14 February 2019 3 min read

What a trip to A&E taught me about research

Of all the unexpected places THIS Institute has taken me over the past year, the busy corridors of an accident and emergency department might be the most memorable.

I remember trying in vain to get my head around all the different scrub colours buzzing past me. While jumping out of the way of the never-ending stream of patients arriving at the doors, I was struck by the sheer lack of space, the importance (or lack) of flow and the corresponding workarounds.

I’ll also never forget the camaraderie, or the simple joy on a paramedic’s face when they found a moment to sip a tea. Inevitably, that joy was quickly replaced by a wry smile as they dumped their freshly made drink when the radio summoned them to another call out.

But above all, I was deeply impressed with the expertise of the staff I met, and their dedication to making healthcare the best it could be. And, as deputy director of an institute that studies healthcare improvement, I couldn’t help but marvel at how much they had to offer to our research. If I came in with any pre-conceived notions about what needed investigation or improvement, they were quick to show me that there was more to the story. In just a few hours with them, I learned so much about how the NHS works. I can only imagine the insights they gain being part of it every day.

These visits got me even more excited about THIS Institute’s commitment to involving NHS staff in our research. And they reinforced the need to do so effectively.

That’s why I’m especially proud of THIS Institute’s latest report Involving NHS staff in research. In partnership with RAND Europe, we used a rapid evidence review and interviews with experts to identify the many reasons NHS staff get involved with research, the barriers that prevent their involvement, and their impact when they do get involved.

For NHS staff reading the report, I suspect the one finding that will come as no surprise is the importance of time. Designing research studies, analysing data and other forms of active engagement are time-consuming, and time is at a premium for NHS staff. That was clear from my short time in accident and emergency, where staff worked at a relentless pace to triage patients and ensure that they were seen in the target time, while offering a high standard of care. It’s hard to find time for research when even nipping to the loo is challenging!

In just a few hours with them, I learned so much about how the NHS works. I can only imagine the insights they gain being part of it every day.

But time is far from the only barrier preventing staff from getting involved. We found that a lack of funding, lack of support, and a perceived lack of knowledge, skills and confidence were also factors. Those perceptions were often related to lack of exposure to research.

When it comes to exposure, our report found that research opportunities were not distributed evenly among NHS staff. Doctors generally have more chances to get involved than other staff groups, clinicians who don’t hold academic post haven’t been involved as much as they could be, and there was relatively little literature about involving non-clinical staff in research. Though some excellent work in recent years has helped level the playing field for a wider range of NHS staff, we’ve only scratched the surface of their potential.

So how do we realise that potential? Our research shows it’s going to take a few different approaches, and we may have to be bold. Can NHS career structures evolve to better support involvement in research? Can time to conduct research be built into the system, beyond clinical and academic fellowship models? What role can citizen science play?

These are tough questions without easy answers. But if we’re serious about doing research that meets the needs of NHS patients and staff, while allowing those paramedics the chance to finish the occasional hot beverage, we need to keep asking.

We’ll take our next shot at answering these big questions in the spring, when we publish the second report in our two-part series on involvement. That report will focus on patient and public involvement (PPI) in research.