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Eleanor Atkins

Eleanor Atkins

Cambridge University Hospitals NHS Foundation Trust
 

How did the CF grant enable your research?

The CF grant enabled me to do my research by supporting my salary for two years. This meant I was able to take time out of training to carry out my research full time. This was such a luxury - able to have the time to sit and work on my projects for weeks and months at a time rather than squeezing in occasional hours around a busy vascular registrar on call rota. It enabled me to dive deep into quality research, choosing methods that were designed to get the best results for the research question, rather than those prioritising time-efficiency. 

 

How did the funding positively impact knowledge and provision of care?

I looked into how patients with chronic limb-threatening ischaemia (CLTI) get from their first symptom in the community to vascular surgery assessment. I looked at what guidance is available for community clinicians, finding many ways in which it can be improved. I mapped pathways in different vascular networks across the country, finding inequalities in how people with suspected CLTI are treated based on their diabetic status, geographical location within networks and frailty, as well as identifying areas of excellence. I talked to vascular clinicians, primary care clinicians and patients about their experiences of CLTI, generating themes related to factors affecting CLTI care. As part of my thesis, I have developed local and national quality improvement priorities, which will be disseminated at national conferences and in journals. 

 

Publications resulting from research supported by the Circulation Foundation

Please see publications below, including other publications I worked on during time supported by the Circulation Foundation:

  • Atkins E, Birmpili P, Kellar I, Johal AS, Li Q, Waton S, Boyle JR, Pherwani AD, Chetter I, Cromwell DA. Understanding delays in chronic limb-threatening ischaemia care: Application of the theoretical domains framework to identify factors affecting primary care clinicians' referral behaviours. J Foot Ankle Res. 2024 Jun;17(2):e12015. doi: 10.1002/jfa2.12015.
  • Atkins E, Kellar I, Birmpili P, Waton S, Li Q, Johal AS, Boyle JR, Pherwani AD, Chetter I, Cromwell DA. The symptom to assessment pathway for suspected chronic limb-threatening ischaemia (CLTI) affects quality of care: a process mapping exercise. BMJ Open Qual. 2024 Jan 24;13(1):e002605. doi: 10.1136/bmjoq-2023-002605.
  • Atkins, E, Kellar, I, Birmpili, P, Boyle JR, Pherwani AD, Chetter I, Cromwell DA. Hospital clinicians’ perceptions and experiences of care pathways for chronic limb-threatening ischaemia: a qualitative study. J Foot Ankle Res 16, 62 (2023). https://doi.org/10.1186/s13047-023-00664-6
  • Speirs TP, Atkins E, Chowdhury MM, Hildebrand DR, Boyle JR. Adherence to vascular care guidelines for emergency revascularisation of chronic limb-threatening ischaemia. Journal of Vascular Surgery Cases, Innovations and Techniques, 2023 Aug 25 https://doi.org/10.1016/j.jvscit.2023.101299.
  • Atkins E, Milner R, Delaney CL; Global Registry for Endovascular Aortic Treatment (GREAT) Participants. Raised BMI is associated with fewer Type I endoleaks in patients treated with the Gore Excluder device: data from the Global Registry for Endovascular Aortic Treatment (GREAT). J Cardiovasc Surg 2023 Jul 17. DOI: 10.23736/S0021-9509.23.12572-9
  • Singh AA, Atkins ER, Boyle JR. Evaluating quality in surgery. Surgery (Oxford) https://doi.org/10.1016/j.mpsur.2023.05.011 Epub 2023 June 10
  • Birmpili P, Cromwell DA, Li Q, Johal AS, Atkins E, Waton S, Pherwani AD, Williams R, Richards T, Nandhra S. The Impact of Pre-Operative Anaemia on One Year Amputation Free Survival and Re-Admissions in Patients Undergoing Vascular Surgery for Peripheral Arterial Disease: a National Vascular Registry Study. European Journal of Vascular and Endovascular Surgery https://doi.org/10.1016/j.ejvs.2023.05.003 Epub 2023 May 9
  • Birmpili P, Li Q, Johal AS, Atkins E, Waton S, Chetter I, Boyle JR, Pherwani AD, Cromwell DA. Outcomes after minor lower limb amputation for peripheral arterial disease and diabetes: population based cohort study. British Journal of Surgery. https://doi.org/10.1093/bjs/znad134. Epub 2023 May 22
  • Atkins E, Birmpili P, Glidewell L, Li Q, Johal AS, Waton S, Boyle JR, Pherwani AD, Chetter I, Cromwell DA. Effectiveness of quality improvement collaboratives in UK surgical settings and barriers and facilitators influencing their implementation: a systematic review and evidence synthesis. BMJ Open Qual. 2023 Apr;12(2):e002241. doi: 10.1136/bmjoq-2022-002241. PMID: 37037588;
  • Birmpili P, Li Q, Johal AS, Waton S, Atkins E, Boyle JR, Chetter I, Williams R, Pherwani AD, Cromwell DA. Outcomes of Surgery for Patients with Peripheral Arterial Disease During the COVID-19 Pandemic in the United Kingdom: A Population Based Study, European Journal of Vascular & Endovascular Surgery, https://doi.org/10.1016/j.ejvs.2023.02.002
  • Birmpili P, Atkins E, Li Q, Johal AS, Waton S, Williams R, Pherwani AD, Cromwell DA. Evaluation of the ICD-10 system in coding revascularisation procedures in patients with peripheral arterial disease in England: A retrospective cohort study using national administrative and clinical databases. EClinicalMedicine. 2022 Nov 12 ;55:101738. doi: 10.1016/j.eclinm.2022.101738. PMID: 36386037
  • VERN COVER study collaborative; Benson RA. Documenting the Recovery of Vascular Services in European Centres Following the Initial COVID-19 Pandemic Peak: Results from a Multicentre Collaborative Study. EJVES Vasc Forum. 2022;57:28-34. doi: 10.1016/j.ejvsvf.2022.10.002. Epub 2022 Oct 20. PMID: 36281225; PMCID: PMC9581639.
  • Atkins E, Birmpili P, Pherwani AD, Mani K, Boyle JR. Quality Improvement in Vascular Surgery. European Journal of Vascular and Endovascular Surgery. Published online: March 29, 2022. Volume 63, Issue 6, 787 – 788 https://doi.org/10.1016/j.ejvs.2022.03.013
  • Atkins E, Stather P, Burrows M, Singh A, Medagoda A, Ezzarghani A, Al-Jundi W, Mughal NA. Outcomes of vascular interventions for chronic limb-threatening ischaemia in nonagenarians Epub May 3rd 2022  J.Vasc.Soc.G.B.Irel. 2022;1(3):65-70 http://doi.org/10.54522/jvsgbi.2022.021
  • Birmpili P, Atkins E, Boyle JR, Sayers RD, Blacker K, Williams R, Pherwani AD. The Vascular PAD-QIF CQUIN: what is it, why is it important, what does it mean for vascular units? 29 March 2022 J.Vasc.Soc.G.B.Irel. 2022; Online ahead of publication. http://doi.org/10.54522/jvsgbi.2022.018
  • Boyle JR, Atkins ER, Birmpili P, Pherwani AD, Brooks MJ, Biram RWS, Gohil K, Williams R, Mouton R. A Best Practice Care Pathway for Peripheral Arterial Disease. J.Vasc.Soc.G.B.Irel. 2022;1(Supp3):S1– S13. http://doi.org/10.54522/jvsgbi.2022.017

 

How did the research award assist your personal career and have you continued to be involved in vascular research?

The research supported by the Circulation Foundation has been incredibly impactful in my personal career. I have been invited to give presentations at several national conferences. My work has taken me across the country, increasing my visibility as a member of the vascular community. I now consider myself a qualitative researcher, and I have contributed to NIHR grant applications as well as many journals as a reviewer. My strong publication and presentation record has contributed to me being awarded a prestigious BSET Endovascular Training Fellowship which I will undertake in 2025.