Internships available for summer 2021
SPCR Internships | Oxford Living Wage £10.31 per hour
Project #1 – Real-time, real world evidence utilising the ORCHID general practice network and database
The Nuffield Department of Primary Care is the home of the Oxford-Royal College of General Practitioners (RCGP) Clinical Informatics Digital Research Hub (ORCHID), a network of 2000 general practices with near real time access to >15 million anonymised patient records. There is scope for projects in infections, particularly influenza, vaccine uptake and effectiveness, diabetes and a range of more contemporary areas such as, COVID community surveillance, frailty, social prescribing, Artificial Intelligence and general practice. Project will suit anyone who would like to gain experience in health data, public health, epidemiology or statistical methods.
Team: Clinical Informatics and Health Outcomes Research Team (CIHO)
Project #2 - Scoping review on sustainable health care and remote consulting
In the past 5-10 years there has been a push to spread and scale-up innovative models of service delivery in health care, including the use of digital technologies and platforms (e.g. Zoom, Teams, WhatsApp) to support video consulting. This has received significant additional impetus through the Covid-19 pandemic, and requirements for physical distancing. At the same time increased attention has been given to the pressing aim of reaching ‘net zero’ in terms of UK carbon emissions, and the vital role of the NHS in delivering this (see e.g. Delivering a Net Zero National Health Service).
This project will focus on the intersection between video consulting and sustainable health care, and explore the potential for reduction in emissions via video consulting, both directly (e.g. changes in travel, repurposing NHS estates) and indirectly (e.g. through the wider supply chain). The student will undertake a scoping review of relevant academic and grey (e.g. policy) literature, map out (and, where appropriate, connect with) key stakeholders and organisations and feed into discussions about the future research and quality improvement agenda. There will be opportunities to learn about conducting a narrative review and analysis, write up findings (potentially for publication in an academic journal) and connect with wider programmes of work on remote and video consulting in the Interdisciplinary Research in Health Sciences (IRIHS) unit.
Project #3 - Review of policy, professional and media coverage of remote consulting in general practice
In July 2020, in the midst of the Covid-19 pandemic and on-going requirements for physical distancing, the Secretary of State for Health, Matt Hancock, announced that consultations in primary should be ‘remote by default’. Our interdisciplinary team has been following exactly that development. Specialising in the study of complex, technology-supported change in health care settings and with funding from the COVID-19 Emergency Fund via the Economic and Social Research Council and National Institute for Health Research, we have been using a variety of methods to make sense of these radical and unprecedented changes. Part of that work has involved capturing the over-arching story of the transition to remote delivery of GP services from the perspective of the patient and citizen. We have already published an account of how the mainstream media (e.g. newspapers, websites) framed the transition from face-to-face to remote services in 2020, available at https://bjgp.org/content/71/702/e1. This internship will build on that work.
In May 2021 Matt Hancock announced that he was scrapping the ‘remote by default’ policy. Others, like the Royal College of General Practitioners, have advised that GP consultations post-COVID should be a combination of remote and face to face, depending on patient need. The debate continues. The task of the student will be to review and summarise how the mainstream media, professional communications (e.g. from Royal Colleges, GP practices) and government have framed and communicated the evolving ‘remote by default’ policy since the start of 2021. There will be opportunities to learn about searching and reviewing varied media (newspapers, websites, government reports), conducting a more targeted search of a sample of sources to pursue themes that seem important, summarising findings and writing (with the aim of producing - with support from supervisors – a journal publication). The overall focus will not simply be on media coverage of evolving remote by default policies but, at a more granular level: ‘How is the message about remote general practice being framed? What metaphors and other tropes and techniques are used to convey what was happening? For what audiences, and why?
Project #4 - Healthcare professionals’ and citizens’ views on optimizing antibiotic use
Antibiotic resistance is a major international health concern recognised by the World Health Organisation. Reducing unnecessary antibiotic prescribing can help mitigate antibiotic resistance. The majority of antibiotics are prescribed in primary care, with a substantial proportion for self-limiting infections when antibiotics are usually not beneficial. Since the Covid-19 pandemic, the threshold for prescribing antibiotics has been reported to be lower, and many usual antimicrobial stewardship initiatives have stopped. It is now important to identify ways to re-focus the antimicrobial stewardship efforts.
As part of our current projects we collected qualitative data on clinicians’ and citizens’ views and experiences related to antibiotic prescribing/use, and more recently about clinicians’ views on the impact of Covid-19 on antibiotic prescribing. This student project will involve secondary analysis of existing qualitative datasets to compare clinicians’ and citizens’ (members of the public) views and experiences about antibiotic use and strategies to optimise it. It may also involve engagement with a Patient and Public Involvement group to discuss the interpretations and ways to resume antibiotic stewardship initiatives. The student will learn about conducting applied qualitative research and writing findings for publication, and will be involved in the wider programme of work on implementing evidence-based interventions to promote prudent antibiotic use in primary care.
Team: Infections and Acute Care
Project #5 - Interrupted time series analysis
Did cancer mortality in the UK decrease after the “two-week wait” rule, for cancer referrals, was introduced (2000)? Did rates of smoking decrease after new rules on smoking in the workplace (2006) or new rules on cigarette packaging (2016)? Did rates of heart disease go up or down after a change (2011) in the guidance for diagnosing high blood pressure? Analysing trends over time, and distinguishing chance changes from true effects of policy, is increasingly important in the study of health policy, but many of the methods we use were developed in economics and may not apply to healthcare data. We seek an intern to review the recent health literature and collect data sets with which to test the suitability of different methods of analysis. Working in the medical statistics group, the intern will learn to use statistical analysis software and to analyse time series data.
Team: Medical Statistics
Project #6 - The cost-effectiveness of testing for Group B Streptococcus in pregnancy based on a cluster randomised trial (GBS3)
Group B Streptococcus (GBS) is a bacterium present in the vagina and lower gut of approximately one in four pregnant women. GBS can come and go throughout pregnancy and is usually symptomless, but may be passed to the baby around birth. Approximately one baby in every 1750 will develop a GBS infection within seven days of birth. Most will recover, but each year in the UK about 40 babies die and one in 14 of the survivors will have a long-term disability.
The Nuffield Department of Primary Care Health Sciences, University of Oxford, has recently started a study to assess the cost-effectiveness of routine testing of women for GBS colonisation either in late pregnancy or during labour, compared to the current risk factor based strategy. The economic evaluation, which takes the form of an economic modelling study, is being conducted as part of a multi-centre prospective two-group parallel cluster randomised controlled superiority trial with internal pilot (GBS3), funded by the National Institute for Health Research Health Technology Assessment Programme. Up to 320,000 women will be recruited from 80 maternity units (obstetric unit or alongside maternity unit) in England, Scotland and Wales.
The successful candidate will contribute to a comprehensive literature review aimed at gathering baseline evidence that will inform the development of the economic model. The candidate will also contribute to other aspects of the economic evaluation, including the design of bespoke economic research instruments and collection of unit cost data. The internship offers an opportunity to gain first-hand experience of undertaking an economic evaluation in the context of a high priority randomised controlled trial.
Team: Health Economics
Project #7 - Consideration of adherence to pharmacological interventions in publishing guidelines and protocols for clinical trials in covid-19
Poor adherence in clinical trials has several important consequences, therefore, it is important that those conducting clinical trials should take steps to try to improve adherence as much as possible and to measure it.
The aims of this project are in two parts:
1. A survey of the currently available guidelines (467 in all) published on the EQUATOR website  to document the extent to which adherence is discussed in each. A word search on the EQUATOR website for the word “adherence” yielded only three hits, one of which is the ESPACOMP Medication Adherence Reporting Guideline (EMERGE). Not all of the guidelines will be eligible for inclusion in this survey. Part of the research will be to classify the guidelines into those that ought to mention adherence and those that need not. The next step will be to make recommendations about how adherence should be included in guidelines. It may be necessary to develop different recommendations for the different types of guidelines that are eligible for inclusion.
2. A parallel study will be undertaken, to determine the extent to which adherence is mentioned in protocols for clinical trials (RCTs) of pharmacological interventions in covid-19. These protocols are listed on the WHO’s website and are available in full through the websites on which they are posted (e.g. clinicaltrials.gov).
If you are interested in conducting this research, please contact one of the following supervisors:
The closing date for applications is noon on 30th June 2021
"Committed to equality and valuing diversity”
How to apply
If you are interested in applying for an internship please submit a CV, personal statement outlining why you are applying for the internship and what you hope to gain from it; and a supporting statement from a personal tutor or equivalent by noon of the closing date to firstname.lastname@example.org. Please include in the subject line which internship you are applying for and for the SPCR Internship please include which project you are applying for (you may apply for more than one project).
Successful candidates will be shortlisted and invited for interview before being formally offered a place.
Internships are paid through the casual payroll and subject to deductions for tax and national insurance.
Internships are not eligible for visa sponsorship and are only available to candidates holding valid right to work in the UK documentation.