Your path in research: Enabling research as a director

Dr Smeeta Sinha is a Consultant Nephrologist at Salford Royal NHS Foundation Trust. After a successful tenure as the trust’s clinical director for renal services, she has recently stepped aside in order to dedicate more time to her research. As part of the NIHR’s Your path in research campaign, Smeeta blogs about the importance of allowing consultants the time and space to do research.

As someone who has worked as a clinical director for five-and-a-half years, it’s a good time for me to look back at the last 15 years of my career. I’ve been fortunate to hold a positon that’s allowed me to play an important enabling role. The roles of directors, or hospital managers in general, are integral to fostering a culture of research within a directorate. It’s about providing leadership that values research and enables other people in the department to pursue research by creating the time and space for them. That’s something I’ve been proud to do.  

Looking back at my own path in research, I’m not a scientist by background. I went to a traditional medical school and, as a registrar, took some time out of the specialist training programme to do some research. I wanted to have a broad base of research and so decided to do a lab-based research PhD at the University of Manchester. So I took three years out to go and work in a laboratory doing basic science. After that, I finished my PhD and went straight into a consultant job.

However, even though I had the PhD background, initially I didn’t do very much research as a consultant. I was very clinical and I was getting to grips with the role, but I did maintain one aspect of my research portfolio, which was clinical research. So as a young consultant, I would support clinics trials within the hospital. I was fortunate that our renal department is very collaborative and so we would – and continue to – support each other’s studies and help recruit patients, both in terms of academic studies and commercial trials which enabled us to grow our research infrastructure.

Since then, I gradually became more proactive and developed my research interests in chronic kidney disease-mineral bone disorder, in particular vascular calcification. I’m now the Principal Investigator for the UK Calciphylaxis Study – a multi-centre, observational study that we’ve been able to deliver in 34 UK renal units, with the support of the Clinical Research Network, and recruit 120 patients. So even when starting small with a small study, it can grow over time if you persist with it. I’m now also the Chief Investigator for a multi-centre international clinical trial which is quite niche and related to my lab-based research. That has launched in the United States and is coming to the UK this month. 

I took over as clinical director for renal services in 2014. At that point, even though our approach was very pro-research, we didn’t have a formal approach in the directorate. We now have a dedicated R&D lead within the directorate as well as hybrid clinical and research registrars and nurses.  As the clinical director, I was keen to support clinicians incorporating research sessions as part of their job plan; the trust is also supporting clinicians with job planned research sessions on an annual basis. This gives staff the thinking space to take the research that they might have done earlier in their career and drive it forward. Only managers have the ability to do that and essentially say, ‘okay we will give you an hour a week for research’. Okay, it's not much - it’s a little bit of time aside. But more importantly, it establishes a culture and it means you attract people who have got academic and research interests. 

I have appointed 10 consultants since I started and all 10 have had MDs or PhDs, so that automatically increases the number of people who are able to deliver research. Our research department has grown and that’s meant we’ve been able to deliver academic and commercial studies, which is why we are one of the highest recruiters in the country. This brings benefits to the research programme, but it also attracts other researchers and attracts more funding so the programme can grow. We have our own MD and PhD students and they build their research moving forward, so it's not wholly dependent on, say, one consultant on one hour a day, and that creates sustainability for the department. 

You hear of vacancies and shortages of doctors in the NHS, but we have never had a challenge with a medical vacancy. I believe that’s not driven by anything other than our research reputation and the fact that health professionals know they have got an environment here where they can continue to do what they have done for their MDs and PhDs.

Working in research is very satisfying because you get to provide patients with opportunity and it adds variety to your role. The other thing is, because the research we do is quite high profile, it means you also get to build connections with international experts in the field. This can help if you’ve got a complex patient and need advice, as you’ve got ready access to experts because you’ve already got those relationships and networks in addition to the wealth of talent you’re surrounded by in the trust already. It’s good to network with people across networks and get different viewpoints.

To anyone thinking of research, even for seasoned consultants who have never done it before, my advice would be to just try a little bit to begin with. Have a look at which trials are out there and what research is out there. Just explore it, because you will have patients who you don’t have a treatment for. It might only be helping to recruit a patient, or helping to identify a patient. I would just try something to start with – just helping with patient recruitment will be good for your patients as well as the research department.