Research fellowships are brilliant in principle; they give talented people the time, space, and support to pursue research ideas that genuinely matter. But in practice? Crossing the boundaries between universities and the NHS often exposes every structural gap, administrative quirk, and cultural difference in the system.
So, I wanted to highlight some of the common challenges faced by research fellows and what we, as institutions, teams, and leaders could do to make the fellowship experience a smoother, more rewarding journey.
1. The Fellowship Application: One Researcher, Two Systems
Applying for a fellowship is already a demanding process, but when it spans both university and NHS organisations the complexity often multiplies.
Researchers are often juggling:
- Two sets of HR processes
- Two finance systems
- Different definitions of “match funding”
- Diverging expectations around costing models
- Contracts that can take months to align
- Confusion about who “owns” the Fellow
And that’s just to get the application submitted.
A fellowship proposal that touches both worlds usually needs approval from multiple research offices, service managers, clinical directors, academic supervisors, and let’s not forget someone who understands research finance well enough to interpret the mysterious funding rules that often seem to contradict each other.
For early-career clinical fellows, this can feel overwhelming and often means doing all of this on top of clinical duties, which is hardly conducive to thoughtful, high‑quality proposal writing.
2. Employment Contracts: Where Am I Actually Employed?
Once the award is secured, the next challenge is navigating the employment arrangements.
Some researchers end up:
- Employed by the university but working clinically in the NHS
- Split across two contracts
- Holding an honorary role in one organisation and a substantive role in the other
- Being paid by one institution while accruing leave in another
- Navigating two sets of mandatory training and induction
- Navigating pension arrangements
Even simple questions like “Who signs my annual leave form?” become unexpectedly complicated. That said, and in fairness, our systems weren’t designed for shared ownership, so unfortunately our researchers feel the strain.
3. Balancing Clinical Work and Research Time: The Eternal Struggle
Nearly every research fellow will tell you the same thing: protecting research time is a battle. It’s not that colleagues don’t value research. It’s that NHS services are stretched, and the researcher’s time often becomes the “flexible” part of the rota.
Common issues include:
- Research days being absorbed by clinical pressures
- Feelings of guilt when stepping away from patient care
- Supervisors supportive in principle but inconsistent in practice
- Lack of a stable workspace
- Having to juggle two sets of expectations
We all know the NHS benefits enormously from research but research only thrives when time is protected.
4. Delivering the Research: Systems That Don’t Talk to Each Other
Once the project is up and running, new practical barriers tend to appear.
These often include:
- Two governance teams
- Two sets of monitoring requirements
- IT systems that don’t communicate
- Confusion over who provides statistical or methodological support
- Challenges accessing clinical systems
It’s therefore no surprise that some researchers feel they spend more time firefighting than researching.
5. How a Joint Research Office (JRO) Might Help Transform This Journey
For the avoidance of doubt, these are suggestions and by no means imply that our JRO has cracked this extremely challenging area. Although individually our organisations have created solutions to enable fellowships to be delivered.
In my head, a JRO sits at the interface of academic and NHS organisations and acts as the ‘connective tissue’ that holds the partnership’s joint research together. When it works well, it provides the solutions to remove friction, provide clarity, and give researchers the confidence that someone is walking this path with them and not just cheering from the sidelines.
Here’s how a JRO could improve both the initiation and delivery of fellowships:
A. Champion Clear, Joined‑Up Pathways
A JRO can work with its constituent organisations to create transparent, step‑by‑step fellowship pathways covering:
- When to speak to whom
- What templates to use
- How to cost the application
- Which approvals are needed at each stage
- Who signs off what
So that instead of navigating two bureaucracies, our research fellows follow one coherent route.
B. Integrated Support and Single‑Point Coordination
Rather than bouncing between university research offices, NHS R&D departments, HR departments, and finance teams, researchers have a process that:
- Is coordinated
- Reduces duplication
- Provides consistent advice
This alone would shave weeks (even months) off the initiation process.
C. Harmonised Employment and Contracting Support
Similarly, A JRO can:
- Enable employment arrangements
- Create joint offer letters or shared contract templates
- Generate consistent guidance to ensure supervisors and managers across organisations know their responsibilities
- Communicate expectations clearly to HR and payroll teams
The result? Less confusion, fewer delays, and a much smoother start for the fellow.
D. Streamlined Governance and Data Access
A JRO can support academic and NHS partners to:
- Develop joint governance templates
- Pre‑agree data sharing pathways
- Provide a single data access approval process
The result: fellows benefit from not having to figure all of this out from scratch.
6. So How Do We Fix All This?
The challenges aren’t inevitable. They’re structural. And because they’re structural, they can be solved structurally. In my opinion, a strong JRO is one of the most powerful solutions we have. But beyond that, we can also collectively:
- Build genuine partnerships between universities and NHS organisations
- Standardise processes for joint fellowships
- Put researchers at the centre, and not the systems
- Share learning openly
- Celebrate and invest in clinical academic career routes
Because when fellowships work well, everyone wins: researchers, teams, organisations, and most importantly, our research participants.
Final Thought
If we want more researchers to step into fellowships and we absolutely do, we need to make the process feel less like navigating a maze and more like being welcomed into a community. A fellowship should be challenging because the research is ambitious, not because the paperwork is. Isn’t that a worthy ambition for all?