How NHS healthcare professionals can play an important part in research
Professor Hywel Williams, Director of the NIHR's Health Technology Assessment (HTA) Programme encourages healthcare professionals to take the next step in their research career and offers his top tips in identifying a good research question. His blog has been published as part of the NIHR's Your Path in Research campaign.
When I started off as an academic dermatologist, there was a perception that research was “for the University” - definitely not the business of frontline staff who had enough to do keeping the NHS afloat. But as the years have gone on, I have realised more and more that some of the best questions about everyday clinical dilemmas come from front-line NHS health care professionals.
I now direct the NIHR Health Technology Assessment Programme – the largest of the NIHR Programmes – that seeks to find out which health technologies work best when applied across the NHS, and if so, are they cost-effective? This includes drugs, talking therapies, physical therapies, and diagnostic tests etc.
Filling our knowledge gaps
We run two main funding streams. The first is our commissioned arm where we identify important questions that the NHS need answering. Some have called this type of research “dull but needed”, but I prefer to think of it as filling in the critical gaps for patients that can’t speak up for themselves. Once we identify a topic, we then advertise a “commissioning” brief saying what we want. Teams of researchers then apply to do the work in open competition. We don’t always manage to identify all the gaps, so our second funding stream is researcher-led whereby teams of researchers can pitch a study question and research plan to us. If you like, the commissioned stream pulls researchers to do the work that we think is needed, and the researcher-led stream pulls us to fund the research that they think is needed. The two work really well side by side.
Playing your part in research
So where do you fit into all of this? Well, we do need expertise, for example, top quality methodologists to put together a competitive proposal, but everyone can be a part of research. After all, NHS research is not a “nice to have” sideline but a core element of a progressive modern NHS. We also know that outcomes in research-active hospitals and community practices are generally better than in those that are not, even for patients who do not participate in research.
There are many ways you can get involved in research. Maybe start by playing your part in helping to recruit into national studies that are supported by your local NIHR Clinical Research Network. Maybe then try your hand at reviewing some research proposals. You might also consider putting yourself forward to become a local principal investigator. Or maybe just suggest a research question to us that we can pick up in the commissioning funding stream – anyone can make such a suggestion.
Asking the right questions
So let’s get practical, how do you identify a good research question?
Tip 1: look out for staff disagreements about which treatments are best for your patients. Disagreements are usually inversely proportional to the evidence, and if opinion is mixed based on current evidence, then you are onto a great uncertainty that is supported by the principle of equipoise
Tip 2: Once you think you have picked up a good question, go to your local library to see if it has already been answered by a systematic review. Ask your local librarian to help you search.
Tip 3: Go and talk to someone with research experience in order to convert your idea into a researchable question that clearly describes the patient population, the intervention which is being tested, what it needs to be compared against and how should treatment success be measured. Your local research design service or clinical trials unit are good places to start
Tip 4: Finally form a winning team with the best people you can find. Remember you don’t have to lead research and write the proposal, but that does not mean you cannot be part of the team as you will see things from your NHS experience that even the best academics and methodologists could miss.
I would like to see more frontline NHS colleagues be included in the NIHR Health Technology Assessment applications that we see. We all have a research path to follow, and we can all play a part however big or small. Research is fun and at the end of the day you know you will be helping to reduce uncertainties that will benefit our NHS patients in the future.
More information about the NIHR’s Your Path in Research campaign is available on the NIHR website.
The views and opinions expressed in this blog are those of the authors and do not necessarily reflect those of the NIHR, NHS or the Department of Health and Social Care.