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Case study: 'My RfPB funding is giving me the basis for a career in surgical research'

Richard Wilkin is a surgeon and Academic Clinical Lecturer at the Queen Elizabeth Hospital in Birmingham. He holds funding from the NIHR Research for Patient Benefit (RfPB) Programme for the SUNRRISE trial, investigating whether a new type of wound dressing could reduce infection rates after abdominal surgery.

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'My RfPB funding is giving me the basis for a career in surgical research'

Author: Richard Wilkin

Developing a research idea

Why did you decide to apply for research funding?

We had what we felt was a good idea for a trial - testing a way to reduce infection rates after abdominal surgery. We wanted to test whether a topical negative pressure dressing applied at the end of surgery could reduce wound infection rates in patients undergoing an emergency laparotomy (surgery on the abdomen).

We know that infection rates in this type of surgery are approximately 25-30%. We wanted to test whether a newer type of wound dressing could make a significant difference to patients, by actively removing fluid produced by the wound. This type of dressing has already been shown to reduce infection rates in other types of surgery.

We knew that we needed funding in order to deliver the trial, and the team that I worked on the application with has previously been successful with RfPB funding.

How did you develop your research idea into a full proposal?

The idea and trial design was worked up by a team involving various experts in Birmingham and the Northwest. I had early access to Birmingham Clinical Trials Unit, who were instrumental in putting together a viable proposal. Other important parts of the team that created the funding application and are subsequently delivering the trial include the NorthWest Research Collaborative, North West Surgical Trials Centre and the West Midlands Research Collaborative. I also had significant support from my mentor Professor Tom Pinkney, who provides senior support on the trial.

One of the unique things about this trial is that we have two trainee collaboratives working together to deliver the research. This type of trial, involving emergency patients, is ideally suited to a trainee structure. In addition to this, the study is also part of the NIHR’s Surgery Associate PI scheme, which aims to increase local engagement and delivery of trials. This is a very exciting new initiative which is open to clinicians at all of our sites.

Support with the research proposal

What other support did you have while developing the proposal?

I had support from the Academic Department of Surgery at the University of Birmingham, the Birmingham Clinical Trials Unit, and the NIHR Clinical Research Network West Midlands, as well as support from the Northwest Research Collaborative team - the trainee collaborative, trials unit and senior surgical support.

Our local NIHR Research Design Service also helped by developing a pack that was sent out to R&D departments and LCRNs across the country to provide information on the trial.

How did you identify team members for your research proposal?

We knew that we needed stats support and health economics support. The trials units involved - Birmingham and Northwest - were instrumental in putting me in touch with key people to help deliver these aspects of the trial.

We also already had a structure for the team - myself and Hamish Clouston, who is the co-Chief Investigator on the trial, worked closely together to coordinate the involvement of trainees and experts in Birmingham and Manchester.

How did patient and public involvement help shape your research?

We had patient and public involvement in the form of two focus groups that met and discussed the trial before the funding application and this work was led by the NorthWest Research Collaborative. They were key to shaping the trial - for example suggesting patient diaries and how these could work. We also have PPI reps on our Trial Management Group and Trial Steering Committee.

Leading my first research project

What it was like leading your first research project?

Very exciting! Having dedicated research time within my job has massively helped (I became an NIHR Academic Clinical Lecturer after we got the grant). It has also been hugely enjoyable and a steep learning curve. One of the challenges has been learning to be patient while others provide their expert input - our experts have numerous trials all requiring their time.

I’ve learned that regular communication is key to getting jobs done and producing a proposal that everyone is happy with. It’s important to always value everyone’s input.

Getting feedback on the study can be difficult - there will always be criticisms, but it’s important to not take these to heart, especially when you know the trial is fundamentally well designed.

What are your plans for your research?

Our research hasn’t been published yet, but on a personal level, I hope to apply for further RfPB funding to support a validation study on a different topic. For the current trial, I hope the results show benefit to patients and we can change practice.

How you think that the NIHR RfPB funding has helped your research career?
It has massively helped. The RfPB funding helped in me being awarded a Lecturer post and the trial will, I hope, give the basis for a career in research.

What advice would you give to other early career researchers who are considering applying for funding?

To go for it. It is possible for people at the start of their research career to be successful as the lead applicants for funding if they surround themselves with an experienced team - especially if that team has a proven track record of success.

At present there are very few trainees that are lead applicants and Chief Investigators, however this can change. As trainees, we can engage with the right people and support organisations to help shape the funding application in order to make it successful.