The Unspoken Voices Project is funded by a HEE/NIHR clinical doctoral research fellowship. This training programme aims to support allied health professionals (AHPs), nurses and midwives to develop as clinical-academic researchers. That is, to be able to continue to work as clinicians in the NHS whilst carrying out research that is relevant to NHS services and patients. One of the reasons that it is thought to be a good idea for clinicians to be engaged with research is because research-active health organisations get better outcomes for patients. The fellowship programme has already provided me with some fantastic opportunities to network with other clinical-academics and to learn about how research can have an impact on healthcare (see TEDx NHS, Conference season). One of the challenges facing the NHS is that there currently aren’t established career frameworks within health organisations that enable clinicians to combine clinical practice with research. I have been reflecting recently on what is happening both locally and nationally, and what more needs to happen, in order to change this so that I (and other trainees like me) can continue in a clinical-academic career after the fellowship has ended.
I attended a meeting with colleagues at the University of Gloucestershire (UoG) at the beginning of December. They are looking to broaden their research portfolio, to work more closely with healthcare providers, and to develop the teaching and training programme that they offer social- and health-care workers. Although UoG don’t currently have AHP trainees in their student population, the health and social care team are keen to expand their offer as well as to find areas of overlap with local research-interested clinicians. It was a really positive experience to be in a room of people trying to find common ground and to build relationships that will expand horizons for all parties. I was reminded how, within healthcare, we often embed ourselves within clinical areas, teams or specialties. It can be difficult for some people to see beyond the opportunities provided within their immediate work environment. The same could be true in trying to develop a clinical-academic career. I am in the fortunate/unfortunate position that my host University is 200 miles away and there are no local Higher Education Institutions (HEIs) with Speech and Language Therapy training courses. This has the potential to be both a barrier to developing a clinical-academic career, and an opportunity to look beyond my immediate milieu. My UoG colleagues and I focused on areas of shared interest (e.g. research methods, building bridges between health research and healthcare providers) and possibilities for future collaboration that will benefit all parties (e.g. teaching, building training courses). I was grateful to meet people who recognised the skills that I am developing as a research fellow and saw beyond my professional label or clinical background.
I was invited to present my clinical academic journey to a meeting in London in December. The aim of the day was to consider how the NHS can develop sustainable AHP research careers. We heard presentations about how the National Institute for Health Research (NIHR) and their Clinical Research Networks (CRNs) are developing the support that they provide AHPs to enter into a career as a clinical academic. A podiatrist collegue and I were interviewed about the highs and lows of our paths into clinical-academic training. Representatives from Solent and from Sheffield health communities provided some possible frameworks for developing clinical-academic pathways, about which the delegates discussed the strengths and limitations. The over-arching theme of the meeting was that, currently, clinical-academic careers are ‘non-linear’. AHPs move between clinical and academic opportunities and there is no standard framework for a career that bridges healthcare provision with research activity. Clinical-academic careers frequently depend on tenacity and courage of an individual. There are heartening developments within strategic NHS bodies to bolster clinical acaedmic careers in future. Significant hurdles continue to be the financial pressure on middle-managers and the lack of a mandate for them to develop such posts.
One of my concerns on entering the NIHR fellowship programme was that I couldn’t see where it would lead me. My modus operandi is as a goal-focussed planner, so I found the lack of a clear pathway post-fellowship was unnerving. As a clinician in the NHS, there is a route you follow when developing clinically, followed by a route into management. There was no obvious job in the existing clinical-managerial NHS career development framework that having a PhD would qualify me to do. Neither is there a clear clinical-academic career framework. What my experiences with UoG and at the workshop in London have taught me is that I need to seek out opportunities, build relationships, look beyond traditional boundaries and expectations, learn from those who have forged their own paths ahead of me and, ultimately, build my own clinical academic career. And then to help others to do the same.