Increasing participation in clinical research has become a key area of focus within the NHS, with the aim of facilitating evidence-based policy, improving health outcomes and reducing health inequality. As such participant recruitment of healthcare practitioners is vital to the success of research studies, and yet many projects fail to recruit sufficient numbers to validate or generalise the data they gather.
Having undertaken several research projects in hospitals around the UK over the past few years, I have found it increasingly difficult to recruit healthcare practitioners to the studies.
Whilst these practitioners profess their desire to take part, they identify their hectic schedules as precluding their participation. This represents an unfortunate irony since much health related research seeks a greater understanding of the system and yet without their participation, the plight of the healthcare practitioner and their patients cannot be addressed.
This irony is further compounded when considering the National Institute of Health Research, Clinical Research Network (CRN) Portfolio, where recruitment data is used to inform the allocation of NHS infrastructure for research. Hence, recruitment to studies takes on greater significance.
Attempts to optimise recruitment and retention for research studies include a range of techniques, such as using large sampling frames, sending reminders, running wide-scale publicity campaigns, providing free helplines and material in the respondents’ own languages. Whilst these techniques may ameliorate the situation, the fact remains that without the time to take part, healthcare practitioners remain passive victims of the very system they labour to support and research cannot gather the data needed for change.
Encouraging healthcare practitioners to participate in research means offering them the opportunities to observe and engage in ongoing studies, yet their full involvement is challenged not just by time, but by the lack of knowledge, skills and support to fully commit to the research venture. Thus, they are disempowered before they start.
I have witnessed the healthcare practitioner’s sense of disempowerment as emanating from the roots of NHS culture and their struggle to deliver care. In this context, research has found the arts in healthcare to contribute to a quality work environment that benefits not just patients, but also boosts staff morale and facilitates practitioner wellbeing. So, whilst pamphlets about NHS leadership may profess to encouraging positive attitudes amongst their staff rather than defeatism, the weight of the healthcare practitioner’s disillusionment could outweigh other aspirations, permeating through to commitment in research. However, this is the context of their work. A primary objective for the CRN portfolio status is to promote clear and accountable research to benefit the wellbeing of the patient and yet somewhere between the policy and the coal face, this incentive seems to have been mislaid.
Building greater insight and delivering more effective support and services, both locally and nationally, relies upon a greater understanding of how the NHS functions at practitioner level. Finding ways to overcome the recruitment challenge therefore sits at the core of service delivery.
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About the author
Dr Kit Tapson works as a researcher exploring the arts in relation to health and wellbeing at the University of Winchester
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