As part of the RCP's Delivering research for all series, Professor Opinder Sahota discusses how he got started in medical research, and shares his 'top tips' for those interested in getting involved.
The most important element of research is asking the question. My research programme is clinically driven – focusing on improving the care and service delivery of older people with musculoskeletal injuries. The programme extends from laboratory work looking at receptors in muscle, to minimally invasive surgical interventions, to innovations in service delivery both in developing new services and service redesign.
As chair for the inpatient falls hospital committee, I was astounded by the high and increasing incidence of inpatient falls. Searching for a solution, I approached a company that manufactured pressure sensors. Following some research, I developed a protocol, built a team and applied for National Institute for Health Research (NIHR) funding.
The most important element of research is asking the question.
In 2009 I was awarded funding to run a randomised controlled trial exploring how to reduce inpatient falls. This used bed and bedside chair pressure sensors linked to radio pagers in acute hospital care. This was my first real experience of being a principal investigator in an external, competitively funded trial. It involved managing a team and running what turned out to be the largest single central inpatient falls trial in the world, recruiting 1,839 patients over 2 years. The study showed that bed and bedside chair pressure sensors reduce inpatient bedside falls, but should not be used as a single intervention strategy to prevent inpatient falls.
As another example, regionally the trusts were keen to develop community rehabilitation teams working in hospitals to facilitate discharge. Although the pilot data was supportive, a formal clinical and cost-effective NIHR-funded study I led showed this was not actually the case and the services were removed.
At national level, although NICE guidance supported the use of regional nerve blocks in acute hip fracture care, I led a NIHR-funded study which found that the use of femoral nerve blocks was ineffective. The guidance was then amended to reflect these findings.
One of the most rewarding aspects of working in research is undoubtedly that you see the direct improvement research can have on patient care. I also really enjoy the stimulating debates research provokes – this process ultimately leads to better clinical practice and outcomes for patients.
One of the most rewarding aspects of working in research is undoubtedly that you see the direct improvement research can have on patient care.
- Time is a big challenge. We are all busy and always being asked to do more clinically.
- Collect baseline data, look at audits, service evaluations. Many trusts have audit support officers, and every firm has students and junior doctors keen to undertake small projects.
- Many trusts offer small pump-priming funds, which could be used to fund a clinical research session.
Challenge yourself and your clinical work
- Ask yoursef 'can I do something better or differently to help improve patient care'? Do you have a concept or a technological innovation?
Speak to your R&D office
- Do you know where they are in the hospital? Do you know how you can contact them?
- Your trust intranet is a good place to start!
Take on the bigger research idea
- When you are ready, speak to academic colleagues, your R&D offce and also the NIHR Research Design Service (RDS). The RDS is a free service offering advice on study design, statistics and health economics.
Find the right funding stream
- Again, speak to your R&D office and the RDS. This could include charity funding, funding from learned societies, or any institutional seed funding.
- The NIHR offers a range of funding streams available to physicians. For example for mental health services there is a funding stream dedicated to this time of research: Health Services and Delivery Research (HS&DR).
- You may have an idea of a concept or even a technologial innovation. Again, there are funding streams dedicated to difference stages of product development.
Professor Opinder Sahota is a consultant in general and geriatric medicine at Nottingham University Hospitals NHS Trust, and an honorary professor in orthogeriatric medicine at the University of Nottingham. You can follow him on Twitter at @ProfSahota.
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