So when I was working clinically, it was 12 and a half hour shifts that could be days, nights, weekends, weekdays. And then when I moved into a research post, it’s Monday to Friday, effectively nine to five. Although it’s flexible, in terms of hours worked. And also changed from 37 and a half hours, if I were to have been full time. I was part time, but to in my post now of full time, is 35 hours a week. But it brings different aspects to it as well. So obviously when you’re working clinically, whilst you might access email a little bit as part of the role, it’s not a big part of my role. Whereas now, the boundaries I guess between working hours and not working hours is a little bit different, in terms of accessing email and working on paper-writing, and those sorts of things, which inevitably fall outside working hours. So it, it’s different.

None of us are funded by the Trust at all and we get what’s called Activity Based Funding Units so we have a target that we set ourselves in many ways but it is also given to us by the Network, Clinical Research Network that we’re affiliated to in this area. And then we have to recruit really a number of, a certain number of patients so if it’s an interventional study then you get 11 ABFU [Activity Based Funding Unit] points, if it’s a non-interventional study with less than 10,000 patients you get 3.5 and if there’s more than 10,000 patients you get one ABFU, so that equates to anywhere between £65 and £85. So half of our funding in my department comes from ABFU funding but that doesn’t really cover the costs of the staff, all of the staff. We get some funding then from supporting and facilitating commercial studies so and one of the high level objectives in the Department of Health is to recruit and open more commercial studies.

So I am with, so I’m paid by the NHS but our posts are funded by the CRN [Clinical Research Network].

Okay.

So that means that it depends on the amount of accruals that we have if we get, if our contracts get renewed or not which puts a lot of pressure on, on, on efficiency of maybe quality of the work that you provide because sometimes there’s a bit of it’s, it’s difficult to define what efficient means. Having lots of patients recruited is probably efficient but also not being able to then follow them up and looking after them properly, is that efficient, I think it is efficient to be able to, you know, to have to, you know, to recruit patients in a smart way so that you’d be able to actually look after them properly and ensure they’re safe and, and that you are actually provided, you’re providing the trial with meaningful findings because if you’re unable to collect the data because you have too much, too many patients or if you’re unable to, you know, follow them up properly, you can see recruited too many patients you then, you will have lots of accruals the next year, you will have lots of midwives, lots of, you know, funding for midwives, the actual quality of the job you’ve done isn’t probably great. So that’s something that I think we probably should all reflect on and I can get there’s room for improvement.

Because I think it’s, some studies are also more time consuming so for, for a patient you have to spend, if you want to do your job properly, if you care you want to spend some time with them and that time is just recognised as one accrual, one patient. Whereas for other studies where the ethical implications are there but they’re still, they’re, you know, minor you can spend less time with patients and that time isn’t recognised in any way and it, it’s, we’re, you know, it’s not encouraged there’s no encouragement for us to spend more time in actual quality of the job that we provide, of the care that we provide so I think yeah that’s probably something that we could look into.

Also all the questionnaire’s I think questionnaires and qualitative research doesn’t count as accruals which is such a shame because it’s so important and there is no, sometimes there’s very little point in having these big numbers if you can’t actually give meaning to the numbers that you have.

I know that there was a comment made on, on a, on an adult ward when I was on there and, and it was during the crisis time at Christmas when the, there was a crisis right across the UK. And one of the sisters suggested that during crisis, should we be doing research and not be relocated back onto the ward? But actually within our Trust, if they wanted the support in any department during crisis, we know that we would, would be asked to go and help. And we do help, I would-, I did help more during the crisis period but I didn’t go onto the ward and do a full shift as a, as a ward-based nurse. But what I did say was-, so I did explain that to her, that we would if we were needed, and if she felt that while I was on the ward she wanted-, the staff needed a bit of help doing anything and I was quite happy to do, to help out, within my capacity for what my knowledge base. But I did say, suggest to her that she, we are contracted as well to our studies and that that’s important too. And that it may be that we have a responsibility to find the patients and consent the patients onto the studies, but balancing that against if somebody, if nurses on the ward are really struggling then of course our Trust is going to pull us off and put us onto the ward, yeah. But I don’t think they realise that that would be the case.