Research supported by our BRC’s Data Analytics cluster “The impacts of COVID-19 on clinical research in the UK: A multi-method qualitative case study” was published in PLOS ONE last week. This research was completed by BRC’s social science researchers Dr David Wyatt, Dr Rachel Faulkner-Gurstein and Dr Hannah Cowan, and Guy’s and St Thomas’ R&D Director, Professor Charles Wolfe.
The UK and the NHS have played a leading role in the global research response to the COVID-19 pandemic – both in terms of scale and speed of set up and delivery. The paper documents the rapid, large-scale reorganisation of research including its staff, resources and priorities and the resulting shifts in work practices. It also examines the impact of national and local decisions on staff, research, care delivery and patient and public involvement.
As an instrumental case study – one that focuses on socially, historically and politically situated issues – the research team used a single site referred to as South London Acute Trust (SLAT) to examine issues that were also faced by other NHS hospital Trusts. The multi-method qualitative case study approach employed questionnaires (n-170), document analysis, observational activities (n-40 hours) and semi structured interviews (n-24) and patient and public involvement activities (4.5 hours) to collect the data. Data were then analysed for both a descriptive and analytical account of a SLAT’s COVID-19 research response and research staff’s experiences. This approach enabled close analysis of how the embedded research system was adapted and repurposed to support the COVID-19 response.
The paper notes the immense contribution of the research system within SLAT, the complexities associated with navigating national and local decision making, and the adaptability of its system and staff. By centralising research prioritisation at both national and Trust levels, halting non-COVID-19 research and redeploying research staff, an increased pace in the setup and delivery of COVID-19-related research was possible at SLAT. National and Trust-level responses also led to wide-scale changes in working practices by adapting protocols and developing local processes to maintain and deliver research at SLAT. These were effective practical solutions borne out of necessity and point to how the research system at SLAT was able to adapt to the requirements of the pandemic. As a result of these adaptations new knowledge was being produced at an unprecedented rate, with SLAT a major contributor to the UK’s COVID-19 research response.
While COVID-19 highlighted the potential to increase the pace of translational research, the authors advise caution in how we envisage future research, ensuring that needs of and the implications for the whole research portfolio are balanced, that research leaders and policy makers take into account the short and long term toll that the emergency response has taken on research staff, and that public voices are embedded in decision-making.
Commenting on the research findings, the paper’s first author Dr David Wyatt said: “Planning for future emergencies should include protocols for the rapid establishment of strategic research prioritisation and the redeployment of research infrastructure and capacity that carefully considers and balances the impact of prioritisation on existing research. It is also crucial that we maintain our methods of involving patients and the public in research, and not let this fall to the wayside in times of crisis. Planners need to recognise that this input is vital in clinical research, especially in an emergency response which requires the patients and the public to respond to clinical-expert advice”
Dr Rachel Faulkner-Gurstein, Research Fellow in Social Science in the Faculty of Life Sciences and Medicine at King’s College London added: “Many research staff found themselves on the frontline of the emergency response while also working to deliver COVID-19 research. These staff experienced the same well-documented stresses experienced by other NHS workers. Future emergency planning needs to acknowledge this human cost. It needs to find ways to mitigate against this, with provision of support for research staff as a national priority.”
To read the full paper please follow this link: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0256871