PHIRST Seminar 25/04/2024 Creating a lasting legacy through evaluation

Welcome everybody to this um PHIRST uh seminar or webinar this afternoon uh entitled Creating (SPEAKER: Elizabeth Orton)   a lasting legacy through evaluation. My name is Liz Orton and I'm the Chief Investigator for   PHIRST light. So I'm just going to do a very short introduction and then um we'll get going with the speakers. Okay so so today's session is um focusing on looking at how we have a lasting legacy of our   evaluations from PHIRST into practice into public health practice. Um and we're going   to think about how we um have that impact in terms of practice policy and also people   development. Um I think we've muted everybody's microphones and uh cameras just to to keep uh   the flow of the session. But if for some reason that hasn't happened please do keep yourself on   mute um unless you're speaking. Um at the end of the session we'll have an opportunity for   question and answers but if during the session you have any questions that you'd like to ask   please do pop them in the chat and we've got somebody monitoring monitoring the chat. So um first of all I thought I'd just give you a a very short introduction to PHIRST Light who we   are organising this session today. As I said my name is Liz Orton I'm the chief investigator for   PHIRST Light and uh we're a collaboration of three universities. The University of Lincoln,   Loughborough and Nottingham where I'm based. Um staff  are based at all three of those universities in   the team. Really quick reminder just in case because we've got a lot of new people on the   call today so I just wanted to do a very quick reminder of what PHIRST is. Um so PHIRST is   a National Institute of Health and Care Research funded program that aims to provide capacity to   undertake evaluations in public health of public health programs, interventions and policies across   the UK. And the the program was initiated to address the problem that often we work in   public health practice but don't necessarily have the evidence um of what works and so we   develop new programs and then they need to be evaluated or indeed we have programs that are   in place but also need to be evaluated to see if we can improve practice further. And so the PHIRST   Light program offers that evaluation expertise um to deliver evaluations in a robust and timely manner. There are eight PHIRST teams across the UK of which PHIRST Light organising today is one of   them and as you can see on the map the evaluations that have been completed so far are throughout the UK. The PHIRST light team um uh based in the three Universities at Nottingham, Loughborough and Lincoln um   just like the other PHIRST teams aims to do uh pragmatic academic evaluations of work  that's already happening in local government. And this is to increase the evidence of what   we have available to us regarding Public Health practice. We've had a very wide range of topics   um to evaluate so far. Today's um speakers are not not from PHIRST Light so it will give you a flavour of the types of things that we do. Um so we have already um recruited the research team we've   been up and running for a couple of years and we have experts from a wide range of areas. We   have a separate independent oversight group that scrutinizes the work that we do and the funding   is for a 5 year period for each of the programs. You will know if you work in local authorities that we   that the NIHR has a call a couple of times a year asking you to provide um expressions of   interests of services or interventions  or programs that you would like to be   evaluated. And these are prioritised and then those that are selected or allocated to the   PHIRST teams to undertake the evaluation. And then we have an oversight group who   is independently chaired um to provide us with critical advice about our evaluations. So who are we? Well this is our team at PHIRST Light on the uh left of the slide you can see   the team based at Nottingham. Um again a wide range of researchers, research fellows, research   assistants and public advisor. And then top right we have the Lincoln team and then bottom right   we have the team based at Loughborough. But we work right  across the three universities in um in a matrix style. So far the projects that we've been evaluating again are based across the UK. So   we have um a a project evaluating um programs to improve the well-being of uh people working in   the night-time economy in Bristol. We've got a project in London and Greater Manchester   looking at training for counsellors for elected members and the impact that that can have on on   wider determinants of health and mental health. Uh a project evaluating a falls prevention program in   the Hampshire area and an evaluation of a school streets project in Newcastle. So   all projects are pretty varied across the across the evaluations that we given. Public um uh input   into our evaluations is is really important is at the centre of what we do. We have um in   PHIRST Light we have a member we have a a co-applicant who was on the original bid who's   part of our team. We have public advisors on our oversight group. We have a Public Advisory Group   who some of who whom today with us today to talk about their experiences in the program. And then for   each project we set up a local public advisory group to support that particular evaluation. So   the public advice is really threaded throughout the whole program. So that's all I really wanted   to say today by the way of an introduction um so I'm going to move on now to the main section of   the webinar which is two um presentations from different evaluations where we'll be   looking at the impact that the evaluation has had. So our first evaluation. I'll stop sharing now. Stop sharing. So our first evaluation is the impact of a co-inquiry collaboration with frontline staff   refine, refining a stop smoking evaluation project uh the change from face to face to telephone specialist   advice in B uh Bedford and that presentation is by Thomas Mills from South Bank PHIRST and   Ruth Dean, Health Improvement lead from um the uh County Council.   Thank you um can you hear and see me OK?  (SPEAKER: Thomas Mills) Er is the the slide shows up? Yeah good um. So good a good afternoon um my name is Tom I'm   a senior research fellow based at PHIRST South Bank and I'm here today with Ruth Dean um who   was um a senior manager of of our local partner uh for a recently completed evaluation. Uh we're   going to talk today about the impact arising from a from a co-inquiry work package um. Just to set   the scene a little bit. I'm going to talk about the broader evaluation to begin with. Um so the PI for   this was Professor Lynne Dawkins and the local government team as Elizabeth said was um spread   across Bedford Borough, Central Bedfordshire and Milton Keynes, BMK uh stop smoking services that were as   shared services ac across these local governments. And the main evaluation question was um will   explore the effectiveness and acceptability of um the shift that the service had done during   Covid towards telephone support and compared that with uh face-to-face delivery um. And this   was achieved by uh let's say um various um quite traditional evaluation approaches across three   work packages. So statistical analysis of routine data, surveys and qualitative interviews with both   staff and service us users to really explore that  shift to telephone support during Covid. Uh also a   cost effectiveness analysis that compared the two  forms of service delivery. But my work package was   was slightly different this was a co-inquiry work  package. And the context for this co-inquiry work   package was was um coming out of that post- Covid um period the service was seeking to really raise   awareness of of the service offer. Um to reach out to communities, to speak to members of the public,   and uh to say again that that the service is still there and the offer that that it has. Um and   actually from the research team's perspective we noted noticed um quite a lack of evidence here in   terms of actually how to do uh community outreach in the context of um smoking cessation service. So   reflecting on that we we developed a research question how can a a smoking cessation service   enhance engagement with underserved communities? And I developed a kind of co-inquiry approach and   in developing this I really wanted to involve  front frontline staff but do so in a way that   wasn't demanding of of their time uh and would fit  and adapt to their busy work schedules. As they did   their community outreach but also of course their  core work in in in in providing advice and support.  Um so we held six co-inquiry sessions over the  course of a year and 13 frontline staff were   involved in those in those co-inquiry sessions.  We reflected on the outreach how it was going   how it might be refined. We also reflected on  data collected through the process uh some   of that data was collected by staff themselves  through reflective diaries um 32 observations of   of outreach events were recorded. I also did uh  observations of eight outreach events um and   also interviewed um eight community members of the  communities being targeted and this was all about   collecting some some good rich qualitative data  to really consider, test, evaluate staff's working   assumptions about about how the out community  outreach was was working. And I should say I   also interviewed um 10 members of staff but  we we're really lucky today because we've got   Ruth here as a representative of the local partner  um I'm just going to end the show so we can come   onto the screen but Ruth do you want to give um  start by giving yourself uh introducing yourself? Yes thank you Tom. Um so as Tom's mentioned my  name is Ruth Dean I have fairly recently moved   (SPEAKER: Ruth Dean) roles but at the time of the evaluation I was  the Strategic Lead for the stop smoking and   Tobacco Control Service for BMK and it's been  fantastic to be able to follow that through   to completion even now that I have moved on to a  different local authority.   Thanks Ruth and and can I ask how you uh personally found the co-inquiry uh component of of this evaluation? (SPEAKER: Thomas Mills) Yes of course. As you've already alluded to the co-inquiry component coincided with the stops making service returning   (SPEAKER: Ruth Dean) to community outreach work post the pandemic so  it was extremely timely for us. Some of the team   had joined the service during the pandemic and  they'd never done outreach work before and none   of the team had done outreach for at least the  last couple of years due to those restrictions.   Uh contextually as you mentioned the service had  shifted to a much more remote model of delivery   over the pandemic with that face-to-face support  shifting to telephone. And as a result we were   really conscious when we decided to resume  outreach work that there were communities   that had not been able to engage with us properly  due to those lockdown restrictions. So our initial   temptation was to get out as much as possible to  try and recover some of that lost time. And I think   that probably fair to say that's more reflective  of our previous style of outreach which tended to   be more reactive perhaps slightly more scatter gun  because we were doing more face-to-face work   in the community we were out and about more we  tended to say yes when invited to do out reach as   far as possible not necessarily always thinking  about where the best time would be spent. So the   co-inquiry work helped us to embed um I think  a more reflective model of practice into our   outreach work which allowed us to scrutinise the  impact each time we attended an event. It helped us   to evaluate where our time was best being spent  and where it was ineffective or poorly targeted.   And it also gave staff a way to formally record  how an event had gone which was positive both in   helping us to celebrate where they' had really  good successes but also to flag where outreach   have been unsuccessful um and a poor use of their  time. So I'd say in summer it was a really positive   and evolving process throughout the duration of  valuation and at a really key transitional time   for for the service. Thanks Ruth that's that's really nice to hear. Um so so what what impact   (SPEAKER: Thomas Mills) would you say did the co inquiry have on on the  local service? I think it was quite significant in terms of our outreach so as (SPEAKER: Ruth Dean) personally speaking as the service manager at the time it helped me   to evolve my perception on where I wanted that  component of the service to be and where I felt   we should be prioritising our time. We worked  much more reflectively as I've said before than   we otherwise would have done and it changed the  way fundamentally that we prioritised, delivered,   and recorded our outreach work. We developed a  community outreach spreadsheet which was themed   around our strategic objectives so when requests  came in if it didn't meet any of those strategic   themes we could say no legitimately it wasn't  a good use of our time. We could also record how   well it had gone so we could review. We went to  that last time it wasn't worth going to and we   had that nicely documented and a real support  for our decision making. Um we said we could see   from our reflective logs which events worked and  didn't and therefore it helped us to build   a really good network of trusted organisations  to work with where we knew events would be well   organised and well targeted. Um we also used the  learning to create a new project specifically   based around community outreach within our  high higher deprivation areas and from that   reflective practice and co-inquiry was built into  the project design from the outset because we had   that new learning about how effective it was as  a way for us to work. I think it also helped us   to see that community outreach did offer staff  opportunities to get out there, demonstrate their   new skills and particularly with the more remote  models of service delivery they weren't getting   the opportunity to do that otherwise. It did  also highlight that outreach is a particular   skill set that is different from clinic work  and that some people are more comfortable   and more adept at doing that than others. So  overall it was a very positive experience for   us as a service and it definitely supported  us into that more reflective strategic way   of delivering outreach. I I think you've you've touched on this when you talked about the the   (SPEAKER: Thomas Mills) the broader staff network um involved in this.  I'm just wondering whether you could elaborate   on that what impact did the co-inquiry have on  on the staff who participated? Yes of course. So   (SPEAKER: Ruth Dean) I think the co-inquiry element was definitely the  it felt like the most accessible way to bring the   whole staff team into the evaluation. The majority  of the stop smoking team work on the front line   of the service as stop smoking advisors and they  have I think fairly limited opportunity to be   involved in wider strategic work. Or exposure to  some of the decision- making process within the   service. I had presented on the evaluation before  at Team meetings I think it lacked meaning out of   context. Whereas the co-inquiry work meant that  the team's experiences, thoughts and opinions   were being directly sought and acted upon and  I think this was really beneficial in helping   them to feel valued and also in understanding  some of the broader work taking place to shape   and improve the service. Additionally I think it's  fair to say there was some anxiety from some of   people in the team about returning to outreach  work post-covid and I think it helped this process   to demonstrate that we are doing this in a mindful  way. That we're scrutinizing the impact and benefit   of it. People's time is being thought about and  used wisely so I think it was really helpful to   have that collaborative element within the team.   Um I'm also interested in because this was co-inquiry  (SPEAKER: Thomas Mills) very different to the other work packages I'm also  interested in hearing how how it really compared   or or related to those other work packages going  on? So I think the co-inquiry work was something   (SPEAKER: Ruth Dean) that we could elicit a much quicker benefit from.   With the more traditional evaluation work packages   there was a more rigid process that needed to be  followed before we could start to understand what   the findings were and begin to implement change. It's worth saying that the evaluation from start   to finish was about two years. Whereas with the  co-inquiry work we were able to see from the   reflective logs and discussions that were taking  place more immediately what we could do to improve   the way that we'll be delivering our outreach work.  And it sounds really simple but I think asking   staff to take a conscious step back and evaluate  each time they did outreach work helped us to break   that more reactive cycle we had been in previously.  And it shared some of that responsibility across   the team rather than that always just sitting  in a top heavy way with management. I think it   was also one of the only opportunities in the  evaluation for us to directly hear from members   of the public who are outside of the service. Some  of the other work packages um sought opinions for   people who'd used the service before whereas this is  people who for some reason were not accessing   us even though they they may be smokers so it  helped us in part to understand some of those   barriers to people accessing our support in in in  a fairly immediate way. Absolutely, thank thank you   (SPEAKER: Thomas Mills) Ruth um I thought I would just share with a share  a research output with with every body um because   that that's what it was all about wasn't it it was  about reaching out after those covid restrictions   have been lifted putting a face on the service so  that was something that that staff used to really   summarise what what they were doing out there. Um  and during those co-inquiry we were reflecting on   this and developing a model so I don't have the  time to to go through through all of this but um   I I thought I just kind of um highlighted it as  as as as one of the the re the research outputs   of this. Um so at the top there you have the kind  of external challenges um and and staff are very   aware of of some of these of some of the kind of  the fallout of broader cultural wars and a sense   of of um Public Health being the being the fun  police um. Also in stop smoking specifically some   of the quite confused messaging on on E-cigga  is e-cigarettes and recreational normalisation.   But actually the these kind of barriers or  challenges if you like were being very kind   of like navigated and and and negated sometimes  by by staff's outreach that are out there chatting to   members of the public as you say Ruth who who are  disconnected and sometime sometimes disconnected   from Health Services altogether. Um building up  those relationships and trust this is the the   activities in the model that section. Also doing  a lot of awareness raising and fact checking   around around e-cigarettes. Careful discussion  around the local services offer of e-cigarettes   which which was new and created a lot of interest  but needed quite careful discussion to ensure that   it's not promoted as a recreational device. This is  a a support to to help people and support people   to to quit smoking and this was part of it because  it it it was both staff wanted it to come across   and it was it came cross um in terms of certainly  among the the people that that I interviewed in   my observations as as a very positive offer. Um uh staff are very keen uh to to not be n-   non-judgmental in in they're making people aware  of the support available um and we were able   to identify um impacts of of this activity. Both  both learning impacts um in terms of knowledge of   the service offer. Feelings of trust in in in the  service, one of my interviewees said uh that that   there is hope um they they hadn't been aware of uh  the service offer but but now they were. And also   doing so actually agreeing uh an appointment there  um and sometimes actually uh having it having it   taken up there uh this um leading to a reduced  drop off rate that that that had been kind of   identified as as something that was that that that  the staff had wanted to to to kind kind of improve.   Um and it and it really did work and you know  some of my interviewees um were people as I   said who were disconnected from Health Services  they didn't know that this offer was there it was   only, they only became aware of it because there  had been an events locally there had been a stall   that that staff had attended they had gone and  they'd heard about it and they got the referral   there but as you say Ruth there were some events  that were sometimes um not not attended um very   well by the public. That had diminished reach and  and and what staff were doing it was kind of like   dependent on the quality of the community events  organised by external partners and that that   realisation was was kind of very real through that  co-inquiry sessions wasn't it that actually needed   to take a more kind of strategic approach because  you know some of the feedback that I was getting   was that um you know it's quite frustrating for  for frontline staff who have gone to an event   that they're twiddling their thumbs because it's quite  poorly organised, hasn't got the reach and they've   got a million other things to do as part of their  core role. Um but it was it was fascinating to see   how how you were were adapting to that and and  and part of that that that the co-inquiry was was   kind of feeding into that um. But that's just  a brief overview of this model but if you're   interested in that please do have a look at some  of our research outputs from this evaluation. So   just to conclude really we think that  co-inquiry is a relatively undemanding way   to engage frontline staff in research with with  various benefits. The impact um as Ruth says it   seems to have a more immediate impact and change  to service delivery here really refining the the   community outreach strategy. Prioritising it um in  terms of really targeting people and communities   that that that there are most most in need um of  that knowledge and and the support provided um   but also thinking through what what is the most  effective use of of staff time in meeting that   need. Um also frontline staff are involved in  a systematic research process and um directly   involved in that um and in in a way that that  we think really complements actually traditional   forms of evaluation um as as Ruth says this was the  one work package that they the service really got   to speak to members of the public um who are not  engaging with the service so there was uh real   real real benefit there in terms of uh involving  the public um. But also for me as an external   evaluator I'm forming relationship with with staff  I'm getting to understand what the service is about   and what what staff doing and then that was really  invaluable as well in in terms of when we went to   kind of um complete the other work packages it  provided me with context to really understand   what what was going on. Um but of course this is  this is supposed to be research as well and and   I think that model is really testament to some  of the research findings that we have from this   and I think it's really interesting context in  in smoking sensation services where you have   that concentration of of smoking in underserved  hard-to-reach communities. Areas where there's   higher levels of deprivation and arguably what  what we might see over the next five, 10, 10 years   is really these more proactive ways of going  out into communities and and facilitating routes   in the importance of this kind of kind of work  and um might actually be become more important   as we go forward. Um so I think some some good  research gains there so I'm going to stop sharing there. Yeah. Thanks Tom is is that the end of your duo? (SPEAKER: Elizabeth Orton) That's, that's the end yeah. (SPEAKER: Thomas Mills) That's great. Well really interesting. I have a question but I'm  just going to give anybody else an opportunity   (SPEAKER: Elizabeth Orton) to ask a question first. I see any hands going  up um so we've um got a qu- is this a question   in the chat uh is there scope for PPI? If so where  are the opportunities? Oh I think is this is that   a question that's more generally in the PHIRST programs. Is there scope for PPI and I can't   tell who's asked that question I'm sorry or was it  specifically for this evaluation? Um if you either   want to clarify the question in the chat or or  or come online then that's fine. I'll ask I'll ask   my question if that's okay and it's to Ruth so  I think Ruth you mentioned that this had really   changed how you um go about um sort of appraising  the value of what you're doing and making sure   that what you're doing is adding value. How will  you as a as a team and I know you said you've   changed job but how will you as a team carry  on um making sure that you have that reflective   practice and also are you intending to spread  this out to any other service areas in the council? I think what we learned it was really important  for us to embed it as business as usual rather   (SPEAKER: Ruth Dean) than it being something that we just do across  one area of our work that actually reflecting on   the work that we're doing its effectiveness, asking staff for their views and again it   probably sounds really straightforward but when  you're busy and you're trying to run a frontline   service you tend to just stick to what you know  and actually changing the way that we think about   the work that we do and reflecting on it more  mindfully I think had a benefit across all of   the service. I think we are not always very good  at spreading that across other teams but I think   that's a really valid point that actually this  is something that we could certainly be sharing   with other parts of the organisation to say look  this has really worked for us and sometimes it's as   simple as just recording the impact of each event  that you've gone to and and marking whether it was   worth doing again because otherwise they come  up again these invitations crop up again you're   keen to show that you're out in the community  and you never really think about whether it's   a good use of your very valuable staff time so  I think that's a good challenge actually to to   make sure that's shared much further. And and did your staff having been involved very much in the   (SPEAKER: Elizabeth Orton) research directly did have they reflected since on  kind of their perspective of you know was research   what they thought it was going to be? Yeah I'm I think the they probably the staff as a whole were  (SPEAKER: Ruth Dean)  fairly disengaged from the evaluation otherwise so  I think once Tom you Tom came to our team meetings,   he came to one of our away days, he interviewed  staff, he attended events with them one to one it   really helped them on a on a more personal level  to understand what we were doing. To understand   that research model to be involved in the wider  work I don't think without that you can present   as much as you like at meetings about the general  evaluation but it didn't mean anything out of   context so I think having that more personal and  having somebody outside of the service doing that   um really helped actually to to further that  understanding for the team. I think if I'd have   done it myself I don't think it'd have had the  same impact as Tom coming in externally.    Thanks, thanks Ruth (SPEAKER: Elizabeth Orton) Can I just com comment on those? Sorry could  I just comment on those? I just think they're   (SPEAKER: Thomas Mills) really interesting questions on the on the first  one you you've got me thinking actually because   in two weeks time I'm I'm doing a presentation on  this to teams from across the local government and   yeah I I think I I might try and pitch it slightly  different as as something that actually it's a   model that that teams more widely might might  explore and implementing I think that's really   helpful and try and think through how how could  kind of like spread spread the way of working. Um   and on the other point um yeah we we are I've been  quite immersed in data but we're kind of like now   thinking about impact and talking to staff about  how they they found the process so uh we will be   going to um the frontline staff but we haven't  yet to to really to to explore questions like   like you mentioned. In terms of like how how they found it and whether they thought research   would be like like like that. Yeah, good, thank you. Um we've got a couple of minutes before the next   (SPEAKER: Elizabeth Orton) presentation so um I think did I see a hand go up  I can't see your hand now it might have gone up   and come back down again. There's a couple of things in the chat I don't know if you want me to address those directly? (SPEAKER: Ruth Dean) Yeah, sure. (SPEAKER: Elizabeth Orton) Um there's one there's one around  the CO verified quits so have we compared the   (SPEAKER: Ruth Dean) effectiveness of face to face versus telephone  support for routine data collection. That is picked   up in in some of the other work packages that  there were some slight confounding factors around   data which are explored in the evaluation in that  we had a much longer period of telephone support   evaluated than we had face to face due to some of  our data recording um time frames um and it was   quite interesting in terms of the different groups  and the difference in in outcomes between face to face and   telephone it wasn't always what we'd expected so I  would recommend I think Tom's put a link there to   the full evaluation. And I'm happy to discuss further  if you want to take my details out of this it's   not a problem. Um and in terms of recording  reflections and learnings Tom developed a   reflective document which kind of co-produced with  the staff to capture specific reflections from the   events and we then developed that into a wider  spreadsheet where we themed it colour coded it and   had different categories about number of attendees  and um number of referrals taken etc so we could   really look at that when those requests came to  that attend that event again. Um so that was really helpful. That's great thank you. Tom? Ooh you're  on mute Tom.   (SPEAKER: Elizabeth Orton) Do you want me to you want me to pick  SPEAKER: Thomas Mills) up the question about the PPIE uh as as used in  this this work package? um so we did   Okay sure. Briefly. (SPEAKER: Elizabeth Orton) So we did. Uh just very briefly. As like PHIRST Light we we try and um embed PPIE through everything that we do. Both (SPEAKER: Thomas Mills)   at the centre level but also the the uh context  of the the particular evaluation so we did have   um a PPIE panel here um who are recruited from the  local service and they're they're ex smokers who   have been through the smokers and they were able  to advise us on things like uh topic guides and   and what have you and but also quite higher  level in terms of actually the research focus   um but for this work package in particular um we  didn't have any PPIE from people who are smoking   and not engaging and that was the group that we  really wanted to crack um. And I was looking to   uh and hoping that I might be able to recruit  as I went about interviewing people and doing   observations out out there but I I wasn't able to  actually recruit someone formerly to the PPIE panel   but I still was able to get that perspective  through the through the interviews and and   and through conversations at the observations  event but I think that's a real challenge to   to really kind of broaden out the PPIE sometimes. Yeah thank thanks Tom and thanks for clarifying   (SPEAKER: Elizabeth Orton) that question. So thank you both that was was  a really interesting presentation and great   see the legacy um that the evaluations had as well. Uh so now I'm going to move on to the second of   our two presentations from from evaluations and  that's an evaluation of Southwark's, Southwark Council's summer   22, 22 holiday activities and food program  with Leandro and Anita. I'll now hand over to you Leandro. Thank you Elizabeth I will just share my  screen and then Anita will start with the presentation. One second (SPEAKER: Leandro Garcia) Hello everyone my name is Anita I  work for Southwark Council as a Holiday Provision   (SPEAKER: Anita Sewornu) Program Officer so I support in distributing the funding and um support providers in delivering   the Holiday Activity Food and Fun Program. And  um I'm here to present our stakeholder network   analysis which was one of our research outputs  from evaluating the program overall. Can we   move over to the next slide. So just an outline  of what we're going to discuss today um in terms   of I'll give you some background regarding the  Holiday Activity Food and Fun Program. The need   for why we did a stakeholder network analysis to  begin with. And then Leandro will continue giving   you the steps and tools that he used for the main  outputs and then it'll come back to me to give you   lessons um and reflective practices as me  working for Southwark Council but also being in   embedded researcher for the PHIRST team, thank you. So the Southwark Council Holiday Activity Food   and Fun Program. Um we may be aware that families are heightened and stressed due to the cost of   living especially during the holiday period so the reaction from the Department for Education was to   fund a Holiday Activity Food and Fun Program.  And this is provided during the longer weeks, the   longer periods of the holidays so the Easter, the summer and the winter school holidays. So we were   not funding providers during the small half-term  periods. The focus of the program is to reach um   children aged between 4 to 16 years old so that's  reception right through secondary school who are   in receipts of benefit related free school meals. Southwark Council they received from department for   Education 1.5 million and that's to cover all three within the academic year of the   holiday periods. Um we funds places for children at holiday clubs and they could be anything from   schools, youth groups, um Church organisations, and children's centres and we designate funds across   the whole of Southwark especially within areas of high deprivation. Um so you may hear of it as 'Food and   Fun Program', 'Holiday Activity Food and Fun Program'.   But Southwark it's known as the HAF program. Next slide. So the aims and objectives of the HAF Program is that young people get to eat more   healthily over the school holidays so the 'Mayor of London Kitchen Social' would produce 'take and   make boxes'. If you're not aware of what they're like - they're like the hello fresh but then the   children would be able to go home with their parents and make meals. So we used to offer that   and during the program children are offered things like sandwiches, just food or hot food   as well especially during the winter programs. We  encourage our providers to um engage in physical   activity so so I was very fortunate to be part of the QA visits our quality assurance visits where   I got to see young people doing sports from tennis from football from netball and if it   was a provider that didn't have outdoor space they were making use of their local parks and   so forth outside to engage in physical activity.  Not only did it focus on food as well as physical   activity but one of the objectives of the program is that they engage in enriching activities that   support their development. In terms of resilience, in terms of character and their well-being. And   one of the examples I could give is going to see a  organisation where they're practicing mindfulness   with the children, or with the teenagers. Also to be safe and socially not isolated and so   with some of the research outputs where we got to do interviews so. One of the questions would be if   you weren't here what would you be doing? Most of the young people are reporting that they'll   just be at home not doing anything or engaging in things that they shouldn't be engaging with. Um having   greater knowledge of health and nutrition where our providers would not only do cooking classes   but also give that understanding of what healthy looks like. As well as being culturally appro-   appropriate um in their delivery of their sessions. And to be more engaged with school and local   services. So trying to um provide a wrap-around support. So in terms of the program for this to   happen the two questions that the PHIRST team were looking at was what can local insights actually   tell us about the impact and the implementation of the program? And what opportunities can we do   to improve the programs? So how best to look at local insights than to ask the service users   themselves. So we had an array of um different research methods that we used: from parent surveys,   to parent interviews, young people interviews, we also looked at attendance data and our focus what   we're doing today is the stakeholder um network analysis. So why did we want to do a stakeholder   analysis? We wanted to look at the impact on the food network overall and where the HAF Program   sits within that. And how our providers actually interact with our local food offer and the network. And from that we could we could see areas of maybe that we need to improve on or any gaps   within that food network. So for example could it be that there's training and development   that's needed for our providers? Could it be that we need to um our resources, are our resources up   to date in where different food networks are for example: food pantries, social supermarkets, because   we also wanted to create that wrap-around support so not that just parents will actually send their   their children to a Holiday Program but we were providing a wrap-around support. Um another, another   element of the stakeholder survey was to try and create to build a recommended supplier list. So our   providers are providing food. Was there somewhere within the food network where - okay this works   best for this provider. Maybe another provider who's struggling with a recommended supplier   there's a we can actually start recommending suppliers to to use and build up a list. So I   will pass you on to Leandro who will focus a lot more on the stakeholder analysis thank you.    Um thank you Anita. And hello everyone. So I'm Leandro Garcia. I'm a lecturer at the Centre of Public   (SPEAKER: Leandro Garcia) Health at Queens University Belfast. Where I uh work with a range of methods related to   uh systems thinking, complex systems, including network analysis and in the last, in the next   two or three slides I will present uh the steps uh that we follow to conduct our stakeholder analysis   and the outputs that we achieved and explain a little bit also what a stakeholder network   analysis actually means. So, the next slide um I have a representation of of a network right so I   have nodes. Which are these uh circles. And we have we have edges represented by these arrows. And this   could be a representation of any kind of network, right. So what we try to do in stakeholder network   analysis is to use the methods and techniques used more widely in network analysis to investigate   specifically uh networks of stakeholders. So in this case uh each node would represent a specific   stakeholder and here have different colours perhaps, representing uh different types of stakeholders for instance. And each one of the arrows would then represent a type of relationship and here   we have dashed and and and full lines representing for instance two different types of relationships.   And once we get a representation of the network uh after uh eliciting the relationships and the   stakeholders uh. We can start ask- we can start asking questions like: how dense of relationships   is the network'? Are there isolated or poly- connected stakeholders? Who are the hubs in this in this   network? Perhaps that uh the identification of hubs might help us to identify certain actors   that for any reason go out of the market for a supplier that goes out from the market could   perhaps disturb a large amount of uh stakeholders on the network itself? What are the prevalent types   of relationships? And this is of course a sample of the questions we can ask ourselves. And if we   imagine that this is a snapshot of the network at a given moment and we take multiple uh snapshots   over time you can also see this network evolving.  And we can think, as Anita uh mentioned before, of   interventions that can increase the resilience of our network. For instance, to all sorts of   disturbance or for instance uh bring to the network uh actors that might be isolated or poly-   connected for instance. So this kind of analysis helps us to create a diagnosis to inform actions   to improve the network structure. So how to become more uh resilient for instance and functional   right. So how we improve the structure itself so that the flow for instance of information,   or of any other materials or goods are optimised in the network. Um, so what are the steps then to   conduct a stakeholder network analysis? So many of these steps are actually very similar to any   other type of survey that we would conduct. So in our case first we define the research question   and and sorry the questions in the survey. Uh and these questions of course are defined also by the   research question more broadly. And they would be very similar to other types of uh surveys that we conduct.  So uh we would have questions about the attributes of the stakeholders responding to the survey so the:   type of organisation, the remit uh, etc, their size, for instance. And questions about uh the   relationships. So each stakeholder responding to the survey would nominate uh and many times qualify   the relationship and by qualifying we mean uh say aspects like of the for each one of the   relationships like: the type of relationship they have, the frequency of the relationship etc. Once we   have the survey uh prepared then there's the survey period uh and the survey period perhaps different   from what we see in other surveys where where we interview uh uh let's say uh um households uh it   might contain one or more uh waves of sampling. So usually would uh usually we do not would not know   uh the full extension of this of the network uh that might be common uh in many situations. So we   start what we call a seed sample uh uh composed by the institutions of people that we know are   part of the network. And as they start to nominate new uh uh stakeholders then we would continue to   interview these new waves of stakeholders to have a fuller picture of the network itself.   Once the survey is finalised uh then there is the data analysis and report. Uh so as you see   the steps are more or less the same as we do with any other uh surveys. Um there are   some specificities uh because we're trying to capture network data and of course in terms of   data analysis uh there are specific specific approaches to analyse network data. Uh there   specific softwares as well that can be used, many of them are free to access, free to use.   Um and those who are more interested and those uh more technical details I'm happy to to share   them afterwards. In our case we use uh online tool to collect the data uh and this tool is   called: 'Stakeholder dot net' - is a tool that we developed here at Queens University Belfast as part of uh uh   an agreement um that we have with the WHO European Office uh who uh requested us to create   a network a tool like that to collect data from uh partner countries across across Europe. It is   a free to use uh uh tool so if you're interested I left here um the link uh and the slides will be shared   or have been shared already so you're h- you're welcome to to try and use it. There will be uh   very soon now in May uh training uh opportunities on how to use this specific tool and again if   you're interest contact me and I can I'm happy to share the the the details of these uh too on   these training courses as well. Um here I have a a screenshot of what the in the questionnaire will   look like for the participants. Um so on our left we have questions are very common known, uh seeing in   other types of surveys. So what for what holiday club do you work for? What's your name? Uh and here   question number three is where this respondent starts to nominate their suppliers in this case.    And here there's already a predefined list of pro- of suppliers that can be uh extended as uh   respondents add suppliers that were not initially uh identified by us. And that extended list of   suppliers then is going to be available for the next respondents. And here on on question number   four, just an example of other kinds of questions we can ask. In this case specifically about uh   what kind of uh food opportunities, or food are offered to the children and families attending   that holiday club? So it's a mixture of questions about the the relationships and questions that we   normally see in surveys asked about the institution themselves. So here I have two examples of outputs.    Uh maybe it's not great to see so uh here we have the geographic boundary of the Southwark   Council right uh represented here. Each one of these nodes are either a a HAF provider, a food   supplier, uh or a a service that the have programs that signpost families to go for different services.   And here each one of these dots are geographically represented within the Council.    Uh and you can see for instance in this case uh who, uh which providers, or which suppliers, sorry,   each one of the HAF programs are using. Perhaps if they are using uh suppliers that are far away from   them ask why they're kn- you know searching for food suppliers uh farther than they uh other options   they could have uh close to them. We also can see for instance where perhaps uh programs might be less   uh uh the density of programs will be less uh than in other areas. Or suppliers for instance   etc. This is another way of visualising the same kind of outputs but in this case uh each one of   these uh dots represent either a a HAF program, or a supplier, or another um uh sign of services that the   the HAF programs sign post to. And here there is no geographic uh data defining where the the   circles are positioned. It is much more in terms of uh helping to visualise the network itself and here   the bigger the node the more connected that node is with other elements in the network. Uh so again   we can see here for instance that some perhaps food suppliers provide food to many more uh   uh HAF programs than others. And perhaps you know uh if there is a disturbance or something happens   with that food supplier we can see uh the poss- possible knock-off effects on the network. So that's   all I had to show uh right now I will uh call Anita to uh speak about the lessons and uses and reflections over to you Anita. Yeah, next slide. So um in terms of reflections. So I think it was   (SPEAKER: Anita Sewornu) important for me to be an embedded researcher on the grounds at Southwark and also be liaising   with the PHIRST team so we used, we would have weekly meetings and I'll be able to pass on   any information to the team. Especially with our providers in actually getting the survey completed   so one of the things that I noticed was the timings um. With every re- research you have deadlines and   I noticed that when, I'll give an example. When we had to distribute the survey um we distributed the   survey on reflection at a bad time um that wasn't convenient for the providers um and so we changed   the way that we did that that and with research you adapt as well um and so we changed that for   the next holiday period in terms of making it part of our monitoring and evaluation um rather   than the beginning of the program. And we saw the difference in terms of responses so where I had   asked providers please fill in this questionnaire um this survey there was a low response   because providers were focusing on actually getting the program delivered and sorted um   and coordinating and getting all their activities in order. But then there was a massive push when we   did it again um at the end of the holiday period as part of the monitoring and evaluation that we   asked them for. So that was a good learning point and something that we will continue going forward   when we need to retrieve information from our  providers. Um also as embedded researcher the   development of the relationship I had as a program officer with the actual providers I   think strengthens. Especially re- relaying to them the importance of data when we're working in a   field of data and we understand the importance of data it's not often those on the ground do   understand that. So I had times where I was able to um liaise with providers and and explain to them   why are we asking for such information. Why are we having parent interviews? Why are we asking   for the stakeholder analysis? And be being able to connect the dots for the wider council objectives   especially under Southwark's sustainable food strategy.   And I think being part of being on the ground at   Southwark, as well as an embedded researcher helped me strengthen that relationship with our providers   and give them more depth and understanding to why are we asking for these things. Um as mentioned   with the monitoring and evaluation I gave an example of um the timings into when we actually   plan interviews, when we actually coordinate these surveys, and the deadlines that we want them um to   be received by. All of the things that we've done with our research outputs not just the stakeholder   analysis has now been put into an implementation plan for delivery. To actually improve   the HAF program and so that's really good and we, I'm now able to add timelines, um strengthen   our relationships with other food food providers, um and also build a recommended supplier for our   providers, which actually is, gives them a lot more time to plan the program itself rather than the   other external things which they do struggle with.   Um capacity building. It was very. In our team we   are a small team that actually coordinates with the Holiday Activity Food and Fun program so me   coming in post was a lot easier for them to deal with the 'business as usual'- B.A.U. side of things with   the HAF program and then me working with the PHIRST team to ensure that the research outputs   are done. Um and yes challenges as mentioned um because of capacity um juggling the two I would   say that it was interesting for me personally as an embedded researcher because I felt like I was   doing my dissertation all over again after how many years. So that was a really good thing and I   think it's something that we will be doing in the future. Of using people maybe residents to become   embedded researchers in programs as well such as this. So yeah I think that's me are there any questions? Thanks both uh that was again another really nice um kind of uh presentation explaining   (SPEAKER: Elizabeth Orton) you know h- how these evaluations are really kind of making a difference in practice um. Again I'll   go first if that's okay? Um so I I just wondered Anita if you could say a little bit more about   how you were received in the local authority in terms of being embedded researcher how does that   kind of or how does the embedded researcher model kind of fit with the local authority did did you   have to do a lot of work to make that accepted? No. I think with the team that I'm in research  (SPEAKER: Anita Sewornu) is their focus, evaluations, we we commission programs, so midpoint reviews. Um one of the things   one of the recommendations that actually came from the evaluation was having a centralised   booking system and that was something we were already working on so it was really interesting   for local authority to see that some of the recommendations are things that the team are   already working on. So this just gave us even more rationale and evidence asz, that we were   working towards our main objectives. And that also it fits in with the wider Council strategies as   well in terms of tackling inequalities. Um who we are reaching, the accessibility of reach and   making sure that we reach the right target groups as well. Yeah, so that alignment with the strategic   (SPEAKER: Elizabeth Orton) goals of the organisation is important. Yes. (SPEAKER: Anita Sewornu) Yeah. Any any other questions there for Leandro or Anita? (SPEAKER: Elizabeth Orton) Not seen anything pop up so. Oh Tom?   Yeah I'll ask a question, Anita it strikes me there's  (SPEAKER: Thomas Mills) some sim- similarities here in terms of the impact with your embedded researcher approach,   in terms of like working closely with providers, staff, and generating reflective practice, and um   yeah um use of data, things like that  and it seems to be similarities there um   I guess my my question is for Leandro. How did the, because the the social   network analysis was really interesting, how did that analysis generate, generate impact? Thank you Thomas. To be honest I guess that's a better questions better question for   (SPEAKER: Leandro Garcia) Anita as she is the person bringing the results connecting directly with the people uh locally   Anita do you feel it be uh in position to to answer that question better probably better than me? Yeah, Thomas can you ask the question again? (SPEAKER: Anita Sewornu) I'm, I'm wondering how the the social network (SPEAKER: Thomas Mills) analysis that that helped generate impact?   So I think with the social networking that we had (SPEAKER: Anita Sewornu) it was the communication with the providers was really important and in terms of the timing. But it   was I think, I would say we had meetings so we had a meetings with our providers to actually   explain about the the future um evaluation that we were going to do. So ahead of time. And I think   that actually influenced the impact in them actually getting the work done. Because it was   for providers, it was extra work for them. They would then have to find parents to actually   fill in the survey. Because we don't have the parents details. So they would then have to find   the the young people that we would have to interview. So getting them to understand the   reason we were asking for this information, and joining those links to like I've mentioned the   wider Council objectives and also pin pointing how it would be impactful for them as a provider. So   for, if I give an example the foods. So a lot of the providers had a problem in terms of their   recommended suppliers from our quality Insurance visits as part of our business as usual that had   been fed back that they've had problems with food providers and by doing something like   this we were able to actually navigate this is a good provider this is what people are using   this is the feedback that we've been getting. And then as you can see with Leandro's um analysis   the bigger the nodes that's how more providers were beginning to use that recommended supplier   so be it. Or sign post to this particular food bank. And as I mentioned earlier it was also the   wrap-around support which was one of our objectives. If I speak from the parent point of view where in   the evaluation as a whole not many of them knew that the HAF program was somewhere where they   could actually access wider support. And so if you go back to the network analysis and   you look at how people are sign posting, you also saw the differences with the amount of   people that were not signposting. Which then went back to the parents actually relaying back they   didn't even know that they could be sign-posted. So that that's where the impact, where we were   able to match the dots. You found one element and then another element came came in if that makes sense. I'm gonna I'm going to have to draw that to a close. We got, we have got another question but   (SPEAKER: Elizabeth Orton) we're a bit over time now so because I want to give enough time for the PAG discussion   in a minute if people do want to have a quick convenience break by all means do go. But Marcia   did you have did you want to ask your question anyway and and we perhaps have a brief answer to that? Ooh you're on mute.   Yeah, just yeah just a brief both  um presentations were really interesting um this  (SPEAKER: Marcia Hudson) one and the smoking one um thing I wanted to ask um um Anita and um Garcia I think   um what does success look like for you at this stage? Um I'm I'm looking I'm listen I'm listening   to when you say about the um the hubs and you talk about the forum and forums and the fact is that   you can get questions out there which is really good. But um the one I what I thought about when we   talked about the wrap- wrap-around service I thought that's wonderful. But for you as a researcher um at   the stage that you're in now what does success look like? If DfE continue their funding. Because it ends this year. (SPEAKER: Anita Sewornu)   that's what success looks like for us. Um but looking at how- Without the funding? (SPEAKER: Marcia Hudson)) Without without the funding. So this evaluation has actually helped and it's a piece of work that I'm   working on now. If DfE do not continue the funding. What does HAF look like? What do we want HAF to   look like? And that's what the evaluation has done because we've had local insights and we've also   got our strategic goals to meet. So that's what the evaluation has helped us to do. To prioritise yeah.   That's great thanks. And um I can see Kris has got your hand up. Again we're gonna go straight   (SPEAKER: Elizabeth Orton) into the next session after this so go ahead Kris. This was just a question from the chat Liz. So, um the question in the chat to the team was (SPEAKER: Kris Clements) I wonder what um what have been the main hurdles of the  stakeholder analysis and what the team would have done differently if they had to do it all again? So we did do it again. Yeah, we actually did do it again. Um what I mentioned earlier was we   (SPEAKER: Anita Sewornu) didn't we got a low response the first time around that we did it and after discussions   um with the providers it was the timing. We had distributed it just before they started   a Holiday Program and anyone who knows when you're organising something that's the last.   You're not even checking your emails so the next time around that we did it we incorporated it as   part of the data collection that we do as business as usual and then the response increased. Very quickly. Two, very quickly two things. Uh one of them well one of them is that uh one   (SPEAKER: Leandro Garcia) thing that we also notice in the first round is that some of the providers were reluctant to   share what they see as a strategic information. So once they visualise uh the potential for uh   for the uses of you know the outputs from the analysis that also facilitated the the engagement uh in   the second wave so that's another thing. And and a third thing uh is you know network analysis can be very   technical as well and there are lots of measures that can be used etc. So uh the other thing we need to   be very careful is how to transform whatever comes out from the technical work in something that is   in a language that's useful for those using that information at the end. So instead of having pages of   technical numbers etc or something that is perhaps simpler but more uh uh people can engage you know   and do enact um using that information.   Okay. Thank you, thank well thank you to both sets of speakers  (SPEAKER: Elizabeth Orton) for your presentations and um and we look forward to looking at those evaluations in more detail. I   guess if they're not published already they will be soon and we'll be able to see see that. So I'm   now going to move on to the last bit of the session we when we were thinking about impacts   from our evaluations we were conscious that some of the impact we hope to achieve is through our   public participation in the research so maybe that's impact directly on the public participants.    Maybe it's an indirect impact on the lasting legacy of the evaluation through to the public.    So we thought it would be quite interesting to invite three of our members of our Public Advisory   Group from PHIRST Light to have a conversation about their experiences of impact. So we um we're   all conscious that the uh public involvement in research standards were launched in 2019 and we   wanted to focus on three of those um standards in this particular conversation. So thinking about the   Governance, how how public involvement is managed as part of research. Thinking about um impact on on   the members of the PPI members but also um the public more generally and then thinking about   how we make sure that our public engagement is inclusive of all of our communities. So   that's where our questions are going to or our conversation is going to be focused. Um so first   of all can I ask our three public advisers to introduce themselves so Beauty, Marcia and Pradeep. I'll   go with Marcia just because you're top right at the moment on my screen. Um sorry, hello I'm Marcia uh   (SPEAKER: Marcia Hudson) lovely to meet you all uh this has been a really um interesting thing to be involved in first and   thank you very much for involving me in this. Um my um background I'm a registered nurse, registered Midwife   now retired from that. Um I've been in regulations for the last 10 years and now I'm looking at the   community I'm very involved in the community um and some of the community that I actually am   involved with knew me when I was a little child so they see me in the light that I'm there to serve   them basically. And um be there as um they're um they are my elders um and so that really impacts a lot   of what I do as a community and engaging with them so that's a bit about me.   Thanks Marcia and then Pradeep, you're down on my bottom right. (SPEAKER: Elizabeth Orton) Thank you, good afternoon. My name's Pradeep. Yes I I I've joined the PAG group   (SPEAKER: Pradeep Khutti) and bring in my lived experience and suppose uh the in terms of what's called a portfolio career   Uh so I've 20 plus years as a carer for various members of of my family. Um dealing with my   own health issues so it's dealing with Health and Social care in that respect. And then with   the portfolio career it's public appointments at National, Regional, and Local level in the areas of   housing law and regulation and health thank you.   and Beauty. (SPEAKER: Elizabeth Orton)   Good afternoon everyone um my name  (SPEAKER: Beauty Tshuma) is Beauty Tshuma I'm based in the North East I work for a local uh Mental Health Trust. Tees Esk and Wear   Valley um uh NHS trust. My role is a minority ethnic lead and link as it were. I work with   communities, new and emerging communities that have settled in the North East. My background is social work   I have worked uh in the community for a long time so I've been part of of the PHIRST uh PHIRST Light   Group for a few years now and I'm involved in the Newcastle Schools project. Thank you. Thanks Beauty.   (SPEAKER: Elizabeth Orton) Okay, so um I'm going to come to Pradeep first if that's okay. So I wondered if you could talk to us   a little bit about the PHIRST Light Public Advisory Group how it works and how the um advisers feed   into the various different projects? Certainly, um well we're the the PAG group as such there is a   (SPEAKER: Pradeep Khutti) very diverse group itself uh from experience and from the protected characteristics uh there's 10   of us at the moment I think there could be 11. Um and two of our members, er the Co-public applicant   and one other sit if you like on the management / board side uh and we therefore have a bi- laterally, if you like, um relationship with the management that feeds back information to us and   us to the management. Uh the rest of us as such we undertake the various programs that come through   the that require evaluation. And it's it's up to us it's I whether we're interested in the   particular project or not. Um and we therefore you know volunteer to do that. Uh for myself I'm under   undertaking two projects that are going through the process at the moment. The first one deals with   the, at East Sussex deals with the the prevention of homelessness. Uh homelessness itself, and mental   and health well-being, and trying to create a holistic approach rather than just signposting. So   so what I'm doing is liaising as such between the main PAG group ourselves, and with the East Sussex   one. So actually part of the East Sussex PAG group itself and we've gone through from the beginning   onwards. From selecting and recruiting the PAG group at East Sussex. To the various questions   we need to go through the various review of documents um to actually make sure that people   can actually evaluate once we get to that stage. Uh and then you know it' be about dissemination   and a review process. So that is still ongoing we're at the point where we're nearly I think   completing uh the actual um questionnaires and so the evaluation process will start. One   of the great benefits of the group itself was recruiting people who had had experience of   homelessness which was very difficult to do. Uh and around issues of uh reimbursing people for   their time and how that should look like because there was issues about whether we should be re-   um contributing or reimbursing people and maybe  affecting their lifestyles if they're homeless.    Um that was one of the issues. The second group um project rather is called Thrive and that's   to deal with the prevention of mental health um and and retraining local counsellors regarding   their mental health. As a hook to really see how that training can implement into the strategies and   policies of the people that they represent and the local authorities that represent so what's   the ongoing impact. So it started off in uh London itself uh that's completing and we've started in   Greater Manchester at the moment. And we've done the training to I think three groups of um various   local counsellors and recruiting from them onto the onto the project itself. So we can actually view   over the long period what is their involvement in terms of the strategy and input as counsellors in   the area. So they're the two uh projects at the moment that I'm taking part on. And as I said   that if we're taking a local project we then lia- we're involved in that but we take that back to the main   PAG group and have a review session and where we are etc and have that fed back to the to to   the management itself. And then we also want from the management um where what the other are what's   happening there as just to keep up to date. As I mentioned before one of the things that we are   reimbursed for our time and I think there are set um criteria in terms of how much work you're doing for that. Yeah, and uh and you said that you um choose whether or not an evaluations of interest to you do   (SPEAKER: Elizabeth Orton) how has that worked out in terms of has there been a good spread of of projects for different people   to be involved with according to interests? Oh yes. I think that that's the that's the icing on the   (SPEAKER: Pradeep Khutti) cake if you like you know you see something you like and you go I'm interested in that. And it's   open obviously uh. And for those people uh I think we've had two recent members who who kind of very   keen and saying what projects are coming on board and we want to get involved in. So we we I think at   the moment it's not a question of that there's a project that any of the PAG group is not   willing to undertake. Yeah, that's great, thank you, thanks  for your insight on that one. Um I'm going to move   (SPEAKER: Elizabeth Orton) into ask a question of Marcia now. Marcia, I know you're really passionate about um making sure   that public health evaluations reflect different communities. I just wondered if you wanted to say   a little bit more about that? Um yeah. Yeah, thank you. I did not know that I was passionate about  (SPEAKER: Marcia Hudson)  the community. I I didn't I really didn't know I didn't I just knew that I was involved in   health care and those sorts of things and when I started, when people kept hearing that I was retiring and   heard that I was standing back the community came forward and um I started to learn so many things   that I didn't realize. And I I really want to share that when you talk about the the part of the NIHR   when we look at um not just not governance but inclusiveness. How do we become inclusive with   our community when our community in some ways are just trying to find out who they are. And our our   community is evolving in so many ways and yet we are looking at inclusive. Um so we ourselves   as we look at inclusiveness there's such a story that we don't even know yet. So so many things that   we don't know about being inclusive. So that in my little world that I was in I started to find out   different things like for instance one lady that I knew as a child when I um one day a community   engagement person came to me and she said: "Marcia um so and so was walking on the street in her slippers   and her night dress and we had to bring her to the emergency room." This lady didn't know her, didn't   know me before, but she was a community engagement person. She came to tell me that this person from   the Caribbean Community was doing this. And what what I realised was this person lived maybe 50   60 years on this street and so as she, as you age your comm- your home becomes an extension of your   community of the street that she's on. So walking out of her front door in her night dress and her   pyjamas and her slippers was just a thing that was just normal for her because as she aged and   her mind and her brain health was being affected.   Um her mind took her out further into the street   it wasn't something that she meant to do. It was just something that happened and she didn't see   abnormal. But what happened is eventually she was put into a nursing home and when she went   into the nursing home she was put into a nursing home with people and behaviours and mannerisms that she didn't know. It was a people that she wasn't used to because she was brought up in a community   that's all she knew that was that she chose to be in. And now she found herself and she, I remember   when going to see her in this nursing home and she said, cuz she knew me as a little child, she   said Marcia: "how can I stay in here I don't know these people, they don't know me how can I live in   here, I can't, I don't think I can do it." Um that was one example. Then I started to find other   things people in the community, in the Caribbean Community got started to be get become older and   get admitted to hospital and as they got admitted to healthcare, or they had to see their GP, certain   things happened and as they aged certain things happened. They would go into speaking um Patois which   is one of our lingos it's it's it's broken English um because remember the Caribbean was from the   British Empire so it was always acceptable. But as they got older people didn't understand what they   were saying so they started to give them labels of being confused, or having dementia, when really what   they were doing was speaking. But people that were treating them didn't understand what they were   saying and didn't realise that it wasn't dementia, and it wasn't confusion, and and also they joke. The   Caribbean population we joke a lot with sense of humour. So there's things that they were saying it was   just normal for them but they started to get these labels attached to them. And, the, basically what I   started to understand is that when we speak about inclusion it's not such an easy term as that we   can just throw out there because there's so many dimensions to it. Um we talk about uh one person   she, he, was in hospital and I always knew, we knew that he never wanted to die in hospital and he   wanted to go home. When he came in the 50s and in the 50s he bought a house and um he always lived   in this house he brought up his children in that house and he was in hospital and I remember going   to see him and he had his socks on and he had and he said to me, he stood up from from the hospital   bed and he looked out the window and he said: "Marcia, how did I get from here", and he looked at his socks   "to here". And he was on the top building of this hospital. And I knew what he was saying to me is Marcia  I need my shoes because I need to get out of here and because he knew he needed to be home to die.    I linked him up with the Macmillan service which was incredible with his daughter I linked up   with his daughter and his daughter contacted the Macmillan service. And they spoke to the consultants   in the hospital and a day or so the, everything started to roll. The health care set in, everyone   set in, and within a day and a half he was home. They got the hospital bed in his front room. He was   able to have the windows and look at his front, his road, that he lived on and I I saw him relax. I saw   that smile, I saw him just relax and I, you could see in his eye you could just see him relax and.    So what I'm talking about about is this, this PHIRST project what it is it looks at so many things. And   what we're doing is we're involving the community and this is how we're going to be able to address   research more because once we involve and we use um for instance our hubs and our forums to and you   know just get the word in get just get information and um and use participation I think that's going   to be something quite interesting.   Yeah, so making sure so that the researchers shouldn't assume things  (SPEAKER: Elizabeth Orton) they shouldn't assume that they understand or know that we really need to draw on that   expertise from our public contributors who have the connections back to their communities. And remembering as well that the public contributors are are  learning as well, we're we're we're learning new   (SPEAKER: Marcia Hudson) we're learning our community we're getting, there's things that we didn't know that we didn't know!    Yes, and you get more and more expertise in that   (SPEAKER: Elizabeth Orton) Expertise, yes yes yes yes, I've grown I've  (SPEAKER: Marcia Hudson) grown, I've grown in a in a couple years I can't, this is a new life for me. That's amazing, thank you, thanks Marcia. (SPEAKER: Elizabeth Orton) Okay, and just again just for time I'm  going to move on now to Beauty last question for you. Um so so I I I know that you are uh do a lot of work with Refugee groups and and comm- and their    communities. I wondered how you, if you've got some advice about how you would encourage people from   those communities to take part in research? Okay, thank you for that question. As I said earlier I   (SPEAKER: Beaty Tshuma) work with uh refugees and these we term new and emerging communities. I'm sure you are aware that   we've had uh four different resettlement schemes in the  UK recently: the Afghan, the Syrian, and the Ukraine   resettlement. These communities are coming in, into services that were developed without   them in mind. When I'm uh working with these communities my role is to educate and orient   to life in the UK. I share with uh communities why it's important for their voice to be heard,   why they must get involved in um sharing their lived experience. This explaining that this is a   potential legacy for the future generations.  Many of them won't be going back to their   home countries, or they'll be here for a long time so it is important for their voices to be heard. I   come from the African Community and we are fairly new communities, probably 30 40 years in, so the the   way we absorb information and take part in any uh project is from understanding from the people   like us. We ask someone: "Can you tell me, you went to this service, what is the Mental Health Service? How   did they treat you?" So, that is important when um working with a uh different communities to   understand their points of reference, where do they come from. Uh empowering people, uh includes,   uh explaining, and and making things simple to understand. As professionals it's easy to use   uh you know the language we use every day. We need to break things down and explain how they   look, what they mean in the ground. For for for example, research, what is research? You need to   break down that research it, what it means and how it is implemented. I explain to family communities   that the research uh if you are part of that, it will be, it will take years probably when your   grandchildren are born whatever you do today it will impact on their lives. So it is important to   explain what is uh data, what are they collecting, what is it for, how is it used, and as researchers   I'm sure, and people working in public health we're aware of the data gaps and data bias that exist uh.    For instance, traditionally men were used and in a lot of studies and with the medicines we use today   that are used by women and men so the gaps that exist are from these communities. We are moving   already to the concept of personalised medicine looking at tailoring treatment to suit people's   needs. So it is important for these communities to be part, we, we all understand and aware of how they   were, the pandemic these communities were hit hard.   So to address those inequalities we need to really   drill down and talk to people and get their lived experience. Understand the intersecting needs and   barriers to accessing, for example, why have they been labelled hard to reach? My view will be to twist   that on its head and say they have been ignored or they have been marginalised. Because I tell   the communities: "why are you hard to reach because that's what people believe you are". And they say:   "we've been always here Beauty we are not hard to reach". So as professionals and if we are really   interested in looking at inequalities we need to be creative, innovative in our approach. As I do-   can I stop and then ask another question? Because I could go on for the whole day! And it's really fascinating listening to you and and all of you (SPEAKER: Elizabeth Orton) and I think what you're saying is that you know   we we as researchers really rely on our Public Advisory Group to to provide that, both the trust   with their communities, to provide the insight, to provide the connection, and the interpretation and   sort of spanning different different boundaries I suppose um to make sure that our research is   relevant to to everybody. And and we really appreciate that um so I'm going to end with   a final short answer I'll do a kind of you know end of the night wrap-up or end of the day wrap   up um. So if you could just give me one little snippet each of you and I'll start with Pradeep, um   what would you like uh to the the legacy of the PHIRST Light Public Advisory Group to be?  I think it's it's a much greater recognition of the public involvement and getting that role across all   (SPEAKER: Pradeep Khutti) sections of our society whatever it is in which are areas. So that that that feeds into what Beauty   was saying that we get more encouragement from the public to actually take part and so what I   would ultimately what I want is better sustainable, transformation in health care, outcomes in health   and social work. Thank you. And Marcia? What would you like the le- legacy of the Public Advisory Group to be? (SPEAKER: Elizabeth Orton) Ooh, sorry Marcia you're on mute. Um I I'm just thinking that um, not outlining governance and anything else but I think   (SPEAKER: Marcia Hudson) inclusion needs to be rethought because we have put a lot now over the last few years   in inclusion. Now we need to take it up to the next level. What inclusion really really does mean. Thank you. And Beauty? (SPEAKER: Elizabeth Orton) I could say the same  for for both uh because we always use these big   (SPEAKER: Beauty Tshuma) words and uh what do they mean in practical terms? Uh tackling inequalities what does it   mean? Is it the same as in equality and equity are two different things. So it's it's it's for   us to step take a the legacy will be for Public Health Providers, researchers to really um er and   pick the language that they are using to suit the communities so that when they come back   and uh want to engage further they've laid the groundwork. We need to change the way we work so   that it is as Pradeep said before. It is normalised behaviour for any Community to say: "I am feeding   into this you know research or I'm part of the PPI involvement", because it's everyday language   so, that's it for me. That's amazing. Thank you  all so much for um for that uh conversation   (SPEAKER: Elizabeth Orton) and for supporting the the webinar today. And thank you to everybody who's attended it's been   excellent um attendance, we had well over a 100 people dialing in today. Um I think for me it's   shown just what ripple effect evaluations can have. Both in terms of the immediate evaluation results   but then the knock-on impact that these evaluations have on communities, on the public health teams, and   how they continue their work in other areas. We're leaving behind tools for people to use   and I've seen in the chat some conversations about, well can we share that, can we can we have   a copy of that. That's really important as well as one of the outputs for these webinars and um   and to to really get the public and everybody more exposed to research so that there's more   people willing to take part in research and the importance of our Public Advisory Groups in and   public participation in research to do that. So so some really fascinating learning today thank you   all for attending. There'll be another webinar are in the not too distant future so please   do keep an eye out for the date of when that appears. And thank you once again for attending.