South East England Research Articles

Our approach to developing communities of practice to foster research capacities for the adult social care workforce.

Efforts to build and foster adult social care research in England have historically encountered more challenges to its growth and expansion compared with health research, with a sector facing significant barriers in facilitating research activity due to a lack of resourcing, poor valuation or understanding of the profile of social care research. The landscape for supporting research in adult social care has been rather bleak, but in recent years there has been recognition of the need to foster a research community. The National Institute for Health and Care Research in England have committed to investing in social care research capacity by funding six adult social care partnerships, with one based in Southeast England. Three large online networking events were held in the first year of the project to engage managers and practitioners from the local authority and from the wider adult social care sector. These took place in July and November 2021, with a last event in March 2022. Two COPs were identified, following an ordering and thematising process of feedback from the networking events, of: (a) Supporting people with complex needs throughout the lifespan, and (b) Enhancing, diversifying and sustaining the social care workforce. Whilst it would be premature to identify their long-term impacts, through the facilitation of 20 COP meetings held so far, alongside the engagement platforms and enrichment resources, these have provided a space for regular communication in the sector, knowledge sharing and networking between COP members. The COP framework offers a collaborative approach to initiating research from the grass-roots level in adult social care. This paper focuses on how the COP model offers great promise for knowledge-exchange providing a forum to generate and disseminate knowledge around social care in our two COP domains.

SP2.1 The Impact of Cholecystectomy on The Symptom Relief and Quality of Life of Patients with Gallbladder Dysmotility

Abstract Aims The aim of this study was to demonstrate the impact of laparoscopic cholecystectomy on the physical and mental health of patients with gallbladder dysmotility. Methods Retrospective data was collected from patients who had undergone a Hepatobiliary Iminoacetic Acid (HIDA) scan between June 2012 and June 2022 in a District General Hospital in South East England. Patients diagnosed with gallbladder dysmotility were then contacted and asked to participate in a telephone interview regarding their symptoms. Their health-related quality of life was measured using the HRQoL SF-12 v2 questionnaire. Differences in the resolution of symptoms between those that had undergone a cholecystectomy and those who did not, were assessed using a chi square test. The two groups were then compared using the student t-test to assess statistically significant differences. Results 94% (n=31/33) of participants in the non-cholecystectomy group demonstrated persistent biliary pain symptoms as opposed to the 6% (n=2/33) in the cholecystectomy group. A statistically significant improvement in five out of the eight domains of the HRQoL SF-12 questionnaire was demonstrated. These domains include PCS (physical component summary), MCS (mental component summary), mental health, general health and bodily pain. Conclusion The results of our retrospective analysis demonstrate an improvement in both the physical and health-related quality of life symptoms in patients who underwent laparoscopic cholecystectomy. These findings support the use of laparoscopic cholecystectomy as an effective method for managing gallbladder dysmotility.

Current and future risk of unprecedented hydrological droughts in Great Britain

The UK has experienced recurring hydrological droughts in the past and their frequency and severity are predicted to increase with climate change. However, quantifying the risks of extreme droughts is challenging given the short observational record, the multivariate nature of droughts and large internal variability of the climate system. We use EC-Earth time-slice large ensembles, which consist of 2000 years of data each for present-day, 2°C and 3°C conditions relative to pre-industrial, to drive hydrological models of river catchments in Great Britain (GB) to obtain a large set of plausible droughts. Since future warming is certain, the uncertainty in drought is mainly associated with uncertainty in precipitation. Estimates of unprecedented extremes show that the chance of a summer month in a given year drier than the observed driest summer (1995) is projected to increase with future warming (from 9% in the present-day (PD) to 18% in a 3°C warmer world (3C) for southeast England). For winter, the chance of a dry winter month drier than the observed driest winter (1991–92) slightly decreases (from 10% - PD to 8% − 3C for southeast England) but the chance of the driest winter does not change significantly with future warming. We add value to these probabilistic estimates by sampling for physical climate storylines of drought sequences characterised by dry spring-summers, autumn-winters and consecutive dry winters. Dry spring-summers are estimated to become drier with future warming primarily driven by reduced precipitation in summer. Dry autumn-winters may become wetter mainly driven by the general trend of more precipitation in winter although drought conditions triggered by moderate autumn–winter precipitation deficits may worsen given the higher likelihood of being followed by a dry summer. Similarly, drought impacts of consecutive dry winters, a particular risk for slow-responding catchments in the English Lowlands, may worsen with future warming as the intervening summer is projected to become hotter and drier. These storylines can be used to stress-test hydrological systems and inform decision-making.

Non-theatre emergency airway management: a multicentre prospective observational study.

Emergency airway management events are common, unpredictable and associated with high complication rates. This multicentre prospective observational study across eight acute NHS hospitals in southeast England reports the incidence and nature of non-theatre emergency airway management events. Data were collected from non-theatre emergency airway management, including adverse events, over a continuous 28-day window, and recorded on an electronic case report form. Events were classified according to type (advanced airway; simple airway; and cardiac arrest). A total of 166 events were recorded, with 111 advanced airway events involving tracheal intubation or tracheostomy management. Senior personnel with three or more years of airway management experience were present for 105/111 (95%) advanced airway management episodes. There was a significant reduction in consultant or equivalent presence out-of-hours (21/64, 33%) vs. in-hours (34/47, 72%) (p < 0.001). We found high utilisation of videolaryngoscopy (95/106, 90%) and universal use of capnography for all advanced airway management events. This was lower during cardiac arrest when videolaryngoscopy was used in 11/16 (69%) of tracheal intubations and capnography in 21/32 (66%) of all cardiac arrest episodes. Adverse outcomes during advanced airway management (excluding during cardiac arrest) occurred in 53/111 (48%) episodes, including hypoxia (desaturation to Sp O2 < 80% in 14/111, 13%) and hypotension (systolic blood pressure < 80 mmHg in 27/111, 25%). Adverse outcomes were not associated with time of day or experience level of airway practitioners. We conclude that there is a disparity between consultant presence for advanced airway interventions in- and out-of-hours; high utilisation of videolaryngoscopy and capnography, especially for advanced airway interventions; and a high incidence of hypotension and hypoxaemia, including critical values, during non-theatre airway management.

Living well while providing support: validation of LTCQ-Carer for assessing informal carers’ quality of life

PurposeDespite international policies to support the health and wellbeing of informal (family) caregivers, there is no consensus on how to evaluate the effectiveness of carer support. We aimed to develop and validate a new quality-of-life measure for carers (LTCQ-Carer) and to assess its potential for use within a clinical pathway.MethodsPsychometric properties of LTCQ-Carer were tested through cognitive interviews (qualitative phase) and a pilot survey (quantitative phase). Participants were family caregivers of people recently diagnosed with mild cognitive impairment (MCI) or dementia, recruited through one of 14 memory clinics in south-east England. They self-completed the new measure and comparative existing measures (EQ-5D, ASCOT-Carer). Ongoing feedback from memory clinic staff on potential use of LTCQ-Carer was collected.ResultsInterview participants (n = 10) found all draft items of LTCQ-Carer relevant and prompted inclusion of a new item on ‘time to yourself’. Responses from survey participants (n = 107) indicated acceptability (low missing data), high internal reliability (Cronbach’s α = 0.95), and a general construct (single factor loadings 0.43–0.86 for all items). Observation of predicted associations with EQ-5D and ASCOT-Carer supported construct validity. Responsiveness requires further testing as evidence was inconclusive. Clinical staff feedback on potential use was positive.ConclusionLTCQ-Carer is a valid new measure for assessing family caregivers’ quality of life across broad health and social care domains, expanding the range of high-quality tools for evaluating carer support. When used concurrently with patient assessment, it could highlight carer needs and prompt appropriate family support at the earliest point in the clinical pathway.

Mental health and ACEs for adults in child protection and care proceedings: Audit of psychology service in Southeast England

Limited research has been conducted about the prevalence and impact of Adverse Childhood Experiences (ACEs) and mental health difficulties on those with children’s services involvement in the UK. Audit data were taken from 111 cognitive and psychological assessment reports in adults aged 18 to 55 within SWIFT specialist family service in Southeast England between May 2019 and April 2021. Descriptive analyses were conducted to show ACE type and prevalence, gender, and mental health (depression and anxiety levels) using self-report and measures such as the Generalised Anxiety Disorder questionnaire (GAD-7), Patient Health Questionnaire (PHQ-9), and Hospital Anxiety and Depression Scale (HADS). Our cohort displayed higher levels of difficulties than the general population, i.e. experiencing multiple ACEs (53.2 per cent). The female participants in our cohort expressed a higher number of ACEs and reported greater symptoms levels of depression than males. Ensuring the provision of trauma-informed therapeutic intervention may aid these individuals with making and sustaining meaningful change and escaping the intergenerational trauma cycle. Future research exploring causation and identifying potential therapeutic provisions with this population is necessary.

The development of arable cultivation in the south-east of England and its relationship with vegetation cover: A honeymoon period for biodiversity?

The onset of prehistoric farming brought unprecedented changes to landscapes and their biodiversity. Past biodiversity patterns are broadly understood for different parts of Europe, and demonstrate trajectories that have been linked to prehistoric and historic demographic transitions, and associated land-use practices. To our knowledge, this paper is the first attempt to directly link evidence of agricultural practice from the archaeological record to biodiversity patterns. Records of fossil pollen are used to estimate plant and landscape diversity patterns, and novel approaches are employed to analyse 1194 harmonised archaeobotanical samples (plant macrofossil remains) spanning the prehistoric and Roman periods, from southern England. We demonstrate changes in the use of crops and gathered edible plants and non-linear trends in cultivation practices. Whilst, overall, cereal production is characterised by ever larger and extensive regimes, different trajectories are evident for most of early prehistory, the Middle Iron Age and the Late Roman period. Comparisons with the Shannon diversity of fossil pollen records from the same region suggest a positive relationship between developing agricultural regimes and landscape scale biodiversity during the prehistoric period. The Roman period represents a tipping point in the relationship between expanding agriculture and pollen diversity, with declining pollen diversity evident in the records from the region.

Understanding the Barriers and Enablers for Seeking Psychological Support Following a Burn Injury

Burn injuries can be traumatic and distressing for patients, with a prolonged period of recovery. This qualitative study aimed to explore adult burn patients’ perceptions of the barriers and facilitators to accessing psychological support in a Regional Burns Service in Southeast England. Participants (five females and six males) were under the care of the burns unit and were not currently accessing psychological support. Eleven semi-structured interviews were conducted. Responses were analysed using thematic analysis. Four main themes highlighted how access to psychology was influenced by communication between the patient and service, beliefs about mental health, environmental challenges, and patient hope. Recommendations for improving access to burn psychological care included (1) the provision of patient resources to increase awareness and reduce stigma; (2) psychological skills training to encourage staff to recognise distress and respond appropriately; (3) staff training in the practice of cultural humility; (4) increasing psychological presence in outpatient appointments and via routine follow-ups.

Conceptualising prospective first-generation entrants’ higher education decision-making as an ‘ecology of intersecting influences’ and an ‘elastic plane’

ABSTRACT This paper draws on research conducted in four publicly funded secondary schools in the South-East of England that explored the higher education decision-making of prospective first-generation university entrants accessing school-based widening participation interventions. It begins by introducing an ‘ecology of intersecting influences’ approach that opens up the multifactorial and uncertain nature of decision-making. Interviews with staff and focus groups with young people (aged between 13 and 18) highlighted the incremental and inter-dependent nature of higher education decision-making but also the importance of attending more closely to the diversely constituted, non-linear intersections between its situated, structural, material, temporal and relational dimensions. In the English context, these include a highly socially stratified university sector and graduate labour market plus significantly increased personal costs, all of which make it harder to calculate the individual ‘worth’ of a university degree. The paper concludes that when higher education decision-making is conceptualised as both an ‘ecology of intersecting influences’ and an ‘elastic plane’, this better captures how opportunities and constraints differently play out in the decision-making of prospective first-generation entrants over time, avoiding the imposition of normative, homogenising and limiting assumptions about the difference made by different family/social positionings.

Modelling the impact of trapped lee waves on offshore wind farm power output

Abstract. Mesoscale meteorological phenomena, including atmospheric gravity waves (AGWs) and including trapped lee waves (TLWs), can result from flow over topography or coastal transition in the presence of stable atmospheric stratification, particularly with strong capping inversions. Satellite images show that topographically forced TLWs frequently occur around near-coastal offshore wind farms. Yet current understanding of how they interact with individual turbines and whole farm energy output is limited. This parametric study investigates the potential impact of TLWs on a UK near-coastal offshore wind farm, Westermost Rough (WMR), resulting from westerly–southwesterly flow over topography in the southeast of England. Computational fluid dynamics (CFD) modelling (using Ansys CFX) of TLW situations based on real atmospheric conditions at WMR was used to better understand turbine level and whole wind farm performance in this parametric study based on real inflow conditions. These simulations indicated that TLWs have the potential to significantly alter the wind speeds experienced by and the resultant power output of individual turbines and the whole wind farm. The location of the wind farm in the TLW wave cycle was an important factor in determining the magnitude of TLW impacts, given the expected wavelength of the TLW. Where the TLW trough was coincident with the wind farm, the turbine wind speeds and power outputs were more substantially reduced compared with when the TLW peak was coincident with the location of the wind farm. These reductions were mediated by turbine wind speeds and wake losses being superimposed on the TLW. However, the same initial flow conditions interacting with topography under different atmospheric stability settings produce differing near-wind-farm flow. Factors influencing the flow within the wind farm under the different stability conditions include differing, hill and coastal transition recovery, wind farm blockage effects, and wake recovery. Determining how much of the differences in wind speed and power output in the wind farm resulted from the TLW is an area for future development.

Dementia care coordinator service in Kent and Medway: a realist evaluation protocol.

Dementia care is a key priority for both NHS England and the UK government. National guidelines highlight the importance of care coordination to address the challenges people living with dementia and their carers can encounter when trying to access the health and care system. To counter these challenges, Kent and Medway Integrated Care Board (ICB) have recently implemented a proactive dementia care coordinator (DCC) service to support people with dementia and their carers from pre-diagnosis to end-of-life care. To understand how the DCC service works (or does not work), for whom, and in what circumstances. The findings will inform service development and future investment decisions. This study will use a realist approach to evaluate the DCC service in Kent and Medway ICB, south-east England, which has a population of 1.9 million, comprising 42 primary care networks (PCNs; groups of general practices) each having a DCC. An initial programme theory will be developed from existing literature, and in collaboration with stakeholders. Mixed methods, including questionnaires to DCCs, service provider metrics, and qualitative interviews, will be used to collect data on service provider and service user experiences. Interpretive comparative analysis and narrative synthesis, including evaluation of service costs against outcomes, will produce a refined final programme theory. The results from this project will produce evidence-based recommendations to help improve service delivery and possible service expansion. This protocol describes a realist evaluation designed to investigate the recently implemented DCC service in Kent and Medway ICB.

Evaluation of the NHS England ‘Op COURAGE’ High Intensity Service for military veterans with significant mental health problems

IntroductionIn November 2020, The NHS for England launched a pilot High Intensity Service (HIS) programme for treating military veterans complex mental health problems. Seven regional grants were awarded to manage...

Expectations versus Reality: Achieving Impact from Social Work Practitioner Research in Challenging Circumstances

Abstract This reflective article examines the claim that social work practitioner research is more likely to lead to impact. We reflect on the impact that we achieved as part of a social work practitioner research within an acute hospital in the South-East of England. First, we explore the literature on social work practitioner research and impact. Second, we outline our original research project. Third, we examine the individual, organisational and cultural impact we believe we achieved before reflecting on how our views and motivation towards impact changed throughout the research journey. Fourth, we discuss the barriers to achieve our original impact aspirations and reflect on the factors influencing our energy and motivation to achieve impact. Finally, we reflect on the factors that enabled us to achieve impact.

Community-based volunteering in response to Covid-19: people, process and planning

PurposeThe Covid-19 pandemic saw a dramatic rise in the number of people volunteering to support older people shielding at home. This study aimed to determine the processes by which volunteers were rapidly engaged in their communities and their impact on the older people who were supported and health and social care services.Design/methodology/approachThe study took place in South East England between May–August 2020. Semi-structured interviews were conducted with 88 participants including health and social care practitioners (n = 12), leaders of voluntary, community and social enterprise (VCSE) organisations (n = 25), volunteers (n = 26) and older people receiving volunteer support (n = 25). Policy and procedure documents were sourced from the VCSE organisation leaders. Data were analysed thematically according to a framework method.FindingsThe authors identified key themes of People, Process and Planning. People: volunteers had a significant, positive impact on older people in their communities, with volunteers themselves, also benefiting. Process: VCSE organisations needed to work together and with health and care providers to avoid gaps and duplication of services. VCSE organisations were able to act quickly, by-passing many complex operational procedures. However, there was a need to ensure the safety of both volunteers and older people. Planning: Looking forward, there were concerns about the long-term funding of VCSE organisations and the availability of volunteers.Originality/valueThis study took place during the first wave of the pandemic, hence, it provides a snapshot of how voluntary organisations operated at this time and highlights the importance of integration with health and care statutory services.

Melting the Snowy White Peaks: The needs, expectations and experiences of Black, Asian and minority ethnic student nurses to support equitable nursing education and career progression

BackgroundThere is an under-representation of Black, Asian and minority ethnic nurses in senior positions within the UK's national healthcare system. ObjectivesTo understand student nurses' perspectives on the role of race and ethnicity on career expectations, course learning and delivery, and areas for additional training and skill development for all nurses in understanding structural inequalities in healthcare. DesignQualitative study involving semi-structured interviews. SettingsUniversity in south-east England, UK. Participants15 nursing students (14 women, one man) from a range of ethnic backgrounds, age-groups and nationalities. MethodsInterviews lasting 30–60 min were conducted with nursing students and thematic analyses undertaken. ResultsFour inter-related themes were constructed: altered career expectations, lack of understanding, absent discussion of racism and missing representation. Experiences of racism were not uncommon for students from Black, Asian and minority ethnic backgrounds and these experiences affected these students' career expectations. Students described a lack of understanding about racism and that it was a taboo topic on their course and in placements. ConclusionsFindings highlight an urgent need for universities to challenge existing nursing curricula to ensure inclusive, anti-racist educational provision that works equitably for all future nurses. The importance of representation was highlighted among those who deliver courses, in the content of nursing curriculum through inclusive education, decolonised curricula and with student voices embedded to enable the development of culturally-competent nursing graduates.

A difference in larval mosquito size allows a biocontrol agent to target the invasive species.

As the global temperature rises in the coming decades, Aedes albopictus is expected to invade and establish in South East England, where Culex pipiens is currently the most common native mosquito species. Biocontrol measures that use local cyclopoid copepods against Ae. albopictus may be compromised if the copepods prefer alternate Cx. pipiens prey. In this study, I assessed the predation efficiency of Megacyclops viridis copepods against Ae. albopictus larvae from France and larvae that hatched from egg rafts of Cx. pipiens collected in South East England. The experiments were conducted at 15 and 25°C, which are representative of present and future summer temperatures in South East England. Ae. albopictus larvae that survived the course of the experiment in the predator-absent controls were significantly smaller than Cx. pipiens larvae that survived in the absence of predation. The background mortality of Cx. pipiens larvae increased with the 10-degree increase in temperature, and the smaller size of surviving Cx. pipiens larvae at 25°C, relative to survivors at 15°C, suggests that larger Cx. pipiens larvae were more likely to die at the higher temperature setting. Across all experimental treatments, the ratio of copepod body length to mean prey length, based on larval lengths of survivors from the corresponding predator-absent controls, was a significant predictor of the copepod's predation efficiency. Adding temperature setting to the predation efficiency model as a predictor did not improve model fit. Within the mixed prey treatments, the predation efficiency of M. viridis was 34.5 percentage points higher against Ae. albopictus prey than against Cx. pipiens prey. The higher predation efficiency that M. viridis exhibited against invasive Ae. albopictus prey, likely due to the smaller size of these larvae, supports the future use of M. viridis as a biocontrol agent in the United Kingdom.

Pterosaur teeth from the Lower Cretaceous (Valanginian) Cliff End Bone Bed, Wadhurst Clay Formation, Wealden Supergroup of southern England, and their possible affinities

Until now there have been no formal descriptions of pterosaur remains from the Cliff End Bone Bed of the Lower Cretaceous (Valanginian), Wadhurst Clay Formation, Wealden Supergroup, of south-east England. This horizon yields abundant vertebrate material representing both aquatic and terrestrial taxa and recent examination of a large collection of vertebrate remains obtained by a private collector has led to the discovery of two isolated pterosaur teeth, both referable to the same taxon. Tooth crown morphology differs from that of teeth informally reported from the Wadhurst Clay Formation and attributed to ornithocheirids in being triangular in lingual and labial view, labiolingually compressed with well-defined carinae on the mesial and distal margins and with a low basal cingulum. Their possible affinities are discussed, and they are tentatively, but with some uncertainty, attributed to an istiodactylid. If this attribution is correct, they represent the earliest record of Istiodactylidae to date.

BT13 MySkinDoctor: lessons learnt from assessing 120 000 teledermatology patients

Abstract MySkinDoctor is a novel teledermatology platform that enables dermatologists to review images submitted directly by the patient via their smartphone, in addition to any metadata and the standard general practitioner referral. The three sets of data are used to triage or provide advice and guidance to National Health Service patients throughout the south east of England. Since its inception in 2019, the service has completed the assessment of &amp;gt; 120 000 cases. Analysis of the data shows that an unnecessary first appointment has been avoided in 48% of cases. This has led to a sharp reduction in waiting times in the areas in which it is being used (an average of 6 weeks) vs. neighbouring areas where waiting times remain between 27 and 50 weeks. Another benefit of the service is that, on average, each patient using it submits three digital images that are subsequently tagged inter alia with their age, sex, body location and the consultant’s diagnosis. This has resulted in a large, and growing, digital image library with associated dataset of patients that has been used to develop an artificial intelligence platform called ‘dermXai’. Using convolutional neural networks for image identification has produced an accuracy of determination of &amp;gt; 90% for the top 20 conditions seen. We will discuss the implementation schedule and regulatory challenges that need to be met in order for dermXai to support clinical decision-making. There are also environmental and economic benefits associated with using MySkinDoctor. Since its inception, it has saved &amp;gt; 40 000 road miles—over twice Earth’s circumference. This is a CO2 saving of 16 488 kg. The benefit to patients and their carers in terms of saving travel and regaining otherwise lost productivity time is difficult to quantify but could be studied prospectively. Patient-led digital dermatology is the obvious evolution of traditional teledermatology and our successful experience with MySkinDoctor and dermXai in southern England provides a template for a national service that will eliminate backlogs and significantly reduce patient waiting times. Conflicts of interest: Dr Bav Shergill is the Chief Medical Officer of MySkinDoctor Ltd and a Director of dermXai.

Strongyle egg reappearance periods following moxidectin treatment in horses in Southeast England

AbstractBackgroundA reduction in the egg reappearance period (ERP) has been suggested to be an early indication of emerging anthelmintic resistance in strongyles.ObjectiveTo measure the strongyle ERP following moxidectin treatment of horses in the southeast of England.Study designProspective study.MethodsHorses with a faecal egg count (FEC) of ≥400 strongyle eggs per gram (EPG) in a routine screening sample were enrolled into the study. Moxidectin (400 μg/kg) was administered per os and FEC tests repeated every 2 weeks for 16 weeks.ResultsForty‐eight horses completed the study. The mean EPG prior to treatment was 1047 (range 375–2137 EPG). In all but two horses, FEC was 0 EPG 2 weeks after moxidectin administration. In the remaining two, the FECs were each 12.5 EPG (97.8%–98.3% reductions compared to pre‐treatment FEC). At 4 weeks post‐treatment, 6 horses had positive FECs (96.6%–99.2% reductions). At 6 weeks, 11 horses had positive FECs (83.8% reduction in one horse; &gt;90% reduction in 10). At 8 weeks, 21 horses exhibited positive FECs (&lt;90% reduction in 2). At 10 weeks, 27 horses had positive FECs (&lt;90% in 6). At 12 weeks, 31 horses had positive FECs (&lt;90% reduction in 11). At 14 weeks, 34 horses had positive FECs (&lt;90% reduction in 13). At 16 weeks, 38 horses had positive FECs (&lt;90% reduction in 17).Main limitationsWeights of some horses were estimated using weigh tapes rather than a weighbridge. Dosing of the horses with moxidectin was carried out by owners.ConclusionsThe results indicated acceptable efficacy of moxidectin at 14 days after treatment; however, the ERP pattern measured across the group suggests that this anthelmintic has a considerably shorter suppressive effect on strongyle egg shedding than measured when it was first introduced (12–16 weeks).

‘I didn’t know girls could coach football that well’: the experiences of female football coaches in the South East of England

Although women’s football has seen a significant growth of participation in recent years, this has not reflected in the number of female coaches. In this semi-structured interview research, we examine 10 female football coaches’ experiences in the South East of England. Our findings document three central findings: (1) participants were motivated to pursue a coaching career either due to a love of football, an alternative to a playing career, or were inspired by a recent increase of female role models in the game; (2) the institutional support networks (i.e. those established by the game’s governing body, the Football Association) were inadequate, forcing them to seek support from elsewhere, such as their family; and (3) consistent with previous research, all participants in this research had encountered some form of sexism in their coaching careers. Accordingly, this article contributes to a growing body of research centered on female coaches’ experiences of football.