The main focus for this research time award will be the development of a technology-enabled pathway for arthroplasty patients within Wales.

I plan to develop my own portfolio as a Chief Investigator. My main focus for this research time award will be the development of a technology-enabled pathway for arthroplasty patients within Wales. Using the advantages of emerging technologies to better inform and prepare the patients through their journey from diagnosis to discharge, it is likely that we will be able to improve outcomes, reduce variation and decrease costs. It could improve timely communication and information, tailored to the patients in need for intervention but could also mitigate the staffing issues.

I plan to focus on the following aspects and submit funding bids, such as to Research for Patient and Public Benefit to:

• Undertake further research into the identification of patients undergoing multiple revisions, as well as extending the length of follow-up far beyond the current maximum of up to 14 years. With an ageing population and a trend towards surgery at younger age, it is imperative to extend the follow-up period and analyse the outcomes of hip replacement surgery well into the second and third decade.
• Explore whether there is an increased risk of unsatisfactory outcomes and further contacts with the healthcare providers as a result of reoperation/revision, and if this is for similar or different reasons to the reason for failure of the implant at the time of first revision.
• Investigate the effect of comorbidity such as diabetes, inflammatory arthritis, and specific neurodegenerative diseases (eg, dementia, epilepsy and Parkinson’s disease) on outcomes following THR. Identification of these patients within the database has been proven to be possible and is underway. Currently we are analyzing and discussing the different methods used to perform an in-depth analysis such as exact matching, propensity score matching or we could revert to a multistate analysis, using only the selected cohort of patients.
• Investigate the impact of neurologic diseases on outcomes of hip replacement surgery following hip fracture. It is anticipated that there could well be an increased number of patients suffering from neurological conditions (for example Parkinson’s disease, dementia) fracturing their hip and needing acute surgery. I believe that avoiding complications and reoperations might be even more important in these frail patients, presenting with an acute hip fracture.

In addition to this, I will work with the R&D Department to undertake Portfolio and Commercial activities as Principal Investigator, such as PROP OA (CPMS 39562). I am currently supporting studies with the Research Delivery Team, however I am limited in my capacity. This award will ensure I have dedicated time to support further projects in addition to developing my own portfolio and building academic and industry links. I am currently working with Swansea University, University of Wales Trinity Saint David and Nurokor to develop a project looking at chronic pain. I plan to continue this work and look to secure an Honorary Senior Lecturer Post. I will also look to link with Speciality Lead, Kate Button, to look at the current research landscape and future needs.

As part of this funding I plan to support the Researcher Development Team to deliver training to potential researchers and look to develop my mentoring skills, so that I can promote research across the health board and beyond as a research champion.

This protected time would also allow me to increase productivity, increasing the publications and disseminations from the health board and further strengthening its position as a strong forward-looking healthcare provider with research facilities and outcomes. This could provide the necessary traction to attract the new generation of doctors, nurses and allied health professionals to be able to provide a future safe and well-staffed service.