Published: 20 February 2020
Dr Barny Hole, kidney doctor and NIHR Academy member, recently ran a small conference during his NIHR Doctoral Research Fellowship. He shares how it has helped him to further his research and career aims.
I think I will look back on this event as a milestone in my early clinical academic career. Suddenly, I had a line of communication with the professional, patient and research bodies interested in kidney care in the UK. Vitally, the voices of people living with kidney disease were at the centre of the process, fuelling my enthusiasm for ongoing work in this area.
My NIHR research
I’m doing an NIHR Doctoral Research Fellowship, which allows me to undertake a PhD examining how people at risk of kidney failure decide between treatment options. I am particularly interested in the decision that some make to decline dialysis and the risk of over-treatment in this setting. I am using specialised surveys called choice experiments to quantify the importance of life expectancy, symptom control and hospital-free time to those deciding what to do.
I am fortunate that my Fellowship funds my salary, my PhD tuition fees and training programme, and the costs of my research project. Previously, I was an NIHR IAT Academic Clinical Fellow, which equipped me with the skills and experience I needed to proceed to doctoral level.
NIHR’s support has allowed me to say yes to a huge number of opportunities and consider new angles that my clinical and research career might take. The NIHR has provided generous funding to cover the costs of patient and public involvement work, helping me to make sure my research is aligned with what is important to the people it relates to.
Running an event
Although multiple UK groups are working to address the potential for over-treatment with dialysis, no forum for sharing enthusiasm and expertise was available. The opportunity to apply for a small grant to support multi-disciplinary research into the ethical, legal and social dimensions of health led to the idea of running a conference to deliver this.
I conducted a stakeholder power analysis to identify who needed to be involved in the event. Patient panels helped to identify the simultaneous risk of under-provision of dialysis as a great concern to people living with kidney disease. This parallel risk of over- and under-provision formed the focus of the event, which I designed and ran with two colleagues.
We ran Dialysis - Getting the Right Balance on 27 November 2019 at the University of Bristol. A diverse group of 58 delegates attended with a stated aim to 'generate recommendations for the organisational changes, research and resources needed to reduce over- and under-provision of dialysis in the NHS'.
The whole conference was based upon the responses to a pre-conference survey, completed by over 250 people. The day involved individual and group activities, debate and discussions. We interspersed activities with a play based on the experiences of a person living with kidney disease, tours of the building and plenty of tea and coffee! The day concluded with a keynote lecture from Hilary Bekker, Professor of Medical Decision Making at the University of Leeds. A full report detailing the pre-conference questionnaire findings and recommendations will be published in collaboration with the organisations that supported the event.
Ensuring research is impactful
For my research to impact patient care, it will need to influence culture and practice in UK kidney medicine. This event felt like a step towards that. I set up strong collaborative working relationships with researchers in other universities and I was able to describe my research and ideas in front of the people whose work I had been following for years.
I would wholeheartedly encourage anyone considering holding similar events; I expect it to benefit me for years to come. Securing a small grant and using it effectively will look strong on postdoctoral applications. The organisational and administrative skills I have learned will be of great benefit in the future. The collaborations, contacts and friendships that I have made are already paying dividends.
My only caution relates to the time involved. From inception to delivery, the event consumed hundreds of hours of my time, which came as an opportunity cost to other projects. My advice to other NIHR Academy members would be to be honest with themselves and their supervisors about the time involved early on. Time management is a vital skill to develop during a PhD, and like the topic of the conference, getting it right is about balance. Most importantly, the event you run must be worth such a great investment – I am confident that ours was. I am grateful to my collaborators, Dr Lucy Selman (University of Bristol) and Dr Anna Winterbottom (University of Leeds); to all who attended the conference; The Bioethics, Biolaw & Biosociety Research Strand of the Elizabeth Blackwell Institute, University of Bristol for funding the event; and the organisations that supported it.