School of Health Sciences
 

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Fiona Moffatt

Associate Professor, Faculty of Medicine & Health Sciences

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Biography

Fiona obtained a B.Sc. (Hons.) in Physiotherapy from the University of Manchester in 1991. She subsequently completed an M.Sc. in Physiology at University College London in 1997. Fiona's clinical expertise is the management of the acutely ill adult and patients with cardio-respiratory dysfunction. She is the co-author of a textbook and chapters in this field. Fiona has also worked as an extended scope practitioner within a Critical Care Outreach Team.

In October 2010, Fiona commenced a PhD jointly funded by The Foundation for the Sociology of Health and Illness and The University of Nottingham. The PhD explored how contemporary UK policy discourse constructed the rights and responsibilities of healthcare professionals in terms of productive healthcare, how this is made manifest in practice, and the implications for professional autonomy/identity. The thesis is titled "Working the production line: Productivity and professional identity in the emergency department". The PhD was awarded in March 2014.

Fiona's post-doctoral work has focused on a range of topics including: Management of musculoskeletal pain, First Contact Physiotherapy, Health Service Delivery, Physical Activity (particularly in the aquatic environment).

Fiona is currently the Director of Postgraduate Research for the School of Health Sciences.

Expertise Summary

  • Qualitative methodologies
  • Ethnography
  • Implementation Science
  • First Contact Physiotherapy
  • Swimming and aquatic exercise to promote health

Teaching Summary

Fiona delivers the Continuing Professional Development module in year 1 of the Physiotherapy and Sport Rehabilitation B.Sc. Programme. She also co-convenes a module on Exercise and Sport in Specific… read more

Research Summary

Fiona's research interests include: physical activity; management of musculoskeletal pain; First Contact Physiotherapy; sociology of the healthcare professions; healthcare organisational sociology;… read more

Selected Publications

Working the production line: Productivity and professional identity in the Emergency Department

Abstract

In the UK the National Health Service (NHS) faces the challenge of securing £20 billion in savings by 2014. Improving healthcare productivity is identified by the state as essential to this endeavour, and critical to the long-term future of the NHS. However, healthcare productivity remains a contentious issue, with some criticizing the level of professional engagement.

This thesis explores how contemporary UK policy discourse constructs rights and responsibilities of healthcare professionals (HCPs) in terms of productive healthcare, how this is made manifest in practice, and the implications for professional autonomy/identity. Using analytical lenses from the sociology of professions, identity formation and the Foucauldian concept of governmentality, it is proposed that policy discourse calls for a new flavour of professionalism, one that recognises improving healthcare productivity as an individualised professional duty, not just for an elite cadre but for all healthcare professionals. Adopting an ethnographic approach (participant observation, semi-structured interviews, focus group and document analysis), data is presented from a large UK Emergency Department (ED), exploring the extent to which this notion of self-governance is evident. The study elucidates the ways in which: professional notions of productivity are constructed; productive work is enacted within the confines of the organisational setting; and tensions between modes of governance are negotiated.

The findings of this study suggest that HCPs perform identity work via their construction of a multidimensional notion of healthcare productivity that incorporates both occupational and organisational values. Whilst responsibility for productivity is accepted as a 'new' professional duty, certain ethical tensions are seen to arise once the lived reality of 'productive' work is explored within the organisational field. The complex interplay of identity work and identity regulation, influenced by the co-existence of two differing modes of governance, results in a professional identity which cannot be represented by a static occupational/organisational hybrid, but rather one that is characterised by continual change and reconstitution. Understanding healthcare productivity from this perspective has implications for professional education, patient care, service improvement design and the academic field of the sociology of professions.

Fiona delivers the Continuing Professional Development module in year 1 of the Physiotherapy and Sport Rehabilitation B.Sc. Programme. She also co-convenes a module on Exercise and Sport in Specific Populations and contributes to the Cardio-respiratory and Developing Evidence-Based Practice modules.

In the PGT programme, Fiona co-convenes a module on Criticality, Clinical Reasoning and Appraisal in Practice. Within her PGR role she contributes to the delivery of the School of Health Sciences' PGR training programme, and regularly delivers sessions on Understanding and Expressing Criticality in Your Writing for the Researcher Academy.

Fiona is interested in the use of e-learning tools, inter-professional learning and simulation.

Current Research

Fiona's research interests include: physical activity; management of musculoskeletal pain; First Contact Physiotherapy; sociology of the healthcare professions; healthcare organisational sociology; and implementation science. Methodologically, Fiona has a special interest in qualitative research (in particular ethnography).

PhD Students (completed):

Dr Ben Smith

Dr Rob Goodwin

Dr Tendai Ngwerume

Dr Abigail Tronso

Dr Josephine Ampiah

PhD Students (in progress):

Paapa Ampiah

Ahmed Alanazi

Joanne Harrison

Agatha Adogho

Rachael Tucker

James Holroyd

Emad Alkhatib

Fahad Alotibi

Catherine Conchar

Hayley Carter

Matthew Low

Past Research

Working the production line: Productivity and professional identity in the Emergency Department (PhD Thesis)

Abstract

In the UK the National Health Service (NHS) faces the challenge of securing £20 billion in savings by 2014. Improving healthcare productivity is identified by the state as essential to this endeavour, and critical to the long-term future of the NHS. However, healthcare productivity remains a contentious issue, with some criticizing the level of professional engagement.

This thesis explores how contemporary UK policy discourse constructs rights and responsibilities of healthcare professionals (HCPs) in terms of productive healthcare, how this is made manifest in practice, and the implications for professional autonomy/identity. Using analytical lenses from the sociology of professions, identity formation and the Foucauldian concept of governmentality, it is proposed that policy discourse calls for a new flavour of professionalism, one that recognises improving healthcare productivity as an individualised professional duty, not just for an elite cadre but for all healthcare professionals. Adopting an ethnographic approach (participant observation, semi-structured interviews, focus group and document analysis), data is presented from a large UK Emergency Department (ED), exploring the extent to which this notion of self-governance is evident. The study elucidates the ways in which: professional notions of productivity are constructed; productive work is enacted within the confines of the organisational setting; and tensions between modes of governance are negotiated.

The findings of this study suggest that HCPs perform identity work via their construction of a multidimensional notion of healthcare productivity that incorporates both occupational and organisational values. Whilst responsibility for productivity is accepted as a 'new' professional duty, certain ethical tensions are seen to arise once the lived reality of 'productive' work is explored within the organisational field. The complex interplay of identity work and identity regulation, influenced by the co-existence of two differing modes of governance, results in a professional identity which cannot be represented by a static occupational/organisational hybrid, but rather one that is characterised by continual change and reconstitution. Understanding healthcare productivity from this perspective has implications for professional education, patient care, service improvement design and the academic field of the sociology of professions.

School of Health Sciences

B236, Medical School
Queen's Medical Centre
Nottingham, NG7 2HA

telephone: +44 (0)115 95 15559
email: mhssupport@nottingham.ac.uk