‘No decision about me, without me’ – introducing our Clinical Lead for Research Inclusion, Dr Ash Kotecha

To mark Equality, Diversity and Human Rights Week 2023, we spoke to the Clinical Research Network South West Peninsula’s new Clinical Lead for Research Inclusion, Royal Devon University Healthcare NHS Foundation Trust Consultant Cardiologist Dr Ashish Kotecha.

Ash, who is also the CRN SWP’s Cardiology Specialty Research Lead, is passionate about improving patients’ lives through research, and about creating a fairer society. As he explains, research needs to be relevant and applicable to everyone if it is to be truly effective in improving outcomes for all.  

What is your background in research?

Cardiology is a very research-oriented specialty, and there have been many innovations during my career to make outcomes better, both in terms of prevention and treatment. If it wasn’t for research, we simply wouldn’t have these things.

As a result, we would have more patients with ill health, which is not good for patients in particular, but also for the society in general. As an example, there is a significant financial advantage in preventing heart attacks, so benefiting both the individual and society. I believe if someone has had a heart attack and needs an operation, then in a way, we've left it too late. Research is the only way to identify ways to help prevent and treat diseases, and that is my motivation for getting involved.

I have worked in many different departments across the South West so have a good network in the region, and when the SRL role came up I felt I could be useful in promoting the NIHR among my fellow clinicians, as well as boosting the region’s profile in the field of cardiology research nationally. Despite challenges from the pandemic, we have continued to do well in non-commercial and commercial research here in the South West.

What are you going to bring to the research inclusion role?

I grew up in India, and then trained in various places in the UK before settling in the South West. Getting to this point in my career has been a challenging journey. This has enabled me to understand first-hand the barriers and the prejudices which exist, as well as understanding conscious and unconscious bias, having lived it personally.

I have been involved in charity work in this sector for a while now in one capacity or another. When this research inclusion role came up it seemed only natural to apply.

Why do you think inclusion in research is so important?

There is a phrase which I actually have written up on the wall behind me in my office: ‘no decision about me without me’. It is a principle the NIHR has used to help design research inclusion guidance. The UK is a thriving multicultural nation, and health and social care, including procedures, medication, facilities etc., needs to meet the needs of the present population. Research outcomes are much stronger if they are applicable to the whole population, rather than to select groups.

However, there are a lot of barriers involved. Our main challenges here in the South West are not necessarily around race or ethnicity, unlike other areas in the country, but to do with low socioeconomic strata and low education. Challenges can be geographical, something very relevant to our region. Language can also be a barrier, especially with the growing diverse population locally. Researchers need to consider all this to ensure research study participation across the population, and that the results are applicable to all.

Simply put, to me, inclusion helps improve the quality and effectiveness of the research project.

Anything else you would like to add?

I'm really encouraged by the efforts to embed inclusion in health and care research nationally as well as locally. It’s great to see that everyone in the NIHR is very dedicated to this cause, because it needs strong leadership and active team participation to implement these significant changes to our working culture and practice.