PhD title: Mixed Methods Study of Depression Research Clinics as a means of addressing the primary-secondary care gap in NHS service provision.

PhD title: Mixed Methods Study of Depression Research Clinics as a means of addressing the primary-secondary care gap in NHS service provision. 

Principal supervisors:   

Dr Neil Nixon (School of Medicine) – neil.nixon@nottingham.ac.uk  

Funded by the Mental Health Mission, Office for Life Sciences/NIHR, as a single PhD Studentship Award, we have a fully funded (stipend at UKRI rates, PhD fees (for UK nationals only) and research costs) three-year full-time PhD available to start on the 1st October 2025.

The overall theme of this PhD programme is improving clinical assessment and research access for patients falling between primary and secondary NHS care. The successful candidate will join the research community at the Institute of Mental Health (IMH), Nottingham; and the multi-disciplinary team working as part of the Mental Health Mission. 

Programme description: There is a well-acknowledged care gap for patients suffering clinical depression, who find themselves beyond the expertise of primary care clinicians but not yet ‘at threshold’ for secondary care. Despite this, the UK has no settled service structure to address this gap, with the consequence that alternate diagnoses are missed and genuine clinical depression is under-treated, likely resulting in more persistent mental health problems and higher overall costs (e.g. through repeat GP attendance). Related to this, there is a barrier to research access for patients in primary care who are otherwise eligible for clinical trials led by specialist, secondary care clinical academics with access to the necessary clinical research facilities. Using funding from a national initiative called the Mental Health Mission (MHM), aimed at increasing UK research capacity in mental health, we aim to assess these gaps in clinical assessment and research access; with the aim of enhancing both. The PhD will assess new research clinics set up at the juncture between primary-secondary care within Nottinghamshire, reporting findings both within the national MHM mood disorders network and through peer reviewed publications.

PhD description: Based at the IMH, Nottingham, this PhD will be a jointly supervised mixed-methods project, initially assessing what service key stakeholders (including commissioners, patients, clinicians) would like to see in the current treatment gap; followed by an assessment of the new research clinics that explicitly includes these stakeholder-derived criteria. A scoping review, alongside initial semi-structured interviews and focus group transcripts subjected to thematic analysis, will build a picture of what key stakeholders want. Clinic outcomes will then be assessed through metrics coming from this initial analysis, to assess how far they have successfully addressed the problem. The new clinics run by specialist secondary care clinicians will have a phased opening through late 2025, offering both clinical advice and access to research for people referred by their GPs with Difficult to Treat Depression (DTD; defined as a significant ongoing burden despite usual treatment). They will start within primary care sites in two geographical locations of Nottinghamshire (mid-Notts and Aspley), where the local population has been considered underserved, through lack of financial means and confidence to attend more central locations. Additional sites will be offered through 2026-2027, including at the team base of the Nottingham Specialist Depression Service (NSDS) and South Nottingham. Current MHM funding for the clinics runs to January 31st 2028, which falls within the timeframe of the PhD and will allow full analysis of impact. Given the nature and profile of the PhD, within the MHM, there is scope to publish and potentially influence future practice. The successful applicant will need to be able to relate to a wide range of stakeholders, including those in local clinical settings, national meetings of the MHM; and to have interests across both qualitative and quantitative approaches to healthcare analysis.

Further information: Applicants should have either a minimum 2.1 undergraduate degree in a relevant area (including healthcare, biomedical science, health economics, or other related field); or a minimum 2.2 undergraduate degree with a Masters degree (or expected to gain a Masters within 6 months). The ideal candidate will also have experience of working with healthcare professionals, patients with mental health conditions; and research methods including quantitative, qualitative and health economic approaches.

Informal enquiries may be addressed to the Nottingham MHM programme lead for mood disorders and lead supervisor of this PhD: Dr Neil Nixon, Clinical Associate Professor in Psychiatry, University of Nottingham, neil.nixon@nottingham.ac.uk

To apply, candidates should send their CV and a short cover letter (<1000 words) outlining why they are applying to be part of this PhD programme and what they believe they can offer to: neil.nixon@nottingham.ac.uk. The email subject line should be: “MHM PHD APPLICATION”. Candidates should also provide the contact details for 2 referees, one of whom should be their most recent academic supervisor (or line manager in relevant employment, if applicable). Please note, offers of study will be subject to 2 satisfactory references being received. 

Closing Date for Applications: Monday 2nd June 2025, 5pm (UK time).

Provisional Interview Date: Monday 16th June 2025.

If you will not be able to attend an interview at the University of Nottingham on this date, please make this known when you email your application to Dr Neil Nixon so alternative arrangements can be considered if possible. 

PhD Start Date: 1st October 2025, or as soon as possible thereafter. 

Closing Date: 02 Jun 2025 Category: Studentships