Navigating systems of care and their intersections in the context of multimorbidity: a qualitative study of working-age adults

Multimorbidity (the presence of two or more ongoing medical conditions) increasingly affects working-age people, especially in socially disadvantaged groups. Previous research has shown that although the prevalence of multimorbidity increases with age, the absolute number of people with multimorbidity is higher in adults aged under 65. Amongst people living in the most deprived areas, the onset of multimorbidity occurs 10 – 15 years earlier than in the most affluent areas.

The PhD student will join the APOLLO-MM project team (www.polypharmacy.org.uk) and develop an independent project to study the lived experience of working-age adults who are affected by multimorbidity, with a particular focus on patients with co-existing physical and mental comorbidities.

The successful student will conduct an in-depth, longitudinal ethnographic study focusing on the lives, experiences and practices of patients living with multimorbidity in east London. The student will follow these patients over a period of 12-15 months, exploring their experiences as they navigate the home, workplace, and health care, social care and welfare systems and their intersections, exploring what self-management means in this context. We will work with the successful candidate to refine the specific focus of sociological enquiry, guided by their interests and experience.

The project will involve a range of qualitative research methods. It will include: literature review; in-depth narrative interviews; semi-structured interviews; creative ethnographic methods such as the development and deployment of tools to elicit rich accounts of patients’ lives (e.g. audio-diaries, photo-diaries). Where possible it will include observation of patients in their homes and observing encounters (face-to-face or ‘remote’ encounters e.g. telephone/video encounters) with health and social care services to study their interactions with a wide range of agencies. The research will be conducted during the recovery phase of the COVID19 pandemic and as such also offers opportunity to learn how different models of service in this landscape are impacting on patients’ lives and their ability to self-manage. We will import relevant social theory to analyse these in-depth case studies and inform the analysis and synthesis of a rich dataset.

Aside from academic outputs (the PhD thesis and related academic publications and presentations), the successful candidate will be encouraged to apply for a public engagement grant to support the development of creative patient/public resources to improve the care of patients with complex needs.

Applications are especially welcome from candidates with an interest in and/or experience of working with disadvantaged communities and minority ethnic communities. Knowledge of and fluency in relevant local languages (e.g. Bengali/ Sylheti) would be desirable but is not essential.

NIHR ARC North Thames
This studentship is funded by NIHR ARC North Thames, a collaboration of 50+ partners, including leading universities, NHS trusts, local authorities, clinical commissioning groups, UCLPartners, industry and organisations representing patients and the public. The appointed PhD student will receive a stipend of £17,803 per annum plus a fee waiver.

In addition to PhD training opportunities at their host institution, all ARC PhD students will benefit from training provided by the ARC Academy. Our doctoral programme focuses on practical aspects of applied health research and encourages our PhD students to attend and present at scientific meetings aimed at disseminating the findings of ARC research.

Project-specific skills and experience required
Essential skills:
A good grasp of qualitative research methods and at least some experience of using qualitative methods (e.g. interviews)
Acceptance that this post involves interacting with people who may be ill, confused or in distress. It may include travel to and fieldwork in homes, health care/social care/welfare settings (in accordance with Government and University guidance on safe working practices in the context of COVID19) and working as a lone field researcher in unpredictable circumstances.

Desirable skills:
Experience of ethnographic and/or participatory forms of research
Experience/interest in researching with disadvantaged communities
Ability to communicate in local languages (e.g. Bengali/ Sylheti)

Eligibility
• Candidates should hold a Master’s in a relevant discipline (or complete their Master’s by January 2021) and have a minimum of a 2:1 or equivalent in their first degree.
• Applicants should preferably have knowledge of the UK health and care system.
• All applicants require excellent written and verbal communication skills and should be willing to work collaboratively in multi-disciplinary and multi-professional teams.
• Due to funding restrictions, applicants must be entitled to pay tuition fees at the 'home' rate for study on a Higher Education course in England as per the criteria specified by the UK Council for International Student Affairs (UKCISA) https://www.ukcisa.org.uk/Information--Advice/Fees-and-Money/England-fee-status

How to apply
To submit your application or make an inquiry about the application process, please email [Email Address Removed]
Your application should consist of:
• A CV (qualifications, work experience, publications, presentations and prizes) & contact details of two academic referees.
• A personal statement (300 words) describing your suitability for the proposed project including how your research experience, skills and interests relate to the topic.
• A 1-page proposal of how you would develop the PhD project that you are applying for.
• A completed eligibility confirmation form https://clahrc-norththames.nihr.ac.uk/wp-content/uploads/2020/07/PhD-eligibility-confirmation-form-2020.docx