Viewing archives for Dr. William Fleming

Forget meditation; Oxford study reveals a smarter way to beat stress and it could supercharge your productivity

The Economic Times

A study from the University of Oxford challenges traditional stress management advice centered on self-care. Published in the Industrial Relations Journal, it analyzed over 46,000 UK workers and found that mindfulness training, stress management, and resilience coaching offered little to no improvement in well-being. Instead, volunteering and charity work stood out as effective, boosting purpose and belonging. The research suggests stress is best relieved through helping others, not isolated self-care.

Mental Well-Being at Work: Why and How to Measure It

Rotman Magazine

The business case is clear: A one-point increase in employee well-being on a scale from one to 10 leads to an average 12 per cent increase in productivity.

How to keep humans at the centre of NHS digital transformation

Healthcare Leader

For several years, digital transformation has been promised as a solution to the rising pressures on the UK’s health service. Digital as the default delivery method is believed to be the solution to speeding up access to care, freeing up physical access for those most in need, and meeting financial pressures. And it’s not just the UK; globally, health leaders are advocating and driving the digitisation of care.

Yet for digital transformation to be successful, research persistently shows that service users must be central to the development and roll-out of digital solutions. To include service users, novel techniques are required. That’s where Human-Centred Design comes in.

In our recent paper, published in JMIR Human Factors, we discuss the complex challenge of including service users in the design and delivery of digital transformation. We focus specifically on mental health.

Mental health services are an especially promising area for digital innovation. Digital diagnostics can speed up signposting to necessary services. Chatbots are promised as a cheap, scalable, and rapid solution for psychiatric treatment. Health promotion, education and prevention can be supported remotely through digital resources. As can rehabilitation.

However, in 2022, it was estimated that there were over 15,000 mobile mental health apps already, with more predicted now. The problem is making tools stick. Research on uptake of digital tools shows that only where these tools are developed alongside users are they effective. For example, platforms for peer mental health support, or parent-led therapy for children, have been developed with their stakeholders and led to improvements in care.

How can this be achieved? In our paper we outline the method of Human-Centred Design (HCD). HCD is a method developed from design and commercial user-experience. It requires iterating between problems and solutions along with relevant stakeholder groups, or ‘actors’. In mental health, these actors include service users, clinicians, caregivers, public officials, and many more. The process requires:

empathising with the situation;
a discovery phase to understand needs;
defining the problem at hand;
designing the correct solution;
prototyping and testing the solution
planning and implementing the best option.

To be even more specific, we have defined HCD for mental health services as:

A practical iterative approach to the design, development, and reform of mental health systems, services, and products, that is achieved through communication, iteration, and empathy with users’ needs, desires, experiences.

The UK government, a long-time global leader in digital transformation, showed this is viable. We write about how NHS Digital, under the guise of NHSX, led HCD discovery projects to support the reform of the Mental Health Act. The primary recommendation emerging from this was that there should be electronic ‘advance choice documents’ to set out future care preferences, especially in cases of detention. Such a suggestion does not require artificial intelligence, but could make significant improvements to the dignity people receive in severe cases. However, it does require ongoing resource and commitment for success.

Readers might note that at no point in the HCD process I outline above did I specify the solutions were digital. One key message, both from our stakeholder engagement and from reviewing state-of-the-art literature, is that ‘the solution may or may not be digital’. We call this ‘digital solutionism’: assuming that digital transformation is going to solve all our healthcare problems.

True service user involvement requires openly identifying the problems in service delivery. At times, certainly, digital transformation can lead to more efficient and even higher quality delivery. Yet those designing and delivering policy and services must recognise what is vital: we must choose the solution for the problem, not pick up a hammer and look for a nail.

For digital transformation of all health services to be successful, we must include the most important people in that design and delivery. As well, we must recognise its limits. Human-centred design offers us an approach for both.

William Fleming is a Research Fellow at the University of Oxford’s Wellbeing Research Centre

Human-centred approach essential in digital transformation of strained NHS mental health provision, say researchers

Adopting a human-centred approach pioneered in computer science and engineering can support the expansion of mental health provision in the UK, according to new research published in the journal JMIR Human Factors.

Researchers from the Wellbeing Research Centre at the University of Oxford, the NIHR Applied Research Collaboration East of England at the University of Cambridge, University of East Anglia, and the University of Hertfordshire, reviewed existing evidence of human-centred design and digital transformation in the context of the NHS’s strained mental health provision.

The UK is not alone in facing growing demands for assessment, diagnosis, and treatment of mental health conditions. Increased waiting lists and prolonged referral times suggest funding and infrastructure are struggling to keep up with demand.

Digital transformation of the NHS and other linked services (both public and private sector) has long been touted as a solution to many of these problems.

The concept of human-centred design originated in the fields of computer science, engineering and ergonomics and is defined in this context by the authors as:

“a practical, iterative approach to the design, development and reform of mental health systems, services and products that is achieved through communication, interaction and empathy with users’ needs, desires and experiences”

Adopting such principles is designed to guide value and wellbeing creation in the delivery of products, systems, and services.

Using a human-centred approach in the design of new and existing digital mental health services could, according to the authors, enable greater responsiveness to patient needs and therefore improve patient outcomes.

The authors also highlight four specific UK policy recommendations:

Replace the digital transformation directorate currently within NHS England with an independent, cross-departmental digital transformation commission;
Further development of standardised processes and impact evaluation methods;
Creation of new national-level standards to better connect NHS mental health services with other government departments;
And explore the possibility of expanding human-centred design principles in further policy settings at both local and national levels.

Dr William Fleming, a Research Fellow at the Wellbeing Research Centre at the University of Oxford, and corresponding author of the new paper, said: “The digital transformation of our health services is already happening in a race to meet demand. But we can’t just assume the right answer is digital. We need any change to include the individuals who rely on these services as well as those who work to provide them.”

Diane Pochard, a co-author on the paper and, at the time of writing, a digital transformation lead within the Department for Health and Social Care, added: “Years of stretched capacity, rising demand, constant reorganisations, chronic underfunding and funding volatility have left our healthcare system in perpetual recovery mode with users’ needs lost in translation.

“As we are rushing to implement AI across frontline services we must apply the lessons learned from past digital transformation efforts – particularly the critical importance of user-centeredness. We cannot tech our way out of our dysfunctional system. The solution isn’t more technology, but a system where we consistently prioritise user value and where technology is an enabler.”

‘Human-Centered Design and Digital Transformation of Mental Health Services’ is published in the journal JMIR Human Factors.

Human-Centered Design and Digital Transformation of Mental Health Services

William Fleming, Adam Coutts, Diane Pochard, Daksha Trivedi, and Kristy Sanderson

Abstract

Mental health services face a multitude of challenges, such as increasing demand, underfunding, and limited workforce capacity. The accelerated digital transformation of public services is positioned by government, the private sector, and some academic researchers as the solution. Alongside this, human-centered design has emerged as a guiding paradigm for this transformation to ensure user needs are met. We define what digital transformation and human-centered design are, how they are implemented in the UK policy context, and their role within the evolving delivery of mental health services. The involvement of one of our coauthors (DP) in the design and delivery of these policies over the past 5 years provides unique insights into the decision-making process and policy story. We review the promises, pitfalls, and ongoing challenges identified across a multidisciplinary literature. Finally, we propose future research questions and policy options to ensure that services are designed and delivered to meet the mental health needs of the population.

Health lifestyles at work: availability, barriers and participation in workplace wellness

William Fleming

Abstract

The workplace is an ever more popular site for health promotion, but remains an underexplored factor in health lifestyles theory; whereas, sociological accounts of workplace wellness typically view it critically as managerial control. These perspectives both miss that participation in workplace wellness may constitute socially structured health lifestyles. Addressing this gap, I extend a theoretical model to bring together health lifestyles theory and critical wellbeing studies. To support the model, I provide an empirical account of the availability of, participation in, and barriers to workplace wellness. I analyse a multi-organisation sample of British workers (N = 27,919 individuals; 143 organisations) to reveal that engagement with wellness has distinct associations with multiple social factors (class, race and gender), job factors (level, contract, working hours and commute), and organisational context. Theories of health lifestyles ought to include work characteristics and managerial regimes, and critiques of wellness must analyse how social position affects workers’ experiences of wellness.

Volunteer days are vital to employees’ wellbeing…and your business—this CEO explains why

Fortune

And this isn’t just anecdotal evidence. According to a University of Oxford study, volunteering is the only workplace wellness offering that has a positive effect on employees’ well-being.

“My study analyzed data from about 50,000 employees from over 250 companies in the U.K. Volunteering was the only one of these interventions which showed…improved well-being,” says study author William Fleming, a sociologist and research fellow at the University of Oxford.

So if volunteering makes your employees feel good, more engaged at work and more productive—how could you say no?

The human resources reckoning

Financial Times

The area of wellbeing exposes some of HR’s weaknesses. “Many HR teams pay for services from a variety of vendors that aren’t bringing positive effects,” says William Fleming, research fellow at the University of Oxford’s Wellbeing Research Centre. Last year, he found that programmes and apps to sooth stress and teach mindfulness made no difference.

The problem, he notes, is that many HR departments are stuck between having too little and too much influence. This may become more of an issue in the coming years, as AI begins to play a bigger role in the workplace, taking on more of the tasks people do.

“We recommend organisational change and improving job quality,” Fleming says. “How many HR managers decide how many hours people work, how much autonomy people are given in their team, how many staff are assigned to tasks, how technology is introduced? These are the types of things that really drive wellbeing at work. Yet they can fall outside the remit of HR and instead [are] based on executive decisions or line manager discretion.”

Do wellness interventions actually make employees feel better?

Irish Examiner

Yet, a question remains: Do wellness interventions make employees feel better?

William Fleming, a research fellow at the University of Oxford’s Wellbeing Research Centre, attempted to answer this question in a study published last year.

[…]

His study looked at a wide range of wellbeing interventions and controversially concluded that almost none had a lasting impact on worker wellbeing or job satisfaction.

“While these findings do not entirely discount positive effects for some individual workers, any such effect may be averaged out by a negative effect elsewhere,” he concluded.

The Rise of Mental Vulnerability at Work: A Socio-Historical and Cultural Analysis

William Fleming

In recent decades, mental health has grown into a fraught and explicit public issue with considerable public and corporate policy attention. Mental health problems are reported to be both very prevalent and increasing, no more so than in the rising rates of work-related mental illness like burnout. What explains the ubiquity of mental health discourse and the growth of work-related mental illness in contemporary society? There is a vast scholarship in the social and health sciences seeking to explain these trends with national and international datasets, but the full answer remains elusive. For Ari Väänänen in The Rise of Mental Vulnerability at Work: A Socio-Historical and Cultural Analysis (TRoMVaW), we must look to transformations in the dominant modes of production and employment, especially the changes in the subjective experiences of work and life.

Väänänen comprehensively reviews the currently dominant theories why work-related mental well-being is such a growing problem (Chapters 3 and 4). The first explanation comes from positivist research in labour sociology, economics and psychology, claiming work is just more cognitively demanding and intense than it used to be (e.g. Green, 2006). The second explanation, in a similar paradigm, suggests the standard employment relationship developed in the Fordist, post-war era has degraded to produce new forms of ‘precarity’ (e.g. Standing, 2011). The other group of dominant theories are from critical and constructivist sociologists, both generally developed from Foucauldian ideas of governmentality, that argue society and subjectivity has been psychologized (e.g. Rose, 1999) and medicalized (e.g. Armstrong, 1995). For Väänänen, all four positions have strengths, but omit personal, cultural and political explanations, while also relying on a ubiquity and universalism that is neither sufficiently substantiated, nor provides a complete explanation. Väänänen’s summaries of these research streams on the relationships between work and mental health are excellent; any reader, regardless of familiarity with the topic, will benefit from engagement. Yet Väänänen’s criticisms of these research approaches are the real theoretical hook for TRoMVaW, opening the door to proceed.