Sam Browne is an advanced practitioner physiotherapist at the Royal Victoria Infirmary where he specialises in musculoskeletal conditions and in particular those causing chronic and persistent pain.
Sam’s specific area of research interest is pain management and in particular how through evidence-based education health care professionals can support patients to self manage and improve their experience of pain with a specific focus on access for minority and disadvantaged groups.
Sam explains: “Pain Science Education (PSE) is a core component of contemporary pain management. It aims to improve an individual’s pain-related health literacy – their understanding of their condition and perception of the pain they are experiencing – and robust evidence has demonstrated that PSE can improve a person’s experience of pain.
“However, little is known about the patient experience and effectiveness of PSE within minority and disadvantaged groups, and/or when it is delivered via an interpreter.
“This is important as persistent pain appears to disproportionately affect those from disadvantaged backgrounds, and some ethnic minority groups as shown in a recently published Versus Arthritis report entitled “Unseen, Unequal, and Unfair: Chronic Pain in England”.
“Poor pain literacy within these groups may be widening the inequalities gap. Further work is needed to better understand this, and quantitative, qualitative, or mixed methods approaches might be employed to do so.”
One third of people in England affected by chronic pain
The Versus Arthritis report highlighted that chronic pain (defined as pain which has lasted more than 12 weeks despite treatment or medication) affects around 15.5 million people – a third of the population in England.
Furthermore 5.5 million people (12% of the population in England) have high-impact chronic pain, the most disabling form which means a person struggles to take part in daily activities.
It reported that the impact of chronic pain is unequally felt across different groups in society. People with chronic pain were more likely to live in deprived areas and more likely to be from some minority ethnic groups, if they were women, or if they were older.
“Health inequalities and musculoskeletal pain intersect between my academic interest in pain, my clinical work in musculoskeletal pain management, as well as my personal ethics. I feel a moral obligation to contribute to the research in this field to improve patient care for disadvantaged groups.”
NIHR PCAF Award
Sam was successfully awarded a NIHR Pre-doctoral Clinical Practitioner Fellowship (PCAF) and is now in his second year.
Ewan Dick, Associate Director of Allied Health Professionals and Therapy Services said: “Sam and the rest of the team play an important role in supporting patients with musculoskeletal conditions with the impact of chronic and persistent pain. However we know that some patients are less able to benefit from the support, education and interventions and widening the health inequalities that some people in our community experience.
“Sam is hugely passionate about this topic and his research will, for the first time explore some of these patients experiences, helping to understand how we might better provide information and advice to improve their care and experience.
“There is so much we can learn from this work and it is vital that we can understand and proactively tackle the barriers that prevent some people in our community from accessing and benefiting from the support that can enable them to reduce the impact of chronic pain.”
Increasing research impact whilst strengthening academic links
The highly competitive and prestigious fellowship was awarded by the National Institute of Health and Care Research and is funded by NHS England – (formerly Health Education England (HEE) through the Integrated Clinical Academic (ICA) Training Scheme.
The fellowship is being hosted by the Newcastle upon Tyne Hospitals NHS Foundation Trust working in close partnership with Teesside University.
Sam’s research journey
Sam qualified as a physiotherapist in 2013 and has always been drawn to research as a way of improving outcomes in clinical practice.
Sam explains “In my first post, as a Junior Rotational Physiotherapist at Lincoln County Hospital, I created and led a bi-weekly journal club to analyse and discuss research papers to improve clinical practice in the physiotherapy department.
“Later, in my role as a senior physiotherapist at Rotherham Hospital NHS Foundation Trust, I provided in-service training. This included a literature review and then presentations on various topics such as pain science education and on clinical diagnoses like tennis elbow.
“As part of my senior role, I conducted a service evaluation project measuring the effectiveness of an exercise and education group for patients with persistent back pain. From this, I made recommendations for service improvements based on the data collected and patient feedback.”
For me, being awarded the NIHR ICA Internship represented a step-change in the direction of my career, and it opened many doors for me to be able to participate in the research world.Sam Browne, Advanced Practitioner Physiotherapist
Now, as an Advanced Practitioner Physiotherapist at Newcastle Hospitals Sam has helped to evaluate clinical services and write clinical practice guidelines to guide colleagues.
In 2019-2020, he completed the NIHR ICA Internship and led a service improvement project on referral guidelines for a musculoskeletal pain management service. The approach he used was based on a qualitative Delphi approach. This has since been written as a journal article and published in a peer-reviewed journal called “Pain and Rehabilitation”.
Sam sees these achievements as the turning point in his research career. He says “For me, being awarded the NIHR ICA Internship represented a step-change in the direction of my career, and it opened many doors for me to be able to participate in the research world.
“Most important, was meeting and working with my current supervisor Professor Cormac Ryan, a Professor of Clinical Rehabilitation at Teesside University whose research interests primarily focus on pain science education as a treatment for people with persistent pain.”
Of Sam’s research work Professor Ryan says: “Sam is doing exciting work in the field of Pain education to improve the service provided to non-English speaking patients. This is vital work to maximise access and ensure that good pain management is available for all.”
Following his internship, Sam applied for a small research grant through the Physiotherapy Pain Association to explore the experiences of physiotherapists delivering pain science education via an interpreter to patients with limited English proficiency.
“This study is ongoing and I am collecting data from this,” continues Sam. “I am also involved in an ongoing scoping review on the inclusion of ethnic minorities in Pain Science Education studies and my PCAF training includes various post-graduate modules about research, Pain and Culture, and Health Inequalities.
“In addition to this, the PCAF has allowed me to become involved in various projects and groups with an interest in Pain Science Education. I am aiming to submit my PhD proposal next year.”
Sam’s research is supported by a wide range of Trust-led, regional and national collaborations, intrinsic to ensuring he can meet the objectives of his Fellowship.
“I am delighted to have been awarded my NIHR PCAF,” says Sam. “My current focus is the completion of my training plan in association with this, with the view to develop a competitive Doctoral application for the NIHR DCAF scheme by the end of 2024.”
He continues: “The Trust has supported me in the pursuit of my ambitions to craft a clinical academic career. Specifically, my clinical academic mentor Dr Linda Tinkler has been instrumental to my development as a clinical academic thanks to her invaluable insight into the clinical academic working, her support in developing my applications, and her guidance in navigating the overall world of research.
“For example I have made connections with the research design service as well as the overarching NIHR Applied Research Collaboration Northeast and North Cumbria (NIHR ARC NENC) contributing to the key research theme of health inequalities and marginalised communities.”
“I have taken part in the 4Ps programme designed by Newcastle’s NMAHPs research team to help researchers develop their skills across four different areas – person, place, plan, and project – which has helped develop me as a researcher.
“Additionally, my line manager, Karen Storey has been endlessly supportive and flexible in accommodating my research hours alongside clinical practice, helping me to develop my clinical academic career.
“Through my NIHR internship and PCAF I have been able to develop relationships at local universities, as well as national academic institutions. I would like to thank my fantastic supervisors, Professor Cormac Ryan from Teesside University, and Professor Pat Schofield at Plymouth University for their endless positivity, patience, and encouragement.”
Professor Schofield said: “Sam is a pleasure to work with, he is so motivated and enthusiastic and his topic is really interesting and much needed to the world of pain for those who do not have the English language skills and yet are so much part of our multicultural society.”
Fostering innovative clinical academic careers
A key priority for our NMAHPs Strategy is to increase research opportunities and impact whilst strengthening our academic links.
We do this in Newcastle by fostering innovative clinical academic careers and attracting external funding and national fellowships through our unique mentorship approach and collaborative working.
Pre-doctoral Clinical and Practitioner Academic Fellowship (PCAF)
The PCAF scheme supports nurses, midwives and allied health professionals (NMAHPs) wishing to develop a career combining research with clinical practice.
PCAF provides salaried time and funding for personalised programmes of academic training that help awardees to acquire the skills and experience needed to submit a competitive application for doctoral level research training enabling research ideas to become ‘real live’ research projects.
You can find out more about PCAF and other NIHR Integrated Clinical and Practitioner Academic Programmes on the NIHR website
and also by contacting the Newcastle Hospital’s NMAHP Research team.