Developing and evaluating a co-designed complex intervention to support multidisciplinary decision-making and patient-centred care in gestational breast cancer (gBC)

Gestional breast cancer (gBC), defined as breast cancer diagnosed during pregnancy, presents a rare and highly complex clinical challenge.1 Women and clinicians must make time-critical treatment decisions under uncertainty, balancing maternal and foetal outcomes across multiple specialties.1-3 Although clinical guidelines exist,1applying them consistently in practice is difficult, and many women report limited support in understanding options and expressing what matters most to them. 3-4 Working with leaders in gBC research, this PhD will develop and evaluate a co-designed intervention to improve multidisciplinary team (MDT) decision-making and patient-centred care in gBC. The project will integrate analysis of real-world care pathways, evidence synthesis, and qualitative research with women and clinicians to identify gaps in decision-making and care coordination. These insights will inform the co-design of a novel intervention comprising two components: (1) an MDT decision-support toolkit and (2) a patient-facing values-clarification and decision-support tool. Working closely with NHS partners, clinical experts, and the national charity Mummy’s Star, the postgraduate researcher will use co-design and user experience methods to develop a prototype, followed by evaluation of its acceptability and usability in NHS settings. This interdisciplinary PhD offers training in co-design, qualitative and mixed-methods research, implementation science, and digital health development. The project has strong potential to improve care quality and patient experience in gBC, with wider relevance to other complex, multidisciplinary conditions.

1. Armstrong A, Gandhi A, et al Royal College of Obstetricians and Gynaecologists. Pregnancy and Breast Cancer: Green‐top Guideline No. 12. BJOG: An International Journal of Obstetrics & Gynaecology. 2025 Nov;132(12):e194-228.

2. Baxter MA, et al Harris J. CAnceR IN PreGnancy (CARING)–a retrospective study of cancer diagnosed during pregnancy in the United Kingdom. British Journal of Cancer. 2024 May 3;130(8):1261-8.

15 |3. Harris J et al. Cancer diagnosed during pregnancy: a qualitative study of women’s psychosocial experiences during treatment and survivorship. Supportive Care in Cancer, 2026

4. Harris J et al. What do we know about the psychosocial issues associated with cancer during pregnancy? A scoping review and gap analysis. BMJ open. 2023 Mar 1;13(3):e063283.

Open to UK nationals only.

This PhD will involve the co-design and development of prototype digital tools to support cancer care and complex healthcare decision-making. We are therefore seeking a motivated candidate with experience in either quantitative or qualitative research methods, and ideally some experience of both. Experience in the development, evaluation, or implementation of digital tools would be beneficial, but is not essential.

Applicants with expertise in one methodological area will be considered, provided they are willing to develop skills in the other. Internal and external training opportunities will be available to support the student’s development in areas such as data science, behavioural science, implementation science, digital health, and mixed-methods research.

Applicants from health sciences, including nursing and midwifery, psychology, medicine, digital health, health informatics, or related disciplines are encouraged to apply. We particularly welcome applicants with an interest in interdisciplinary cancer research, patient-centred care, digital innovation, and improving decision-making within complex healthcare settings.

Ideally, applicants should hold a first-class or upper second-class undergraduate degree in a health sciences or related subject, and a postgraduate degree in a relevant discipline. Applicants with equivalent research or professional experience will also be considered.

The successful candidate will work as part of an interdisciplinary team of researchers, clinicians, patients, and other stakeholders. Excellent communication, organisational, and project management skills will therefore be important. The candidate should also be self-motivated, collaborative, and committed to delivering high-quality research.

Promoting equality, diversity, and inclusion is at the heart of the University of Surrey. We welcome applicants from all backgrounds and actively encourage applications from people with diverse career paths, regardless of age, disability, ethnicity, gender, sexual orientation, or other protected characteristics.