‘It makes us very proud to be part of something that’s both national and international. I personally didn’t feel that we had any choice and thought it was absolutely the right thing to do. I’m not surprised there’s an answer, I’m just pleased it’s a positive one.’ – Dr Sophie Fletcher
National Recovery Trial
We caught up with Dr Sophie Fletcher, who was the principal investigator for the National Recovery trial here at University Hospital Southampton NHS Foundation Trust (UHS). Oxford researchers have a network of 175 centres around the UK that participate and contribute, and UHS was one of them. This was one of the largest COVID-19 treatment trials in the country.
This trial’s approach is known as a flexible arm study. Each arm represents a different drug being used in the trial and a computer is used to randomise patients to land on a particular drug. Results from the trial have shown low-dose dexamethasone can save the lives of patients with serious COVID-19.
Getting to know Sophie
Sophie has been a consultant here at UHS since 2012. She has trained in a combination of respiratory, general medicine and intensive care medicine and has accreditation in all three. Before becoming a consultant, Sophie was purely clinical and had not undertaken a research role before. One of Sophie’s interests both clinically and from a research perspective is in scarring lung diseases or interstitial lung disease, which Southampton happens to be the regional centre for. When the opportunity to work in the Recovery trial arose, someone with experience in both respiratory disease and respiratory research was thought to be best placed.
How did Sophie and her team help to support the fight against Covid-19?
Working on the frontline meant that Sophie and her team were in the best position to recruit and bring people into the trial. She told us that it was all about inspiring the team and getting them to pitch in, as well as getting them to understand why we were doing the trial.
Her role was to advertise the trial and raise awareness to other colleagues. They worked together to inspire one another and pitched in ideas to make it happen. The research nurses who worked alongside the team had a variety of backgrounds ranging from working in ED, ophthalmology and musculoskeletal research, but none had a background in lungs. This reflects an inspiring level of versatility of the research nurses here at UHS.
Sophie tells us that she and her team were challenged clinically as there were many sick patients arriving in a very short amount of time. The inclusion criteria for the trial were very brief which meant there were lots of patients that could participate. Participants had to be over 18 years old, and had to currently be in hospital with COVID-19. She admits that this was the shortest protocol that she has ever seen for a clinical trial.
To adapt to these challenges as an organisation, Sophie and her team spent time converting the infectious diseases ward into a high dependency unit, which resulted in huge infrastructural changes across the Trust. New monitors, cabling and equipment were quickly brought in and staff teams were merged together to adapt to these changes.
How does UHS support a role in research?
'Opportunity is the best way to describe it. It’s not straight forward or easy, but the opportunity is there. If you have the interest and the attitude and are willing to give it a go, then the research department will support you. If you’re successful, they will support you again. It’s not a certainty; you do have to put the effort in yourself. To begin with, you have to do over and above your clinical work. You can’t expect the opportunity to research to be built into your job right from the outset, but the opportunity to prove yourself is certainly there.'