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Article History

Received: 18 February 2021

Accepted: 1 June 2021

First Online: 16 July 2021

Declarations

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: The University of Leeds School of Healthcare Research Ethics Committee gave ethical approval for the study (approval number: HREC16–044), which was performed in accordance with the Declaration of Helsinki. For the Phase 1 interviews, participants received a written information sheet, to which they gave their written, informed consent. Where face-to-face interviews could not be arranged and telephone interviews took place instead, verbal consent was recorded and documented in the relevant transcripts. As is customary in ethnographic research, during the ethnographic phase of the study it was not feasible to obtain written consent from staff in the vicinity while undertaking observations (observations took place in busy locations with staff entering and leaving frequently, and work could have been disrupted if the researchers attempted to obtain written consent). Instead, a poster was displayed and an information sheet was given to any interested parties. These documents, and the researchers themselves in person, made it clear that staff had no obligation to be observed, and were free to decline before, during and up to 48 h after observation. Patient care was not observed. There was no ethical requirement for consent to be documented in the ethnographic phase. In the more controlled environment of the meetings observed and informal interviews conducted in this phase, an information sheet was given to participants, and their written, informed consent was obtained. All the above arrangements were included within the ethical approval for this study.

: In accordance with the ethical approval for this research, interview participants were given an information sheet which explained data they provided might be used in publications, with identifiable information removed, and they confirmed they had read and understood this when signing the consent form. The information sheet for the ethnographic observations also explained that data collected could be used in publications, with identifiable information removed, and participants were free to decline before, during and up to 48 h after observation.

: We have the following competing interests to disclose: CG is a member of the Myocardial Infarction National Audit Programme (MINAP) Academic and Steering Groups, and RF is co-PI for the Paediatric Intensive Care Audit Network (PICANet). There are no competing interests to disclose for any of the other authors: LM, NA, JG, ME, JL, RAR, DD, MM or RR.