Being a health services researcher

I always planned to be an archaeologist. In fact, ultimately I had my eye on the Directorship of the British Museum (nothing like a bit of ambition). Off I went to do my degree in archaeology and anthropology at Cambridge, having spent the summer excavating an Iron Age Hill Fort in Hampshire. Anyway, as it turns out, Neil MacGregor’s job is safe. Too many lectures on the evolution of wheat, and I decided I must have been misguided. Instead, the unexpected combination of primatology, genetics, statistics, and anatomy led me to the biological anthropology department. I still have particularly fond memories of trying to identify cause of death in ancient skeletons, but felt in the long run that perhaps this was too arcane for my social conscience. After a short turn in public relations for various health-related charities, I finally admitted maybe I was interested in academia, and started an MSc in Public Health at LSHTM. Surprisingly, the organisation and delivery of health care, and how this impacted at both an individual and population level, was actually pretty exciting. Fresh out of my MSc, I took a research assistant post at KCL, looking at out-of-hours primary care. The combination of intellectual debate, absolute tedium (data entry for 3,000 50 page questionnaires, anyone?), flexible though long working hours, and like-minded colleagues was great.

So, twelve years later, here I am back at Cambridge University. I am pleased to report my work still retains that unique blend of being required to spend half the day developing a new conceptual model for care planning in long term conditions, and the other half stuffing envelopes for a questionnaire mail out. I wouldn’t want it any other way. The programme of work I am project managing is looking at the use of patient feedback surveys in primary care in relation to the assessment and improvement of GP-patient communication. It’s a long and complex process to generate data across the multiple studies contained within the five year programme, and it needs everyone to be happy to roll their sleeves up and get on with it, whether that is intellectually contributing to the development of a new measure for assessing consultation quality, or driving around a town two hours away trying to find a post office which will accept 1,000 A4 envelopes for a survey mail out. I work closely with a team of six other researchers, as well as a team down at our collaborators on the project at Exeter Medical School. And I love it.

In many ways, HSR is similar to my original love of biological anthropology. It’s a bit difficult to get a handle on as a discipline. There aren’t really very many “health services researchers” (though our number is increasing), just as there aren’t many “biological anthropologists” (or there weren’t in my day). Instead, health services research gets conducted by a melting pot of all sorts of different disciplines, brought together by the common interest in trying to improve, in however small a way, the organisation and delivery of care. The circuitous routes most of us have taken is of course sometimes challenging (you try putting a statistician and a sociologist together to agree a sampling strategy…). But health services research is very much a developing discipline, and I’m happy to be along for the ride.

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  • The Cambridge Centre for Health Services Research (CCHSR) is a thriving collaboration between the University of Cambridge and RAND Europe. We aim to inform health policy and practice by conducting research and evaluation studies of organisation and delivery of healthcare, including safety, effectiveness, efficiency and patient experience.