Linda Cantwell is an advanced practitioner dietitian at Mersey Care NHS Foundation Trust. In January 2025 Linda started an NIHR Doctoral Clinical Academic Fellowship to research nutritional prehabilitation intervention in head and neck cancer patients. In this article, Linda shares her career journey and gives some advice to other clinical health professionals who may be interested in pursuing research.
The start of my career
I’ve always been passionate about biology, so it was no surprise when I specialised in physiology during my Science undergraduate degree in Dublin.
Back then, I didn’t want to go into research because I thought it was mostly lab based. Yet looking back, I realise that I was always drawn to research activities that involved engaging with people. In fact, after my undergraduate degree, I did some voluntary research assistant work.
In 2012, I completed a master’s in dietetics in Edinburgh which led to my first community dietetic job in Liverpool, where I’ve been and advanced my career ever since.
I was very lucky in 2014 when my manager applied for funding to support the development of an Advanced Clinical Practitioner within our home enteral feeding team. I was successful and completed the master’s in Advanced Practice at the University of Chester. This increased my clinical, research and leaderships skills significantly. I gained extended skills in enteral feeding and tube care, undertook research in blended diets and joined the Parenteral Enteral Nutrition Group (PENG) specialist group of the British Dietetic Association.
I think the more you grow, you find out what you want to do and how you want to make a difference in terms of your career.
Going through the master’s programme as a mature student, I felt I had more life experiences which allowed me to better connect with patients and professionals, and I had more of an idea of where I wanted my career to go.
Growing interest in research
From 2016 onwards, I worked as an advanced practitioner in home enteral feeding and specialised my role within head and neck cancer. After a few years, I wanted to develop the research pillar of my advanced practice further as I felt there were things that we could be doing to improve the outcomes and experiences for those patients.
Yet I always thought that if I wanted to do something as big as a PhD, I would have to give up my clinical role.
In 2019, I saw in one of the Trust’s newsletters, the opportunity for the Early Career Researcher Development Pathway come up through NHS Research & Development (R&D) North West. That’s when I became aware of the career trajectory of Clinical Academics, who combine their clinical career with a research career.
I realised that research didn’t have to only be in a lab, and importantly I didn’t need to leave my clinical practice to pursue it.
I was successful in my application and found a mentor to support me. My five-year plan was to apply for a Doctoral Clinical and Practitioner Academic Fellowship (DCAF).
The DCAF provides the opportunity to develop you as a clinical academic and research leader of the future, someone who can lead large research projects and support others in that endeavour.
The application is quite a significant feat and to be successful in your application you must show commitment to clinical academic research and have a robust research and training plan.
To prepare for this, I did a Pre-doctoral Clinical and Practitioner Academic Fellowship (PCAF). This backfilled me for two days a week so I could complete a comprehensive systematic review to identify the evidence gap for my research.
As the DCAF application is so competitive, I applied for several funds, including the Applied Research Collaboration North West Coast internship, to allow me to complete more research training, increase my skills and develop a robust research plan.
It took five years for me to complete a successful DCAF application and throughout this process I was still working clinically.
I believe that people who work in clinical practice are the key to effective and meaningful research, because they understand the complexities of introducing interventions within a patient specific context.
Nutritional prehabilitation for head and neck cancer patients
I started my DCAF in January 2025. It aims to develop, implement and investigate the feasibility of a co-produced nutritional prehabilitation in head and neck cancer intervention for patients treated with radiotherapy and or chemotherapy.
On diagnosis, up to 60% of patients with head and neck cancer are at risk of malnutrition. This is due to the location of the tumour which can affect eating and drinking, but head and neck cancer is also highly associated with deprivation, and so people may already be malnourished and vulnerable when they come to us. Treatment can then make someone’s already malnourished state worse, reducing their quality of life.
Prehabilitation involves optimising people nutritionally, physically, and emotionally, before their treatment.
The purpose of the research is to create a nutritional prehabilitation intervention with patients, carers and health professionals. We will design it with patients from a range of backgrounds to ensure it works for everyone.
My advice to anyone interested in clinical academic research
If you’re at the beginning of your research journey, I recommend that you find a mentor to help you navigate this complex world. Look for someone with a PhD who has similar research or clinical interests to yourself.
I know it can be daunting to approach someone that is more experienced in the field than you, but people love talking about what they are passionate about and they will be eager to help the next generation of researchers.
I also advise that you look for research opportunities in your area. NHS R&D North West and the NIHR Applied Research Collaboration (ARC) both support early career researchers. I wouldn't have gotten where I am today without their programmes.
There is a great working relationship between Mersey Care and the University of Liverpool to drive research forward and encourage clinical staff to get involved. So, now is a great time to utilise those networks and pursue research.
I’m speaking at the next Mersey Care AHP forum on the 25th February if you would like to find out more about the research journey. You can book your place in the prospectus or contact me on linda
