Our first NIHR Nrewcastle PSRC Theme Implementation Management Group meeting, thankfully shortened to TIMG, for our theme on safer, integrated care environments was great! It was a meeting that could not have better met its terms of reference. Providing input and advice on the theme direction, priorities, and strategies to investigate them.

We had stakeholders from organisations and sectors who could understand the big-picture problem being addressed in the theme and were generous with their suggestions and signposting. It helped that they were all clearly champions in their fields of work and motivated towards improving practice around integrated care and patient safety.

As a theme lead, getting a steer on the key issues in relation to the topic areas we currently have active projects was invaluable. But the most significant discussion point was about something myself and researchers in our theme had not come across; ‘Shared care’. As soon as this was mentioned as an area of possible interest from our ICB representative, other TIMG members contributed their emotive perspective. This highlighted something that was clearly causing contention in practice on multiple fronts with implications on patient safety, with seemingly little being done to resolve and/or investigate and optimise.

This piqued our interest; something under the radar and causing this much drama was worth investigating. Our first delve into literature was unsuccessful in retrieving anything. Dr Google was more fruitful with a few guidance and policy documents to describe shared care as ‘an agreement to ensure seamless prescribing and monitoring of medicines which enables patients to receive care in an integrated manner’. 

This seemed like something we could be looking into. The available documents, however, made this initiative sound quite benign and actually like something that could work out really well for patients. So, why the drama?

The following weekend, I happened to be having a social encounter with a family member, who is also a practising GP. So, over coffee and cake I asked about shared care. I was not prepared for the head-in-the-hands response. The implementation and reality of this agreement in clinical practice sounds messy, complex and potentially riddled with risks to patient care through monitoring, identifying and addressing fluctuations in chronic conditions in patients who are often experiencing multiple long-term conditions and have complex health and social care needs. Also, shared care appears to be here to stay in the NHS…at least for a while.

So, what has this meant for us within our theme; we have started to look at this problem more systematically. Given the lack of published evidence on this initiative, stakeholder engagement will be crucial to understand it better in terms of its design, delivery and implementation, work out the risks and potential benefits and investigate how patient safety is protected and consolidated. It looks like our first TMIG has flagged a potential theme priority…watch this space!

The PSRC PhD SafetyNet Networking Event was held on the 4^th March 2024 in Leeds, bringing together students and supervisors from across the 6 PSRCs in England. It was a fabulous day with an opportunity to learn from one another and grow collaborations in a supportive, nourishing environment.

Before the event, I was excited to meet fellow PhD students and learn more about the work that other PSRCs are doing. However, like other new PhD students that I had spoken to, I didn’t really know what to expect or what I would gain from the event. Quite adventurously, after discussion with my supervisors, I decided to take the leap, and submit an abstract for a protocol that I had just written up for developing logic models on step-down virtual wards. Imposter syndrome kicks in, “I am only a few months into a PhD- what have I got to talk about?” On the other hand, I knew that delivering presentations and the thought of public speaking were my worst nightmare. That said, I also knew that I needed to fight my fears and start somewhere!

When the email came back saying my abstract was accepted – an inner shriek of excitement, surprise and panic kicked in! “Where do I start?” Amidst the feeling of anxiety and perceived inexperience, I procrastinated and delayed even thinking about the presentation. With some reassurance and moral encouragement from peers and supervisors, I knew that this was the ideal opportunity to share my plans for the PhD. The event was a supportive environment of like-minded people, many of whom were likely to be on, or had been through, the same journey making this a perfect forum for feedback, sharing knowledge and developing key skills. It was great knowing that many other students were presenting their work (or planned work) at the event via a poster or oral presentation.

Everyone is at a different stage of their journey, but it was great to see how people support each other and in research this should not be under-estimated. Personally, listening to more advanced PhD students gave me the inspiration to see the future and that ‘I can do this!’. Similarly, talking to newer PhD students gave me the confidence to see how far I had come in my experience to date and that in fact, I may have some bits of wisdom to share which may help others.

Great Opportunities

In my opinion, I found that the PhD SafetyNet event opened the door to shared learning practices, a community of peer support in patient safety research and great opportunities, such as: 

• Networking
• Learn Together Discussions

Prior to starting my PhD, I was jokingly dubbed by my fellow research interns as ‘the networking queen’, however I never truly thought about why networking was so important. Reflecting on my journey so far, I would not have started my PhD without networking and speaking to people who were happy to share their experiences. I have come to realise that often these little informal chats and introductions can lead to great connections, bringing wisdom and expertise further down the line. 

Whilst some experts suggest that networking is a start to building connections for your long-term career¹, it is vitally important to recognise that networking is a mutual ground for positive exchange of knowledge and support. Conferences and events such as these are vital in enabling trainees to develop and apply competency in key skills such as presentations, communication, dissemination of their work and equally networking.² We are fortunate within the NIHR PSRCs to have these networks of peer support and building communities of practice together in patient safety. The saying goes ‘it is a small world’ but on reflection, in the research world you can’t really work in isolation. It is often the work of great teams and collaborations that is needed to make an impact.

These discussion workshops were valuable and allowed people to connect and share experiences. I found the ones I attended useful, and I chose the sessions that were relevant to me. In particular, I was keen to attend the session on ‘Navigating the first 6 months of your PhD’ as it was unlikely that I would get this experience elsewhere, other than rich discussions with the people who have just experienced it or experiencing it currently. This was potentially the start of building great academic networks, peer support and collaborations in patient safety moving forward. I learnt helpful tips from the other students, namely technical tips and basic key skills that are essential. For example, some discussions revolved around how to organise your literature, how to make notes, and several types of software that may be useful. Other workshops explored various aspects of research such as the importance of Patient and Public Involvement and Engagement (PPIE), Equality, Diversity and Inclusion (EDI), co-design in research, writing effectively and Impact and Dissemination.

In summary, events like the PhD SafetyNet Event provide a fantastic opportunity for PhD students and their supervisors to share work, learn from each other or establish connections. I look forward to attending more of these events throughout my PhD and beyond.

Acknowledgements and thanks go to the Yorkshire and Humber PSRC for hosting the event this year.

References

• Pickman, A., & Chauveron, L. Networking: How to market yourself and your PhD. In J. B. Urban & M. R. Linver (Eds.), Building a career outside academia: A guide for doctoral students in the behavioral and social sciences. pp. 151–160. American Psychological Association; 2019. https://doi.org/10.1037/0000110-014
• Subramanian S. The importance of conferences and networking in PhD and postdoctoral training. Current Protocols Essential Laboratory Techniques. 2020 Dec;21(1):e44

14^th March 2024 was the Academic Career Development (ACD) Forum in London, for all the ACD leads and the theme for the day was ‘research culture’. Representing the Newcastle PSRC, we headed down. It was our first such day. We’d put our training community’s video forward for sharing as a message from our community. And we were ready to learn all things great and mighty – directly from the NIHR Academy!

The usual train cancellations aside, we arrived relatively organised and alert. We found ourselves positioned at different tables, which was good as we got to create new links. We heard about some of the newer Academy schemes, were given feedback from the Postdoctoral event and listened to presentations on how we can develop and nurture a diverse research culture. We shared our community’s video and received some great feedback, which we will relay to our fellows (they did all the hard work on this) (Newcastle PSRC Academic Career Development Community Video). We had some lunch, swopped notes with colleagues old and newand made plans on how we can all be more collaborative. And then it was time to head home.

Our main learning from the day didn’t really hit us until on the train home, when we had a good 3 hours to unpack what we had heard, and to reflect on what it all meant for our Newcastle PSRC, and our wider Newcastle Health Innovation Partners’ Academy. And the more we reflected, the more we realised the substantial change that is in the horizon.

The times are changing. The next 5-10 years will see the stepping down of a whole generation of “training people”. Those of us who have lived and breathed training, career development and capacity building for the past 15-20+ years. Those who coined the term training lead, who came up with the idea of NIHR Academy, and who set up how we do things now. Those of us who have helped lead  the implementation across regions.

At the same time, the hugely positive shift – from historical hierarchies to much more multidimensional points of differences and richness of perspectives – is now, fortunately, looking inevitable. Not the least made so by the healthy refusal of the next generations of leaders to bow to such hierarchies but, instead, actively challenge us all to enact a more open, broad culture – for everyone.

But what does all this mean? I think it means: the future for the future leaders is now. If we have done our job of the past 15 years well, then the future is bright.

Within the Newcastle University School of Pharmacy and the NIHR Newcastle Patient Safety Research Collaborative, Dr Charlotte Richardson, Dr Matthew Cooper, Dr Daniel Okeowo, Dr Anna Robinson-Barella, Professor Hamde Nazar and  Dr Jason Scott (Northumbria University) secured funds from the NIHR to host 4 student internships. The internships are designed by the team to support the development of the students and to provide an opportunity for them to get involved in the innovative research they lead.

The students worked on two research projects (one led by Matthew and one by Charlotte) over the course of 8 weeks. The students, Liesel and Trinette (Stage 4), along with Eman and Bella (Stage 3), worked in pairs on the projects—an umbrella review on social prescribing and a qualitative project focused on the experiences of ethnic minority carers.

Liesel, Trinette, Eman, and Bella summarised their experiences below.

Congratulations to our Safer management of polypharmacy in multile long-term conditions research Co-theme leads Professor Adam Todd and Professor Barbara Hanratty on getting their commontary; “Beyond polypharmacy to the brave new world of minimum datasets and artificial intelligence: thumbing a nose to Henry” published in the BMJ Quality and Safety Journal.

Professor Barbara Hanratty, Professor Adam Todd