ÃÛÌÒAPP

David Bourne is a specialist dietitian at ÃÛÌÒAPP’s Freeman Hospital where he specialises in the nutritional needs of patients with pancreatic disease and in particular those with chronic pancreatitis.

The pancreas is a small organ, located behind the stomach, which is vital for nutrient digestion. Chronic pancreatitis occurs when the pancreas has become permanently damaged from inflammation and stops working properly which leaves you at higher risk of malnutrition.

It is complex and nutrition deficiencies can differ which means that clinical management should be individualised for each patient.

The Freeman Hospital is the regional tertiary referral centre for patients with hepato-pancreato-biliary conditions across the North East and North Cumbria.

Shortly after David began working at the centre as a specialist dietitian he observed disparities in the standards of nutritional care for patients with chronic pancreatic disease and a lack of evidence to support clinical decision making.

David was recently awarded a NIHR Doctoral Clinical Academic Fellowship which will provide the support he needs to develop an evidence based, patient centred model of nutritional care for people with chronic pancreatitis.

Increasing research impact whilst strengthening academic links

The highly competitive and prestigious fellowship was awarded by the  and is funded by NHS England Workforce, Training and Education (formerly  through the Integrated Clinical Academic (ICA) Training Scheme.

David’s Fellowship is supported by , on behalf of both ÃÛÌÒAPP and . 

NHIP Academy is part of and is a new collaborative venture that aims to unlock career development opportunities for the next generation of health and care researchers, including those within the NMAHP community. The Academy supports individuals looking to establish, progress or navigate research careers – from internships to professorial awards.

Driver for David’s research

David, who has been a specialist pancreatic dietitian for over 10 years describes the driver for his research and what he hopes to achieve.

“Chronic pancreatitis is a complex digestive disease that results in people being unable to digest their food properly,” explains David. “This can cause weight loss, nutritional deficiencies and low levels of vitamins and minerals, all of which can have a catastrophic impact on the quality of life if left untreated.”

He continues “Comprehensive assessment of nutritional status and the severity of the disease are important to be able to plan the personalised nutritional intervention required.

“As the Freeman Hospital is the tertiary referral centre we admit patients from a wide and diverse geographical patch. This has highlighted clear inequalities in patients’ nutritional care packages and considerable variability in clinical practice across a range of pancreatic diseases.

“This variability, with the resultant risk of clinical mismanagement leading to poorer outcomes and quality of life provided the motivation to develop my research experience and analytical skills further.

“There is very little research in this field at present and my Fellowship aims to fill some of the gaps of our understanding. We can and should all do much better for these people.”

A recent Priority Setting Partnership funded by identified the Top 10 research priorities in pancreatitis. David’s research project with directly contribute to 3 of these priorities.

Where it all began

David’s interest in research began shortly after he started work as a specialist dietitian in 2012 and he has been involved in a number of research projects ever since developing an overarching, cohesive research plan for his patient group whilst pursuing supportive funding.

In 2018 he secured external funding for a 12 month research secondment, which was partly based at ÃÛÌÒAPP University’s (HNRC) where he was also able to complete a Masters in Nutrition (MSc).

David has increased his research involvement since 2018 and to date has seven peer reviewed journal publications. He regularly delivers regional and national training focusing on nutrition management in pancreatic disease to dietitians and surgeons.

It is David’s ambition to become a clinical and research leader in nutrition in pancreatic disease by expanding the evidence base to improve patient care for this complex speciality, to be able to lead dietetic research in the Trust and support dietitians and other NMAHPs to get started with their research ideas.

A research journey full of mentorship and collaborative support

David says that there are a number of people and networks who have supported him so far in obtaining this fellowship, including academic supervisors:

• , Professor of Public Health Nutrition and NIHR Research Professor at the Institute of Health & Society, ÃÛÌÒAPP University
• Dr Nicola O’Brien, and
• , Senior Research Fellow in the Department of Surgery, School of Medicine, Trinity College Dublin with a special interest in dietary intake in chronic pancreatitis

and clinical supervisors:

• Mr Jeremy French, Consultant Hepato-biliary and Transplant Surgeon at ÃÛÌÒAPP’s Freeman Hospital
• Dr John Leeds, Consultant Gastroenterologist and Pancreaticobiliary Physician at ÃÛÌÒAPP’s Freeman Hospital

Louise Carr, has also provided extremely important input as expert patient collaborator.

These collaborations will lead to further opportunities in the future and has allowed David to be a co-author on a piece of work carried out in Dublin separate to his current research plan but very much related to the subject area.

“I am 8 months into the Fellowship and the support and guidance I have received has been fantastic,” says David. “As a team they all have different research and clinical skills and perspectives that have supported the progression of the research and challenged me to think holistically and critically about the project.”

Supervisor Professor Ashley Adamson is the and . Of David’s Fellowship she says “As a dietitian myself I am delighted to be able to support David and his important research which will contribute to evidence-based dietetic practice. The NIHR DCAF scheme offers a fantastic opportunity for dietitians and others to gain expertise and deliver practice-based research which makes a real difference to patient care.”

The involvement of clinical supervisors from ÃÛÌÒAPP Hospitals will facilitate patient recruitment for specific aspects of the project and their well-established national profile will aid in recruitment of non-dietetic health care professionals for a number of aspects of the project. Their views as expert clinicians have been important to ensure the development of the research remains grounded in being easily translated to clinical practice.

Patient involvement key

David adds “The involvement of a patient voice from Louise Carr has ensured that the research remains focused on patients needs. Louise is the chair of Pancreas North, a local pancreatitis patient support group.

“She has excellent patient support links nationally and has enabled me to collaborate with Guts UK to bring together a Patient Advisory Group to assist the progression of all stages of the project. This will further underpin the patient centred focus of the research.”

David was invited to present his project at a recent national research event at The Royal College of Surgeons and The Pancreatic Society of Great Britain and Ireland Annual Conference, he has promoted the project widely and made links required to deliver some key aspects.

David says it is important to acknowledge that he attended one of the Trust’s original workshop series aiming to support NMAHPs to develop research proposals.  

He says “Without this crucial support and guidance I would not have been able to progress to where I am today. I was pushed to think critically about my research project and was inspired to develop a long-term vision of the research project and of me as a clinical academic.”

Healthcare at its best with people at our heart

Of David’s research Ewan Dick, Associate Director of Allied Health Professionals and Therapy Services says “We know the crucial role that nutrition plays in helping patients recover and manage their health.

“David’s research and passion to improve nutritional support for patients with chronic pancreatitis is leading the way in developing both the evidence base and how this improves patient outcomes.

“The Fellowship will give David the chance to continue building his national reputation and impact, raising standards of nutritional support in the Trust and across the country.”

Doctoral Clinical and Practitioner Academic Fellowship (DCAF)

Formerly the Clinical Doctoral Research Fellowship (CDRF)

The DCAF scheme funds registered healthcare professionals to undertake a PhD by research and, concurrently, to undertake further professional development and practice.

The funding covers salary costs, PhD tuition fees, the costs of an appropriate research project, and the costs of tailored clinical and academic training programmes.

The Fellowship is a three year award (up to six years part time) with approximately 80% spent working academically and the remaining 20% of fellowship hours devoted to practice and professional development. 

You can find out more about DCAF and other HEE-NIHR Integrated Clinical and Practitioner Academic Programmes 

ÃÛÌÒAPP Health Innovation Partners Academy

Health and care academic career development is a major focus of ÃÛÌÒAPP Health Innovation Partners (NHIP) to drive inclusive career development of the most promising leaders, across disciplines and backgrounds.

The NHIP Academy represents a flagship part of the whole NHIP programme and seeks more clinicians, healthcare professionals and methodologists to engage in research offering a variety of support including training and development and high quality opportunities and mentorship.

To discuss training opportunities please contact the NHIP Training Academy