then submitting a full-length application, in October 2019 we were delighted to learn that our proposal had been accepted – out of 91 registrations of interest for the 2019 PHPES funding call, ours was one of only 10 proposals that were successfully funded!

Best-laid plans

By the time the project started in April 2020, we were living in very different times to when we planned the evaluation, due to the Covid-19 pandemic.

We had hoped as researchers to be embedded within South Tyneside Council; this was not possible.

We had planned to include the Locality Hubs within our evaluation; these were not able to be launched.

Routine data we had planned to include in a cost consequence analysis (a form of economic evaluation where separate costs and a range of outcomes are presented to allow readers to form their own opinion on the relevance and relative importance of interventions) were either not collected or were severely impacted.

Moving from Plan A, to Plan B, to Plan C is commonplace in research, however, throw a global pandemic into the mix and you can find yourself quickly wheeling through all the letters of the alphabet whilst trying to stick to the original plan for your research! Despite the hurdles we had to overcome – the dedication and commitment from our colleagues at South Tyneside Council, and the Fuse team endured, and we were all determined to deliver on the project.

Insightful discussions at the Fuse Research Event in South Tyneside

Fast-forward to the present day and we have completed our evaluation. Thankfully, only being able to meet virtually is a thing of the past and on Wednesday 12 October we were joined by practitioners from local authority and third sector organisations, researchers, and students from across the region, for a Fuse Research Event at The Customs House in South Shields, to finally share learning from our evaluation! The event included academic contributions from myself, Ruth McGovern (study lead), and Sam Redgate, along with Anna Christie, Tom Hall (Director of Public Health), and Chrissy Hardy (Public Health Practitioner, Children & Young People) from South Tyneside Council.

Supporting young people’s mental health

Our findings showed that the successful implementation of Alliances in public health and social care related services within Local Government is dependent upon achieving a system level approach, whereby thinking, methods, and practice are applied to better understand public health challenges and identify collective actions across services. Placing local people at the heart of the system, and creating a cultural shift is also key to a successful Alliancing approach. Mental Health Champions and Young Health Ambassadors were found to influence system change by generating mental health awareness and facilitating more inclusive and supportive environments for children and young people.

As well as sharing findings from the evaluation, we wanted this in-person event to be interactive and collaborative, and asked those who attended to think about the similarities and differences between the Mental Health Champion and Young Health Ambassador initiatives. I thought it was really interesting that people recognised that these initiatives share a similar ethos, with commonality of goals and outcomes – to support young people’s mental health, in both proactive and reactive ways. Attendees felt it was important that both approaches are organic, with ideas emerging ‘from the bottom-up’. Volunteers can utilise the Alliance in a productive way, by accessing training and events, and securing buy-in from senior stakeholders, with support from Chrissy, the facilitator of both initiatives. I was so grateful for all the meaningful and insightful contributions provided, which are proving to be very useful in guiding the write-up of our findings – ensuring that they are as relevant to practice as possible.

We are very thankful to our colleagues at South Tyneside Council for collaborating with us on this project (despite the barriers we faced along the way!) – and we really hope that the findings from this work will help shape their future policies and practices. Personally, this evaluation provided me with an opportunity to learn more about current local initiatives, engage with passionate practitioners and young people, and build some really fantastic relationships with colleagues at South Tyneside Council. I thought that the event was a wonderful way to bring people together from across the region, to share our findings, and to draw the project to the close. A big thanks to the Fuse team for making it happen!

Find out more:

 

Paper: A realist approach to understanding alliancing within Local Government public health and social care service provision (In Press)

Fuse: Evaluating the Best Start in Life Alliance

NIHR SPHR: South Tyneside Best Start in Life Alliance / Public Health Practice Evaluation Scheme (PHPES)

My passion for research comes from always asking "why?"

Posted by Pascal Landindome Navelle, FRSPH, Public Health Research Operations Officer and Doctor of Public Health Student at Teesside University.

In today's Fuse blog, Pascal gives his top tips for anyone starting out in research, and shares his own experience which began working with Fuse and Teesside University.

His advice? A passion for the "why?" question and accessing the right mentorship.

As part of the NIHR ‘Your Path In Research’ campaign.

 

After working as a clinician for several years, I felt that my impact on service users was limited. So, upon a thorough reflection, I was inspired to progress into public health research, where I felt I would have a broader impact on society.

Research work is fascinating as it provides a clear pathway to contributing to advancing the knowledge of the disciplinary sector to which I am dedicated. The importance of research should go beyond conceiving theoretical works that would only find a physical location in a library. Research should be "living", circulating, interacting, multidisciplinary, and impacting the environment.

What I enjoy about research is that it allows me to pursue my interests, learn something new, hone my problem-solving skills and challenge myself in several unique ways. Working on a faculty-initiated research project enables me to work closely with a mentor–a faculty member, and other experienced researchers. With a self-initiated public health research project, I can leave the community with a service that represents the distillation of my interests and studies and, possibly, a real contribution to knowledge.

There are many training and support systems that I have found valuable during my career. Researchers usually embark on increasingly diverse careers, where collaboration, networking and interdisciplinarity have become more important. Critical reading, academic writing and critical analysis are valuable training and support required of a researcher. Transferable skills, such as effective communication and problem-solving abilities, have helped me operate more effectively in different work environments.

Starting a research career can be daunting but exciting! The challenge of getting the support needed to achieve my dream came true when I enrolled at Teesside University for a research degree. This began by getting involved with AskFuse (Fuse’s responsive research and evaluation service) and with Associate Professor Dr Peter van der Graaf, working on an enquiry to evaluate Northumbria NHS Foundation Trust’s staff health and wellbeing resources during the pandemic, as part of my PhD research. This then led to working on the South Tees Arts Project (STAR) with Peter, a pilot study to co-produce wellbeing measures with primary school children, their parents, teachers, and artists for a school-based dance intervention. I supported the data collection, analysis and report writing for the STAR project as a Research Assistant and even wrote a song for the engagement activities with children in the research!

I had the opportunity of getting mentorship and some academic resources to enhance my knowledge. I connected and contacted very experienced researchers in the field of public health who supported my interest in growing as a research professional. Through the people I’ve met, I have had the opportunity to work on exciting but substantial research projects that have had a massive impact on the public health community.

My top three tips for somebody starting out in research are:

1. First and foremost, you should be motivated, passionate, and curious about your research topic – do it for science, not tenure! No one ever became a successful scientist with the sole premise of being awarded the Nobel Prize. And remember that plans rarely work out the way you thought they would.
2. Be prepared for a challenging career. Research is ever-changing. Be prepared for the change that research comes with strengthening your problem-solving skills to enhance the fun aspect of research. Problem-solving skills refer to handling difficult situations and overcoming complex challenges. They involve breaking a problem down into its parts, thinking critically about each element, analysing the information you find and using that information to form an effective solution. Having strong problem-solving skills will help make you an asset in your research practice and help you advance your research career.
3. Finally, be proactive, network and connect more with like-minded professionals. Sometimes, the key to getting to places is not what you know but who you know. We can learn a lot from talking to peers and senior colleagues. Attending symposiums, seminars and conferences is a great way to meet people who share common interests with you but have different experiences.

The NIHR has supported my career development through the provision of training, access to leadership development opportunities, networking events, mentoring and guidance on research funding.

The NIHR launched the Your Path In Research campaign this week. Better research leads to better services for the public. That’s why the NIHR want to encourage organisations and social care and public health professionals to play an active role in research, as a way to deliver even better services.

The Your Path in Research campaign highlights how people can make research part of their careers. Some amazing researchers have shared their experiences, how they started in research and what advice they can give to researchers that are considering adding research to their careers.

Take your first step in research today.

Stigma: Where’s the Harm?

Posted by Dr Michelle Addison, Assistant Professor, Durham University

Stigma is a knotty, ugly problem we have in society: it marks out (often painfully) what is considered shameful, abject or contra to social norms, and impacts vulnerable and marginalised people the most. It seems intuitive to say it is unfair and unjust, but why then does it persist? 

Discussions of stigma are not new; we are all generally aware that stigma is something to be avoided and we could all very likely give some examples of it in action – benefit claimants, people who use drugs and ex-offenders are often easy targets and regularly feature in news headlines because stigma continues to be sensational – it elicits a voyeuristic feeling that is both intoxicating and a warning to us too. The use of stigma is further exacerbated by the ‘Cost of Living Crisis’, ‘Rising Interest Rates’, Fuel and Food poverty, and the withholding of the Government White Paper on Health Inequalities. We understand then that stigma is harmful, and yet we recognise it is powerful to those who can wield it.  

Erving Goffman discussed stigma using the concept of the ‘spoiled identity’ whereby certain aspects of who you are become discredited and devalued in his now infamous work Stigma: Notes on the Management of Spoiled Identity (1963/1990). This notion of a spoiled identity is also implicit in his observations of patients residing in ‘asylums’, the conditions impacting these people, and the roles of those working there (1961). Indeed, Goffman was acutely interested in the medicalisation and performance of roles in these settings and how behaviour was shaped by social expectations of ‘in-mates’, ‘guards’ and ‘medical staff’. The treatment of patients, he noted, was complexly bound up with expectations of socially acceptable roles and the reinforcement of discredited behaviours and identity.

What we learnt from this is that stigma matters in the social organisation and hierarchies of people and places in medicalised and wider social settings. But what tends to fly under the radar in early stigma research is the question of ‘in whose interests’ does stigma serve?  Professor Imogen Tyler later critiques Goffman’s work (2020) in her book ‘Stigma: The Machinery of Inequality’ for overlooking the power relations that are integral to how we understand stigma, and why indeed, stigma continues to persist. Tyler shows us that there is a ‘craft’ to how mechanisms of stigma operate and function to maintain political power and a social order that hinges on systemic and structural inequalities around class, race, gender (and not limited to) to reproduce privilege for the dominant factions. This is a hugely important step in stigma research because it draws attention upstream to how and why stigma is weaponised (Scambler, 2018) and the social harms that impact marginalised and minoritised individuals and communities in society – which is the subject of my forthcoming article (Addison, 2023). This is further evident in the recent Stigma Kills (2021, 2022) campaign launched by the NHS Addictions Provider-Alliance which gives credence in particular to the impact that stigma has on the health and wellbeing of those communities that are most harmed through health and social inequality.

THREAD: (1/3)

Stigma Kills. But it shouldn't have to be this way.

Introducing our new #StigmaKills campaign. https://t.co/wgVnROwb5P pic.twitter.com/Rc35eCxo1M

— NHS Addictions Provider Alliance (@NHS_APA) February 8, 2022

This growing concern about the effects of stigma on health and wellbeing, arising out of social harm, led to our recent Fuse event Inequalities, Social Harm and Weaponised Stigma: Emerging Research and future priorities which brought together academics, practitioners and the public to discuss these key issues. I presented work from my Wellcome Trust research looking at stigma and how this relates to health inequalities amongst people who use drugs. In this study I highlight how the weaponisation of stigma is harmful, negatively impacts physical and mental health, and inhibits health seeking behaviours for fear of being judged and marginalised by service providers and the wider public.

Joanne McGrath discussed her NIHR funded research into women living with multiple disadvantage and complex needs and how they access services. In this talk she highlighted how escalating problems around homelessness, stigma and deteriorating physical and mental health have a cumulative impact in women’s lives.

Our ‘expert by experience’, Margaret Ogden, shared moving insights into the effects of stigma on her own life and how her mental health was harmed as a result.

Later, Mark Adley discussed his Doctoral work (which is funded by the NIHR Applied Research Collaboration (ARC) North East and North Cumbria (NENC)) and his recently published paper which explores stigma within-groups towards people who use the drug Spice. In this talk, Mark showed how intersections of identity mattered and how increased contact with people who used Spice helped to reduce levels of stigma. He highlighted the role of education programmes within service provision to help draw attention to the harms arising out of stigma and how practitioners might mitigate these effects.

This event was also an opportunity to launch our new Palgrave edited collection Drugs, Identity and Stigma (Addison, McGovern and McGovern, 2022). Our book calls attention to the impact of stigma experienced by people who use illicit drugs, and through this we show that stigma is powerful: it can do untold harm to a person and place with longstanding effects. Through an exploration of themes of inequality, power, and feeling ‘out of place’ in neoliberal times, this collection focuses on how stigma is negotiated, resisted and absorbed by people who use drugs. Dr Kelly Stockdale, a contributor to the book, spoke at our Fuse event and shared insights from our research into the challenges of navigating a custodial environments (prison and police) and the impacts of stigma from the point of view of people who use novel psychoactive substances (NPS). Collectively, our work in this area brings together a range of frameworks and data and draws attention to the damaging effects stigma can have on health inequalities, recovery, mental health, recidivism, and social inclusion.

Our knowledge and understanding of the harms that stigma does to health and wellbeing is still growing – as such, it is critical that developing stigma research becomes a priority in future inequalities research agendas, against a backdrop of political and economic crises. Whilst the social determinants of health are often tangible and measurable, providing the much-needed evidence base to tackle widening health inequalities, it is imperative that we think differently and critically about how stigma operates. In my own research I have tried to show that stigma operates at a symbolic level meaning it is not possible to treat stigma as something which is material and objective, to say ‘here is stigma’ – we must think more deeply about stigma as inscribed with meaning that becomes apparent through its effect on and between people (see also Addison, McGovern and McGovern, 2022).

I called this blog ‘Stigma: Where’s the harm?’ to be a little provocative to you, reader – on the one hand, stigma is so normalised in our society that we forget to see it, so I encourage you to pause and reflect on where the harm resides – like a million little paper cuts, stigma is painful and gets under the skin doing very real harm. On the other hand, my question is also a call to action to understand how and why stigma is weaponised, and how it leads to social harm amongst under-heard and underserved people. It is my strong belief that this is vital work if we are to tackle and reduce widening health and social inequalities right now.  

 

References:

Addison, M. (forthcoming, March 2023) ‘Framing Stigma as an Avoidable Social Harm that Widens Inequality’ in Emery, J., Powell, R., and Crookes, L. (eds.) The Sociological Review Special Issue

ADDISON, M., MCGOVERN, W. & MCGOVERN, R. E. (eds.) (2022) Drugs, Identity and Stigma, Houndsmill, Basingstoke and Hampshire, Palgrave Macmillan.

ADLEY, M., ATKINSON, A. M. & SUMNALL, H. R. (2022). Including the multiply excluded: a mixed methods study exploring intragroup stigma towards people who use synthetic cannabinoid receptor agonists. Drugs: Education, Prevention and Policy. DOI: 10.1080/09687637.2022.2025766

GOFFMAN, E. (1990) Stigma: Notes on theManagement of Spoiled Identity, London, Penguin Books

GOFFMAN, E. (1961) Asylums: Essays on the Condition of the Social Situation of Mental Patients and Other Inmates, London, Penguin Books

SCAMBLER, G. (2018). ‘Heaping blame of shame: 'Weaponising stigma' for neoliberal times’. The Sociological Review Monograph, 66, 766 - 782.

SINGH, S. (2019) available at: https://samiasingh.com/

TYLER, I. (2020). Stigma, The Machinery of Inequality, London, Zed Books.

Images:

1) Artwork by Samia Singh, https://samiasingh.com @samiasingh_art

2) Book: Drugs, Identity and Stigma, © 2022 Springer Nature Switzerland AG. Part of Springer Nature, ISBN : 978-3-030-98285-0, https://link.springer.com/book/10.1007/978-3-030-98286-7#about-this-book

Media representations of disabled people

Posted by Laura Navin, Health and Social Care student, Northumbria University

Picture by Laura Navin

Negative media representations of disabled people still exist in society and this needs to be addressed. I have dyspraxia which is a learning difficulty, and I sometimes struggle with my co-ordination, communication, processing and speed but it has not stopped me from achieving my goals!

In the media, disability tends to be portrayed through a medical or deficit model, with disabled people often treated as pathetic.^1,2,3 TV charity shows such as Children in Need encourage pity for disabled people² and people with disabilities are still seen as “the heavy burden of care”; “the helpless victim”.³ Yet even when well-meaning, encouraging pity is discriminatory as it creates stereotypical and negative assumptions about disabled people². These negative representations can decrease a disabled person’s self-esteem and make them feel like they are not part of society.^1,4

The issue is heightened by the absence of disabled people and their voices within mainstream media which might help to reclaim the narrative and counter negative stereotypes. As Caroline Casey, founder of The Valuable 500, a global movement putting disability on the business leadership agenda, has suggested “from daytime TV to adverts on social media, to the articles which publications run, representation and visibility of persons with disabilities simply does not reflect our society”. This was brought to light recently for example, when Sia’s decision to cast a neurotypical actress in the role of an autistic female protagonist in her upcoming film was widely criticised.

There are more positive portrayals of disability in the media however. Harry Potter star, Daniel Radcliffe has dyspraxia and acted as an inspiration to many when saying, “do not let it stop you. It has never held me back.”. In 2018, Lee Ridley from the North East won Britain’s Got Talent and in 2021, EastEnders star Rose Ayling-Ellis became the first deaf contestant on Strictly Come Dancing. Even these more positive representations are emblematic of the failure to represent disabled people as everyday, ordinary citizens however. As Lee Ridley claims, “Our government has a very weird relationship with disabled people. We are either seen as superhuman or as some sort of burden”.

Portrayals of disabled people as a burden on society have been shown throughout both austerity and the Coronavirus pandemic. Disabled people have been mocked as ‘scroungers’ in television shows and newspapers, with arguments that incapacity benefit had become a ‘lifestyle choice’ for the lazy, and that a disability benefit crisis was responsible for the UK economic crash resulting in the disproportionate targeting of disabled people within austerity measures.^5,6 Covid has been argued to be one of the biggest media outbreaks medicalising disabled people.^1,7 During the pandemic, disabled people were seen as ‘vulnerable’ and had to isolate from society.^5,8 ‘Vulnerable’ is a label that is often rejected by people with disabilities and its adoption does not portray the importance of disabled people’s rights and viewpoints.⁹ Labels such as ‘vulnerable’ or ‘immunocompromised’ when used to explain differential susceptibility to illness have also been argued to result in an unreasonable, unpleasant message about the value of disabled people’s lives. The sunflower lanyard which could be worn by disabled people to show they were exempt from wearing face masks helped in some ways to increase disability awareness and create more understanding, support and respect towards disabled people. However, this is another form of labelling, and not all disabled people want to identify their disability to the world. Greater understanding and training on disability ethics is urgently needed to avoid this sort of discrimination and support disabled rights more systemically.^9,10

 

It is also important that disabled voices are heard in society and that the media represents disabled people in a more positive light. Sometimes when I tell people about my dyspraxia they feel pity for me, but this is not what I want. I am telling my story to inspire others, not create sympathy, so please do not feel sad for me, feel happy for me! I have succeeded in my academic studies and graduated from university with second-class honours as a student with dyspraxia. I have been involved in podcasts and dissertation writing to raise my voice as a disabled person and in doing so I hope to give others the confidence to do the same. I am now studying for a postgraduate certificate in education (PGCE) to teach health and social care. I hope to continue to raise my voice and to inspire others.

Part of our Fuse blog Student Series

The Fuse blog Student Series showcases posts by students who have been challenged to write a blog as part of their studies at one of the universities in the Fuse collaboration, the NIHR School for Public Health Research, or perhaps further afield. The authors may be new to blogging and we hope to provide a 'safe space' for the students to explore their subject and find their voice in the world of public health research.

The views and opinions expressed by the author are those of the author and do not necessarily reflect those of Northumbria University or Fuse, the Centre for Translational Research in Public Health.

References

1) Cameron, C. (2014) Disability Studies: A student’s guide. London: SAGE Publications Ltd.

2) Barnes, C. (1992) Disabling imagery and the media: an exploration of the principles for media representations of disabled people. Halifax, England: The British Council of Organisations and Disabled People and Ryburn Publishing Limited.

3) Goethals, T. et al. (2020) ‘I am not your metaphor: frames and counter-frames in the representation of disability’, Disability & Society, 12 (1), pp.1-19. DOI: https://doi.org/10.1080/09687599.2020.1836478.

4) Casey, C. (2020) ‘Where all the disabled people on screen? We must increase representation or risk reinforcing damaging stereotypes’, Independent, 1 December. Available at: Where are all the disabled people on screen? We must increase representation or risk reinforcing damaging stereotypes | The Independent (Accessed: 22 March 2022).

5) Ryan, F. (2019) Crippled: austerity and the demonization of disabled people. London: Verso.

6) Briant, E. et al. (2013) ‘Reporting disability in the age of austerity: the changing face of media representation of disability and disabled people in the United Kingdom and the creation of new ‘folk devils’, Disability & Society, 28 (6), pp.874-889. DOI: 10.1080/09687599.2013.813837.

7) Shakespeare, T. et al. (2021) ‘Triple jeopardy: disabled people and the COVID-19 pandemic’, The Lancet, 397(10282), pp.1331-1333. DOI: https://doi.org/10.1016/S0140-6736(21)00625-5.

8) Courtenay, K. and Perera, B. (2020) ‘COVID-19 and people with intellectual disability: impacts of a pandemic’, Irish Journal of Psychological Medicine, 37, pp.231-236. DOI: 10.1017/ipm.2020.45.

9) Singh, S. (2020) ‘Disability ethics in the coronavirus crisis’, Journal of Family Medicine and Primary Care, 9 (5), pp.2167-2171. DOI: 10.4103/jfmpc.jfmpc_588_20.

10) McLean, S. and Williamson, L. (2007) Impairment and disability: Law and ethics at the beginning and end of life. Oxon: Routledge-Cavendish.

Going beyond research to empower involvement and smash stereotypes

Posted by Sheena Ramsay, Professor of Public Health & Epidemiology, (and team: Emma Joyes, Emma Adams, Laura McGowan) in collaboration with Fulfilling Lives Newcastle Gateshead Experts by Experience

The way researchers approach some groups is often not sensitive to or inclusive of their needs. For example, the information can use technical language (such as ‘licit substances’ or ‘quasi-experimental’) which can be difficult to understand and off-putting. This can lead to people not wanting to take part in studies. Which means that new research insights, including changes to practice, can exclude those who are often most impacted.

Over the last two years, we have been working with Fulfilling Lives Newcastle Gateshead and their Experts by Experience Network of individuals with lived experience of multiple disadvantage. We have explored perceptions of services and programmes relating to oral health and related health behaviours - such as substance use, smoking, and diet - for people who experience severe and multiple disadvantage (a combination of homelessness, substance misuse, and offending). From the beginning, the Experts by Experience Network has shaped our work and helped us ensure it is accessible to those we want to speak to the most.

One of the ways that the Network has shaped our research is by helping us to create a video to help reach out to potential participants for our research - particularly people who are often excluded in research studies, such as people experiencing homeless.

Our team worked with the Experts by Experience Network to look at ways to get people involved in the research. We wanted to work with those who had insights into the issues we hoped to study, so that we could communicate the research in a way that would resonate with people. Together, we co-created an animated video as a means of reaching out to people, so they could find out about the research and how to take part.

The infographics in this blog show what we have learnt from this process of co-creating the video and the value of co-production.

Creating a video provided an easy way in which organisations (such as Crisis, Fulfilling Lives, and other providers) and local Expert by Experience networks could share information about the study.

Those involved in creating the video were able to draw upon their experiences to help shape the content. One of the members of the group shared their experience of the process:

“Some of us in the Network feel really strongly about this issue and have personal experience of it ourselves so we were keen to be involved and share our ideas and opinions.”

Another member said:

“I joined this project because my own oral health has been something I've been embarrassed about in the past so I thought I could add something useful to this work.”

We have tried to map out how we designed our video in the image below.

The video has also been shared nationally with a wide range of organisations that support severe and multiple disadvantage groups in Newcastle and Gateshead, London, and Plymouth to promote engagement with policy and commissioners, local authority, criminal justice system, primary care, and third sector organisations. Producing a video was no easy feat, but it was a simple way of sharing our research with people who are pressed for time. You can check out the video below.

 

A clear benefit of engaging with people with lived experience was having their input on how best to communicate our research widely. They provided real-life stories and examples, which helped create the narrative for the video. They helped challenge stereotypes of ways in which people can be portrayed in research studies - this resulted in modifying the images and language used in the video which were much more realistic and sensitive to the people we were wanting to engage. This has helped our research team become more aware of and appreciate the importance of stereotyping and how it can result in putting people off taking part in research.

The benefits reached beyond the research team and the video (the below infographic highlights some of these), as many of the Experts by Experience echoed how involvement has led to them feeling empowered and one member wrote a blog about their experience.

We plan to build on this collaboration as we continue our research and gain further input on findings from our study and next steps.


This study ‘Improving the oral health and related health behaviours of adults experiencing severe and multiple disadvantage: evidence synthesis and qualitative stakeholder research’ is funded by the NIHR Policy Research Programme (grant reference NIHR200415). The video was supported by Newcastle University Engage FMS. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

Levelling Up: welcome news or overly ambitious and unrealistic?

Posted by Chloe Beck, Health and Social Care student, Northumbria University

Before his resignation, Boris Johnson unveiled his flagship ‘Levelling Up’ plan. Hailed as the ‘defining mission’ of his Government, this new plan strives to transform the United Kingdom by increasing opportunities and prospects for the whole population. It aims to shift Government focus onto the so-called ‘forgotten communities’ of Great Britain, through a decade long project consisting of twelve missions that have been given status within UK law. Although changes are now afoot in the Government, both candidates to replace Johnson - Liz Truss and Rishi Sunak - have stated their continued commitment to the policy. It seems therefore, that levelling up is here to stay (for a bit longer at least). But what might this mean for inequality in the UK and are its goals likely to be reached?

Rishi Sunak visiting Yarm in North East England, December 2021

As might be expected with such a bold promise, the Levelling Up plan has been both welcomed, and branded as overly ambitious (Wood and Swift, 2022). Some see the policy as a serious attempt at understanding and reacting to the regional inequalities that exist within the United Kingdom (HM Government, 2022; Wood and Swift, 2022). Supporters view the policy as a sensible plan, with missions that are collective and recognise the links between health, skills, education and the economy (Wood and Swift, 2022). It’s certainly clear that Levelling Up promises some huge and much needed changes to healthcare services and for the population within the UK (including upgrades to hospitals, increased GP appointments, new fruit and vegetable prescriptions to help tackle food insecurity, changes to the school curriculum to support healthy eating, and community hubs to tackle diagnostic backlogs). Whether these changes are do-able in the context of continued staff shortages and already under-funded health services remains to be seen.

The Labour party has described Levelling Up as a rehash of recycled policies (Harari et al., 2022), with others stating that it is too aspirational and impractical (Pope, 2022). It is argued that the policies breadth and scope may make it hard for the Government to maintain focus and could create a scattered approach (Newman et al., 2022; Pope, 2022; Wood and Swift, 2022).

One of the major problems appears to be a lack of long-term funding into the whole Levelling Up plan, with funds only extending to 2030 (Swinney, 2022). Levelling up may not be fully achieved if funds dwindle once 2030 comes around. Calls for Government to extend Levelling Up plans beyond 2030 (Swinney, 2022), to ensure its longevity and successfulness are unlikely to be met, especially in a political environment where short-termism is the norm and where the maximum term of a Parliament is five years (Marsh, 2013). Likewise, critics suggest that an agreement needs to be made between political parties to ensure Levelling Up is not scrapped once a new Government comes into power (Davenport and Zaranko, 2020; Swinney, 2022).

Even despite levelling up actions, differences in productivity between areas within the United Kingdom will likely remain (Atherton and Webb, 2022). This is because different places have different roles within the economy, with London being top of the chart for professional services, and Wales for the manufacturing sector for example (Sykes and Lisle, 2021). Setting area specific goals and targets (Atherton and Webb 2022), and implementing types of spending (Mason 2022) which take into account the specific demographics and economy of an area may help to combat this issue. Though, of course, this local variation may pose alternative challenges due to mixed ideologies and inconsistency with ideas laid out in the original white paper.

Setting aside concerns about feasibility, it has also been found that many disadvantaged areas are not prioritised within the plan (Atherton and Webb, 2022). This demonstrates a lack of attention and care towards the very thing that the plan is aiming to fix: inequalities! Data journalists at The Guardian found that some of the most deprived localities are receiving far less financial support than some of the most affluent areas, with Bromsgrove in Worcestershire receiving £148 per person and Knowsley in Merseyside receiving no money per person for example. This chimes with Rishi Sunak’s comments about redirecting funding away from disadvantaged areas and towards wealthier towns.

Overall, the new Levelling Up plan has both its positives and negatives. It is a clear start at aiming to try and reduce longstanding inequalities within the United Kingdom. However, the extent to which these policies will be followed as they have been set out is unclear, and only time will tell whether it manages to achieve its missions and ‘level up’ the country.

The cynic in me thinks that this push for equity may also have something to do with attracting votes...

Part of our Fuse blog Student Series

The Fuse blog Student Series showcases posts by students who have been challenged to write a blog as part of their studies at one of the universities in the Fuse collaboration, the NIHR School for Public Health Research, or perhaps further afield. The authors may be new to blogging and we hope to provide a 'safe space' for the students to explore their subject and find their voice in the world of public health research.

The views and opinions expressed by the author are those of the author and do not necessarily reflect those of Northumbria University or Fuse, the Centre for Translational Research in Public Health.

Image: HM Treasury, OGL 3, via Wikimedia Commons

What impact did a blanket ban on new takeaways have in Gateshead?

Posted by Heather Brown, Professor of Health Inequalities at Lancaster University

At the end of a road I used to live on, there was a wonderful curry house that always smelled amazing every time you walked by, even if it was 8am in the morning and they were just starting to prepare the food for the day. Whilst I lived there, I ate more takeaway curries then I have in any of my other many houses which were not so conveniently located to delicious smelling food.

The food available to us in our environment is likely to influence what we eat and subsequently our health. The use of planning policy can be one way for both local and national government to help shape a healthy environment by limiting or restricting where certain types of food outlets can be located. About half of all local authorities in England have some type of planning guidelines to restrict new fast-food outlets. In England there are three main types of planning policy used to promote a healthy food environment:

1. restricting new fast-food outlets near schools.

2. restricting new fast-food outlets if the density of existing outlets has surpassed a certain threshold of all retail outlets (e.g. no more than 20% of all outlets can be fast-food).

3. restricting new fast-food outlets if childhood obesity rates are above a certain threshold (e.g. above 20% based upon data from National Childhood Measurement Programme for children aged 4-5 and 10-11).

What Gateshead did

Gateshead Council, like many local authorities in North East England, has childhood overweight and obesity rates that are higher than the national average. To try and reduce childhood overweight and obesity to less than 10% by 2025, Gateshead implemented all three types of planning guidance (a school exclusion zone, restricting new outlets by retail density, and restricting new outlets by childhood obesity rates). This is effectively a blanket ban on establishing a new premise for use as a fast-food outlet if the building was not already being used for that purpose. Buildings that were being used for fast-food could change ownership and continue to sell fast-food. This guidance was implemented in June 2015.

As part of an NIHR Applied Research Collaboration (ARC) North East and North Cumbria (NENC) funded project, we evaluated if Gateshead Council’s approach to planning had any significant impact on the density and proportion of fast-food outlets in Gateshead compared to other local authorities in the North East which did not have any type of planning guidance. Data on food outlets came from the Food Standards Agency Food Hygiene Rating Scheme Data. Our analysis covered 2012-2019 (we did not include data during the Covid-19 pandemic because planning guidance on what type of food outlets could provide takeaways was relaxed) - a subject covered earlier this week in the Fuse blog post How Covid-19 changed the takeaway landscape by Callum Bradford from Teesside University.

What we found

We found that compared to other local authorities in the North East, Gateshead’s planning policy reduced the density of fast-food outlets by around 13 per 100,000 people and the proportion of fast-food outlets by around 14%.

Next, we are going to look at if this change in the density and proportion of fast-food outlets has had any impact on childhood overweight and obesity between 2015 to 2019 and if this did anything to reduce inequalities in childhood weight.

If you would like to read our paper in Social Science and Medicine on the impact of Gateshead’s planning policy on the food environment you can find it here.

The NIHR ARC NENC has also summarised the research here: Putting the brakes on fast food – evaluating the use of planning policy to support public health.

How Covid-19 changed the takeaway landscape

Posted by Callum Bradford, Research Associate, Teesside University

During the Covid pandemic, you may have seen the memes for how there are two types of people during lockdown. First there were those who used lockdown as an excuse to exercise more, eat well, and generally take care of themselves in a manner of which they had never had the time for previously. Then there were those who out of sheer boredom, decided to drink and order takeaway on more days than not as it was ‘something to do’.

As you can probably guess, I very much fell into the second category.

To my detriment, takeaways typically sell food which is relatively cheap, high in calories, low in nutritional value, and (annoyingly) very appetising; all delivered to your front door in a matter of minutes. Now I don’t want to come across as anti-takeaway, or anti-business, there is a place in our society for unhealthy food, nor do I blame anyone else for my questionable dietary choices. However, I’m sure most of us agree that we can have too much of a good thing at the impairment of not only our own health, but also the health of the high-street.

Apparently I’m not the only one who is too easily tempted by takeaways, with local governments implementing planning regulations to further prevent this takeover-of-takeaways, in the knowledge that our willpower is often lacking. You’re likely familiar with some of the rules already in place, such as no takeaways within 200m of a school, or that most restaurants and pubs can only provide takeaway food on an ‘ancillary’ basis.

However, with the Covid-19 lockdowns pubs and restaurants lost their ability to trade. In an attempt to combat the potential loss of business, the government introduced new temporary measures allowing these businesses to trade as takeaways, without needing to apply for planning permission. In other words, my options for takeaway just increased threefold, and by ordering-in I was ‘doing my bit’ to keep businesses open.

As we were now stuck indoors, every occasion was now an excuse for a takeaway; Birthday? Takeaway. Passed Uni? Takeaway. Anniversary? Slightly fancier takeaway with cocktails (highly recommend).

With these temporary regulations in mind, we consulted with various planners, public health leads, and environmental health officers from across the North East, to better understand how these regulations were impacting their roles, alongside any public health trepidations they may have (if my diet alone wasn’t enough cause for concern).

The main theme throughout our conversations was an overwhelming sense of uncertainty. Covid had an unprecedented impact on the priorities of local authorities. Because of this, they could not organise the infrastructure needed to identify how many businesses were choosing to trade as takeaways. Even today as we slowly return to a sense of normality, the role of collecting this data appears to be unassigned as authorities play catch-up on work lost to Covid. Therefore, as you can imagine, gauging the impact of these regulations became very challenging and speculative. There was also uncertainty around how and when these regulations would end, or what elected members planned to do (if anything) about the potential long-term consequences to health.

Surprisingly, the main finding from our research had little to do with the regulations themselves, but rather how Covid has accelerated change in the takeaway landscape. During Covid, we all developed new habits (for better or worse); one of which was the use of online delivery services such as Deliveroo and Uber Eats.

Despite the temp Covid regulations now ending, with these delivery services, many businesses that could not originally offer takeaway now can, and local authorities have limited ability to prevent them from doing so since they aren’t technically providing the deliveries themselves. A quick search on Deliveroo in Middlesbrough for example offers me delivery for Burger King, Starbucks, and Creams Cafe. None of these options are well-known as takeaways, but all now provide the delivery of unhealthy food. And although these services were technically available pre-Covid, the pandemic has led to a huge increase in their popularity, allowing for more unhealthy-food options and the changing of shopping habits. There are also traffic implications. Have you ever tried to walk through Liverpool city centre during lunch hour? Attempting to dodge Deliveroo riders on their bikes as you stroll through town is quite the experience.

To summarise, the Covid pandemic had an unparalleled impact on public health professionals, to the extent that the government implementing new regulations regarding takeaways was considered low priority. Ambiguity surrounding the impact of these regulations remains, with the ending of the regulations becoming somewhat nullified given the rise of online delivery.

In conclusion I offer some advice. if you’re trying to eat healthier, writing a blog post on takeaways whilst doing ‘research’ on Deliveroo, might not be the wisest of ideas – speaking from experience.

Read the full paper: The impact of COVID-19 on the hot food takeaway planning regulatory environment: perspectives of local authority professionals in the North East of England

Part-time work can be a game changer for families and a smart strategy for organisations

Posted by Belinda Morgan, flexible work expert & author; Amelia Lake and Helen Moore, researchers from Fuse at Teesside University

Part-time work has the potential to change lives. Done well, it can drive hugely positive outcomes for individuals, families and society. But its potential isn’t widely understood, so part-time work still sits largely on the sidelines of organisational strategy – under-rated and under-utilised.

And even organisations who are leading the way with the accessibility and implementation of part-time work, are rarely doing it well at all levels. It’s still very uncommon to see senior leaders working part-time.

Amelia Lake, Fuse Associate Director, and Helen Moore, Fuse Associate, at Teesside University are bucking this trend. Both work in senior level roles in public health research, leading teams and both work part-time.

Amelia and Helen were two of the senior leaders I interviewed when writing my book Solving the Part-Time Puzzle: How to decrease your hours, increase your impact, and thrive in your part-time role. They shared their stories about how they make their part-time arrangements work, and the benefits they experience from working in this way.

Helen Moore (left) and Amelia Lake (right) both work part-time in public health research

Amelia said, “When I first started working at Teesside University, I would frequently get asked what was my ‘side hustle’ when I wasn’t at work and people were surprised to hear that I was doing family activities with my (then) young children. While I appreciate working part-time is a privilege, it allows me a better work-life balance and time with my children.

“During the pandemic, and post-pandemic, childcare has been difficult to access, and being part-time means some days of the week can be less stressful in terms of childcare. Working part-time means I work even more collaboratively with colleagues as their support when I am not at work is important. It can be hard to switch off emails and alerts on non-working days, and I don’t always do it, but I know it is important.”

Helen said, “It was, and is, important for me, as the primary carer of young children (I have two sets of twins) with a husband who works away in the Merchant Navy, to be able to have some flexibility around when and how I work. This supports me in being able to take them to, and pick them up from, school several days of the week, and to not have to rely all of the time on either family help (which can feel like an imposition) or paid childcare (which is both expensive and difficult to find when you have four children).”

So why is it so rare to see senior leaders working part-time? Largely because there’s an embedded belief that senior leadership roles are the most challenging to do part-time. Many people will tell you it’s impossible – and that it’s not even worth attempting.

Stories of leaders like Amelia and Helen are hugely important, because we badly need more senior leaders leading the way and working part-time. When senior leaders do so it demonstrates to others that part-time work is acceptable and encouraged, and that it’s possible to keep growing a career while working part-time.

The individual and family wellbeing benefits are quite clear, and should be reason enough for organisations to start creating more part-time work opportunities. But the reality is that more encouragement may be required.

The good news is that there are some other big reasons for organisations to get on board with this.

A clear and highly relevant advantage for employers is talent attraction and retention. In the context of the ‘great resignation’ of 2022 this is a critical consideration for organisations looking to find creative ways to solve the talent shortage.

Firstly, it allows employers to retain their talented people who reach a point where they want or need to work part-time.

In Amelia’s words, “We need to see more people in leadership roles working part-time. I was promoted to Professor in my part-time working pattern which illustrates that it is possible to do high quality impactful work building capacity and also doing research, while working part-time. Teesside University has both promoted me and supported me in my part-time role.”

It also enables employers to tap into a hidden talent pool of highly qualified people who either can’t or choose not to work full-time. They include people with caring responsibilities, people with health issues, and people at retirement age who would stay in the workforce longer if given the opportunity to work part-time.

Helen said, “I strongly believe that working part-time doesn’t equate to a reduction in performance, and that it is demonstrated by my promotion to Associate Professor and being one of two Teesside University Star Award Research Excellence finalists in 2021.

“Being supported by Teesside University to work part-time in a senior role enables me to both lead the work of the University’s successful Evaluation and Impact Team, and to be able to be present and care for my four children.

“Having managers who were willing to try something new, even take a risk, and recruit a person to work part-time hours to establish and lead a new team has paid off and worked well – it has enabled me to grow significantly as both a researcher and a research leader.

“Roles similar to mine which I have previously considered, have been strictly full-time hours only, and did not feel open to someone with other commitments like me. There are a lot of talented people who for various reasons would like to work less than full-time hours, and I’m hopeful that my experience shows it is possible.”

This is also, of course, about inclusion. The consulting firm Timewise warns that if a company’s diversity, equity and inclusion (DEI) programmes aren’t underpinned by a commitment to flexible working that includes part-time, they will struggle to be fully inclusive. 'This will not only have a negative impact on their gender pay gap, but is also likely to impact their employer brand'

As well as the talent related benefits, there are also productivity benefits to be reaped by organisations who are willing to introduce more part-time roles. Organisation for Economic Co-operation and Development (OECD) data confirms that productivity (defined as output per working hour) improves with shorter hours. Across the world’s richest countries, higher productivity correlates with lower working hours.

The power and potential of part-time work really is huge. It can be a game changer for families and a smart people strategy for organisations.

Belinda Morgan is a flexible work expert and author of the new book Solving the Part-Time Puzzle: How to decrease your hours, increase your impact, and thrive in your part-time role