When COVID-19 first emerged, I was working as an anaesthetist and intensive care doctor in one of the busiest environments imaginable. We were bracing for the worst: ventilators, oxygen, PPE, and even staff could run out. The sense of impending doom was overwhelming. Then, the RECOVERY trial arrived, offering a beacon of hope. I was convinced it was our only hope at improving outcomes for our sickest patients, so I took on the role of local principal investigator at Buckinghamshire Healthcare NHS Trust.
A unique intensive care (ICU) perspective
As an ICU doctor, I was face-to-face with the most critical COVID-19 cases. Seeing patients struggle for every breath propelled me to do more. When I heard about the RECOVERY trial, a national effort to identify effective COVID-19 treatments in hospitalised patients, I immediately signed up our hospital. My frontline vantage point helped our staff see that this was not an 'extra task' but a vital extension of our patient care.
Building an army in a small district general hospital
In the beginning, it was just me and a single research nurse. We were a team in a district general hospital facing enormous challenges. With COVID-19 cases rising sharply, it felt like we were barely keeping our heads above water. I realised I needed a 'research army' to make RECOVERY a success. This meant rallying people from all corners of the hospital. We started small, but through relentless communication and support, we grew into a robust team, each person playing a crucial role in patient recruitment and trial logistics.
Dr Raha West in PPE
Lightning-fast setup
The trial itself was incredibly straightforward to launch. We registered our interest and recruited our first patient in under a week, unheard of before the pandemic. Then, on the Saturday of the first Easter bank holiday in 2020, I personally ran small group training sessions during the hospital’s morning handovers (where the largest gathering of doctors took place). That day, I spent 12 non-stop hours guiding colleagues through the process, and we enrolled 20 patients. By the second week, we had already surpassed 70 participants. This rapid success stemmed from a simple trial design, good planning, and our new 'army' of staff who felt empowered to be part of something that could genuinely save lives.
Multidisciplinary collaboration
A team-based approach was essential for sustaining momentum. I spoke to matrons, nurses, pharmacists, doctors, and even the Trust CEO; anyone who could help. We created quick-reference guides, posters, and intranet updates so everyone knew how to screen and enrol eligible patients. To keep spirits high, I handed out 'Recruiter of the Week' and 'Significant Contributor' certificates and used small gestures like thank you cards and chocolate biscuits to show appreciation.
Even when I caught COVID-19 myself, I kept encouraging my team. I’d guide them through consent forms and randomise patients over the phone between coughing fits. It was exhausting, I was unwell, but every new participant got us closer to finding an effective treatment.
Patient and public engagement
Most patients were eager to join the trial despite being seriously ill and isolated. We maintained a 90% consent rate, an incredible show of solidarity in a frightening time.
Beyond the hospital, I spoke publicly about the RECOVERY trial at every opportunity, from local media interviews to a national NIHR webinar. I even participated in discussions with former patients that were broadcast online. By sharing genuine stories and answering real questions, I helped the public understand the importance of clinical research, which motivated more people to take part.
Game-changing results
Before long, the trial produced a landmark discovery: dexamethasone significantly reduces deaths in hospitalised COVID-19 patients. I found out just days after my birthday and remember crying tears of relief. It felt surreal to go from the chaos of the ICU to helping announce a lifesaving breakthrough on the BBC. Equally important, the trial also clarified which treatments did not help, sparing patients from ineffective therapies.
Sustaining momentum through challenges
Over time, staff rotations changed, and fatigue set in, making it harder to keep everyone engaged. I introduced a quality improvement initiative to review and refine our recruitment strategies and joined the NIHR Associate Principal Investigator scheme. We infused new energy into the team by mentoring junior doctors and medical students to recruit and consent patients.
Recognised for driving success
My unique perspective as an ICU clinician and local lead for a small district general hospital helped drive RECOVERY’s success in Buckinghamshire. By embracing the 'research army' mindset and reaching out through media and webinars, we showcased how rapidly collective effort can transform patient outcomes. I was honoured to receive recognition from our CEO and an NIHR Clinical Research Network award. Still, the greatest reward was knowing that our hospital’s determination contributed to a global solution.
Lasting impact
The simplicity of the RECOVERY trial and its collaborative structure proved that embedding research into routine clinical care can quickly answer critical questions.
Enthusiasm, robust communication, and genuine team support were vital to our success, even under crisis conditions.
Being an intensive care doctor and local Principal Investigator for this historic study has been one of the greatest honours of my career.
Dr West is currently finalising her PhD in perioperative lidocaine and colorectal cancer following the completion of her clinical trial work. She now provides intensive care services at a healthcare facility in London.