Published: 05 July 2019
Dr Tracey Mills is a Senior Lecturer in Midwifery at the University of Manchester. She holds funding from the NIHR Research for Patient Benefit (RfPB) programme for her research into pregnancy care after stillbirth and neonatal death, and is a co-investigator for a NIHR Global Health Research Group on stillbirth management and prevention in Sub-Saharan Africa.
The research idea
Why did you decide to apply for research funding?
I have been a lecturer at the University of Manchester since 2012. I’d completed my PhD in 2008 but significantly changed direction from laboratory based studies to applied health research after 2010 following a move to the Division of Nursing Midwifery and Social Work.
I’d previously had small research grants for exploratory work in my field, but I wanted to develop an intervention study to apply evidence to change clinical practice.
What is the research idea that you applied for RfPB funding to address?
The idea was to improve care and support for women and partners in pregnancy after stillbirth or neonatal death by enhancing continuity of midwifery care and peer support.
NIHR Research for Patient Benefit (RfPB) is a prestigious programme which focuses on research that aims to directly impact on the quality of care for NHS patients, which fitted well with my proposed research.
Developing the proposal
How did you develop your research idea into a full proposal?
I’d already identified a research mentor when I took up my lectureship - Professor Dame Tina Lavender, Professor of Midwifery in my Division. She was an obvious choice, I had previously worked with her to develop exploratory studies and we have developed an effective relationship, she has extensive experience in conducting applied health research.
The research proposal took around 9 months to develop into a full application. I worked closely with Professor Lavender to develop the original research idea, then identified key individuals to join the research team. These included a statistician, health psychologist, health economist and a service user who provided advice on specific aspects of the design of the study.
I also made early links with the Local Clinical Research Network to identify possible study sites and build relationships with clinical teams who would be involved in the research, since it involves changes in clinical practice.
What other support did you have while developing the proposal?
Apart from my mentor, I also had support from the lead Trust through the midwifery research co-ordinator and the Trust R&D manager. The major issue in the initial stages of preparing the application was understanding the costing, including various definitions of NIHR research costs which can be quite complex.
I attended a course run by the NIHR Research Design Service North West to support preparation of RfPB applications. We were assigned an RDS adviser and met for regular sessions. This was helpful because it meant there was an expectation of progress with the application over the sessions, providing an impetus to work on the proposal.
How did you go about writing the research application?
I took the lead and did the majority of the writing. To tackle it, I broke the application down into sections. I sought advice from relevant individuals, who also provided some content for certain sections. I shared initial drafts with my research mentor and relevant members of the research team. After feedback and revisions, the drafts were shared more widely throughout the team.
How did patient and public involvement help shape your research?
Patient and public involvement (PPI) has been integral to all aspects of the study. We invited Claire Storey, a bereaved mother with extensive experience of supporting parents during subsequent pregnancies and the current Co-Chair of the International Stillbirth Alliance, to join the research team at an early stage.
To gain local service user perspectives on the planned research, a PPI bursary was obtained from the NIHR Research Design Service North West to support a consultation event at Burnley General Hospital. The workshop, chaired by a local specialist PPI consultant, was attended by six bereaved parent service users, researchers, the Head of Midwifery and three clinical midwives.
We are developing relationships with local services users and have invited three women to join our technical advisory group. We hope they will help us refine content of the intervention (such as the support group programme) as we move forward with the research.
What support did you receive from staff at the NIHR RfPB programme?
The successful application was a resubmission - the initial feedback from the original was mostly encouraging and constructive and helped us to refine the proposal. During this period, the application process changed to two-stage, and I think this is a much better approach - the full applications are time-consuming and it is helpful to have an initial assessment prior to completing more extensive work.
Being awarded funding
What happened once you found out that your project had been awarded funding?
I was really surprised and pleased, but very quickly realised this was only the start. There is an enormous amount of work required to get a study up and running.
I’m only a few months in but it has been very hard work and quite stressful at times; as chief investigator everything is your responsibility. Luckily I’ve had good support from my mentors and local research teams.
What are your next plans for your research?
We are progressing well with recruiting participants and learning useful lessons about what works well and what are the main challenges. As this is a feasibility study looking at whether it is possible to do this type of research, we are also starting to think about follow on research. Our aim is to conduct a larger trial to assess the effectiveness of the intervention across the NHS.
What advice would you give to other early career researchers who are considering applying for research funding?
Allow enough time to develop your proposal and consult with others. Choose your research team carefully, people often promise much and deliver little. Academics who have attended panels or with successful applications can provide useful advice. Be persistent and resilient, I learnt a lot through numerous rejections and criticism.