Healthcare for People with Fibromyalgia: Moving from Design to Delivery

Fibromyalgia is a common, complex condition with symptoms of pain, fatigue and sleep disturbance, yet patients are dissatisfied with current health care services and believe no-one takes responsibility. The recently published Getting It Right First Time Report for Rheumatology recommends that care for patients with non-inflammatory painful MSK conditions such as fibromyalgia should be provided in primary and community care settings and include reablement support. 

 However, there is little evidence on the best way to organise health services for fibromyalgia. The PACFIND study funded by Versus Arthritis and led by our team aims to develop a new model of care for people with fibromyalgia to help improve care. Co-designed with patients and other key stakeholders, the new model will address key symptoms prioritised by patients in a way that supports self-management, underpinned by robust scientific principles. It is likely that a modular service model comprising of several components will be produced. This could involve a new role of professional care (e.g., from allied health professionals), more patient-led (peer-support, online platforms) and / or new modes of delivery (using technology).

 To facilitate implementation of the new service delivery model within the NHS, we will produce a detailed description of the new model of care. However, fibromyalgia is a contested condition and there are significant challenges at individual, organisational and policy levels to implementing a new model of care for fibromyalgia into a complex and rapidly changing healthcare system.

This PhD (starting early 2023) will focus on evaluating initial implementation of the new model of care in around 4 services across the UK, representing diverse organisational and healthcare contexts across the UK. A flexible evaluation using a case study approach, incorporating both quantitative (e.g., survey) and qualitative methods (e.g., interviews, ethnography), and drawing on complexity informed and social science lenses, will examine how the model (and its components) function in a real-world setting. Specifically, interactions between macro, meso and micro factors, the extent to which adaptation to local contexts is possible and if and how intended outcomes are achieved or not.

 The PhD studentship will form part of a wider evaluation. Findings will be synthesised together to refine the proposed care model and produce a framework to guide further spread and up scaling in a way that is both timely and adaptive to different healthcare contexts and facilitates sustainability. Patient partner involvement has been an integral part of the PACFIND programme and work with our existing patient collaborators and wider PPI group will continue into the implementation and evaluation phase.

 This PhD is nested within the Epidemiology Group, which is part of the Aberdeen Centre for Arthritis (ACAMH) and recognised as a Centre of Excellence in Rheumatology by the European Alliance of Associations for Rheumatology (EULAR). The PhD sits within a programme of health services research in rheumatic and musculoskeletal conditions. This interdisciplinary programme brings together clinicians, researchers, decision makers and patients, and combines several different approaches; routine health care data, epidemiology, and qualitative methods, with an emphasis on patient-centred involvement and co-design. Our approach aims to development person-centred, effective, and sustainable improvements in health and well-being for those living with arthritis and musculoskeletal conditions. The student will benefit from joining this vibrant hub of inter-disciplinary research and the opportunity to learn from other PhD students, research fellows and UK-wide collaborators. 

Candidates should contact the lead supervisor (Dr Rosemary Hollick) to discuss the project in advance of submitting an application, as supervisors will be expected to provide a letter of support for suitable applicants. Candidates will be informed after the application deadline if they have been shortlisted for interview.

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APPLICATION PROCEDURE:

International applicants are eligible to apply for this studentship but will have to find additional funding to cover the difference between overseas and home fees (approximately £17,000 per annum)

• Formal applications can be completed online: https://www.abdn.ac.uk/pgap/login.php
• You should apply for the Degree of Doctor of Philosophy in Applied Health Sciences to ensure your application is passed to the correct team
• Please clearly note the name of the supervisor and exact project title on the application form. If you do not mention the project title and the supervisor on your application it will not be considered for the studentship.
• Candidates should have (or expect to achieve) a minimum of a First Class Honours degree in a relevant subject. Applicants with a minimum of a 2:1 Honours degree may be considered provided they have a Distinction at Masters level.
• General application enquiries can be made to [Email Address Removed]