You’ve heard of clinician scientists. We’re applying the same model to public health



TYPE Prevention Centre News

How many researchers do you know who see the direct application of their findings on the health of their community every day? I do.

Often, when I drop my children off at preschool or school, I see a poster or hear teachers talking about a new health promotion program that has been directly informed by my research and that of my colleagues.

I’m lucky enough to be one of approximately 30 university-employed staff embedded in Hunter New England Population Health (HNEPH), a dynamic population health unit of the Hunter New England Local Health District (LHD). My daily work is around delivering health services to the community, and within that role I am meeting my academic goals in a way that I don’t think would be possible in any other environment.

Like clinician scientists, whose laboratory research is directly informed by the problems they encounter in their patients on the ward, we are scientists who are also policy makers and practitioners. Rather than soliciting partnerships with academics or universities to commission research, in the Hunter New England Population Health model, academics are responsible for both services and research.

Researchers make up a third of the staff of the population health unit. They are integrated into teams that design, develop, implement and evaluate health services to the community. The needs of the service are paramount, and the research is undertaken in order to deliver the service better.

I have a joint appointment with the University of Newcastle and the LHD. I manage a large budget allocated by the health service, I’m responsible for delivering KPIs and I have staff employed by the health service. The evaluation of the health service becomes our academic output.

Every day, I overlay the health service’s objectives with research objectives. I use my research experience and skills to work out how we can deliver services better. The research becomes the service, and the service becomes research.

Typically, we’ll develop an evidence-based program and recruit a PhD student to evaluate it. We’ll involve health service staff as well as other external experts from our academic networks to advise on how to further innovate in this particular area. Then we’ll work out how to use the pilot data to apply for a grant to take the research further.

Our model is explicitly designed to build capacity in PhD students, ensuring they are competitive for a range of career options when they graduate. They are exposed to different levels of government and work across our broad program of work to gain competencies in different areas. It means we all work together as a team. There’s no competition as we’re all involved in each other’s projects.

Our students are supervised by panels of supervisors working on different projects, giving them a range of experience. They also often have the opportunity to supervise another PhD student in their final year, meaning their publication rate is very healthy when they graduate.

There’s no doubt that our model has been beneficial. For researchers, it means we get the support and infrastructure of a health service to apply our trade. I don’t have to worry about applying for highly competitive grant funding, apart from to fund the relatively small proportion of my research in which I am pursuing my own research interests.

It’s also benefited population health. Some of the programs we’ve developed and piloted have been scaled up successfully across Hunter New England, NSW and Australia. We’ve also learned from rigorous evaluation that programs based on good pilot data and pretty convincing evidence can be completely ineffective, sparing us from further investment.

The success of our model has been partly due to our location in Newcastle. We are helped by the fact that we are operating in a relatively small metropolitan centre with one health service, one university and one research institute. We’re lucky enough to enjoy enduring collaborations and to retain our high calibre colleagues.

But I think our model has broader application. Based on our experience, I would recommend all end-user organisations to consider embedding academic staff in senior leadership positions. Greater knowledge exchange and alignment of research with health policy and practice needs makes sense for all of us.

For more information: Wolfenden L, Yoonga SL, Williams CM, Grimshawd J, Durrheim DN, Gillham K, Wiggers J. Embedding researchers in health service organizations improves research translation and health service performance: the Australian Hunter New England Population Health example. J Clin Epidemiol. 2017;85,3–11. doi: 10.1016/j.jclinepi.2017.03.007