Interview with Mirza Lalani – Researcher in Residence
08 AUGUST 2017
It is just over two years since Tower Hamlets Integrated Provider Project now known as Tower Hamlets Together, became one of the first 29 vanguards to be announced. Vanguards were tasked with transforming care for patients, communities and staff, testing out new ways of delivering healthcare that could be the blueprints for the future of the health and care system.
Tower Hamlets Together is all about health and social care organisations working more closely together to improve the health and wellbeing of people living in Tower Hamlet. This means providing services in a more coordinated way to reduce duplication and improve the overall experience and outcomes for the people who need them
Mirza Lalani has been appointed as the embedded researcher for a qualitative evaluation of the Tower Hamlets Vanguard. He will look in detail at changes made in the borough to see if these have resulted in a better experience for patients.
What will your new role involve?
There are three over-arching aspects to the research. Firstly, I plan to look at the implementation of the changes made. How changes were introduced? Has it served patients well? How did the six different health and social care partners develop the infrastructure to work differently and streamline services? Did they avoid duplication and how did they respond to challenges and teething problems.
Secondly, I will focus on partnership working. How joined up is it in reality? How does this impact on service delivery and the professionals providing care?
Thirdly, I will be seeking out local people to be involved in this evaluation to hear their views and experiences. I want to understand if the vanguard has actually improved the patient’s perceptions of the services they receive and if it is accountable to its citizens.
How will you approach this evaluation?
I will be using the ‘Researcher in Residence’ model which means I will be a member of the vanguard team, involved in discussions, decision-making processes and participating, not just observing. This will not be a standard data collection and analysis exercise – such an approach can be limited when trying to get a true picture. The evaluation will be formative and developmental, and co-designed with key stakeholders within the vanguard. I have been an embedded researcher in previous projects and being part of a team enables you to get down to the nitty gritty and gather richer data.
With this approach, how can you ensure that you stay objective and avoid being influenced by the project team?
You have to be mindful of your role and purpose. You have a different focus. But it enhances your understanding to be close to decision-makers as they circumnavigate challenges. You are an additional resource and being embedded engenders good working relationships. The objectivity comes from the diversity of the evaluation partners (and participants) in terms of their professional background, skill sets, experiences and discipline.
What attracted you to this role?
I thought this was an intriguing project and I have a genuine interest in this area of work. I was drawn to it as it is patient-centred. I am keen to know – is integration and change really happening? What are the political issues? Has it reduced costs? Has it reduced inequalities?
What do you think we can learn from projects like this?
You don’t have to be an academic researcher to test new ways of working. In-house evaluation adds a lot to health care but there is a tendency to want to measure and quantify everything – bed days for a care episode, waiting times, patient satisfaction, etc. These formative, qualitative evaluations provide some context and narrative for the numbers, instead of just asking ‘what’ works, an embedded researcher is well placed to explore, ‘why’, ‘how’ and ‘what works in a specific context’- it validates and gives meaning to what we all do.
What type of research did you do prior to this?
I have been working in health services evaluation in the UK and in low income settings. I previous worked on a programme to evaluate a quality improvement collaborative in SE England.
My PhD research at the London School of Hygiene and Tropical Medicine evaluated health systems for the regulation and quality of medicines in West Africa with a specific focus on Senegal.
What are your impressions of Tower Hamlets so far?
Positive and I am particularly struck by the incredible diversity – all extremes in one borough! But it feels friendly!
What has been your career journey?
I am a Pharmacist by profession. I worked in primary care for a few years. But I knew I had broader interests so I undertook a Masters at the London School of Hygiene and Tropical Medicine in the Control of Infectious Diseases and then a PhD.
How did you end up in the field of research?
I always liked reading! Research was different. I liked the idea of influencing or shaping policy one day – research informs us and gives us confidence to do new things – and stop doing other things which are no longer valid.
What is the most exciting research finding you have been involved with?
It won’t sound very exciting but I evaluated patient safety initiatives in secondary care. We were surprised at the benefit of only small amounts of money and resource investment and that individual will and motivation can facilitate vast improvements at a local level despite the lack of directorate support.
How do you relax?
Walking. I am always dragging my family to National Trust sites. It’s good family time. I like exploring. I cycle too.
What is your favourite book or film?
I’ve just read The Man in the High Castle by Philip Dick. I loved the Lord of the Rings Trilogy, both the books and the films. I’d love to go to New Zealand one day to where it was filmed.
Who would make the guest list of your celebratory dinner party?
Nelson Mandela, David Cameron (only to understand what he was thinking (or drinking) when he called an in/out referendum), Michael Mcintyre, Muhammed Ali and Emmeline Pankhurst.
Final question: How did it feel to be the questionee instead of the questioner?
Strange at first but it’s refreshing to be able to talk about myself for once!
Mirza was interviewed by Janet Flaherty, Head of Communications at ELFT