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Owen Gustafson: Physiotherapy in research

Owen GustafsonOwen Gustafson, Clinical Academic Physiotherapist, Oxford University Hospitals NHS Foundation Trust

If you want to make a difference and improve patient care at scale, then the only way is through research.

That’s the view of clinical academic physiotherapist, Dr Owen Gustafson, who works in the Intensive Care Follow-up Clinic at the John Radcliffe Hospital in Oxford.

“As a clinician, you make a difference to the patients you see,” he says. “As a leader, you can have an impact on many more patients, by improving the quality of the service overall. But if you want to really ensure that all patients receive the best possible, evidence-led care – and in my case, that’s recovery from critical illness – then you need to do the research to support that.”

For Owen, the route from his first grant application to achieving his PhD in 2024 was a long one. He’d already been working as an intensive care physiotherapist for several years before getting the go ahead to run a rehabilitation class for patients who’d been recently discharged from the Intensive Care Unit (ICU).

He expected to hear about issues such as muscle weakness and shortness of breath. But to his surprise, a large number of patients seemed to be struggling with shoulder problems.

Intrigued, Owen wrote up his observations and they formed the basis of his first presentation to an academic conference, for the European Society of Intensive Care Medicine in 2012. The same year, he successfully applied for a small grant to run a single centre study to determine the prevalence of shoulder problems in former ICU patients.

“It was hard,” he recalls. “Although the grant supposedly bought out my time to do the research, that wasn’t the reality, so I did it on top of my day job. And I was doing a Masters’ in Research at the same time. I completed the study, but I didn’t really have the time – and, to be honest, back then, the skills – to write up the results for publication.”

Luckily, an opportunity arose for a year’s secondment at the Critical Care Research Group at the University of Oxford, working on a study led by Nurse Researcher, Dr Sarah Vollam. During that year, Owen was able to get the results from his own study published, drawing on the expertise of the research team around him.

The team also helped him to develop an application for a NIHR doctoral fellowship, which he submitted on his return to full-time clinical work, but unfortunately, he was not successful. Then the Covid-19 pandemic arrived, which pushed all other considerations to the side for a time – particularly for those working in intensive care.

Owen eventually found time to rework and resubmit his application and was awarded the NIHR doctoral fellowship in January 2021. It turned out to be a completely different experience to his first study nine years earlier.

“The fellowship bought out my time 100%, so I was able to continue with 20% of my clinical work and dedicate 80% of my time to research,” Owen says. “I was determined to make the most of that opportunity and do more than just my PhD with that time. So, I worked with colleagues at the Critical Care Research Group on funding applications for other studies, some of which were successful and are still ongoing.”

The fellowship also paid for Owen to spend two weeks in Melbourne, which has the biggest group of ICU rehabilitation researchers in the world. Owen has worked hard to build his research network over the years, working with colleagues not just across Oxford, but also in Coventry, Reading, Milton Keynes and Swindon for his PhD study.

Owen gained his PhD from Oxford Brookes University in 2024. He then won a NIHR Biomedical Research Centre post-doctoral award, which bought out 25% of his time to allow him to analyse the data and write journal publications from his research. He’s hopeful that collaborating on further studies with colleagues in the Critical Care Research Group will enable him to dedicate more of his time to research, but finds the post-doctoral landscape for NMAHPPS (Nurses, Midwives, Allied Health Professionals, Healthcare Scientists, Pharmacy Staff and Psychologists) quite challenging.

“There’s a well-established pathway for clinical academics who are doctors, but for NMAHPPS, it’s far less clear,” he explains. “The situation has improved so much since I was applying for that first grant, and the pre-doctoral support now is really good. But both healthcare trusts and higher education institutions need to adapt to make space for clinical academics who are not doctors, and help them find a career pathway in research. It’s a nationwide problem, though there is work ongoing in Oxford to try and address it.”

Despite the challenges, Owen is a strong advocate for the importance of NMAHPPS in research.

“When you count all of the healthcare professionals within NMAHPPS, that’s a huge proportion of the NHS workforce and a huge proportion of the delivery of care,” he points out. “That care delivery and those interventions need to be informed by evidence, and that evidence comes from research.  You need clinical academics to bridge that gap, to identify the problems that arise in clinical care that need to be looked into and to ensure that research questions are clinically relevant and applicable to clinicians on the ground.

“I firmly believe that clinical academic NMAHPPS play a vital role in improving patient care through research. Research isn’t for everyone and there are certainly easier jobs in the NHS. But I’m motivated by making things better for patients and for me, research is the way to do that.”