Summary of the impact

Research by the University of Southampton's Work Futures Research Centre has contributed significantly to the design of management change processes and policies across a range of organizations in the UK and internationally. The Centre's research has informed a new training and qualifications framework and improved programme performance for healthcare workforces involved in digital innovation; led to new recommendations for sustainable workplace design to enhance employee well-being and productivity promoted by the British Council of Offices as part of their evidence base on office re-design; and influenced the development of organizational and professional guidelines for gender equality at work.

Underpinning research

The modern workplace is changing, driven by advances of globalisation, the proliferation of digital technologies, increasing worker mobility and challenges of sustainability. Spending cuts necessitate fundamental redesigns to public sector work and organizations, and longer term changes to the structure of the workforce are underway. Employees' expectations are shifting as the workforce becomes more diverse, and employers are struggling to adapt organisational cultures to changing gender, race and age profiles.

The University of Southampton's research into changing forms of work and organisation began in the late 1990s with studies by Susan Halford, Professor of Sociology, and Pauline Leonard, Professor of Sociology, into issues of gender and race in the workplace. In 2010, Halford and Leonard co-founded the Work Futures Research Centre (WFRC), a University Strategic Research Group. They provided evidence of sustained inequalities despite legislative and cultural change. Their 2001 book Gender, Power and Organizations [3.1], is a defining text in the field, adopted in countries from Brazil to Finland and Australia as a key teaching text and receiving 200 citations (Google Scholar).

Halford and Leonard's ESRC project (1997-2001) on gender, race and professional identities in the NHS established the importance of differentiation between hospitals in professional identities and work practices. Based on this, a 2003 report [3.2] found racism manifest in access to training and careers among UK graduates, highlighting the need for more transparency in selection processes. A 2006 book [3.3] drew on empirical research of doctors and nurses in the NHS to show how gendered organisational cultures impact on individuals' identities in their daily working lives.

More recently, Halford and Leonard turned to how the physical design of workplaces affects employee wellbeing and productivity. A study in 2008 funded by The British Council of Offices (BCO) explored the effect of office design on performance, productivity and practice in FTSE 100 companies and public sector organizations. Leonard found [3.4] workplace design has a significant bearing on individuals' motivation, working relationships and wellbeing, leading her to devise new models of consultation that can be replicated in other work environments. She discovered scepticism among employees towards environmental initiatives, which are often viewed as cost- cutting measures.

From 2007 to 2013 Halford carried out studies [3.5, 3.6] into how increasing digitisation of healthcare work impacts on the organization and delivery of services. Two projects funded by the RCN (2005, 2010) examined the impact telemedicine, electronic booking and large scale information systems have on the professional and organizational aspects of healthcare work; in particular for older workers. In two National Institute for Health Research (NIHR) projects (2008, 2011), Halford evaluated a new Computer Decision Support System (CDSS) for emergency and urgent care, intended to achieve workforce savings by enabling clerical staff to make clinical decisions and to rationalize and integrate services in line with Darzi recommendations. She also explored work, training and organizational practices required to implement CDSS. An evaluation of the NHS 111 service, to replace NHS Direct, found that the work required to make the system function effectively was considerable and varied significantly from place to place. This research demonstrated that innovations are not quick or cheap technical fixes to current funding constraints.

References to the research

Published Outputs

Research Funding

• 1997-01: Gendered Organisations, Gendered Identities? Contemporary Change in the NHS, ESRC, Halford and Leonard, £35,000.

• 2001-04: Workplace Transformation, (industry funded, details removed to preserve anonymity), Halford c. £5,000.

• 2005-08: Space, Power and Communication: the dynamics of convergent ICT in the Norwegian Health Care System, Norwegian Research Council 5.75million NOK (approx. £530,000). Halford (CI) with Aud Obstfelder (PI), Ann Therese Lotherington and Kari Dyb (Norwegian Centre for Telemedicine/NORUT Social Science Research).

• 2005-06: New Working Spaces and Motivation, University of Southampton, Leonard, £1,000.

• 2007-10: Office Space: Performance, Productivity and Practice British Council of Offices, Leonard. £15,000.

• 2008-10: Same Technology, Different Settings: workforce management, planning and training implications, Service Delivery Organization, NHS. Halford (CI), with Cathy Pope (PI), Val Lattimer, Carl May, Chris Salisbury, Jane Prichard and Wendy Hall (Universities of Southampton, Bristol and Newcastle), £397,000.

• 2010-14: Organizing the Third Sector, ESRC, Halford and Leonard, c. £300,000 (as part of the ESRC Third Sector Research Centre).

• 2010-13: Ageing healthcare workers and ICT: Making healthcare workplaces healthy for 50+, Norwegian Research Council c.7.8m NOK. Halford (CI) with Ann Therese Lotherington (PI), Aud Obstfelder, Gier Bye, Britt Kramvig and Natalia Kukarenko.

• 2011-13: The work, workforce, technology and organisational implications of the introduction of a single point of access for urgent (non-emergency) care in England, NIHR, Halford (CI) with Turnbull (PI), Pope, Prichard and May, £300,000.

Details of the impact

Our wider research impacts

Twenty years of influential research by the University of Southampton's Work Futures Research Centre have informed international public and practitioner understandings of managing and adapting to organisational change. The research has informed debate over the introduction of digital technologies to health services, challenging practices of workspace design management, providing the research evidence underpinning best-practice equality policies in the NHS and other professional contexts. Halford and Leonard have produced a number of high quality research outputs which have been widely cited in public and practitioner debates and influenced conceptual debate on the nature of a fair and vibrant society.

Digitized technologies at Work

A series of projects (RCN (Research Council Norway) & NIH) have explored the impact of digitization on the organization and delivery of healthcare. The research, which has been significant for policy makers, IT manufacturers, hospital managers and professional leaders, has revealed unanticipated outcomes of digital innovation, and suggested strategies for inclusive innovation, workforce training and management. The RCN research was conducted in close collaboration with those responsible for technological innovation, who used our findings to improve the implementation process. For example, Ann Britt Neilsen, leader for implementation of Electronic Patient Record (EPR) in nursing, University Hospital North Norway ``Your research has been very helpful ... it was `research in action' [and] it changed my understanding in the process, which made implications for my decisions". `The NIHR research evaluated the organisational implications of a new Computer Decision Support System - NHS Pathways (NHSP) - designed to enable clinical triage by non-clinicians. Southampton's research informed the Department of Health's strategy for national roll-out of the new 111 service, set to replace NHS Direct as a cheaper and more effective solution for `urgent but not life-threatening' health issues', in two key ways: first, the research contributed directly to revising existing training provision and is paving the way for the establishment of a new national qualifications framework for NHSP; second, by providing critical support to the on-going performance improvement programme with 111 providers, strengthening the case for clinical supervision and leading to improvements in both 111 and 999 call sorting. The research has shaped Department of Health analysis of the work and workforce implications of NHS Pathways and 111 roll-out. Jackie Shears, Head of NHSP, Department of Health attributes the improvements made to their processes as a direct output: "Members of the NHS Pathways team have ... benefitted directly from the findings of the research, both from the published work and in the presentations that the researchers have made to us and at workshops for our commissioners and service providers ... The first project ... has had a direct impact on the design of our training programme ... The second ... is providing critical support to enable us to implement a performance improvement programme with all 111 providers, and to support reinforced compliance with conditions in the license that were being flouted by 111 providers ... As a result we are seeing improvement in 111 call sorting and 999 call sorting". Insights from this research were included in recent WFRC evidence to the 2012 Parliamentary Health Committee report Education, Training and Workforce planning.

Making workplaces work

Leonard's project `Making the Workplace Work' made recommendations to practitioner members of BCO, including commercial property developers, architects, property tenants, facilities managers and senior managers. Studying the effects of workplace redesigns in organisations such as PricewaterhouseCoopers, Hewlett Packard and the National Trust, Leonard outlined a consultative model and guidelines that can be followed by organisations planning significant redesign of workspaces. The final report currently forms part of the BCO's web-based research evidence base for its members (in the BCO top ten most popular reports, with 172 downloads and 168 additional visits online). Jenny MacDonnell, Head of Research, BCO, received feedback from the BCO Members' Peer Review Panel. The research was `" good, interesting and useful piece of research". Leonard's research was `Editor's Pick' in `Government Today' and also published in `Public Servant' and its key recommendations were adopted by construction engineers, Mott MacDonald, in their management of effective sustainable working practices and have been disseminated via their corporation newsletter and website. Mark Travis (Head of Workplace Change, Mott McDonald) says "This brings a different and valuable insight to all of us working in the area of workplace design". He continues, "As engineers, we tend to focus on the issues of physical design and workplace efficiency when we do our work. It is a valuable perspective to be helped to see the issues through the eyes of those who live and work in the offices we design".

Gender, race and ethnicity in the workplace

Halford and Leonard's 2003 research into the impact of race and racism on the careers of medics, in collaboration with the British Medical Association (BMA), continues to influence best practice for workplace interventions in equality and diversity across professional and public services. The research was widely disseminated by the BMA and has framed their good practice guidelines as well as those of NHS managers, health care practitioners and other contexts such as the Judiciary and the Scottish public sector. Halford and Leonard's research into gender, careers and organisation were recognised with plenaries at `think-tank' discussions on `Gender and Equality- Where Next?' at Cumberland Lodge (2011) and the House of Commons (2013), attended by Members of Parliament, the Judiciary and Police Force, senior Civil Servants, and practitioners http://publicpolicy.southampton.ac.uk/genderequality. Our study conducted with the BMA, based on our previous academic research on gender, race and careers is: cited as one of `several high profile studies' used as key evidence in constructing the BMA's (2011).

Work futures and the Third Sector

In 2010 Halford and Leonard commenced research on Third Sector work and organisations (as part of the ESRC funded Third Sector Research Centre), providing important evidence on the working lives and careers of paid and unpaid workers. User-engagement activities include a one- day conference organised by Halford and Leonard in 2011, ` Work futures in the third sector' which was attended by 40 activists, staff and volunteers from the third sector to inform and stimulate policy debate. In addition an article in The Association for Research in the Voluntary and Community Sector Bulletin (2011) and discussions with Skills Third Sector and NCVO at the TSRC's National Conference (2013) have informed policy debates on the learning and skill needs of third sector workers.

Sources to corroborate the impact

5.1 Graduate Market Trends, 2009 on the limits of female pharmacists' labour market choices: http://ww2.prospects.ac.uk/downloads/documents/HECSU/GMT/GMT%20summer%202009.pdf See page 15 which uses Halford and Leonard (2001)

5.2 Aranda, K. & Jones, A. (2008) `Exploring new advanced practice roles in community nursing', Nursing Inquiry, 15 (1): 3-10. http://onlinelibrary.wiley.com/doi/10.1111/j.1440-1800.2008.00393.x/abstract;jsessionid=EBC9C5A10F6E5673D511D5733A893CC1.d04t01?deniedAccessCustomisedMessage=&userIsAuthenticated=false See page 4 which uses Halford and Leonard (2006)

5.3 National Institute for Health Research http://www.netscc.ac.uk/hsdr/projdetails.php?ref=08-1819-2175.3

5.4 Parliamentary Health Committee report Education, Training and Workforce planning (additional written evidence EV w221, see 5.2). http://www.publications.parliament.uk/pa/cm201213/cmselect/cmhealth/6/602.htm#evidence

5.5 Government Today http://www.securingthefuture.co.uk/academic/13944-stop-presenting-sustainability-as-a-con?feature=1 Public Servant http://www.publicservice.co.uk/feature_story.asp?id=21869 Edition Dec 2012 Leonard's research is used in both publications

5.6 BMA's (2011) New guidance Good Management Practice: guidance for all doctors. Available at: http://www.gmcuk.org/4b___New_guidance_Good_Management_Practice__Guidance_for_all_doctors___Annex_E.pdf_38858924.pdf; Cooke, Halford and Leonard's (2003) report is used on page E11

5.7 Scottish Government's `Fair Enough? Fair for All Progress Report (2011) Available at: http://www.scotland.gov.uk/Publications/2003/11/18472/28688; Cooke, Halford and Leonard's (2003) report is drawn upon in Appendix E

Users who have provided corroborating statements:

5.8 Head of NHS Pathways Team, Department of Health.

5.9 Head of Research, British Council for Offices.

Users who may be contacted:

5.10 Head of Workspace Change, Mott MacDonald.