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As part of this year’s national NIHR #ShapeTheFuture Campaign, we’re shining a spotlight on Practice Research Fellow, Diane Sellstrom – who is leading research into care and decision-making for head and neck cancer patients, alongside her role as a clinical speech and language therapist.

Reflections from a researcher: How a Practice Fellowship is helping me to build on 27 years of clinical knowledge to explore new pathways of care

Diane Sellstrom is a speech and language therapist and head of department at Newcastle’s Freeman Hospital where she specialises in head and neck cancers.

In 2022, she was awarded a Practice Research Fellowship with the NIHR Applied Research Collaboration (ARC) North East and North Cumbria (NENC) to conduct research looking at pathways of care and decision-making for head and neck cancer patients who develop ‘late-effects’ caused by scarring from radiotherapy. This often develops after the patient has been discharged from the specialist team and therefore can go unrecognised until symptoms are significantly impacting on the patient’s physical health.

She is carrying out her research alongside her professional role – dedicating two days per week to the project, over two years.

Diane is one of  16 Practice Research Fellows supported by the NIHR ARC North East and North Cumbria. The Practice Fellows provide an important link between applied research and frontline practice, working between the ARC NENC and regional health and care providers to deliver high quality applied health research linked to priorities in their own fields of work.

Diane’s Fellowship explores incidence, management and pathways for patients experiencing late side-effects of head and neck cancer treatment and aims to understand the impact of living with these symptoms.

Her Fellowship is linked to the NIHR ARC NENC research theme of ‘Knowledge Mobilisation and Implementation Science (SKIM)’ – which focuses on using research and knowledge in innovative ways, to improve health and care across our region.

Diane said: “These Practice Fellowships offer exciting opportunity for clinicians to engage in research and work collaboratively, tapping into an established network of clinical and academic experts. As a service leader, I am passionate about developing the research agenda and encouraging staff to engage in research opportunities. This Fellowship will help me to better support those around me to do that.”

The Fellowship allows Diane to build upon her 27 years of clinical knowledge during which time she has successfully secured funding for new and innovative developments, as well as a wealth of research experience having previously completed an NIHR MClinRes (Leadership) with Newcastle University.

She has contributed to several publications as lead and co-author, has been involved in multi-centre collaborations and has been invited to speak at national conferences.

Patient involvement is key

Another invaluable aspect of Diane’s work has been the input from patients in co-designing the research project. Their input has ensured the questions that Diane is asking are relevant and the methods used to find the answers are appropriate.

Jennifer Dunbar has been involved as a patient advisor, and said:

“As a survivor of head and neck cancer I have struggled with various side effects caused by my treatment since the very beginning. Six years down the line I find more are developing and those side effects I already had are getting worse and together they have a huge impact on my quality of life.

“It is so important to me to help with this research piece, as I have found it difficult to get answers and guidance for my own challenges, and often have to spend time working through various options with my team to find answers.

“If, by sharing my experiences with the research team, I can help them help others then it is the least I can do to repay all the support I have had.”

Diane is delivering three strands of work:

• A scoping review to pull together what we know and don’t know about late effects of head and neck cancer treatment, specifically those related to eating and drinking difficulties.
• A mixed-methods study exploring the impact of living with late effects and mapping the symptoms experienced and healthcare journey back into the specialist team.
• A survey of practice among specialist SLTs in the UK regarding diagnosis and management of late effects.

She added: “My aims centre around improving our understanding of these late effects (with a focus on those related to eating/drinking) and identification of unmet needs. Some patients only re-enter the system following emergency admission with significant swallowing difficulties, weight loss, chest co-morbidities and/or breathing difficulties. Earlier intervention could potentially prevent such admissions and enable patients to maintain their quality of life for longer.

“Working collaboratively with knowledge mobilisation experts within the ARC NENC will also ensure the findings of these projects reach maximal potential impact.”