Department Name:
London School of Hygiene and Tropical Medicine

Supervisors names and email addresses:
1) Professor Andrew Hutchings (Andrew.Hutchings@lshtm.ac.uk)
2) Professor David Cromwell (david.cromwell@lshtm.ac.uk)
3) Professor Jan Van der Meulen (jan.vandermeulen@lshtm.ac.uk)
4) Professor Ellen Nolte (ellen.nolte@lshtm.ac.uk)

Funding Status:
Directly Funded Project (UK and EU Students Only)
Stipend: £17,803

Application Deadline: 5 January 2020

Interview date: 29 January 2020

Duration:
3 years, full time

 

Project Description;

The configuration of cancer services is rapidly changing. Service delivery is being re-designed in order to diagnose cancer earlier, accelerate access to treatment, improve patients’ experience, reduce side-effects of treatment and enhance cures for cancer.

Two developments are at the centre of this change: 1) centralisation of services creating hub-and-spoke models and 2) increased use of specialist multi-modal treatments.

Existing research has shown that:

• up to a third of cancer patients ‘bypass’ their nearest cancer centre (‘patient mobility’)
• cancer centres that offer innovative treatments and employ clinicians with strong media profile are attractive to patients (‘patient choice’)
• a hub-and-spoke configuration improves outcomes of specialist treatments but has a detrimental impact on equity of access (‘centralisation’)
• comorbidities may create an ‘implicit barrier’ within referral pathways such that patients with comorbidities may get ‘lost’ to the system (‘equity and efficiency’).

This studentship would address the impact of comorbidities of cancer patients on access to specialist cancer treatments (especially, specialist multimodal treatments), safety (especially, side-effects), patient experience (patient-reported), and patient-centred outcomes (cancer progression, survival) in an era of ongoing top-down redesign of cancer services, which creates an increasingly complex structure of cancer services provision.

The student will mainly use existing data as we will analyse linked national data sets, including national cancer registry data, radiotherapy and chemotherapy data, and Hospital Episode Statistics. These analyses will build on our extensive experience in modelling patient mobility and care pathways, and short and long-term patient outcomes at a national level.

A key innovative element is the use of data from geographic information systems for the purpose of location-allocation and patient-choice-and-demand modelling.

The student will have access to detailed national data on the current organisation and availability of specialist cancer treatment modalities and supporting services. This work builds on our extensive portfolio of National Clinical Audits within the Clinical Effectiveness Unit, the collaborative unit of the London School of Hygiene and Tropical Medicine and the Royal College of Surgeons of England: https://www.rcseng.ac.uk/standards-and-research/research/clinical-effectiveness-unit/projects.

This will allow assessment of the impact of both patient and service characteristics on access to and outcomes of cancer services using multilevel modelling.

Project-specific skills and experience required:

Essential skills: being able to carry out statistical analyses of large complex data sets (e.g. regression techniques, time-to-event analysis, choice analysis, multilevel modelling); the project will analyse English administrative hospital data linked to national cancer registration records.

Desirable skills: having experience in using geographic information systems; the project will include analyses of patient mobility patterns as well as location-allocation modelling.

All candidates should hold a Master’s qualification (or complete their Master’s by September 2020) in an appropriate discipline and have a minimum of a 2:1 or equivalent in their first degree. Applicants should preferably have knowledge of the UK health and care system. All applicants are required to have excellent written and verbal communication skills. They should also be willing to work collaboratively in multi-disciplinary and multi-professional teams.

Enquiries email names and addresses:

Prof Jan van der Meulen: jan.vandermeulen@lshtm.ac.uk or Prof Andrew Hutchings: Andrew.hutchings@lshtm.ac.uk

Training opportunities
PhD students will be entitled to the full range of PhD training opportunities at their host institution. In addition, all PhD students will benefit from the training provided by the NIHR ARC North Thames Academy (The Academy). The Academy brings together PhD students from across ARC North Thames, to create a community of students training in applied health research. The Academy works alongside each host institution’s graduate training programme to equip students with the skills needed to work at the interface of academia and health services.

Our doctoral programme focuses on practical aspects of applied health research, such as the skills required to undertake research in health care and public health settings, to engage patients and the public in research, and to navigate relevant ethical and research governance approval systems. In addition, we aim to provide students with an understanding of how their work fits into current NHS structures and applied public health research environments. PhD students will be expected to attend and present at scientific meetings aimed at disseminating the findings of ARC research.

Publication and wider dissemination:
It is expected that results of the PhD research will be publishable in good quality, peer-reviewed academic journals and communicated at conferences. The research would also be expected to generate outputs tailored to applied health research, public health practitioner, and policy-making audiences.

Eligibility
Candidates should hold a Master’s qualification in a relevant discipline (or complete their Master’s by September 2020) and have a minimum of a 2:1 or equivalent in their first degree. Applicants should preferably have knowledge of the UK health and care system. All applicants require excellent written and verbal communication skills and should be willing to work collaboratively in multi-disciplinary and multi-professional teams.
Due to funding restrictions, applicants must be UK/EU nationals. Please refer to UK Council for International Student Affairs (UKCISA) for the criteria.

How to apply
If you have queries about potential projects or would like to discuss these in more detail, please contact the appropriate supervisors by email. In case of any difficulties in making contact, please email ARC.academy@ucl.ac.uk 

Your application should consist of:

• A CV (to include qualifications, work experience, publications, presentations and prizes) plus contact details of two academic referees (references will be taken up for all shortlisted candidates).
• A personal statement (300 words) describing your suitability for the proposed project including how your research experience, skills and interests relate to the topic.
• A 1-page proposal of how you would develop the PhD project that you are applying for.

Please send your application to ARC.academy@ucl.ac.uk