Data Collection

I employed data triangulation using a combination of interviews and document review for my data collection. This section elaborates on the process followed for both these modes of data collection.

4.6.1 Interviews

Semi-structured interviews with open ended questions and themes for discussion (see Appendix C for the topic guide) were employed so that respondents could talk about their experiences without being led by the interviewer (Silverman, 2006; Yin, 2009). In this process, there is an element of ‘qualified naïveté’ (Kvale, 2007) as well as I needed to be open to new or emergent ideas rather than be influenced solely by pre-supposed assumptions. Kvale (2007) warns against a total lack of awareness of the topic being researched, as the interviewer needs to have a level of sensitivity and discernment to highlight the various nuances of the themes being studied. There is therefore a tension between these two contrasting needs – that of naïveté and that of sensitivity to the research subject (Kvale, 2007), and this needs to be kept in balance. During an interview, respondents themselves may discover new things they were not aware of earlier, and may change their perceptions of a theme, and embark on a process of reflection, making the interview a learning process for both participants of the interview (Kvale, 2007).

Majority of the 51 interviews were conducted as voice calls over the telephone or Skype, due to time and place constraints. 21 interviews were conducted face to face, and 1 interview was a video call via Skype. All interviews with key informants (second phase of

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interviews) were recorded using a Livescribe smartpen. Informed consent was obtained and recorded from all interview respondents after providing them with details regarding the purpose of the research. Participants were assured of their confidentiality and privacy, with a clear and mutual understanding of who could access the information they provided (Kvale, 2007).

My first stage of data collection involving sensitising interviews was useful in helping me improve my interviewing technique. As I transcribed these before I embarked onto the main interviews, I was able to see some of my faults such as unconsciously leading questions and interrupting the respondent with a follow-up question. I realised that in instances when I wanted further details on the issue being discussed, it was usually sufficient and less intrusive to use elaboration probes (Patton, 1990) rather than cutting in to verbally raise a question. I kept these points in mind, and made a conscious effort to avoid these pitfalls in the later stages of my data collection.

All the interviews were transcribed completely by me. Though a time consuming process, I chose to do the transcribing manually on my own, using it as an opportunity to familiarise myself with my data, and to use the transcribing process as an interpretive tool in itself (Lapadat, 2000). I had over 48 hours of recorded interview data in total (see Appendix A), and spent approximately 190 hours transcribing them.

As I was predominantly interested in the informational content of the interviews rather than the linguistic details, I employed denaturalised transcription and chose to omit most of the pauses and response tokens (such as ‘hmm’, ‘uhm’, etc.) indicating a momentary pause for thought (Lapadat, 2000; Oliver, Serovich and Mason, 2005). In some instances, non-verbal cues can be very important, as in the case of one respondent who was

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extremely cautious with what he said, given the sensitive nature of the topic being discussed, and pointed at pictures or documents to indicate who or what he was referring to. Whenever possible I noted down the gesture used and what it was meant to indicate, and used my handwritten notes to link to the right points in the transcript.

I recognised there would be a likelihood of some ‘privileged’ stakeholders in my sample (Leys, 2002), given the context specific nature of the research question, and the need to address it. As a result, the majority of my respondents were clinicians (see Appendix A). I did find that despite my efforts to form a sampling framework by identifying individuals from specific organisations (see section 4.5), it was hard to pin certain respondents to a single representative body as several of those in the professional bodies also worked with Connecting for Health and other Department of Health units or with academia. Table 4.1 below provides a summary of the distribution of respondents across different categories (bearing in mind that these categories overlap). More details are provided in Appendix A which lists the 37 key respondents, their various affiliations and the organisations which are included in the categories specified in Table 4.1. The affiliations listed for each respondent are not necessarily their current ones, but also include past relevant affiliations which may have caused me to include them in my sample.

Table 4.1 Distribution of respondents across categories

Category Number of

respondents

Clinical professional bodies 12

Non-clinical professional bodies 4

Government/ Department of Health/ NHS bodies 20

Consumer and patient groups 2

Industry 6

Policy advisors / politicians 4

Academia 10

107 4.6.2 Documentary data

Documents provide useful sources for data triangulation, thus improving the validity of research (Patton, 2002; Miller and Alvarado, 2005). In tracing historical events and discourses, documents provide a frozen snapshot of aims, accounts and debates pertaining to the subject being investigated (Miller and Alvarado, 2005). This preserved account of events is invaluable for the purpose of uncovering factual descriptions and both individual as well as collective views of key stakeholders in a project. Their ‘inter- textuality’ and characteristic of drawing upon other relevant documents in the field may be seen in the example of parliamentary consultations, responses from key stakeholder groups and published reports by government bodies.

Miller and Alvarado (2005) highlight three points to address when using documentary data: the document selection process, the social exchange of documents and source criticism. The first of these has already been discussed (see section 4.5). The social exchange of documents relates to their accessibility and availability. As my document sample was intended to include publications by the UK government, the NHS and professional bodies, these reports were easily accessible online. The sensitive nature of the NPfIT does mean however, that there would have been confidential reports and accounts which were not made available to the public. I did gain access to a few such reports through my interview respondents. One report I received was unlikely to have been a confidential report, but was however unavailable on the Connecting For Health website as it was dated almost ten years previously and did not seem to be available in the online archives. The third point, namely source criticism, requires a critique of the authenticity and accuracy of the source (external critique), and the ability of the source to be a reliable source of information (internal critique). As discussed by Hall and Rist (1999),

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document analysis is dependent upon the quality and reliability of the document under study. The documents I shortlisted were published by government bodies, the NHS, or professional bodies, all of whom are either the originator of the topic under discussion, or are reputed and capable of providing an informed and representative account of the discussion at hand. The reports were accessed from the websites of the organisations publishing them, or from the Department of Health website which housed all the responses to consultation documents in a single place.

While the documents selected were from reliable sources, their public nature gives reason to be cautious in accepting them at face value, as they may be polished and strategically written for targeted groups (Miller and Alvarado, 2005). This point surfaced during some of the interviews, when respondents highlighted concerns regarding the lack of transparency and ethical procedures in the publication of certain reports.