Please tell us a bit about yourself and your role?
I describe myself as an “academic clinician” as opposed to a “clinical academic” since I have kept myself rooted within the NHS. I have, over the years built the multi-specialty, award winning Specialist Spondyloarthritis Service which provides tertiary specialised care for over 3000 people with SpA and related conditions. The service is a clinical and research hub with over 50 clinical trials completed in the last 15 years whilst utilising research to improve patient care through earlier diagnosis, enhanced treatment options and strategies and achieving better longer term outcomes. From starting as a single handed consultant I am really lucky to now a large team including comprising consultant colleagues fellows, specialist clinical and research nurses, project and data managers and other admin staff.
What inspired you to take part in research?
I was introduced to research by Professor Emery. I was working in his team as a senior house officer when he tasked me to help with the first seminal interventional trial using a TNF inhibitor drug in rheumatoid arthritis. Seeing the huge impact of this drug on people’s joint symptoms and quality of life fascinated me, and have never looked back. I have always been a “why?” person so it was a matter of being in the “right place at the right time”, since we were pioneering research into biologic drugs and advanced imaging techniques to treat and characterise rheumatoid arthritis, axSpA and other immune mediated diseases. Twenty years on, this research has contributed to change the lives of many people and revolutionise service provision models worldwide with hardly any inpatient care needed for rheumatology patients these days.
How do you envision it impacting patient care?
Medical knowledge in recent decades has advanced immensely, yet we cannot become complacent. If we take rheumatic diseases for example, these are well treated worldwide, yet we do not know what causes these conditions so we cannot cure them. Our current work within the NIHR Leeds Biomedical Research Centre is directed at very early diagnosis before co-morbidities and disability settles in, and disease prevention, to identify factors associated to the development of psoriatic arthritis in people with skin psoriasis.
What career challenges did you encounter, and how were they addressed?
Many over the years! And largely related to misunderstandings about what research is, and attempts to compartmentalise it aside from clinical practice. All the research I have been involved in during my career has had immediate translation into improved patient care and higher levels of satisfaction for patients and staff. Yet, there is always the need to secure funding not only to conduct specific pieces of work, that is a research study, but to ring-fence the time needed to do it. Going forward, dedicated time should be embedded in job plans not only for doctors but any health professional interested in research.
What are some key learnings from your research career?
Research is the core of everything we do in medicine, and indeed life! Any innovation needs to be tested first to make sure that it is safe and works. This principle applies not only to medicine but engineering, nutrition, sports! Research should be embedded in daily NHS work, and we all need to contribute to it in some way or other. You don’t need huge budgets or a large team, if you are investigating something to learn facts and reach conclusions or draw learnings, that is research.
Any word of advice to anyone considering a research career?
You do not need a PhD or to lead a huge clinical trial to be considered a researcher, but luckily there are clear academic avenues for clinicians and other HPs within NIHR that will facilitate a research career within the NHS. A good starting point for instance is to join the National Institute of Health and Care Research (NIHR) Associate Principal Investigator Scheme or contact R&I for information on opportunities available in Leeds. And importantly, look for a mentor, a trusted adviser who can inform and guide you in your chosen area of work. Aside from passion and wanting to make a change, you will need lots of patience, good organisational skills and grit, if you do: go for it!