Date: 21 March 2019
The research and development team at Maidstone and Tunbridge Wells NHS Trust (MTW) has grown over recent years. There are 43 team members including research nurses, administrators and governance officers. Recently four research practitioners have been recruited to work within the team.
Clinical research practitioners have a specialist role and bring a wealth of research knowledge and expertise to the delivery of safe, ethical and high quality clinical research care. Many come from a non-medical background or a scientific one and have experience of working in a clinical setting, either in primary or secondary care. The roles have a mix of clinical, academic and practical aspects and they are part of the study teams, identifying studies to run, setting up studies, recruiting patients and work on follow-ups.
Claire Pegg, Trust Lead Research Nurse said: “Employing research practitioners here at MTW has been an important step in growing and developing our team. A research practitioner has a diverse range of skills, many of which complement the conventional role of the research nurse, making them the ideal professional to support and lead on studies. At MTW we now have four practitioners working across oncology/genetics/stroke/women’s and children/neuro/sexual health. Their new ways of thinking and their knowledge has led to changes in the way that we deliver research, meaning that going forward; we will be in a better position to offer more patients an opportunity to take part in research.”
Maureen Williams has worked in research for a short time. She came to her post as research practitioner as a secondment from the oncology multidisciplinary team, to work on the 100,000 Genome Project. The study closed in December 2018 with the achievement of the national target.
Maureen’s fellow research practitioners had worked in research roles before joining MTW. Bethany Jones has a BSc in Molecular Biology and Genetics and has an MSc in Reproductive and Developmental Biology. Before joining Maidstone and Tunbridge Wells NHS Trust in October 2018 Bethany was a research assistant at the Women’s and Children’s Health Research Department at St Thomas' Hospital in London.
Rutendo Nyagumbo is a breast oncology research practitioner. Rutendo’s undergraduate degree is in Medical and Pharmacological Science and she was a clinical trials assistant in Bournemouth Hospital before she began working at Maidstone Hospital in November 2018.
Banher Sandhu started his research career in 2007 in India before moving to the UK. Banher also worked at St Thomas' Hospital in London where he worked in cardiovascular imaging. He then moved to Medway NHS Foundation Trust in 2014 before joining Maidstone Hospital in August 2018.
Maureen said: “I enjoy the patient contact you get with working in research. As I have worked in the NHS for many years I understand the medical terminology used within studies and answer any questions patients may have which they feel unable to ask the doctor.”
Maureen has spoken at meetings about working in research and said: “We have given presentations to non- research colleagues within the trust, raising the profile of research and non-traditional routes of undertaking research. I advise other colleagues from the Trust to become involved in research as we can’t improve treatments without research.”
Maureen is now working on the StartRight: Getting the right classification and treatment from diagnosis in young adults with diabetes. It is often difficult for doctors to tell which kind of diabetes a person has, particularly in younger adults where both Type 1 and Type 2 diabetes are common. This study which aims to improve this situation by helping doctors more accurately tell the type of diabetes a person has when they are first diagnosed.
She is also working on IBD BioResource and the Meningitis ‘Be on the TEAM’ study, working alongside Research Nurses. The study will see if immunising teenagers with MenB vaccines reduces the carriage of meningococcal in teenager’s throats, which could in turn protect the broader community.
Rutendo says: “In clinics, staff and patients think we are nurses but we explain to them who we are and that we have a scientific background. This happens quite a lot in oncology as only medics tend to work in this area.
“There is a shortage of medical staff within the NHS and so it makes sense to use people with non-medical backgrounds to free up doctors and nurses time. Our backgrounds are useful as we have an understanding of how clinical trials work from a scientific perspective. People with a medical background will not necessarily have learnt how clinical trials work and what to do if any problems occur when they were training.”
Banher says: “The NIHR must be given credit for raising awareness that people with non-medical backgrounds can work on research studies. Also, Claire Pegg and Hazel Everest, our R&D Manager saw the usefulness of having Research Practitioners and had the confidence to go down this route.
As research practitioners do not have medical qualifications they are unable to give patients interventions such as drugs or other medicines the study is investigating. Research nurses or doctors within the research study team will need to give drugs, and can be supported by the practitioner. However the studies the research practitioners lead on are non-ctimp.
Rutendo said: “We do have some challenges with the consenting process in our complex oncology studies. We can scan potential participants but the PI needs to be available to consent them into the trial. Although, when I worked on the 100,000 Genome study I was able to consent participants.”
Banher said: “As team members we can do most things but we still need the PI to take overall responsibility.”
The research practitioners are all working on a variety of studies across specialties and studies funded by the NIHR and other funders. Banher is working on Stroke and Emergency studies. Banhur says: “I am interested in following the pathway of Stroke patients and how we can support them through research”.
Banher is working on the PLORAS. Predicting language outcomes and recovery after Stroke study. PLORAS is looking at language difficulties a patient may experience after suffering a Stroke and the aim is to give future Stroke survivors a prediction about their recovery. Patients are screened at Maidstone Hospital and then sent to University College London for an MRI and language assessment.
Banher will soon be working on the CONVINCE trial - Colchicine for prevention of vascular inflammation in non-cardioembolic stroke, a randomised clinical trial of a low dose of an anti-inflammatory medicine called Colchicine used with standard treatment to see if it reduces the risk of a second Stroke. Banher says: “This study has been smartly designed, to have minimal workload for the clinician and have Practitioners and Nurses involved more”. The Principal Clinical Trials Manager from the University of Lancashire, Denise Forshaw is a forward looking pioneer in engaging Nurse/AHP and Practitioners in clinical studies.
Bethany Jones works across specialties and is currently working on Multiple Sclerosis (MS), HIV and sexual health studies and the ADDRESS-2 diabetes study. ADDRESS-2 is a research project that is learning about the characteristics of people newly diagnosed with type 1 with diabetes. An optional blood sample is taken and additional information about their medical history and lives are collected.
Another study Bethany is working on is the MS Register, a study which aims to increase our understanding of what is like living with MS in the UK. Patients with a confirmed diagnosis of Multiple Sclerosis are asked to complete a series of simple questionnaires.
Bethany adds: “I’m also recruiting people to the Safe TXT study which is trailing a safer sex intervention. This study is testing whether text messages providing information and tips helps young people adopt safer sex behaviours. This study is funded by NIHR.
Rutendo is based in the breast oncology team and is currently recruiting patients to six breast cancer studies, including ADDASPIRIN which is assessing the effects of aspirin on cancer returning and survival after treatment in common metastatic tumours. She is also working on three studies which are in follow up.
Dr Kate Jones, Chief Operating Officer, NIHR Clinical Research Network Kent, Surrey and Sussex say: “Clinical research practitioners make an invaluable contribution to clinical research and to the patient experience and are a vital part of our research workforce. It is great to see this profession thriving at MTW.”
The NIHR – working in collaboration with the Academy for Healthcare Science – has established a Directory for Clinical Research Practitioners which will serve as a platform for communication, peer support and consultation. Work is being taken forward jointly by the NIHR and the AHCS to establish a Professional Standards Authority Accredited Register for CRPs. This commitment provides an opportunity to recognise and assure the public of the expertise and professionalism that can be demonstrated by clinical research practitioners as an essential part of a flexible and future facing healthcare science workforce.
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