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I believe that speaking to primary care commissioners across the NHS (rather than only at a few CCGs) has enhanced the richness of my findings"
- Alexandra Jager

Over the past year, I have become a responsive and flexible researcher, finding novel ways to engage with research participants and collect primary data. The challenges and benefits of conducting research during the Covid-19 pandemic are highlighted below.

SPCR studentship looks at how NHS primary care commissioners use evidence

My doctoral research investigates how NHS primary care commissioners use evidence, and in particular data, in their decision making. I used a realist methodology to evaluate complex interventions and social problems. In order to do this, I focussed on understanding for whom a programme works, in what circumstances, and how. I began my PhD with a systematic review and completed my transfer of status in early January 2020. I was planning to commence my primary data collection in the spring of 2020.

A spanner in the works

When I reached out to the CCG for what was meant to be my first case study in the spring of 2020, they told me that their commissioning meetings were no longer open to the public, and that the people who were previously interested in being interviewed were no longer available for interviews"

My original plan for my primary data collection was to complete in depth case studies of 3 to 4 Clinical Commissioning Groups (CCGs). I had planned to complete interviews with commissioners from a range of backgrounds (finance, data analytics, etc.), attend primary care commissioning meetings and document my observations, as well as analyse documents for each case study CCG.

In addition, a CCG was lined up to serve as my first case study: I had previously attended several commissioning meetings as an observer, and several people had expressed an interest in being interviewed. My plan was to replicate this recruitment method across several CCGs, i.e. attend meetings, introduce myself and my research, and find participants to interview. I spent the beginning of 2020 submitting documentation for ethics approval and was on track to commence my first case study in the spring, but unfortunately COVID-19 threw a spanner in the works!

When I reached out to the CCG for what was meant to be my first case study in the spring of 2020, they told me that their commissioning meetings were no longer open to the public, and that the people who were previously interested in being interviewed were no longer available for interviews. I then attempted to use my existing connections to remotely recruit a new CCG for the case study approach, and although I eventually found another CCG that was willing to take part as a case study, they too eventually ‘dropped out’.

More flexibility in the way I collected data

This led me to develop a new, more flexible approach to primary data collection that could be completed remotely. I decided to scrap the case study approach entirely since I felt that it was probably too difficult for CCGs to commit to being part of a research project during the COVID-19 pandemic.

I am still employing a multimethod approach to data collection consisting of interviews, document analysis and meeting observations (in practice this will mean listening to the recordings of primary care commissioning meetings), but I will now interview primary care commissioners across England.

Where available, I will now read and analyse the meeting minutes of the CCGs that the interviewees belong to, but unfortunately the amount of detail captured and availability of meeting recordings will vary by CCG. Interviewees are being recruited using a snowball sampling approach, that is, I am asking my existing contacts in the NHS and interviewees if they will introduce me to further potential interviewees.

although my research has been delayed by several months, I can now confidently say I have adapted well with a viable approach to completing my primary data collection that will not be impacted by lockdowns. I have also found that my redesigned approach has a few unexpected benefits, and I may carry over some of my approaches to future research in a pandemic-free world. "

 

Inevitable delays

Unfortunately, the process of researching, redesigning, and justifying the changes to my primary data collection strategy as well as rewriting and resubmitting my ethics documents has delayed my research by several months. My PhD will also now include a reflection of how COVID-19 has had an impact on my findings and why I had to make the changes I did. In addition, recruiting interviewees has been difficult due to the unprecedented strain the NHS is under.

Surprising benefits

However, there have been a few unexpected benefits to having to redesign my primary data collection strategy and conducting research remotely.

Firstly, since primary care commissioning meetings are now recorded, I can relisten to the recordings and transcribe what people are saying, which is unlikely to have been possible during a live meeting.

Secondly, I believe that interviewing primary care commissioners across the NHS (rather than only at a few CCGs) has enhanced the richness of my findings.

Thirdly, I believe that having all the documentation in an electronic format (for example, signed consent forms and meeting observation notes) is more secure, as I can now store all of my data immediately on a password-protected network drive, rather than carry any physical documents from place to place.

In summary, although my research has been delayed by several months, I can now confidently say I have adapted well with a viable approach to completing my primary data collection that will not be impacted by lockdowns. I have also found that my redesigned approach has a few unexpected benefits, and I may carry over some of my approaches to future research in a pandemic-free world.