Building a new generation of dementia researchers – from health economics to film

A community midwife notices that women recovering from caesarean sections aren't getting adequate pain management – and suspects the guidelines are part of the problem. A nurse practitioner at a homeless health service sees patients with diabetes falling through the gaps of standard care. A physiotherapist working with children with spinal muscular atrophy sees that the UK needs a clinical pathway for a screening programme already established in other countries.

Each of them had a question that mattered. None of them had the time, training, or institutional support to answer it.

This is the capacity building problem in applied health research. The people closest to patients – nurses, midwives, allied health professionals – are often the first to see what isn't working. But clinical pressures leave no room for the structured inquiry that turns observation into evidence and evidence into change. The result: a research workforce concentrated in universities, and a frontline workforce rich in insight but locked out of the tools to act on it.

Our approach and partners

ARC OxTV's research internships gave NHS health and care professionals protected time – typically one or two days a week – alongside mentorship, methods training, and access to academic networks. Development awards provided targeted support at critical career transition points: funding for specialist courses, conference attendance, and time to prepare fellowship applications.

The two programmes worked as a pipeline. An internship could open the door to research; a development award helped clinicians walk through it. Both were small, flexible, and grounded in what participants actually needed. A midwife could use her internship to complete a qualitative study, attend the UK EQUATOR Centre Publication School, and lead a quality improvement project – all within the same funded period. A researcher working on adolescent health could use a development award to establish a young person advisory group, attend specialist training, and prepare a fellowship application.

Partners included Oxford University Hospitals NHS Foundation Trust, Oxford Health NHS Foundation Trust, Luther Street Medical Centre, the National Perinatal Epidemiology Unit, the Association for Young People's Health, and NHS services across the Thames Valley and beyond.

What we found – and why it matters

1. Clinical practice changed in real settings. Holly Edmundson, a community midwife, co-produced and implemented a new postnatal pain guideline at Oxford University Hospitals, including an updated electronic prescribing form – work that began as an internship project and is now embedded in routine care. Ela Orciari transformed diabetes management for people experiencing homelessness at Luther Street Medical Centre, introducing proactive care plans and structured learning for clinical staff that continues beyond the funded period.
2. Research careers took hold. Edmundson has been accepted onto the University of Oxford's DPhil in Primary Health Care and secured an NIHR Pre-doctoral Fellowship. Emilia Bartrum won further NIHR funding to continue her work on balance assessment in progressive myopathies. Melissa Little used her development award to build the foundations for a primary care clinical fellowship in adolescent health. Across the cohort, participants moved into roles that combine clinical work with research – the kind of dual-career posts the NHS needs but rarely builds.
3. Research reached national and international audiences. Francesca Henderson presented her work on newborn screening for spinal muscular atrophy at the SMA Europe Clinical Care Symposium in Milan and fed results into a national SMA-REACH focus group to inform discussions about the UK screening pathway. Steph Taylor won Best SLAM Presentation at the European Association for Haemophilia and Allied Disorders conference. Edmundson delivered a workshop at the International Labour and Birth Conference.
4. New infrastructure was created. Melissa Latchman worked with the National Perinatal Epidemiology Unit to develop a theory of change for the Equal Start project, addressing health inequalities in maternity care. Little established a Young Person Advisory Group of eight adolescents to shape future research on weight, eating disorders, and mental health – infrastructure that will outlast the award itself. Michelle Wilson's research on barriers to research participation among nurses, midwives, and allied health professionals has been submitted for publication and informed a collaborative bid for a training programme for the next generation of healthcare professional academics.

What this means

Small, well-designed investments in frontline staff can produce research that changes clinical practice – not in five years, but during the funded period itself. The midwife who spotted a problem with pain management didn't just write a paper about it; she rewrote the guideline and changed the prescribing form. The nurse practitioner who saw patients with diabetes falling through the cracks didn't just describe the gap; she introduced proactive care plans and trained her colleagues to sustain them.

This model shows what a distributed research workforce looks like in practice: clinicians embedded in services, asking questions that matter to patients, and equipped with just enough time and support to find answers.

What needs to happen next

These programmes end with ARC OxTV's current funding cycle. The career trajectories they set in motion will continue – several participants are mid-application for doctoral and postdoctoral funding – but the pipeline itself needs sustained investment. Without protected time and mentorship for the next cohort of clinician-researchers, the gap between frontline insight and research evidence will reopen.

NHS trusts and integrated care boards need to recognise that research capacity is not a luxury. It is infrastructure – as essential to service improvement as clinical audit or quality improvement. Ring-fenced time for research within clinical roles, even at modest levels, produces returns that far outweigh the cost.

Lessons for future research

Three design features made these programmes effective. First, flexibility: participants used their funded time differently depending on their career stage, clinical context, and research question, so the same programme could support a scoping review, a quality improvement project, or a fellowship application. Second, integration: the programmes were embedded within clinical environments, so questions arose from practice and findings fed back into it. Third, progression: internships connected to development awards, which connected to fellowship applications, creating a pathway rather than a one-off opportunity.

Future capacity building programmes should resist the temptation to standardise too heavily. The diversity of outcomes in this cohort – from clinical guidelines to advisory groups to international conference presentations – is a feature, not a limitation.