Portsmouth fellows support delivery of COVID-19 research

Since the outbreak of coronavirus, CRN Wessex research fellows and trainees across Wessex have been working together to support the delivery of nationally prioritised, urgent public health (UPH) research.

Working collaboratively and sharing resources has been essential to the successful delivery of COVID-19 research and has enabled the region to open 16 UPH studies, seven of which are led by the Wessex network.

In this interview, Dr Laura Wiffen, a Respiratory Research Fellow from Portsmouth Hospitals NHS Trust (PHT), describes her experience of supporting COVID-19 research. 

“I have been working as a Respiratory Research Fellow at PHT since August 2019, supporting delivery of the large respiratory research portfolio including both commercial and locally sponsored studies as well as developing new studies with the Portsmouth Technology Trials Unit. 

“I have also co-authored an Innovate/Asthma UK grant which has been successful and will support my ongoing research evaluating novel diagnostic testing in asthma. In March 2020, with the onset of the COVID-19 pandemic, I re-joined the clinical team as a respiratory registrar to support patient care.

“As a result of the pandemic, the entire research team in Portsmouth has been remodelled, with development of the COVID Trial Team. This is a multi-disciplinary team made up of consultants, specialist research nurses, trial assistants, pharmacists, physiotherapists, midwives and research fellows, tasked with the delivery of UPH COVID-19 research studies. 

“I am the lead research fellow for the RECOVERY trial in PHT, and have also been supporting the Recovery-RS, Stop-COVID19 and ISARIC (CCP) at PHT, whilst my colleagues have also been supporting the vaccine trial in Southampton.

“As well as delivering the above trials, I have also co-authored the CASCADE study evaluating the pathophysiology of COVID-19, with a particular focus on markers of complement activation, inflammation and coagulation in COVID-19 patients and whether these relate to disease severity and clinical outcomes.  

“We hope this trial will clarify the role of complement activation in COVID-19 and have developed a phase 2b trial of a novel anti-c5a inhibitor for potential inclusion in one of the UPH platform studies.  

“I was involved in setting up the RECOVERY trial at PHT. It was essential to engage clinical teams in the study from an early stage, and I helped deliver training both to the newly formed COVID trial team as well as to key clinical departments. I developed local resources for the safe and efficient delivery of the trial, including screening checklists, prescription templates, drug information sheets and daily monitoring checklists. I also wrote a ‘how to’ study guide to support high quality study delivery across the Trust. 

“Alongside the other research fellows, I have screened and consented potential participants and supported randomisation, drug delivery, patient reviews and data follow-up.  The Fellows at PHT have worked closely with colleagues in the wider COVID trial team, recognising that many members of the team have stepped outside their comfort zone and feel confident working in a different environment.

“Understandably, recruitment of patients unable to consent for themselves was received with some trepidation across the hospital but we did not feel it would be right not to ensure this patient group had the same access to research trials. I worked with the Trust’s ethics committee and our elderly care teams to develop pathways for the enrolment of patients lacking capacity which have worked well and been widely used.

“As the number of cases of COVID-19 at our hospital have fallen, I have worked with our nursing team to feedback to healthcare professionals and ward teams about COVID research at PHT and we hope to sustain the partnership between clinical and research teams that COVID-19 has created.

“Working on these trials has been an invaluable experience and it has been a new and different way of working. It has been a great experience to be part of a team that has shown such dedication and commitment to delivering these trials and ensuring that every single patient admitted to the Queen Alexandra Hospital with COVID-19 is offered the opportunity to take part in and has access to potential treatment options that they wouldn't otherwise have had.

“Research has a new visibility with a much greater acceptance and appreciation of its need. The success of this research depended on removing historical barriers and embedding the true ethos of integrated working, resulting in research becoming part of routine clinical care. 

“It has provided a platform on which to build and deliver more hospital-wide and cross-specialty studies, breaking down historic barriers between clinical medicine and research. This will ensure that research is easily available to both patients and staff, allowing us to continue evidence based medicine and therefore provide the best care we can for our patients whilst continuing to work collaboratively across the trust.

“I am really proud of the contribution the research fellow team have made in Portsmouth during the COVID-19 pandemic. During a time of great uncertainty, fellows re-joined their clinical teams and on-call rotas to support patient care but were also given the opportunity to use their research delivery skills recruiting patients into pivotal UPH COVID-19 research studies. Although the COVID-19 pandemic has posed many challenges, it has been a privilege to witness research in action with the discovery of a beneficial treatment for the disease.”