Southampton Academy of Research

Lisa Osborn-Jenkins at University Hospital Southampton (UHS) is researching ways to help patients manage their persistent back pain better.

She is currently undertaking a PhD, funded by UHS, which she secured through support from SoAR.

Helping patients who keep coming back

Back pain is very common. It usually improves by itself within six to 12 weeks, but for some people it lasts longer or keeps coming back. It’s these patients, with persistent or recurrent back pain, that Lisa aims to help.

As a clinical specialist physiotherapist within the Wessex spinal service at UHS, Lisa sees people with a wide range of spinal issues.

Her role within the UHS therapy outpatient team also allows her to work with patients referred for rehabilitation from the spinal service and rheumatology department. She also works with staff referred from the occupational health department.

Supported self-management is recommended for people with back pain. Clinical guidelines focus on first line care, giving personalised advice to enable self-management. This approach has been shown to be more effective than alternatives such as surgery.

“There are lots of treatments that we know are not effective for back pain. We know now that surgery is often not the best thing for the majority of patients,” explains Lisa. “Engaging in activity that you enjoy, building strength alongside managing overall well-being is often the best management approach for people with back pain.”

Yet some patients struggle to manage, and keep coming back to healthcare services. By the time they reach Lisa, they may have already seen their GP and accessed local physiotherapy services, been through private care or been in and out of A&E.

“Patients tell me they keep hearing the same things, but these have not actually helped or translated into being able to do what is recommended,” she says.

Through her PhD research, Lisa hopes to be able to find better ways to support these patients.

“It’s about meeting the needs of people that we are clearly not meeting, because they haven’t found the help they need and keep coming back,” she says, “so together, we can find a way forwards for them.”

Taking the next step

Since 2018, Lisa has been awarded two research fellowships, with support from SoAR.

The first was an HEE/NIHR Pre-doctoral Clinical and Practitioner Academic Fellowship (PCAF). This was followed by a six-month award funded by the NIHR Applied Research Collaboration (ARC) Wessex.

“I was delighted to secure a pre-doctoral clinical academic fellowship through the NIHR,” she says. “This allowed me to build up research experience and skills with support through supervision to build a network of support and apply for further funding opportunities.

“I planned appropriate training including master’s level modules, external courses and attending conference to support my learning needs. I carried out research (secondary analysis of data) to help me focus my research interests and identify a gap in literature. I published this work in a peer reviewed journal and presented several projects at national and international conference, allowing me to build wider networks, collaborate with others and even win awards. I was supported by SoAR throughout it all.”

SoAR also supported Lisa to bring together a group of patients and members of the public to ensure she was answering the questions they felt were important. Through securing a patient involvement fund to support 4 patient and public events (involving 27 people) ensured the planned research was relevant, timely and achievable and even shaped the application, making it more competitive.

Following support through her ARC Wessex funded fellowship, Lisa applied for what is now an HEE/NIHR Doctoral Clinical and Practitioner Academic Fellowship (DCAF).

“These awards are extremely competitive. My application was selected for panel interview and deemed fundable, but not funded on that round,” she explains.

“It was this competitive doctoral research application, alongside a proven track record of two fellowships, which enabled me to successfully apply for a different PhD fellowship funded by UHS. This would not have been possible without the support of SOAR.”

“Bringing together my research and clinical worlds through fellowships has help me identify problems in clinical practice, and plan appropriate research to help overcome them. Implementing new knowledge and changing clinical practice completes that loop. This is what excites me as a future clinical academic.”

Feeling valued

During her PhD, Lisa is conducting focus groups with healthcare professionals who manage patients with persistent back pain in primary care, and interviewing patient who struggle to self-manage. 

She will then observe consultations with patients and clinicians, followed by individual interviews with them afterwards.

Based on the analysis of this data, she plans to go on to develop a prototype of new consultation resource. She then plans to go on to test this in a future trial, after her PhD.

“I’m already thinking way ahead of this PhD in terms of the consultation tool we create,” she says. “And beyond that, ensuring my role here as a clinical specialist physio and independent researcher, bringing together clinical and research priorities to influence the national clinical spine pathway.”

Lisa is grateful for the support she has received throughout her career. As an Allied Health Professional (AHP), she says there are still challenges in developing clinical academic careers, but she hopes to be an inspiration to others in non-medical professions interested in pursuing a clinical research career.

“I feel so valued by the Trust, especially by my departments and managers,” she says, “to be given the support and opportunities to enable me to gain vital funding has made all the difference to my career and aligns with the UHS strategic research plan.”