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Fiona Moffatt

Lecturer, 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 explores how contemporary UK policy discourse constructs 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.

Teaching Summary

Fiona delivers the Personal and Professional Development module in years 1 and 2 of the Physiotherapy and Sport Rehabilitation B.Sc. Programme. She also co-convenes the Complex and Long-term… read more

Research Summary

Fiona's research interests include: physical activity; respiratory dysfunction and neck pain; critical care rehabilitation; sociology of the healthcare professions; healthcare organisational… 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 Personal and Professional Development module in years 1 and 2 of the Physiotherapy and Sport Rehabilitation B.Sc. Programme. She also co-convenes the Complex and Long-term Conditions module and contributes to the Cardio-respiratory and Developing Evidence Based Practice modules.

In the PG programme, Fiona provides input to the Advancing Neuro-musculoskeletal Practice modules (1&2), Advancing Cardio-respiratory Practice and Advanced Practice (Diagnostics). She jointly delivers a module on Advanced Ethnography.

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

Current Research

Fiona's research interests include: physical activity; respiratory dysfunction and neck pain; critical care rehabilitation; sociology of the healthcare professions; healthcare organisational sociology; and implementation science. Methodologically, Fiona has a special interest in qualitative research (in particular ethnography).

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.

  • BENJAMIN E SMITH, PAUL HENDRICK, TOBY O SMITH, MARCUS BATEMAN, FIONA MOFFATT, MICHAEL SKOVDAL RATHLEFF, JAMES SELFE and PIP LOGAN, 2017. Should exercises be painful in the management of chronic musculoskeletal pain? A systematic review and meta-analysis British Journal of Sport Medicine. (In Press.)
  • RACHAEL L TUCKER, FIONA MOFFATT and AVRIL DRUMMOND, 2017. Constraint Induced Movement Therapy in hemiplegic Cerebral Palsy: a national survey of its use by physiotherapists in the UK International Journal of Therapy and Rehabilitation. (In Press.)
  • BENJAMIN E. SMITH, PAUL HENDRICK, MARCUS BATEMAN, FIONA MOFFATT, MICHAEL SKOVDAL RATHLEFF, JAMES SELFE, TOBY O SMITH and PIP LOGAN, 2017. Current Management Strategies for Patellofemoral Pain: An online survey of 99 practising UK physiotherapists BMC Musculoskeletal Disorders. (In Press.)
  • BENJAMIN E. SMITH, PAUL HENDRICK, MARCUS BATEMAN, FIONA MOFFATT, MICHAEL SKOVDAL RATHLEFF, JAMES SELFE, TOBY O SMITH and PIP LOGAN, 2017. Study protocol: a mixed methods feasibility study for a loaded self-managed exercise programme for patellofemoral pain Pilot and Feasibility Studies. (In Press.)
  • FIONA MOFFATT, ROB GOODWIN and PAUL HENDRICK, 2017. Physiotherapy-as-first-point-of-contact-service for patients with musculoskeletal complaints: Understanding the challenges of implementation Primary Health Care Research & Development. (In Press.)
  • FIONA MOFFATT, STEPHEN TIMMONS and FRANK COFFEY, 2016. ED healthcare professionals and their notions of productivity Emergency Medical Journal.
  • 2016. Stress Management for Students on Clinical Placement University of Nottingham. . HELM. 01/01/1900 00:00:00
  • ANN B. GATES, ROGER KERRY, FIONA MOFFATT, ADAM MEAKINS, JANE S THORNTON, SIMON ROSENBAUM, ALAN TAYLOR, IAN RITCHIE and KARIM KHAN, 2016. A movement for movement: exercise as everybody’s business? British Journal of Sports Medicine.
  • MOFFATT, F., MARTIN, P. and TIMMONS, S., 2014. Constructing Notions of Healthcare Productivity: The Call for a New Professionalism Sociology of Health and Illness. 36(5), 686-702
  • MOFFATT, F. and JONES, M., 2014. Physiotherapy in Intensive Care. In: BERSTEN, A., ed., Oh's Intensive Care Manual 7th. Elsevier. 38-46
  • MANDY JONES and FIONA MOFFATT, 2002. Cardiopulmonary Physiotherapy Bios Scientific.
  • Navigating NHS services . Health E-Learning and Media Team. 08/24/2012 00:00:00

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