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Reflections on research

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‘It’s an ethical minefield’

When is a study research and when is it service evaluation? You could be forgiven for confusing the two, and that’s before I throw audit into the conundrum as well.

Only projects categorised as research require NHS ethics approval. With the occasional peek at guidance that attempts to define all three activities, available from the National Research Ethics Service (www.nres.npsa.nhs.uk), I can generally make a correct judgement as to when a study of mine requires NHS ethics approval.

But I have not always been right and if I, as an established researcher, can have a view different from an ethics committee, then what hope does a
novice or developing researcher have?

An average NHS ethics application would normally take me a day, having navigated several applications in recent years. Other more complex studies have taken more than twice as long.

So why did I spend a day and a half recently, seeking ethics approval for a study clearly defined as research by the originating funder – which, incidentally, was the Department of Health – only to be told by the ethics committee that I needn’t have bothered as it was clearly service evaluation?

Having learnt a hard lesson, my latest study is kindly being checked out by an ethics committee chairperson before I even download the application form, as I myself believe it to be service evaluation. This same study is funded as research and I am badging it as research, not least for the benefit of my CV.

I will eat my hat if the ethics committee says it is research and I need to do a full application. At least I am genuinely trying not to waste people’s time – mine and theirs – by providing a lengthy application form to be critiqued by eight or so members on some committees.

Other less scrupulous researchers will try to pass off their work as service evaluation when they truly believe it to be research. In these cases, ethics committees can do a valuable job in not letting them get away with it. In my experience, such studies are the ones with dodgy practices such as providing misinformation or the playing down of risk to participants.

The key issue here is that there is a grey area. The poor researcher is at the mercy of the individual personalities within the ethics committee membership. Having attended several ethics meetings, I have realised that opinions of what constitutes research vary from member to member.

The outcome of your application therefore may depend on which committee you apply to, who is there on the day you attend (if invited) and the views and influence of the chairperson. My advice is to choose your committee wisely and, if in doubt, check it out.

Tracey Williamson, research fellow, older people/user involvement, Salford Centre for Nursing, Midwifery and Collaborative Research, University of Salford

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