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					                               UNIVERSITY OF NOTTINGHAM

                            RECRUITMENT ROLE PROFILE FORM

Job Title:                   Clinical Research Fellow

School/Department:           School of Community Health Sciences - Division of Epidemiology
                             and Public Health

Salary:                      £30,992 to £34,061 per annum, depending on skills & experience

Job Family and Level:        Clinical Academic

Contract Status:             This post will be offered on a fixed-term contract for a period of
                             three years

Hours of Work:               Full-time

Location:                    Division of Epidemiology and Public Health, Clinical Sciences
                             Building, Nottingham City Hospital

Responsible to:              Professor Richard Hubbard, Professor in Respiratory Epidemiology

The Purpose of the New Role:
The overall aim of this fellowship is to enable a respiratory medicine clinical trainee to become
a national leader in lung cancer care in the UK. The funding for this fellowship is provided by
the Roy Castle Lung Cancer Foundation. By training an individual in a range of health service
research methods, audit/clinical improvement methods and clinical aspects of lung cancer we
aim to allow the fellow to develop into a knowledgeable advocate for people with lung cancer,
who will be able to push forward service improvements effectively. The main focus of the
fellowship will be to train the fellow in health service research relating to lung cancer, and this
will centre on a detailed analysis of the National Lung Cancer Audit, and a number of other
relevant clinical datasets, using a range of epidemiological and statistical methods. We will also
aim to introduce the fellow to some qualitative research methods to provide additional tools to
help untangle and improve the patient pathway. During the fellowship period we will also train
the fellow in advanced clinical aspects of lung cancer care. We have used this model of training
previously (Anna Rich and Helen Powell) and have found this to be both productive from a
research output point of view and popular and rewarding to the fellow.

Main Responsibilities:
 Carry out research as directed by the appropriate Research Leads
 Maintain accurate research records
 Publish work in high impact scientific journals
 Provide figures and other contributions for grant applications
 Attend National/International conferences to present work
 Interact with other members of the research team and collaborate with and complement
  their research
 Interact with members of the Roy Castle Lung Cancer Foundation and the National Lung
  Cancer Audit
 Present work at departmental research meetings
 Obtain additional training in new techniques as required to carry out the research
 Register for a PhD and work towards obtaining this higher degree
 Carry out other duties as directed by Professor Hubbard and Dr Tata
Clinical Responsibilities:
 To be trained in advanced bronchoscopic procedures such as EBUS, as well as ensuring
   adequate competence at thoracoscopy
 Have clinical exposure to allied professionals, such as oncologists, surgeons, palliative care
   physicians, Lung Cancer Specialist Nurses (eg time in theatre, clinics etc)

Research Responsibilities:
 Attend a number of respiratory meetings (BTS, BTOG, ERS, ATS) during the fellowship
  period and will present their research at these meetings
 Submit a PhD thesis and 4-5 papers for publication
 Learn complex data management and multivariate regression methods and some basic
  qualitative research skills
 Feed back their research findings to the steering group, to the Roy Castle Lung Cancer
  Foundation and also to the population of people with lung disease (probably through our
  established links with local Breathe Easy Groups)
 Learn the relevant clinical skills to enable them to become a lung cancer lead
 Contribute to the critical mass of lung cancer researchers in the group centred at the
  University of Nottingham and help to support other new researchers in this area

Proposed Research Schedule:
Year 1
During the first year the Fellow will be trained in large dataset management and statistics and
will use the NLCA audit – linked to HES – to investigate the following questions:

   1) To what extent do trusts and networks vary in the use of treatment (surgery and
      chemotherapy) for people with stage I & II disease and good Performance Status. What
      are the main underlying patient and trust level factors that explain this variation?
   2) To establish what proportion of people within the NLCA die early (by 30 and 90 days)
      and what are the main patient and trust level features that predict early mortality?
   3) To determine if we can identify organisation level features that predict whether a trust
      performs well or badly with regard to key performance indicators (use of surgery in
      early stage disease, survival). To what extent does the performance of a trust remain
      stable over time?

We will use our established methods and experience of using the NLCA to guide the Fellow
through this research programme. The skills needed for these analyses include generic data
management skills, logistic regression and survival analysis methods. All analyses will be
performed using Stata (version 12). On the basis of our previous work we anticipate that this
will lead to 2-3 publications and a number of conference abstracts. This work will also form the
basis of the first year report.

Year 2
For the second year the aim is for the Fellow to study the care pathway for people with lung
cancer from the early pre-diagnostic interactions in primary care, to the referral process and
secondary care intervention to final treatment and outcome. To do this we will link primary
care data from The Health Improvement Network (THIN) to secondary care data from HES and
NLCA and also to the National Cancer Registry– this is the first time that these four datasets
have been linked to answer these questions and as such this presents a significant challenge
with regard to data management. However the work done in the first year will provide an
excellent grounding in this research and the skills required, and in our division we have 15
years of experience of using primary care data so we are confident that this project is
achievable. Our specific research questions will be:
   1. Do patients who have potentially curative interventions differ from those who do not in
      terms of their early interaction with primary care?
   2. To what extent are patients who are admitted and diagnosed with lung cancer as part
      of an acute admission seen in primary care in the last year before diagnosis? Is the
      pattern similar in people who die in the first 3 months after diagnosis? Is the pattern
      similar for people in the registry who have a “death certificate only” diagnosis of lung
   3. Using primary care data (THIN) and secondary care data (HES) what is the best
      measure of co-morbidity in terms of predicting disease outcome and treatment choice?
   4. Are specific characteristics of a general practice associated with more effective cancer
      care – in terms of less acute admissions and better prognosis?

We are developing a fuller protocol for this analysis. Again the statistical skills required will be
multivariate logistic and Cox regression. When looking at practice based variables and
individual level variables we will explore the need for multilevel modelling. This work is again
likely to yield 2-3 publications and since the data linkage will be challenging and novel we
expect the impact factor level of the journals for these publications to be higher than those
used for publication in the first year.

Year 3
In the third year we expect the Fellow to ensure that they have finished the research from the
first two years and to ensure that the thesis is ready for submission on time and that all of the
papers are ready for submission to peer reviewed journals. However we anticipate that there
may still be some additional research time available and if so we would like to take the
opportunity to train the Fellow in some qualitative methods to give them an insight into how
these can be used to provide further understanding on the findings of the quantitative work
and how this kind of data can be used to drive health care improvements and policy. Given the
limited time, this work will only be a brief introduction to qualitative work and we will probably
need to focus on just one research area. The precise area will depend to some extent on the
questions that arise from the quantitative work – but examples might be:

      The patient perspective on early interactions with primary care
      What was the important trigger or triggers that made the person with lung cancer first
       seek help from the health service?
      At the time of diagnosis what was the persons view on the likely outcome for people
       with lung cancer?

Knowledge, Skills, Qualifications & Experience
                   Essential                                   Desirable
Qualifications/        MBBS or equivalent                      Evidence of academic
Education                                                        excellence
                       MRCP or equivalent
Skills/Training     Medical training                            Respiratory medicine trainee
                                                                 At least 6 months experience
                                                                  in the area of lung cancer
Experience             At medical SHO level                     Respiratory Registrar
                                                                   Clinical experience at ST2
                                                                    level or above or equivalent

                                                                   Previous experience of clinical
Statutory/Legal        Satisfactory Enhanced disclosure
                        is obtained from the Criminal
                        Records Bureau
                         Full GMC registration with a
                           licence to practice

Personal               Good team player, ability to work       Good presentation skills
Attributes              hard to deadlines and deliver

Because of the nature of the work for which you are applying, this post is exempted from the
provisions of Section 4 (2) of the Rehabilitation of Offenders Act 1974 by virtue of the
Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975.

Candidates are therefore, not entitled to withhold information about convictions, which for
other purposes are “spent” under the provisions of the Act, and in the event of employment
any failure to disclose such convictions could result in dismissal or disciplinary action by the
University. Any information given will be strictly confidential and will be considered only in
relation to an application for positions to which the Order applies.

Due to the requirements of the UK Border and Immigration Agency, applicants who are not UK
or EEA nationals and whose immigration status entitles them to work without restriction in the
UK will be considered on an equal basis with UK and EEA nationals. Other non-UK or non-EEA
nationals whose employment will require permission to work subject to a resident labour
market test may only be considered if there are no suitable UK or EEA national candidates for
the post. Please visit for more information.

Informal enquiries may be addressed to Professor Richard Hubbard, Email: Please note that applications sent directly to this email
address will not be accepted.

Please quote ref. MED09179.
Additional Information

Research Team:
The Clinical Research Fellow will be supervised by our existing lung cancer research team in
Nottingham – the details of which are given below. Our team is currently supervising one
clinical and one non-clinical research fellows working on lung cancer (Powell and Khakwani). Dr
Anna Rich, our previous fellow, has been awarded her MD degree and has secured a consultant
post in Nottingham. The day to day supervision of the Clinical Research Fellow will be led by
Richard Hubbard, David Baldwin, Anna Rich and Tricia McKeever.

 Name                Position                                     Role
 Richard Hubbard     Professor of Respiratory Epidemiology,       Day to day supervision,
                     University of Nottingham                     epidemiological methods
 David Baldwin       Consultant Physician, Lung Cancer Lead,      Day to day supervision,
                     Nottingham                                   clinical training
 Anna Rich           Consultant Physician, Lung Cancer            Day to day supervision,
                                                                  clinical training
 Laila Tata          Lecturer in Epidemiology University of       Methodological advice, NLCA
                     Nottingham, Statistician for NLCA annual     advice
 Tricia McKeever     Associate Professor of Statistics,           Day to day supervision and
                     University of Nottingham                     statistical advice
 Laura Jones         Research Fellow in Qualitative Methods,      Qualitative methods advice
                     University of Nottingham                     and support
 Roz Stanley         NLCA lead for Information Centre             NCLA advice
 Catherine Free      Lung Cancer Lead, Leicester                  Clinical advice on lung cancer

We have also set up a steering group to oversee the training and research process which has
an independent chair (Anne Tattersfield) and lay/patient representation. In addition the NLCA
group feed into this steering group (Peake and Beckett).

Research Environment:
The Clinical Research Fellow will be based in the Division of Epidemiology and Public Health at
the University of Nottingham. The Division which is based in a new purpose built building at
the City Hospital campus. There are approximately 20 clinical/non clinical PhD students in the
Division. The Clinical Research Fellow will be expected to attend and present research at
divisional research meetings. The Division has a particular interest in large clinical datasets
and is ideally suited to work using the NLCA

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