Dr Yu (Maggie) Fu, formerly a joint Senior Research Fellow, working jointly between the Applied Research Collaboration and AHSN for the North East and North Cumbria, and now a Tenure Track Fellow based at the University of Liverpool.
I studied medicine at university and became a junior doctor in 2010, but I was frequently struck by how poorly our healthcare system responded to the challenges of people with mental illness, especially in protecting their physical health needs. I often ended up asking myself: “If I cannot help my patients more effectively, why am I doing this?” I eventually chose to leave clinical practice and move into research with the ambition to explore how I could make a difference in that way.
I began my journey with the NIHR ARC (Applied Research Collaboration) and AHSN for the North East and North Cumbria (AHSN NENC) in 2021. This has been an ideal way as an academic to grow my research independence working jointly for the ARC and AHSN in the North East and North Cumbria where health inequalities are high and general health is poor, and where the mental health burden is high but research delivery is low.
My first project was to gather evidence to inform how lipids management can be optimised for underserved populations, especially those socio-economically disadvantaged in the region. Mental health was a stand out issue for them associated with everything that goes on in their daily lives. The combined ARC and AHSN teams effectively plugged me into key individuals and organisations such as the North of England Commissioning Support Unit (NECS) and Health Equality for Ethnically Minoritised Communities (Haref) who have been actively working together to support underserved populations during the pandemic. Connecting with the right people in these organisations via the ARC and AHSN was critical to reaching the population that we were targeting in a timely way.
Linked to being part of the NHS Beneficial Changes Network (BCN), a joint ARC and AHSN project was funded by the national NHS Insights Prioritisation Programme (NIPP). This project aimed to evaluate a digitally deployed, GP remote consultation video intervention aiming to reduce opioid prescribing in primary care. In response to the impact of Coronavirus (COVID-19), a new process was initiated involving text messaging a video communicating the rationale for reducing opioid use, and seeking feedback from patients on whether they would like support. This project evaluates the potential benefits, risks and economic consequences of broader implementation in 100 GP practices across the region. It also helps to address health inequalities given the fact that opioid prescribing rates are disproportionately high in the North of England. The evidence produced will invariably be relevant for other regions to replicate this work to better manage opioid prescribing.
Being able to tap into established networks and collaborations with key individuals, I was very much motivated to focus on making a difference in health services for underserved populations. I was greatly supported by both the ARC and the AHSN who connected me with senior academics, clinicians, PPIE partners, data processors and the leading mental health trust – Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust (CNTW). This enabled me to form a fabulous project team in terms of expertise clinically and methodologically linking both the North East and North Cumbria and Greater Manchester regions, for a project funded by National Institute for Health and Care Research (NIHR), which is looking at establishing culturally competent mental health services. The intention is to focus on ethnic minorities with mental health difficulties who live in the North East and Greater Manchester. To me, creating a great team is half of the battle, with support from both the ARC and the AHSN, I feel that I can almost reach everybody!
In this project, we will gather information and data collected by the NHS before, during, and after lockdown in areas where a large proportion of ethnic minorities live, to compare changes in service use and how they affect people. We will also talk to people with lived experience to explore what has worked well during the pandemic and how they would define a high-quality service. This research will help us to create a list of proposed effective and acceptable services and features. Patients, public, professionals, and commissioners will then be engaged to rate how important these services or features are to them. The results will be discussed with all stakeholder groups to make recommendations on how mental health services should be provided and the core ingredients for culturally appropriate care.
Along with these projects, I have developed expertise in using a mixture of methods to help answer my research questions, including routinely collected healthcare records that allow me to explore clinical pathways and associated outcomes and identify gaps in services received and needed. I also talk to people every day about my research, including patients, public members, university students, academics, service providers and commissioners. These conversations and working relationships have been greatly enhanced by the collaboration between the ARCs and AHSNs, helping to ensure that my projects are evidence based, and driven by the views and preferences of the people the services serve.
The ARCs and AHSNs partnerships have really opened new doors in terms of delivering comprehensive research and evaluation. Challenges in terms of recruiting participants and engaging with the right people in the system have been greatly eased by tapping into both organisations’ connections and knowledge.
A lot of people that I talk to find it hard to believe that I left clinical practice after training for so many years. But I never feel that I have left my patients, I am providing them with better services in a different way through research.