Prof. Jane Sandall

My research interests have come to be concerned with two questions: 1) How the social and cultural shaping of maternal health policy influences the organisation and delivery of healthcare work, and the services that women and their families receive; 2) How professional knowledge and practice are shaped by, and mediated through new reproductive technologies and exploring the social and ethical implications of these.

Studies of UK maternal health professionals and users of services have included - skill-mix and substitution in maternal health care, the evaluation of a range of midwifery-led care programmes and disparities in care programmes, the management of intrapartum transfer, and comparative work on the social and cultural shaping of maternity policy in Northern Europe and North America.

Research on reproductive technologies has compared midwives' attitudes and practice regarding prenatal screening in UK and Europe; ethnic minority women's experiences of prenatal screening; the social and organisational implications for women and health professionals of the implementation of an innovative one stop clinic offering first trimester prenatal screening technology for Down's Syndrome, and the experience of staff working with pre-implantation diagnosis.

My current interests are focused on developing greater sociological understanding of the relationship between context and health care practice using complex intervention frameworks for evaluation and the use of institutional ethnography. I have led a Cochrane Review of midwife-led care, and I am working with others on the development of access, quality, optimal outcome indicators in maternal health care.

Future work is focused in the area of safety and quality in maternity care and I am leading a programme of work which is theoretically informed by theories of risk and safety, and occupational jurisdiction on innovation in service delivery and health technologies in the NIHR King's Patient Safety and Service Quality Research Centre. Specific projects include management of escalation of care in acute medicine and maternity and the governance of therapeutic innovation in health care. In addition I am a co-investigator on Birthplace, a national study of birth outcomes in the home, midwife led, and obstetric led units and a NIHR programme on obesity in pregnancy.

Research in the UK on service reconfiguration has included pre-trial work assessing the impact of innovative continuity models of midwifery care for mothers, babies and maternity staff. Findings have informed the recommendations for birth care in Sir Ara Darzi's review of health services in London and ongoing work on maternity by NHS London.

In DH commissioned research, a workforce analysis of the role of maternity support workers in England informed future NHS workforce policy which raised questions about workforce skillmix and shifting occupational boundaries in healthcare and the governance of unregulated workers. Findings informed guidance provided by the Chief Nursing Officer for England in May 2007 to maternity services to review the working practices of all support workers within maternity services and NMC advice for non-regulated healthcare staff. Resulting in invitations by the Royal College of Midwives, the Nursing and Midwifery Council and some LSA Regions to inform future thinking in this area.

Research funded by the ESRC Innovative Health Technologies Programme offered insights into participants' responses to the new emerging technology of prenatal screening; their views about its routinisation; understandings of complex probabilistic information; and feelings about family involvement in genetic decision-making. Findings informed the Human Genetics Commission Consultation and the National Down's Screening Programme model of best practice, and resulted in an invitation to contribute to two international meetings on technology diffusion. Research funded by the Wellcome Trust has explored the actual and potential ethical, social, clinical and legal dilemmas genetic developments and new reproductive technologies pose for practitioners, scientists, policy makers and others working in PGD and findings have been disseminated to diverse audiences including genetic counsellors, scientists, clinicians and other practitioners; social science, legal and ethics conferences; and a variety of public engagement events including Festival of Science seminars.