51cg

Biography

Zoë Skea joined the Unit in 1999. She graduated in Sociology from the University of Glasgow in 1995 and gained an MSc in Health Services and Public Health Research from the 51cg in 1999 and her PhD in 2005. Since joining the Unit, Zoë's portfolio of research involves sociologically informed investigations of stakeholders’ experiences of healthcare and of health services research. Zoë has particular interest and extensive expertise in using qualitative approaches to investigate patients’ perspectives of their care and treatment and also clinician – patient relations.

Research Overview

Zoë currently has particular interests in:

‘Person centred care’ and associated concepts such as shared decision-making and support for self-management; clinician-patient communication issues; and issues relating to patient support and information provision. She also has interests in using evidence from patient/public and health professionals' perspectives to inform the design of health care research (e.g. clinical trials). 

Zoë is always willing to discuss potential PhD supervisions and postdoctoral mentoring arrangements within these broad areas. Please contact Zoë at the e-mail address shown above or enquire at the Graduate School /study/postgraduate-research/

Current Research

'Come and work here!' Exploring the role of local community-led initiatives to improve recruitment and retention of healthcare staff in remote and rural areas (funded by NIHR). 

Recruitment and retention of healthcare staff in rural and remote areas is a challenge for health services. Much of the focus of research in this area has been on work organisation and practitioners themselves. However there has been less focus on the experiences of the people in remote and rural communities and what they themselves can do to attract staff. Some communities have experimented proactively with initiatives to promote their local area; to get involved in the recruitment and selection process; and to welcome and integrate new health professionals and their family members into local life. These community-led initiatives are often ad hoc and undocumented; there is potential learning about what has worked and what has been less successful that remains untapped.

This project has been suggested by the public research partners on our current CSO study on recruitment and retention in remote and rural areas as a way to capture this learning. 

Enhancing recruitment  and retention of rural doctors in Scotland: A mixed methods study (Funded by the Chief Scientist Office). 

Providing healthcare for people in remote and rural areas is a priority for Scotland. Provision depends on being able to recruit and retain doctors in these areas: when a local GP retires, or a small hospital cannot attract enough doctors, this can affect community sustainability. There is evidence that people born and/or brought up in remote and rural areas are more likely to want to work there, but little evidence exists about how to attract new people from diverse backgrounds to such areas and how to keep them there. This research will use qualitative interviews to better understand the experiences and motivations of doctors with respect to remote and rural jobs Scotland, and in doing so gather information on factors which influence career decision making in relation to remote and rural working. The interview findings will be used to develop a Discrete Choice Experiment (DCE) survey. This will provide insight into the value of different factors, and the degree to which respondents are prepared to trade off one factor against another. Hospitals and general practices cannot change where they are located, but this information will inform new ways to attract and retain doctors to remote and rural localities, which can be tested in a later study.

Past Research

Examples of recently completed projects include: 

Baby boxes and parental capabilities: developing a measure of social outcomes. 

The introduction of baby boxes is a unique Scottish policy within the UK, aiming to improve health outcomes for babies and provide practical support for new parents in Scotland. The overall aim of this study is to provide the methodological underpinnings for a future longer term study which will seek to design a holistic measure of wider social benefits. We anticipate that this could support not only a future evaluation of baby boxes but also other health interventions with an intended public health outcome. 

Specific aims:

To improve understanding of how issues relating to the introduction of baby boxes have been reported in a sample of media coverage.

To explore how issues relating to the introduction of baby boxes have been publicly discussed within a sample of online parental discussion forums.

To investigate how a range of Scottish parents feel about and respond to baby boxes as they roll out into routine practice.

PAtient-centred Care for Fibromyalgia: New pathway Design (PACFiND)

This project (funded by Versus Arthritis) aims to improve healthcare services for patients with fibromyalgia. Fibromyalgia is a common condition with symptoms of pain, fatigue and sleep disturbance. There is not much evidence on the best way to organise health services for fibromyalgia. Patients are dissatisfied with current services and believe no-one takes responsibility.

We will gather information from patients about their current healthcare. We will work with health professionals to understand how services are organised. We will then identify what better care for patients with fibromyalgia looks like. We will also estimate the benefits and costs of existing and alternative care models. By the end of the study we will have developed a new model of care for people with fibromyalgia. The model will prioritise what people with fibromyalgia think is important. It will be cost-effective and ensure better outcomes for patients. We will develop a plan for how the service can be put in place to ensure higher levels of patient satisfaction across the country. We will also produce an online resource offering information and support to patients via Healthtalk.

Using Care Opinion for patient-centred quality improvement

NHS Scotland formally supports the use of Care Opinion as a way for patients and families to give feedback to the NHS and for hospitals to identify improvements which could be made to respond to patient comments.  This project will involve 1) analysis of recent comments about NHS Grampian services and how staff have responded, and 2) interviews with staff at different levels in the organisation about their experience of working with Care Opinion data, to understand their concerns and how they can be better supported to use Care Opinion. The lead investigator is already involved in two English studies on how staff use different types of patient experience data for quality improvement, including online data. This project will bring learning from those projects into the Scottish context, and pave the way for a Scotland-wide study of Care Opinion.

Funding and Grants

2022-2023 National Institute for Health Research. ‘Come and work here!’ Exploring the role of local community-led initiatives to improve recruitment and retention of healthcare staff in remote and rural areas.Locock, L., Hollick, R., Murchie, P., Skatun, D., Skea, ZC. & Watson, V. £243,666.53.

2021-2022 NHS Grampian Endowments.  Remote and rural healthcare: Pilot study to investigate experiences, differences and changes to medical care for people living in remote and rural areas of Scotland.'  Maclaren A, Locock L, Skea ZC, Wilson P, Skåtun D £11,957

2020-2022 Chief Scientist Office. Enhancing Recruitment And Retention Of Rural Doctors In Scotland: A Mixed-Methods Study. Locock L and Cleland J, Evans J, Hollick R, Murchie P, Skåtun D, Skea ZC, Watson V, Wilson P, Denison A. £298,984

2019-2020 NHS Grampian Endowments. Baby boxes and parental capabilities: developing a measure of social outcomes. Skea ZC, Locock L, Ryan M, Morgan H, Black, M. £10,427

2018-2019 NHS Grampian Endowments. Using Care Opinion for patient-centred quality improvement.Locock L, Entwistle V, Skea ZC. £11,959

2016-2018 NIHR Health Technology Assessment Programme. (REBALANCE) REview of Behaviour And Lifestyle interventions for severe obesity: AN evidenCE synthesis. Avenell A, Skea ZC,  Aveyard P, Boyers D, de Bruin M, Webber L, MacLennan, G. £478,689.71

2014-2015 NHS Grampian Endowment Fund. Entwistle V, Swinton J, Oldroyd L, Skea Z, Sierawska A. Shared Decision-Making with Adults with Learning Difficulties: Pump Priming a New Research Theme for Person Centred Care. £11.670

2013-2015 The Health Foundation. Entwistle V, Cribb A, Watt I, Skea Z, Owens J. Re-conceptualising support for self-management of long-term conditions (Concept:SSM). £259,597

2011-2012 Prostate Cancer UK.  Skea Z & MacLennan S (Joint CI), McCann S, N'Dow J. Support groups for men who have prostate cancer, their families and friends: identifying best practice models. £24,680

2011-2012 Scottish Cancer Research Network.  Skea Z & MacLennan S (Joint CI). Information for choice in urological cancer: What people need, prefer and use. £21,629 

2009 -2012 CSO Postdoctoral Fellowship in Health Services and Health of the Public Research. Schumm K, Campbell M, Ramsay C, Skea Z, MacLennan S, N'Dow J. The acceptability and usefulness of a trial participation decision aid: a mixed methods study of patients and clinicians in the UK.  £167,975

2001-2005 CSO Research Training Fellowship.  Skea Z, Entwistle V, Watt I, Russell E. Communication in different arenas: the case of MMR vaccine.  £81,850

2000-2001 CSO small grant. Bhattacharya S, Entwistle V, Skea Z, Templeton A. Decision making in hysterectomy for heavy menstrual bleeding: how satisfied are women? (A pilot study).  £20,575

Teaching Responsibilities

Zoë is currently the Course Co-ordinator for two 51cg courses - Qualitative Health Research PU5529 (on-campus) and Qualitative Health Research PU5039 (fully online). These courses form part of the Masters in Public Health and Masters in Global Health and Management programmes. She also contributes to the following courses: Evidence Based Health PU5031; Systematic Reviewing (PU5526);Fundamentals of Research Design (PU5027); Work-Based Placement with Health and Development Sector Organisation (PU5521); and Standard Project in Public Health (PU5910).

Zoë has developed a range of post-graduate research proposals within her programme of research (including an MRC doctoral training grant proposal and has been involved in two cross-college PhD studentship applications with colleagues from IAHS and CASS).  She has supervised numerous MSc projects to successful completion (MSc in Health Services and Public Health Research; MSc in Public Health), one MPhil (Mental Health), one CSO postdoctoral fellow, and two PhD students (IAHS). She currently supervises an Elizabeth Russell Post-doctoral Research Fellow and two PhD students (IAHS).

Zoë provides one-to-one expert advice to colleagues within HSRU (and across IAHS) on a range of project proposals /funded projects (particularly in the area of qualitative methodology/mixed methods research).