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Find out how social scientists in our department are shaping primary health care through collaborative, theory-driven research. From digital health to health inequalities, their research helps shape policy, improve services, and understand the social factors influencing health and care.

A bustling crowd of 18 people pass by an oversized stethoscope to illustrate the medical field of social science in health care

By Sara Shaw, Catherine Pope, Chrysanthi Papoutsi and Lisa Hinton

Social sciences play a vital role contributing to the evidence base for primary health care and wider health and social care systems.  But what do social scientists actually do, how do we do it, and what difference do social sciences make? On 9th May 2025, social scientists, drawn largely from two research groups in our department – the Interdisciplinary Research in Health Sciences (IRIHS) group and the Medical Sociology and Health Experiences Research Group (MS&HERG) –­ came together to share and celebrate the work we do, explore interconnections and think about the questions above.

We suspect that our department has one of the largest groupings of social scientists in any UK Primary Care Department, possibly in any UK medical school/faculty. We come from a variety of disciplinary backgrounds, including sociology, policy studies, anthropology, social psychology, demography, social geography and political science. Some would argue that epidemiology and economics are also social science disciplines. Our research groups include clinicians (GPs and allied health professionals) and we work closely with other research groups; for example, the Hypertension and Cancer groups were represented at the meeting, as were colleagues from the Health Behaviours and Infections groups.

It’s more than just qualitative methods - theory is important

IRIHS and MS&HERG are known for their expertise in qualitative methods, and indeed we discovered during the day that sometimes ‘applied social science’ is seen as synonymous with these methods. Presentations established that this is indeed a key strength, but we also lead mixed-methods research and bring a range of methodological and theoretical expertise to our collaborations. In particular the day highlighted that we bring knowledge of a range of social theories that are key to gaining a deep understanding of systems, complexity and context, exploring health and care experiences, and how staff and patients do things in their everyday work and lives. Much of our work examines health care interventions and implementation, as well as synthesising evidence, and translating evidence into policy and practice.

In the first session of our day, we quickly established that, between IHRIS and MS&HERG, we’ve generated close to £20 million total income over the past 5 years, and built extensive collaborations (internally and externally) across research, policy and practice. We focussed our first session on digital health and noted examples of key contributions with significant impact on policy, such as:

  • The DECIDE rapid evaluation centre which focuses on technology-enabled remote monitoring working directly with policy teams. This centre has supported policy making about winter pressures work in COPD services and the introduction of new digital NHS health checks.
  • The Remote by Default 2 study which has informed the shape of remote general practice in the pandemic and beyond, shining a light on issues of safety and equity and working closely with NHS England.
  • The Together 2 project which completes a 10-year cycle of research on group consultations, with policy-relevant findings about how such groups augment current services and where they can help to relieve some of the pressures across the system.
  •  The NHS App evaluation which used multiple methods (e.g. observation, ‘go along’ interviews) and worked with clinical and non-clinical staff, policymakers and patients to understand workflow, workload, and experiences of the national rollout of the App.
  • The BUMP Trial which tested self-monitoring of blood pressure during in pregnancy, via an app, and informed national maternity policy during the pandemic and beyond.

Each of these studies mobilised social science to understand and crucially explain how and why digital health interventions worked (or did not), teasing out multiple layers of complexity and showing the work and effort needed by staff and patients to bring these technologies into use.    

The session highlighted that care is increasingly digitalised, heterogenous and multi-modal, and this requires innovative methods. Again this played to the strengths of our social science community to use a wide range of methodologies. Some examples presented included:

  • The ModCons study which used team-based ethnography, allowing researchers to be in different parts of general practice sites at the same time, observing triage work from different perspectives, and allowing them to build a rich picture of the flow of patient requests for care.
  • The Search study’s novel approaches to patient and public involvement, grounded in trauma-informed care, to focus on how those with multiple complex needs experience digital exclusion.

The cross-cutting interest in health inequalities and exclusion was a clear connecting thread across the groups, for example in research about NHS111 which demonstrated eHealth literacy inequalities, and new doctoral research exploring the use of AI to support access to eye care for Aboriginal peoples in rural Australia.    

It was striking that the word ‘theory’ was at the forefront of the presentations, underscoring that social scientists are not ‘just’ methodologists. Social theories provide explanatory power, offering a lens through which we can see and analyse the world around us. This brings rigour to our work, and extends its value. In Remote by Default 2, a linked PhD study offered a new conceptual framework to guide thinking about how continuity can be achieved in remote care, and in another study Jutel’s work on diagnosis, and classic theorising by Merton, has helped to explain the social construction of the diagnosis of endometriosis. Theoretically informed research is core to applied social science and makes such work both useful and relevant for frontline practice. Other presentations mobilised theories of socio-materiality, transitions, responsibilisation and frameworks including NASSS to demonstrate this.

The presentations showed too that social scientists work across sectors and in multidisciplinary teams and collaborations. In addition, much of the work that we do uses co-production and participatory approaches designed to maximise inclusivity, diversity and provide a voice for those seldom heard.  We were reminded of our skills in synthesising evidence, and the need, especially in the current political climate, to rebut misinformation and keep striving for equity.

Given the world we live in post-pandemic and with shifts from analogue to digital, research related to digital health forms a major part of the work of social scientists in the department. But this is far from the whole story. Across IRIHS and MS&HERG our research stretches across the organisation and delivery of health and care services; interests in acute and urgent care; patient and staff experiences of care; and technology and innovation.

Presentations in the second session highlighted again that social scientists have broad ranging expertise, for example contributing to developing outcome measures to understand patient and carer experiences of dementia, using experiences to improve the delivery of maternity and postnatal care, and enrolling realist evaluation and review methods to examine “what works for whom in what circumstances” across a range of health and care areas. Studies of care delivery highlighted the challenges of safeguarding when delivering remote care, the complexities surrounding NHS 111, tricky issues involved in managing conflict-expectant consultations, and how ground breaking conversation analysis methods can reveal how risk can be better managed.

Another important thread in the work done by applied social scientists is in augmenting trials – for example the BUMP trial (of monitoring blood pressure at home during pregnancy) and TASMIN5S trial (exploring self-monitoring in stroke care). In both these trials the role of social scientists supporting process evaluations and core work packages was to understand the adoption and use of technologies for managing hypertension. We also learned that social scientists embedded in RCTs often shed light on how we can improve these research designs, for example by questioning representation of race and ethnicity in stroke trials.

The future undoubtedly includes more of a focus on global health and health systems. Primary care doesn’t sit alone and is part of a complex and emergent system of other sectors and specialisms. Increasingly, and especially with the impetus of the Sustainable Development Goals, health systems across the world are looking to primary care systems as the foundation for their delivery, for 2030 and beyond. Social science has much to offer here, alongside primary care and clinical medicine, in designing, evaluating and supporting equitable, accessible and efficient health systems. Such systems are developing in uncertain times, with climate change and financial austerity presenting significant challenges. With one of the largest groupings of social scientists in an academic primary care department, we have an opportunity to bring the people, knowledge, methods and skills together to make important contributions.

At the end of the day we agreed that this event should be the start not the end of a conversation about what we can do next.  We held roundtable discussions on capacity building and career development, and the research groups plan to take these ideas forward so that social scientists here in NDPCHS can keep making a (positive) difference.

Opinions expressed are those of the author/s and not of the University of Oxford. Readers' comments will be moderated - see our guidelines for further information.

 

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