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Women, BAME and rural physicians struggle to access research says Royal College of Physicians

A new survey from the Royal College of Physicians has found inequalities in access to research for women doctors, doctors from BAME backgrounds and those working in rural areas. 

The RCP surveyed 1,137 RCP members and fellows in England, Wales and Northern Ireland, including consultants and trainee doctors, in January-February 2020. The results provided key evidence for the RCP’s new research strategy Research for all: Developing, delivering and driving better research, published today.

Overall, the survey showed that physicians have a very positive attitude towards research, with almost 60% wanting to be more involved. A lack of time is the biggest obstacle to more research participation, cited by over half (53%). Funding, a perceived lack of skills and a lack of supportive culture in their organisation were identified as other key challenges.

However, the survey report Research for all? An analysis of clinical participation in research showed that some physicians struggle to access research, particularly women, doctors from BAME backgrounds and doctors working in rural hospitals.

Survey findings

Women doctors and research

Women are 12% more likely than men to report not participating in research, alongside a strong desire to become more involved. The reasons for this are complex and partly relate to the impact of less than full-time (LTFT) working and women’s own perceived lack of knowledge or skills.

Those working less than full time are 11% less likely to be employed in research roles and women are 17% more likely to be LTFT. This may go some way to explaining why 8% fewer women report being formally employed in research roles than men.

An area where women are more likely to report a barrier than men is in “lack of knowledge or skills” but as the gap was only 4%, more work is needed to better understand women’s significantly lower participation in clinical research.

BAME doctors and research

There is a 13% gap between those who are formally employed in research roles, with 16% of BAME respondents in those roles compared to 29% of white physicians. Overall, there is a difference in participation in research - 5% lower for BAME respondents.

Although still by far the most important barrier, time is a less important barrier for BAME physicians than white physicians. BAME respondents also reported a lack of supportive culture in trusts and a perceived lack of skills as more significant barriers than white respondents.

Rural doctors and research

Just 7% of respondents from rural hospitals were formally employed in a research role, compared to 20% in urban hospitals. However, 40% of physicians in rural hospitals reported an interest in research although they were not involved, compared to 28% from urban hospitals, representing untapped research potential.

The RCP is calling on national bodies including NHS England to increase clinical research activity and access to research, particularly for those currently underrepresented:

  • Research needs a much higher profile within the NHS, more visible support from national bodies, local commissioners, funders and NHS Trusts, and to be incorporated into health service planning
  • NHS research played a huge part in providing a way forward with COVID-19 and we must harness that as we rebuild clinical services and prepare for potential future outbreaks
  • We need dedicated funding for research, especially in rural areas and for NHS trusts to provide more time for physicians to become involved

The RCP’s new research strategy Research for all: Developing, delivering and driving better research recommends several measures to improve access and equity of opportunity in research:

Develop and support the workforce to become research active and innovative by:

  • establishing a clinician researcher credential and encouraging participation in clinical research networks
  • providing resources and funding awards to promote and celebrate research activity
  • understanding and addressing the barriers deterring RCP members from participating in research, especially in relation to equality, diversity and inclusion.

Deliver a system that enables physicians to do research as part of improving care by:

  • increasing clinical time for research by influencing job planning, guidance on advisory appointment committees and criteria in excellence awards
  • working in partnerships to model/pilot ways for trusts to protect time for research that benefits patients and improve funding opportunities
  • ensuring patients feel empowered to support clinicians integrating research into care.

To drive new collaborative ways for physicians to accelerate research for patient and public benefit:

  • promoting opportunities to grow and translate evidence with partners in the health and innovation sectors
  • building alliances to jointly tackle existing and urgent health and care challenges, such as health inequalities and multimorbidity
  • sharing learning and best practice with NHS trusts on integrating research and clinical care.

RCP academic vice-president Professor Cheng-Hock Toh said: "Sadly in this survey we’re seeing the same findings that we did a few years ago, that physicians want to be more involved in research but are facing the same barriers.

"We’ve also discovered that there is inequity of access to research – women, BAME and rural physicians are finding it harder to become involved in research for a variety of reasons.

"It’s clear that we need a step change in the promotion of, access to and support for research across the board in the NHS, beginning at the very top."

Chair of the RCP Patient and Carer Network Eddie Kinsella said: "The RCP Patient & Carer Network fully supports the call for greater investment in clinical research activity in order to drive improvements in patient care, share learning, and promote best practice.

"Working in partnership with patients and carers from the outset will help achieve those goals and ensure that the patient focus is central to all research activity."