Clinical academic on the front line

Research physiotherapist, Anthony Gilbert, was halfway through his HEE/NIHR Clinical Doctoral Research Fellowship (CDRF) when the COVID-19 pandemic hit the UK. Like many clinical academics, this had a massive effect not only on Anthony’s research but also his clinical role and family life.

COVID-19 is a terrible disease and the nature of working in an ITU setting can be very sad.

I tried to get home to see my family when I could during the week, but often I wouldn’t be getting home until midnight and would then have to leave before 6am…. It was lovely getting back and giving my kids a hug but I really missed (and needed) it, particularly on tough days.

From 4am chats at London’s Nightingale Hospital to publishing a quality improvement paper in the BMJ Open Quality, Anthony’s experience of the pandemic has been quite a journey.

Supporting the rapid implementation of virtual clinics

Anthony started his CDRF in 2018, which funded his PhD research on patient preferences for virtual consultations at the School of Health Sciences, University of Southampton. His research and experience in virtual consultations was highly valuable, as in March 2020, the COVID-19 virus changed the way healthcare could be delivered. His hospital, the Royal National Orthopaedic Hospital, set an ambitious target for 80% of outpatient clinics to be conducted virtually from an initial 7% of clinics being held in this way.

My research is on virtual clinics and this left me well placed to contribute towards the roll out of these at my trust.

Anthony was therefore invited to join a small multi-disciplinary team supporting the roll out of virtual clinics. The team succeeded in holding 85% of clinics virtually within three weeks and Anthony was lead author of a BMJ Open Quality paper that captured the learning from this process.

Within my organisation, I feel I have made a useful contribution to clinical care and I have demonstrated how useful a clinical academic can be.

Anthony also volunteered to support clinical services during the pandemic, and was quickly called up for training at the NHS Nightingale Hospital at the ExCel Centre in London. He completed a day of induction, receiving “without doubt the best mandatory training I have experienced”, and he was the first physio on the rota to receive the first patient. The team grew quickly and Anthony was asked to become Deputy Physio Lead, which was a combination of clinical and managerial duties.

It was an incredibly difficult time – the experience of ITU care, being away from my family, the long hours in PPE to name a few of the struggles I had. At the same time, it was one of the most amazing experiences of my life – the people there, the experience of getting patients up on their feet for the first time (I will always be a rehab physio), overcoming my own fears and anxieties about the work.

Anthony is very grateful for the support and understanding he received from his host organisation, his supervisors and the NIHR, who made it very clear in the early stages of COVID-19 that clinical academics would be supported to return to clinical practice as required.

At the Nightingale Anthony had the opportunity to learn from new colleagues, make new contacts and gained a new mentor. However, returning to clinical practice has delayed his research and he is looking to take a three-month extension as a result.

The pandemic has changed the landscape as there is a sudden need for virtual clinics which has meant the impact of my PhD work has been accelerated – it usually takes years for impact of research to be realised. The pandemic has brought the importance of my PhD to life much sooner than I expected and this has motivated me even more to continue to develop as a clinical academic.

Anthony was working in two very different roles in a very short space of time, whilst also trying to keep his PhD alive. As a clinical academic Anthony has developed the skills to manage multiple tasks at once within tight time scales. However, working in a different clinical speciality in a strange environment was difficult, both personally and professionally.

My brain was constantly in overdrive, I often found myself reading respiratory resources in the evenings and during days off.

Reflecting back on the experience is complex and difficult to articulate. I am really glad I volunteered, I feel I have learned and developed a huge amount from the process. I am very proud of my contributions.