Southampton Academy of Research

John Defty is Lead Advanced Clinical Practitioner at University Hospital Southampton (UHS), researching cancer patients’ experiences of using acute oncology services.

He is currently undertaking a four-year PhD three days a week, with two days in his clinical role.

Finding his niche

John trained as an adult nurse, with roles in emergency care and intensive care, before moving into cancer care in 2014. He is now one of four Lead Advanced Clinical Practitioners in cancer care at UHS.

He’s always been interested in research, but wanted to progress in his career enough first to know where his interests lied and what problems needed solving.

“It’s been on my mind to do doctoral level study ever since I qualified as a nurse,” he explains.

Now working within the Acute Oncology Service, he’s found his niche. It is a relatively new service, where patients with cancer can seek specialised urgent and emergency care.

The team treat complications of both cancer and its treatment, such as chemotherapy. Patients may need to visit multiple times, as survival for many cancers has improved significantly and their treatment can last for years.

“Acute oncology at Southampton is  a one-stop-shop for unscheduled care, as part of a cancer patient’s treatment and disease journey,” says John.

Developing acute oncology

Acute Oncology Services currently vary considerably from one hospital to the next. UHS delivers a dedicated facility which runs 24 hours a day, whereas other centres might have assessment rooms within a chemotherapy suite, or a service that runs 8am-8pm.

This variation means there are many unanswered questions about how these services should be run, and what works best. It’s matters such as these that John aims to investigate during his PhD, which is being funded through a UHS R&D Doctoral Fellowship.

During his PhD, he plans to conduct interviews with cancer patients who accessed services and their informal caregivers, asking about their reasons for doing so and their experiences of care.

John will also compare services across several UK hospitals, to identify how differences in service delivery models might influence how people access and experience emergency cancer care.

“The value of clinical academia is that you see a problem, and you think ‘I’ve got an idea for a research question about that’, as well as having the skills to conduct the study itself and then it all goes back into practice to improve care,” he says. “It’s really encouraging to see UHS supporting  the next generation of research-active clinicians. It’s a really important way forward.”

Support at every stage

Ever since John first decided to pursue a clinical academic career, splitting his time between clinical work and research, SoAR have been there to support him.

Four years ago, he met SoAR’s Professor Alison Richardson and Kay Mitchell. After he expressed an interest in becoming a clinical academic, they offered the advice and support he needed to successfully apply for an NIHR Pre-doctoral Clinical and Practitioner Academic Fellowship (PCAF).

This has enabled him to develop the research skills and experience required to secure his current UHS R&D doctoral fellowship. The first stage of his work, also supported by SoAR, was published earlier this year in the journal Emergency Cancer Care.

“Whether it’s connecting me to a community of like-minded people, or pointing me in the direction of individuals who have the right background to help me, or opportunities like being a research champion,” he says, “SoAR has been integral to all of my work, right from the beginning.”