How I’ll use my research fellowship to improve patient care

Layla Bolton is a pre-doctoral research fellow at Charing Cross Hospital. Earlier this year she was awarded a £65,000 research fellowship from Imperial Health Charity to support her research into the barriers facing patients with venous leg ulcers. Here, Layla talks about the initiative and how her study into referral pathways can have far-reaching effects for the NHS.

An estimated 1 in 500 people in the UK are diagnosed with venous leg ulcers, a long-lasting, painful sore that can develop after a minor injury and take weeks to heal. People who are overweight, have difficulty walking or have varicose veins are at risk of developing venous leg ulcers.

For those with the condition, their whole life is affected. Often, they can’t shower, use public transport, go on holiday or even walk. There’s an immeasurable burden on their quality of life.
Even though a venous leg ulcer can be completely treated in just a few months, we’re finding that it can sometimes take up to a year for patients to be referred to us. To be able to improve these patients’ quality of life we need to speed up the referral pathway to ensure they have faster access to treatment.

Removing barriers to treatment

We know there are barriers and my hope with this research fellowship is to find out where they are and how to remove them. Thanks to the funding I’ll be able to hold focus groups with patients and the nurses that care for them to learn about their experiences.

Layla Bolton "The fellowship has been a huge help as it allows me to gain the experience I’ll need for PhD funding, as well as enabling me to attend training courses that I wouldn’t have been able to afford"


The fellowship will also enable me to attend training courses to help me analyse statistics. I’ll be able to mine the data to see when patients were diagnosed, when they were referred to specialist care and when they actually got an appointment. From this, we’ll be able to see where anything goes wrong or falls through cracks in the system, and what part of the process is slowing things down.

If it's the hospital not giving them an appointment for a year, then we need to do something about the services. If we know it's GPs that aren’t referring patients, then we need to retrain GPs and set courses. If we find out that nurses can't refer them, we need to find ways to make this happen.

There’s a huge clinical need for this – by speeding up the process, we can spare patients from needless months of living with painful, isolating chronic wounds.

Freeing up nursing time

We can also help free up much-needed time and money for the health service. According to NHS Benchmarking, eight per cent of the entire district nursing workforce’s time is spent caring for venous leg ulcers. By ensuring patients are referred for treatment within two weeks, we can radically improve the service offered to other patients by freeing up time nurses might otherwise spend caring for these wounds.

My hope is that the data from my research will act as a springboard and help me study for a PhD in the same area, with venous leg ulcer patients and how the speed of care affects their quality of life. I’m hugely grateful to Imperial Health Charity. The fellowship has been a huge help as it allows me to gain the experience I’ll need for PhD funding, as well as enabling me to attend training courses that I wouldn’t have been able to afford.

The research fellowship programme makes you look fundable – now that someone’s given me a chance, so the next funding body might be more willing to do the same.

Have you got an idea for a research project? This year Imperial Health Charity is celebrating the 10th anniversary of its Research Fellowships programme and there has never been a better time to start your research journey. Applications are now open for the 2020/21 programme, which will be funded jointly by Imperial Health Charity and the NIHR Imperial Biomedical Research Centre. The deadline for applications is 12pm on 17 January 2019. To find out more about the programme, visit Imperial Health Charity’s website.