The organization and impacts of clinical research delivery workforce redeployment during the COVID-19 pandemic: a qualitative case study of one research-intensive acute hospital trust.

BACKGROUND: COVID-19 has tested healthcare and research systems around the world, forcing the large-scale reorganization of hospitals, research infrastructure and resources. The United Kingdom has been singled out for the speed and scale of its research response. The efficiency of the United Kingdom's research mobilization was in large part predicated on the pre-existing embeddedness of the clinical research system within the National Health Service (NHS), a public, free-at-point-of-delivery healthcare system. In this paper we discuss the redeployment of the clinical research workforce to support the pandemic clinical services, detailing the process of organizing this redeployment, as well as the impacts redeployment has had on both staff and research delivery at one research-intensive acute NHS trust in London. METHODS: A social science case study of one large research-active NHS trust drawing on data from an online questionnaire; participant observation of key research planning meetings; semi-structured interviews with staff involved in research; and document analysis of emails and official national and trust communications. RESULTS: We found that at our case-study hospital trust, the research workforce was a resource that was effectively redeployed as part of the pandemic response. Research delivery workers were redeployed to clinical roles, to COVID-related research and to work maintaining the research system during the redeployment itself. Redeployed research workers faced some difficulties with technology and communication, but many had a positive experience and saw the redeployment as a significant and valuable moment in their career. CONCLUSIONS: This study explicates the role of the research delivery workforce for the United Kingdom's COVID response. Redeployed research workers facilitated the emergency response by delivering significant amounts of patient care. The public also benefited from having a well-developed research infrastructure in place that was able to flexibly respond to a novel virus. Many research workers feel that the NHS should provide more support for this distinctive workforce.

The changing paradigm of research delivery during a pandemic - a reflective account.

BACKGROUND: As clinical pressures evolved amid the COVID-19 pandemic, the importance of research activity came to the forefront of health and care service requirements. AIM: To illustrate through reflection the experiences of clinical research teams based in the UK during the pandemic. DISCUSSION: The article describes operational experiences in different settings and reflects on important themes and implications for future practice. The authors use a reflective model to share perspectives of leading research delivery roles in geographically and organisationally different settings. A patient's perspective was included from the outset of the reflective process. Delegates at an interactive masterclass conference in April 2021 also contributed their experiences. Seven themes characterise the research teams' response to the pandemic: prioritising, team-building, protection, limitation of autonomy, reduced bureaucracy, collaboration and transformation of process. Balance through compassionate leadership underpinned by ethically grounded decision-making was a theme throughout. CONCLUSION: Implicitly held, tacit knowledge progressed to explicit knowledge, formalising the research teams' responses to the pandemic partly into codified learning. The authors characterise the experience as an 'operational balancing act', whereby significant innovations were integrated into working practices and research delivery. IMPLICATIONS FOR PRACTICE: The pandemic demonstrated what research progress is possible when all resources are diverted to one novel virus. The value of research teams was elevated through treatment and vaccine trials and the contribution of those involved to patient care. This reinforces an invigorated commitment to resources as well as new acceptance of and belief in research as a core care activity across and throughout systems and organisations at all levels.