Professor Nicola Mackintosh

Professor in Social Science applied to Health

School/Department: Population Health Sciences Department of

Telephone: +44 (0)116 229 7262



"Dr Nicola Mackintosh is a Professor in Social Science applied to Health. She has a background in critical care nursing and is a graduate of King’s College London. Her research uses sociological theory and methods to bring new understandings to patient safety and improvement science research. Before she joined SAPPHIRE she worked in the NIHR King’s Patient Safety and Service Quality (PSSQ) Research Centre leading ethnographic research exploring the management of complications in maternity and acute care. Her PhD examined the construct of ‘rescue’. She then moved to the Faculty of Life Sciences & Medicine followed by the Centre for Implementation Science at Kings College London. She was awarded a post-doctoral fellowship within King’s Improvement Science to study patient and family contributions to safety. Nicola has continued to develop her substantial track record in patient safety and improvement research since joining SAPPHIRE. Her current research addresses patient safety cultures and response systems for escalation of care; the role of digital technologies in shaping patient-provider roles; and patient responsibilities around self-diagnosis and self-triage linked to self-care and patienthood. Nicola is SAPPHIRE Deputy Research Group Lead. "


"Nicola was a Panel Member for Research for Patient Benefit Programme (RfPB) East Midlands Regional Advisory Committee (RAC) (2019-2023). She is a reviewer for NIHR Board (HS&DR) (ethnography and qualitative methods). Her current grants include: • N Mackintosh (PI), N Armstrong, E Boyle, C Tarrant, J Anderson, P McParland, T Padden. PremPath: Improving the optimisation and stabilisation of the preterm infant 2023-2025 NIHR PRP • N Mackintosh (PI) C Tarrant N Armstrong ‘Enabling safety culture development practices across maternity and neonatal services’ 2021-3 NHSE/I • P McCulloch (PI) G Bond-Smith A Ghaferi L Kenward C Peden N Mackintosh R Baker L Yao R Lilford et al. RESPOND study (Rescue for Emergency Surgery Patients Observed to uNdergo acute Deterioration 2020-2025 NIHR PGfAR"


Seaton, S. E., Manning, J. C., Draper, E. S., Davis, P. J., & Mackintosh, N. (2023). Understanding the co‐construction of safety in the paediatric intensive care unit: A meta‐ethnography of parents' experiences. Child: care, health and development.

van Oppen, J. D., Coats, T. J., Conroy, S. P., Lalseta, J., Richardson, V., Riley, P., Valderas, JM. & Mackintosh, N. (2023). Co-creation of a patient-reported outcome measure for older people living with frailty receiving acute care (PROM-OPAC). Journal of Patient Experience. 2023;10. doi:10.1177/23743735231158941

Muthelo, L.; Mbombi, M.O.; Bopape, M.A.; Mothiba, T.M.; Densmore, M.; Vanheerden, A.; Norris, S.A.; Dias, N.V.; Griffiths, P.; Mackintosh, N. (2023) Reflections on Digital Maternal and Child Health Support for Mothers and Community Health Workers in Rural Areas of Limpopo Province, South Africa. Int. J. Environ. Res. Public Health, 20 (3) 19 Jan 2023

Sutton, E., Booth, L., Ibrahim, M., McCulloch, P., Sujan, M., Willars, J. and Mackintosh, N., (2022) Am I safe? An Interpretative Phenomenological Analysis of Vulnerability as Experienced by Patients With Complications Following Surgery. Qualitative Health Research, 32(14) 02 Nov 2022.

Bagalkot N, Akbar SZ, Sharma S, Mackintosh N, Harrington D, Griffiths P, Noronha JA, Verdezoto N. (2022) Embodied negotiations, practices and experiences interacting with pregnancy care infrastructures in South India. InCHI Conference on Human Factors in Computing Systems 2022 Apr 29 (pp. 1-21).

Mackintosh N, Agarwal S, Gong QS, Briley A, Sandall J, Armstrong N. (2022) Curating the digital space: Structural gate-keeping and boundary work in maternity care. SSM-Qualitative Research in Health. Dec 1;2:100145

van Oppen, J.D., Alshibani, A., Coats, T.J., Graham, B., Holch, P., Lalseta, J., Mackintosh, N., Richardson, V., Riley, P., Valderas, J.M. and Conroy, S.P. (2022). A systematic review and recommendations for prom instruments for older people with frailty in emergency care. Journal of Patient-Reported Outcomes, 6(1), pp.1-11.

van Oppen, J. D., Coats, T. J., Conroy, S. P., Lalseta, J., Phelps, K., Regen, E., Riley, P., Valderas, JM. & Mackintosh, N. (2022). What matters most in acute care: an interview study with older people living with frailty. BMC geriatrics, 22(1), 1-11.

Carpio-Arias, T. V., Verdezoto, N., Guijarro-Garvi, M., Abril-Ulloa, V., Mackintosh, N., Eslambolchilar, P., & Ruíz-Cantero, M. T. (2022). Healthcare professionals’ experiences and perceptions regarding health care of indigenous pregnant women in Ecuador. BMC Pregnancy and Childbirth, 22(1), 1-11.

van Oppen, J.D., Regen, E., Phelps, K., Coats, T.J., Valderas, J.M., Conroy, S.P. and Mackintosh, N. (2021). Barriers and Benefits Experienced in Qualitative Geriatric Emergency Care Research during the Covid-19 Era. Journal of Geriatric Emergency Medicine, 2(11), p.3.

Mackintosh N. Gong S. Q. Hadjiconstantinou M. & Verdezoto N. (2021). Digital mediation of candidacy in maternity care: Managing boundaries between physiology and pathology. Social Science & Medicine 114299.

Verdezoto, N., Bagalkot, N., Ghode, A., Purohit, S., Murthy, L., Mackintosh, N., Griffiths, P. The Invisible Work of Maintenance in Community Health: Challenges and Opportunities for Digital Health to Support Frontline Health Workers in Karnataka, South India. PACMHCI V5, CSCW1 April 2021

Carter, W., Bick, D., Mackintosh, N., Sandall, J. (2021) Maternal help seeking about early warning signs and symptoms of pre-eclampsia: a qualitative study of experiences of women and their families. Midwifery, 98, p.102992

Xyrichis A Iliopoulou K Mackintosh NJ Terblanche M Bench S Philippou J Sandall J. Healthcare stakeholders’ perceptions and experiences of factors affecting the implementation of critical care telemedicine (CCT): qualitative evidence synthesis. Cochrane Database of Systematic Reviews 2021 Issue 2. Art. No.: CD012876.

Mackintosh NJ Davis RE Easter A Rayment-Jones H Sevdalis N Wilson S Adams M Sandall J. Interventions to increase patient and family involvement in escalation of care for acute life-threatening illness in community health and hospital settings. Cochrane Database of Systematic Reviews 2020 Issue 12. Art. No.: CD012829.

Mackintosh N. Armstrong N. (2020) Understanding and managing uncertainty in healthcare: revisiting and advancing sociological contributions. Sociology of Health & Illness 42 pp.1-20.

Verdezoto, N., Carpio-Arias, FA., Carpio-Arias, V., Mackintosh, N., Eslambolchilar, P., Delgado López, VC., Andrade Trujillo, CA., Vásconez Merino, GX. (2020) Indigenous Women Managing Pregnancy Complications in Rural Ecuador: Barriers and Opportunities to Enhance Antenatal Care. Accepted to 11th Nordic Conference on Human-Computer Interaction (NordiCHI 2020), Tallinn, Estonia, October 25–29, 2020.

Van Oppen, J., Valderas, J., Mackintosh, N., Conroy, S. (2020) Patient-reported outcome and experience measures in geriatric emergency medicine. Zeitschrift fuer Gerontologie und Geriatrie. Zeitschrift für Gerontologie und Geriatrie, 54(2), pp.122-124

Bagalkot, N., Verdezoto, N., Ghode, A., Purohit, S., Murthy, L., Mackintosh, N., Griffiths, P. (2020) Beyond Health Literacy: Navigating Boundaries and Relationships During High-risk Pregnancies. Challenges and Opportunities for Digital Health in North-West India. Accepted to 11th Nordic Conference on Human-Computer Interaction (NordiCHI 2020), Tallinn, Estonia, October 25–29, 2020.

Mackintosh, N, Agarwal, S., Adcock, K., Armstrong, N., Briley, A., Patterson, M., Sandall, J., Gong, Q. (2020) Online Resources and Apps to Aid Self-Diagnosis and Help Seeking in the Perinatal Period: A Descriptive Survey of Women's Experiences. Midwifery, 90, 102803 

Verdezoto, N., Bagalkot, N., Syeda, Z., Sharma, S., Griffiths, P., Mackintosh, N., Harrington, D. (2019). Infrastructural Artefacts in Community Health: A Case Study of Pregnancy Care Infrastructures in South India. In Proceedings of the 7th International Conference on Infrastructures in Healthcare (infraHEALTH 2019), 30-31st May 2019

Finch TL, Girling M, May CR, Mair FS, Murray E, Treweek S, McColl E, Steen IN, Cook C, Vernazza CR, Mackintosh N. Improving the normalization of complex interventions: part 2-validation of the NoMAD instrument for assessing implementation work based on normalization process theory (NPT). BMC medical research methodology. 2018 Dec 1;18(1):135.

Bagalkot, N., Verdezoto, N., Lewis, M., Griffiths, P., Harrington, D., Mackintosh, N., Noronha, J. (2018) Towards enhancing everyday pregnancy care: Reflections from community stakeholders in South India. In Proceedings of the 9th Indian Conference on Human Computer Interaction, pp. 71-74

Cupit C, Mackintosh N, Armstrong N. (2018) Using ethnography to study improving healthcare: reflections on the ‘ethnographic’ label. BMJ Quality & Safety 27: 258–260

Mackintosh, N, Sandall, J, Collison, C, Carter, W, Harris, J (2018) Employing the Arts for Knowledge Production and Translation: Visualising new possibilities for women speaking up about safety concerns in maternity. Health Expectations, 21(3), pp.647-658.

Mackintosh, N., Rance, S., Carter, W., & Sandall, J. (2017). Working for patient safety: a qualitative study of women’s help-seeking during acute perinatal events. BMC pregnancy and childbirth, 17(1), 232.

Carter W, Bick D, Mackintosh N, Sandall J. (2017) A narrative synthesis of factors that affect women speaking up about early warning signs and symptoms of pre-eclampsia and responses of healthcare staff. BMC Pregnancy and Childbirth, 17(1), 63.

Mackintosh N. Terblanche M. Maharaj R. Xyrichis A. Franklin K. Keddie J. Larkins E. Maslen A. Skinner J. Newman S. De Sousa Magalhaes J. and Sandall J. (2016) Telemedicine with clinical decision support for critical care: a systematic review. Systematic Reviews 5 176

Mackintosh N. & Sandall J. (2015). The social practice of rescue: the safety implications of acute illness trajectories and patient categorisation in medical and maternity settings. Sociology of health & illness. Volume 38 Issue 2 Pages: 252-269 [interviewed on Radio 4 Thinking Allowed about the paper 9th March 2016]

Mackintosh N. Humphrey C. & Sandall J. (2014). The habitus of ‘rescue’ and its significance for implementation of rapid response systems in acute health care. Social Science and Medicine 120 (Nov) 233-242

Mackintosh N. Watson K. Rance S. & Sandall J. (2014). Value of a modified early obstetric warning system (MEOWS) in managing maternal complications in the peripartum period: an ethnographic study. BMJ quality & safety 23(1) 26-34

Rainey H. Ehrich K. Mackintosh N. & Sandall J. (2013). The role of patients and their relatives in ‘speaking up’ about their own safety-a qualitative study of acute illness. Health Expectations.

Rance S. McCourt C. Rayment J. Mackintosh N. Carter W. Watson K. & Sandall J. (2013). Women's safety alerts in maternity care: is speaking up enough? BMJ Quality & Safety 22(4) 348-355.

Mackintosh, N., Rainey, H., & Sandall, J. (2011). Understanding how rapid response systems may improve safety for the acutely ill patient: Learning from the frontline  BMJ Quality & Safety, 21(2), 135-144. 

Mackintosh, N., & Sandall, J. (2010). Overcoming gendered and professional hierarchies in order to facilitate escalation of care in emergency situations: The role of standardised communication protocols. Social Science and Medicine, 71(9), 1683-1686. 

Berridge, E.-J., Mackintosh, N. J., & Freeth, D. S. (2010). Supporting patient safety: Examining communication within delivery suite teams through contrasting approaches to research observation. Midwifery, 26(5), 512-519. 

Freeth, D., Ayida, G. Berridge, EJ. Mackintosh, N Norris, B. Sadler, C. Strachan, A. (2009) MOSES:  Promoting Patient Safety in Obstetrics with Teamwork-focused Interprofessional Simulations. Journal of Continuing Education in the Health Professions, 29 (2) 98-104

Mackintosh N., Berridge EJ, Freeth D (2009) Supporting structures for team situation awareness and decision-making: insights from four delivery suites. Journal of Evaluation in Clinical Practice, 15, 46-54



"Nicola is Health Sciences Pathway Lead for Health and Wellbeing ESRC Doctoral Training Programme. Current/completed PhD students: Wendy Carter ‘A qualitative study of factors which influence help seeking by women who develop pre-eclampsia and the response of health care workers’, Health Foundation Studentship, KCL awarded August 2018; Jo Dickens ‘Understanding Multidisciplinary approaches and Parental Input in perinatal mortality REview (the UMPIRE Study)’, University of Leicester; Rebecca Stevenson ‘Patient safety in complex systems: developing and applying ‘Safety II’ in multidisciplinary care for younger people with eating disorders’, ESRC Studentship, University of Warwick; Vimbai Mamombe ‘Breastfeeding support for mothers’ of late preterm infants and their babies: The role of healthcare workers’, University of Leicester; Helen Elliott-Mainwaring ‘The role of visual management tools for the coordination of teams in healthcare’, THIS Institute Doctoral Studentship, University of Leicester; James Van Oppen ‘Development and validation of a patient-reported outcome measure for older people with frailty and emergency care needs’, NIHR Doctoral Fellowship, University of Leicester awarded Aug 2023; Merissa Hickman 'Maternal and paternal futures: responsibilisation practices in the preconception period to ensure health outcomes for babies', Wellcome Trust studentship, University of Leicester; Paul Garvey 'Workload, Staffing and Patient Safety in Healthcare: Examining Practices and Contexts', NIHR PSRC 


"Nicola’s teaching interests include qualitative research methods, patient safety, ethnography, healthcare improvement and implementation science. She is Qualitative Methods Module lead (and was past Programme lead) for the MRes in Applied Health Research and Course lead for the University of Leicester’s ‘Ethnography for Healthcare Improvement Summer School’. She teaches on the MSc in Quality and Safety in Healthcare. She is Senior Tutor for Health Sciences. She has contributed previously to Advanced Qualitative Methods; MSc Implementation Science; Older Person’s Nurse Fellowship; Design and Evaluation of Complex Interventions; and Doing Social Science Research in Healthcare Settings at King’s College London."

Press and media

Nicola was interviewed on 9th March 2016 BBC Radio 4; Thinking Allowed; Patient rescue and resuscitation linked to publication: Mackintosh N. & Sandall J. (2015). The social practice of rescue: the safety implications of acute illness trajectories and patient categorisation in medical and maternity settings. Sociology of health & illness. Volume 38 Issue 2 Pages: 252-269

She was also on local radio in Leicester in 2019 and 2020 promoting her research on Red Flags and symptom checkers for self-diagnosis in maternity


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