Transcript Date:
10 April 2024
Speaker Key (delete/anonymise if not required):
HOST: JACQUES STRAUSS
SOPHIE: SOPHIE CHALMERS
HAZEL: HAZEL RODDAM
MUSIC PLAYS: 0:00:00-0:00:06
HOST: 0:00:06 Welcome to another RSCLT podcast. My name is Jack Strauss.
In this episode we are talking about a really interesting piece of research that has been carried out that looks at the link between research engagement and improved health performance. In other words, if your service is engaged in some research – and we talk more about what this means – what impact does this have on actual outcomes?
We were joined by Sophie Chalmers and Hazel Roddam. As always, I started by asking the guests to introduce themselves.
SOPHIE: 0:00:43 My name is Sophie – Sophie Chalmers. I’m a practising speech and language therapist working in the NHS, and I’m also a pre-doctoral fellow at the NIHR Applied Research Collaboration in Greater Manchester. So, I’m looking into sensitivity in the throat and associated swallowing difficulties as part of my research.
HOST: 0:01:05 And Hazel, could you tell us a little more about yourself?
HAZEL: 0:01:06 I’m a speech and language therapist too. I worked for over 25 years in the NHS, and my area of practice was what we now call neurodevelopmental disorders, so children, on the whole, with quite complex physical learning and sensory impairments. I loved my work, but having got research skills through part-time study, while I was still working clinically, I then moved into an academic post, but it was a research post, not a teaching post. I’m currently working for NHS England, so I’m commissioned by them to lead on the national research and innovation agenda across all AHP disciplines. There are 14 professional AHP disciplines registered for UK, including speech and language therapy.
HOST: 0:01:55 Can I just start by asking how your interest in research actually came about?
SOPHIE: 0:02:03 Yeah, of course. For me, I’ve always been a clinician at heart, and the idea of getting into research really stemmed from probably undergraduate level to begin with, actually, where evidence-based practice was entwined within the curricula. And I didn’t really think about it that much back then, to be honest. But actually, in my first newly qualified role, I was working with adults with acquired communication and swallowing difficulties, and just going around wondering: is this the best way of doing things? Is there a better way to do things? What does previous literature say? Is there anything new and interesting happening that we should be applying?
Moving forward, I started to get involved in small audit projects, service evaluation projects, and collecting just real-world data about evaluating current treatments and practices. That’s really how I started to dip my toe into this world of research. But at the forefront, it was always to… how can we improve patients’ experiences of care? How can we improve their outcomes?
HOST: 0:03:17 And how about you, Hazel? Given that we are going to be talking about research. How do you think about clinical work versus research and the potential tension between those two?
HAZEL: 0:03:30 At the time that I decided to make the move from NHS – from a fully clinical role into an academic role – it was a massive wrench. I can’t describe to you the… how long it took me to make that move, because I was committed to improving services, as Sophie’s just said, for the people, the families, who need our services, but also for us as a workforce delivering the services. Are we working in the best way that we can? How’s everybody else working?
So, when I made that change, I was lucky, I was fortunate; I was able to go to a very small unit for allied health professions research and develop a role, a post, where I was working directly with clinical teams and services helping them to answer their own questions about the way they were delivering services.
For me, that helped because I didn’t feel I’d left clinical services behind, because that wasn’t what I wanted to do, but I was just taking it on another step, to be able to give academic advice to help people evaluate what they’re doing, and does it work, how could it work better? And now – I’m calling it ‘career #3’ – I’ve gone into more of a strategy and policy role with what was called Health Education England and then NHS England. Again, that’s about the national guidance for how we move all services in that direction.
HOST: 0:04:56 Which brings us to the main question, and I will direct this to you, Sophie, as the lead researcher. What did this research actually tell us?
SOPHIE: 0:05:06 If I start just by describing where all of this came from, perhaps. Fast-forward a few years from when I was newly qualified, I had an amazing opportunity to work with a university to develop AHP research in the trust that I was working at at the time. And this is when Hazel alerted me to existing evidence that was published linking research engagement with improved healthcare performance.
We had several conversations about how perhaps a more contemporary update was needed, but with a really specific focus on allied health professionals, and what the impact and value of research engagement was in that particular professional group.
So, we looked at research engagement, and how allied health professionals would be research engaged and what that meant. And when I talk about being research engaged, if I explain that a little bit, we’re talking about that whole breadth of research. Someone maybe attending a journal club, or those applying evidence into practice as part of their day job, or even being involved in [evidence-base 0:06:24] in quality improvement projects, or teams, organisations, who are recruiting to trials, or maybe even starting up small scale research to lots of large-scale studies. We looked at this collection by looking through all that research that existed on that topic.
What we found was, when allied health professionals were research engaged, this was associated with improved patient processes of care. And what I mean by that is improved care pathways and care delivery. So, that’s the headline of what we found.
HOST: 0:06:58 Hazel, can you talk to us a little more about the term, ‘research engagement’, and about engagement with research versus engagement in research?
HAZEL: 0:07:08 In the in the paper, we give a clear definition of what we mean by this term, ‘research engagement’. And we make a distinction between being engaged with research, so that includes the types of activities that Sophie gave us an example, joining a journal club, just keeping yourself up-to-date, feeling confident that you know how to do that and that you get support from the organisation to be able to do that. So, that’s engagement with research.
And then engagement in research means a more active role, and it might be in different ways research delivery, recruiting people onto trials, as Sophie said, or actually yourself developing small-scale, in the first instance, practice-based research and practice-led research, or joining in collaboration with bigger studies.
But people always think of research as being data collection. And something that Sophie said a moment ago is so important that, before you embark on collecting data, it’s really important to… the first step is what’s already published? Because it’s like libraries, or the electronic equivalent now of all these papers, hundreds of thousands of papers on topics which are gathering electronic dust. There’s no value in research unless it’s actually used. That’s what we mean by engagement in research and with research.
We need everything, but we do want to encourage people about the value of making sure you know what’s already there before you start on something new.
HOST: 0:08:40 This is an opportune moment to remind us not only about the International Journal of Language and Communication Disorders, but the IJLCD episodes of this podcast, in which we talk to authors about research that may be of interest to your service. And so, this is one form of engaging with research to keep up-to-date with some of the latest thinking in speech and language therapy.
I then asked Sophie why she thinks this research is so important.
SOPHIE: 0:09:09 The importance of this work is really interesting to me, actually, because it can have value to lots of individuals at varying career levels in different clinical and academic settings. And I can really speak to maybe my experience as a clinician, my experience as being managed, and also as an early career researcher as well.
So, I guess for clinicians on the ground, as it were, they might like to highlight these findings to their managers because they would like to propose the idea that it’d be really good to start running a small evaluation project, or they might like to start leading on a multidisciplinary journal club, for example. And they could use this paper to actually evidence the value of doing that, so to, in essence, justify time and effort towards those different types of activities.
From my perspective, I guess for managers and service providers, it could be used to highlight the needs for more clinical academic roles in a team, for example, or why an individual would like to develop their research skills as part of their clinical professional development.
And then for researchers, particularly in what we found through the systematic review is, we made some quite clear and explicit recommendations for researchers when they are running clinical research studies, where if they’re involving AHPs in either the running of the study, if they’re involved in data collection, or if they’re involved in stakeholder groups, we really need to document the outcomes of these activities. So, what did the AHPs get pre-study versus post-study from being involved in research? And also, it’s really important that we define a name of the professions that were involved as well, so we get good data on that.
HAZEL: 0:11:12 I can’t state enough how important it is that AHP research is visible, and has reputation and credibility. As Sophie’s just saying, a lot of these studies that we looked at didn’t specify which AHP groups were involved. So, they might talk about, for example, a stroke unit in a large hospital, so we know that there’ll be several flavours of AHPs, including speech and language therapists working on that stroke unit, it goes without saying. But because it’s implicit and not explicit, it’s really hard for us to be able to document the evidence of the value of SLTs in the future prospectively having the support from their organisation to continue to be involved, or to be increasingly involved even more.
So, it’s about being able to sell the value of why should services include this engagement with as well as in research? What’s the benefit for the organisation? And we can only say that and win that argument if it’s really transparent, and actually, in print, if you like.
HOST: 0:12:20 I’m hearing two things. This research helps SLTs and their services make the case for time and resource to engage with or in research. But also importantly, we need to look specifically at individual AHPs, be it SLTs, or physios, or OTs, etc., so that we can make more rigorous claims for individual professions – particularly now that, once again, there’s so much talk about NHS reform.
HAZEL: 0:12:54 We do, and we didn’t have that before, so this is like, if you like, a line in the sand.
Part of the value of the paper that Sophie was just talking about, what are the recommendations coming out of the paper? There are clear recommendations for the workforce, and the managers and commissioners of the workforce, also very clear messages for future researchers to make sure that they design their studies to be much more explicit in this.
HOST: 0:13:21 I understand that the timing of this research couldn’t be better.
Hazel, could you tell listeners why this is the case?
HAZEL: 0:13:30 Over the last decade, the AHP research community collectively and the speech and language therapy research community within that, have been moving forward. But it’s been a long slog to get more visibility, to get more reputation and esteem for this to demonstrate the values we’ve just been saying. Over the last four years, things have just happened, pell-mell. The pace of change has been really exciting, and I have been very proud to have been involved in leading that.
I was commissioned, as I said, by the NHS England, as they are now. So, the strategic context was that NHS England, through their Health Education England arm, were investing in this agenda, so allied health research and innovation.
We launched a collective AHP research and innovation strategy in January 22, and later that year, at the end of that year, we hosted an AHP research summit. That was a landmark. That was the first time that we’d done that – to bring together the influencers from across all the AHP professions to identify what are the next steps, what do we need? One of them obviously was investment. Apart from reputation, you need investment. We need money on the table.
As a direct consequence of that summit that we held, we were then invited to conversations with the National Institute for Health and Care Research and the Department of Health and Social Care, and that resulted in the formation of some new dedicated funding streams to support the future of AHP research. Later on last year, November 23, I convened an AHP research think tank, again to say how are we actually going to maximise these opportunities?
Let me tell you what these opportunities are. The announcement came in August 23 to say there was going to be an additional £30m a year for healthcare professional research, and that’s on top of the £30m a year that has already been announced. So, that’s £60m a year recurrent funding for the five years from the date of announcement. And that now widens up eligibility more than ever before for allied health professionals. So, we’ve got to seize the moment! We can’t miss this opportunity, because we said we needed it, and if we don’t take up these opportunities, we’ll be left with egg on our face and we’ll go back to this slow, crawling pace of transformational change.
So, our messages are to make sure that people know about these new opportunities, and that we support people. So, it’s about talent spotting and supporting individuals who might be able to benefit from these research capability building initiatives and streams and go on, if that’s their wish to go on to research careers in the future and become our future research leaders. It’s about securing the best potential leaders for the future.
But it’s also about preparing their managers, their organisations, to release him. So, if there’s backfill funding, that sounds great; the individual gets their equivalent salary costs, and the organisation get full backfill costs.
But it’s a sticking point, because where we’ve got people in highly expert and very, very specialised posts, it’s not easy for the organisations to just replace them at the drop of a hat for a secondment period. So, we’ve got to recognise how we can sell the value to organisations and managers. And we hope that this paper help in those conversations. As Sophie was saying earlier, to be able to actually start conversations within organisations.
Setting the context as well, there’s been another publication which came just in February this year, 24, again from NHS England, and that is a multiprofessional research capabilities building framework. Now, we never had this before, this goes across all nursing, midwifery, and allied health professions. But for the first time, we’ve got concrete descriptors at different job and career levels for how people should be supported to actually continue their professional development in research skills. So, that’s engagement with research, as well as in research.
So, that’s the context and that’s why the timing of this paper was so wonderfully peachy. We needed to have that on the table, and to encourage, as we’ve said, future researchers to now immediately start building this in to their planning. So, in their proposed budgets and their proposed project plans to make sure there is a stream where they’re actually measuring what are the ways that research is being implemented and supported within the organisation? Who’s doing it, obviously? We’ve already said that – be transparent about which allied health professionals.
But in our paper, we also talk about mechanisms that actually support this use of research and support individuals to become more research active. So, those mechanisms also need to be specified in future research.
So yeah, very happy that we managed to get the paper published. And in the links, when people have listened to the podcast, they’ll see the link to the paper, which was published in Biomedical Central, but also the protocol we published in IJLCD the previous year. So, that was a way of marking the territory, putting the flag up to say we’re doing this and we’re following on from the research protocol which had been published 10 years earlier that covered all healthcare professionals. In organisations regardless of the makeup of those healthcare professionals between medicine, nursing, midwifery, allied health, pharmacy, whoever. They weren’t specified, so we felt, as Sophie introduced so beautifully, it was just timely, it was so important that we publish something very clearly about AHPs. It’s it shown us what we do know and where are the gaps.
And there’s a lot of gaps. In the paper, there were a limited number of papers published, so in our review we found a limited number. But that’s important still, because it gives us a starting point. If we repeated this in a few years’ time, what we would really hope for is to be able to say there have been this many more publications, but look how much more specific they’ve been in terms of what they were evaluating.
SOPHIE: 0:20:07 Absolutely. And defining those professions is also of equal importance. We had some very limited number of papers that described very specific professions, but others that were also very broad and, like you said, very implicit. And that’s really important to understand which of our AHP professions are research engaged as well.
HOST: 0:20:37 So, we have the argument, the money for research, there’s a framework that you can refer to, and there are other resources including a video and an infographic that Sophie has made. And then there is the CAHPR website, which stands for Community for Allied Health Professionals Research, which is a fantastic one shop for all allied health professionals interested in research. Links to all of these can be found in the show notes.
Sophie, I wanted to ask you, what would you say to someone who, let’s say, may be interested in research but they’re feeling a bit nervous or hesitant for whatever reasons and haven’t made the leap yet?
SOPHIE: 0:21:19 Yeah, that’s a really excellent question. And my initial response to people who ask this is, the first thing to remember is everyone’s research journey is completely different. The more people you speak to, the variety of journeys you’ll hear, and that’s okay. If someone’s wanting to dip their toes in research, their way of doing it will be completely different to someone else’s.
In addition to that, I’ve always been a really strong supporter of finding your community, so reaching out, talking to lots of different people, both peers, and also people with more experience further down the line, and try to find a really good mentor who is very giving with their time and advice and who is going to support you wholeheartedly by giving you tips and tricks, and also opening opportunities and doors as well, because they be your ally on that journey. And it’s really important that you find someone who will give you that.
HOST: 0:22:25 Great advice. So, find a community, find a mentor. Hazel, do you have any thoughts on how to approach someone to perhaps be a mentor?
HAZEL: 0:22:35 People who work very hard at publishing research, whether it’s in a book publication or an academic journal, you just hope and hope that someone is actually going to read it. So, if somebody gets in touch and says, well, either I’ve read it, or I’ve heard about you, or I’ve heard your name, I wonder, would you talk to me about this, you’re thrilled to bits.
So, I think people who are hesitant, I’d encourage them, get in touch, find out someone either in a similar field or topic or discipline to yourself, but it doesn’t have to be. Anyone who, as Sophie said, might be just a few steps ahead of you, or quite a bit more experienced in the research environment. And they don’t have to be a shiny professor top of the tree. But get in touch and ask them. And all I would say is, make sure you ask very clearly, make it clear why you’re asking, and what actually would be helpful to you, and then keep in contact and say thank you afterwards. So, if you send an email, for example, because we’re all absolutely flooded with emails. But if you get one, which you can tell someone’s taken the time to explain, well, this is what I think I might be interested in, this is what I’m hoping to do in the future, nothing’s set in stone, but I’d be really grateful if you could give me a few minutes of your time for a chat, you’re much more likely to say yes, than the email that just says, oh, right, well, I’d like to talk to you when you’re free. Well, actually, I don’t know how much I want to talk to you. But you can tell the people who’ve just taken that bit of trouble.
And then afterwards a little thank you email or whatever. It goes to build that relationship, which, as Sofie’s just said, might continue into the future and might open more and more doors for you. So, make friends and you will find people are very generous and responsive, I’m quite sure of that. And if they’re not, try someone else.
HOST: 0:24:33 RCSLT have developed ROOT, that’s the RCSLT Online Outcome Tool. And not to ask a leading question, but can you tell us why it’s so brilliant for researchers?
SOPHIE: 0:24:40 From my experience, I’ve used the ROOT when I was one of the lead SLTs in a new Long Covid service. So, if we think about a new area of practice where we didn’t have a lot of real-world data at all. Using therapy outcome measures and using ROOT to collect that in practice was absolutely invaluable, in addition to knowing what people were doing up and down the country as well.
And actually, it gave us a community of clinicians who were gathering similar data to come together and compare what we were doing, what we were doing well, what weren’t we doing well, and have a really nice cohesive place to bring it all together, which was ROOT.
HOST: 0:25:31 And Hazel, that reminds me of when you were talking about bright spots. The ROOT is a great way to potentially identify a service that has really good outcomes for a particular condition, and we can go, okay, well, what are they doing, exactly, which would be a good jumping off point for research?
HAZEL: 0:25:55 Absolutely. I mentioned earlier that when people think about research, they think about data collection and they think in very traditional ways of the types of data you might collect. But real-world data that contributes to real-world evidence of how well services are working is so, so important. There’s all types of evidence.
Our message to people is that actually, yes, what you’re doing on your day-to-day work and a lot of routinely collected data could be so much more valuable and have so much more impact if we can collect it all together then we have a massive dataset, which is what the ROOT tool has done spectacularly already.
So, if people don’t already know quite what the ROOT is, have a look on the RCSLT website to understand more, or just get in touch if you still have questions. Because people up and down the country in their own services could be contributing and getting actively involved, just through the routine data that they’re already collecting.
HOST: 0:26:56 Final question, what are the key messages you’d like to leave listeners with?
SOPHIE: 0:27:03 The key messages from me is, in relation to the research that we’ve described in this podcast, it can really be used by anyone – clinicians, managers, academics, to show the value of being research engaged, which hopefully it will help them to make the case for them to be research engaged in whatever stage they’re at.
But also, we really want to know how people have used the paper to start conversations as well. Who’s reading it? How has it been used? And what have people’s reactions been? And it’s really important now that we’ve got this evidence to showcase exactly how it can be used to support this research agenda for AHPs.
HAZEL: 0:27:47 Just following on from that, as Sophie says, we’d like to know what people are doing. People might not call it research, it might be innovation. But if it’s not documented and shared, we can’t benefit, other services can’t benefit.
So, my role, commissioned by NHS England for the year ahead, is going to be really trying to connect people more. Where there’s exciting hotspots in regions and locations across England in particular, but obviously our RCSLT is UK-wide, as are the other allied health professional bodies, we want to link people up. We want to be able to show exemplars of what’s working well and support people to be able to disseminate that more, so people can contact me either through CAHPR or through the Royal College of Occupational Therapists who are going to be hosting me in my role for the year ahead. But you can also always contact me and Sophie on social media. Particularly Twitter – just send us messages there. Contact us through RCSLT. But as Sophie said, yes, we’d like to hear back. What are people doing and, in particular, what reactions to the paper.
HOST: 0:29:03 A very big thank you to Sophie and Hazel for their time. All the links are in the show notes. And I would again, as I often do, remind you that rating or reviewing the podcast and sharing it with your colleagues is so important. It helps us connect SLT researchers and make people across the profession aware of new opportunities and resources, so that we can advance the profession in the UK and beyond.
Until next time, keep well.
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