Category: Education

In with the new

Following a discussion involving the event’s steering committee and Mental Health Nurse Academics UK (MHNAUK), what was the International Network for Psychiatric Nursing Research Conference has now become the International Mental Health Nursing Research Conference. Next year we meet in Cardiff on September 14th and 15th, and early information can be found here. This site will be updated as further plans are made, so it’s worth checking in from time to time. We’ve also updated our conference twitter feed; clicking takes you there. Our hashtag, which is already in use, is #MHNR2017.

For a taster of the conference, here are links to four of last year’s keynote presentations: Steven Pryjmachuk, Elaine Hanzak, Luciana Berger MP and Bryn Lloyd-Evans:

Meanwhile, I’m pleased to have been elected as Vice Chair of MHNAUK. I’ll be working with the Chair, Steven Pryjmachuk, throughout 2017 and 2018 before becoming Chair at the start of 2019 for a further two years. I’m grateful for the opportunity colleagues have given me, and will do my best to lead and represent the group and the wider field. I anticipate having plenty to do, noting changes ahead in the education of nurses, the funding of students and the run-in to the next research excellence framework. More on all these to follow, I’m sure: with time today to draw attention to the decision by the Welsh Government to continue bursary payments in 2017-18 for eligible students of nursing, midwifery and the allied health professionals. As the press release announcing this makes clear, individuals taking this offer up will need to commit ‘in advance to taking up the opportunity to work in Wales, post qualification, for a period of two years’. Entirely unclear are funding arrangements for the period from 2018-19 onwards.

Playing our Part

A short post this morning to draw attention to Professor Tony Butterworth’s Playing our Part review, this being something which occupied me towards the start of last week. With the support of the Foundation of Nursing Studies Tony is conducting a review of mental health nursing, by mental health nurses. I made the trip to the (very plush) King’s Fund headquarters in London’s Cavendish Square on Monday, where FoNs is currently in residence, to join an educators’ group discussing responses to a series of questions Tony had set for us in advance. The questions were of a type always easier to ask than to answer (‘how do you prepare students to uniquely become mental health nurses?’, and ‘do you think that students should be exposed to some form of basic psychosocial education skills at undergraduate level?’ being two examples). We talked lots about the interpersonal aspects of nursing, and the enduring importance of relational work, but also about the roles that mental health nurses fulfil in managing the system and coordinating care. I’ll be keeping an eye on the Playing our Part blog over the coming weeks as Tony continues his tour through the UK, meeting groups of nurses to draw out their views and experiences. The final report, as I understand it, is due to appear towards the end of the year. 

Elsewhere I’ve been working with co-conspirators to fine-tune next week’s #AfterWhitchurch ESRC Festival of Social Science event at Chapter in Cardiff. I’ll have to post something uniquely about that once we’re done. 

Collaborative care for depression

Happy April. Here’s a new venture for me: blogging for the Mental Elf, part of the National Elf Service. This is a fine site indeed, which André Tomlin set up in 2011 with the aim of helping people find ‘just what you need to keep up-to-date with all of the important and reliable mental health research and guidance’.

Here’s a summary of my first post, which can be read in full by following the link at the bottom.

Ben Hannigan writes his debut blog on the CADET cluster RCT, which investigates the clinical effectiveness and cost-effectiveness of collaborative care for depression in UK primary care.

via Collaborative care for depression: acceptable, effective and affordable — Elf Service – National Elf Service

#MHNAUK meets in Leeds, and talks work and roles

MHNAUK members in Leeds
MHNAUK meets in Leeds

Mental Health Nurse Academics UK met yesterday in Leeds, hosted by John Baker and chaired by Joy Duxbury. Our discussions were wide-ranging: proposed changes to the composition of the English NHS workforce signalled by the introduction of associate nurses; the arrival, in England, of student fees for nursing degrees from 2017; safe staffing (see also this editorial in the Journal of Psychiatric and Mental Health Nursing); plans for #NPNR2016; arrangements for a second student mental health nursing conference; the Shape of Caring; England’s Five Year Forward View for Mental Health; guidance for adult field nurses caring for people with mental health problems; this year’s Skellern Lecture and JPMHN Lifetime Achievement Award; the current call for papers for a themed care planning and coordination issue of the Journal of Psychiatric and Mental Health Nursing (which Michael Coffey, Alan Simpson and I are co-editing); and the hot-off-the-press announcement of a Foundation of Nursing Studies-sponsored review into the role of mental health nurses.

In this post I’ll largely confine myself to some thoughts on the mental health workforce and on the place of nurses within this. Yesterday’s discussions in this area exercised MHNAUK members greatly. Proposed changes to the occupational mix to be found within mental health services, debates over nursing numbers and safe staffing, and new arrangments for the funding of education have the potential to trigger significant turbulence in an already-complex system of care. MHNAUK members rightly identified how the appearance of a new associate nurse role, sitting in between health care support workers and registered nurses, will trigger unrest. This is always the case when professional jurisdictions come under pressure (see here and here for papers I have co-written which expand on this point). In this current case, some registered nurses will see new associates as a threat to their hard-won jurisdiction. At a time when nurses are pressing for safe staffing, some are likely to argue that the introduction of associates will also open the door to role substitution and eventual reductions in numbers of registered nurses, thereby threatening both quality and safety.

Should associate nurses appear, we can be certain that plenty of inter-occupational jostling will take place as support workers, associates and registered nurses (amongst others) negotiate their relative positions and assert control over areas of work. In this regard, abstract descriptions of the tasks which new associates will (and will not) be permitted to carry out will provide only the most limited of guides. Differentiations between who does what will inevitably be hammered out in the workplace.

And what of the cross-UK implications for all of this, given that the Department of Health’s associate nurse announcement is for England only? To me it is unclear how new associates will be regulated, or how transferable their future qualifications might be should any wish to move to, say, Wales. Across the four countries of the UK important differences are appearing in the ways people are prepared for health care practice, and in the funding of this. Student nurses will pay fees in England from next year, but student nurses in Scotland will not and will continue to receive a bursary. Here in Wales (unless I’ve been asleep and have missed a piece of essential news), we will need to wait until after our forthcoming Assembly elections and the formation of a new Welsh Government for an announcement on future financial arrangments for nursing education. Perhaps we’ll hear more about the shape of the future Welsh NHS workforce then, too.

Out of the Asylum

Belated happy new year. Visiting the Royal College of Nursing headquarters in London last Friday ahead of a meeting of the Network for Psychiatric Nursing Research (NPNR) conference committee (more on that below) gave me an opportunity to pop into the ‘Out of the Asylum’ exhibition. I’m glad I did. Texts, photographs and other artefacts illustrate the history of mental health nursing.

2016-01-08 11.25.57Here are some of the pictures I took. These include a photo of the RCN’s copy of a sixth edition of the Red Handbook, displayed alongside nurses’ badges, a Bethlem Royal Hospital pamphlet, a syringe and other items of interest. For more on the Red Handbook see this earlier post, along with this post which includes material from my copy of a fourth edition of the same. Another picture relates a set of regulations for the bathing of patients. 

One of the display boards makes the observation that ‘few mental health nurses now wear uniforms’. As an unfortunate aside, this may need some future updating. From what I’m hearing, the historic trend towards mental health nurses wearing everyday clothes at work is reversing, with numbers of NHS trusts and health boards contemplating a return to uniforms. I regret that. But sticking with the exhibition…

…a final photograph I’m reproducing here is the front sheet of an early 1930s examination paper. Look hard and you’ll see questions on bones, asphyxia and antiseptics (amongst other things).

The NPNR planning meeting, this being the purpose of my trip,  was a productive one. This year’s event (the 22nd) will be taking place in Nottingham on September 15th and 16th. I’ll add more on this when I can, and include some regular updates on this site.

 

 

Community Gateway 

Yesterday I spent the morning at the Grange Gardens Bowls Pavilion in Cardiff at a Community Gateway event. This was an opportunity to hear about mental health and wellbeing, and to learn how local services are set up. The day was organised by my School of Healthcare Sciences colleagues Alicia Stringfellow and Gemma Stacey-Emile, working with members of the community. I appreciated the update on the activities of the community mental health team (CMHT) based in the Hamadryad Centre, and learnt more about what local Hafal and CAVAMH services are doing. It will be interesting to see how mental health, and health more generally, feature in the Community Gateway in the future.

Community mental health teams are often described as the cornerstone of locally accessible, specialist, mental health services. Working with its two local authority partners, Cardiff and Vale University Health Board currently provides eight CMHTS for adults of working age. The team based at the Hamadryad, I was reminded yesterday, covers the south west of the city taking in the Bay, Butetown, Grangetown, Riverside, Canton and Pontcanna. Speaking in the Bowls Pavilion, CMHT manager Phil Ball did a good job in separating out the work of his team from that of the primary mental health support service (which happens to share use of the Hamadryad building).

Meanwhile…

…for anyone wanting to become a mental health nurse, worth noting is that the School of Healthcare Sciences still has some places available for the BN Hons programme commencing in March 2016. The photo here, of a flyer brought to yesterday’s event, gives more information.

Fees, theses and project updates

Last week brought the news that, in England, people beginning nursing degrees from the 2017-18 academic year will need to take out student loans to cover the cost of their tuition fees. The cap on student numbers will also be removed. The Council of Deans of Health broadly supports this move, having previously argued for change. One of the things it points out is that current funding for students (via the agreement of the benchmark price) does not cover the real costs of educating new nurses. The Royal College of Nursing, on the other hand, is concerned that last week’s announcement prepares to break the connection between the NHS and financial support for student nurses, and simultaneously risks making nursing a less attractive career option. This concern particularly relates to mature students and those contemplating a second degree, for some of whom the prospect of additional debt may be exceptionally unappealing. As a nurse academic in Wales I wait with interest to see what policy on fees will emerge from the Welsh Government.

In other news, I find myself engaged in a prolonged period of doctoral student activity. I’ve examined a number of theses in and out of Cardiff in recent months, and have sat with students during their vivas as either supervisor or independent chair. This term has been particularly packed. Plenty of writing has also been taking place: papers and reports are being written from COCAPP, RiSC and Plan4Recovery, and from completed theses I have helped to supervise. Data generation in COCAPP-A has almost concluded, and new research ideas are taking shape. Exciting times, if a little frenetic. 

Higher education Green Paper

The much-trailed higher education Green Paper appeared last week. For the full document, the place to go is here and for a Times Higher summary the link is here. Immediately worth bearing in mind is that higher education in the UK is a matter for devolved government, meaning that most of what the Green Paper says relates to English universities. I say ‘most’ because, as is noted towards the beginning of the document, the Research Councils (like the MRC and the ESRC) have UK-wide remits, whilst the REF and the various editions of the RAE preceding it were carried out on a four-country basis. It would also be naive in the extreme to suggest that universities and policymakers here in Wales can ignore the England-only bits of what the Green Paper has to say; for a nice piece on the Green Paper and devolution, follow this link. And, for an insight into work ongoing in Wales on matters higher education-related, here’s a link to a current review of funding arrangements.

Fulfilling our potential: teaching excellence, social mobility and student choice, to give the Green Paper its full title, proposes plenty of change. It also leaves much of the detail unfilled, and (in at least one analysis) contributes to an emerging higher education policy framework which is both vague and contradictory. One idea is for the Higher Education Funding Council for England and the Office for Fair Access to combine functions within a new Office for Students. Plans for a Teaching Excellence Framework are outlined, along with variable rates of tuition fees. Ahead of the publication of the document there was some talk that REF2014 might have been the last of its kind. What the Green Paper actually says (briefly) is that dual support for research should remain, and that some version of the research excellence framework should continue and be used as the basis for the allocation of government block funding. The next REF, it is suggested, will take place by 2021. But there is obviously more to follow in this context, with sections in the document referring to the administrative burden and cost of the REF and the possible use of metrics to ‘refresh’ quality assessments in between full cycles of peer review. There is also the small matter of having to determine, if the Higher Education Funding Council for England disappears, which body should in the future assume the task of allocating quality-related funding to English universities.

Meanwhile, the sole nurse to get a mention in the Green Paper and its surrounding commentary is Sir Paul Nurse, Nobel Laureate, President of the Royal Society and chair of the review into the UK’s research councils. Nurses, of the type of which I am one, have to look elsewhere for the specifics on possible future arrangements for the organisation and funding of health care professional education and for debates in this area.

Public Uni

After finishing work next Thursday (October 15th 2015) I’ll be heading off to Chapter to take part in the 7th Public Uni. At Public Uni, which is organised by Marco Hauptmeier in the Cardiff Business School, academics get a ten minute opportunity to present their research to an assembled audience. I gather there is some retiring to the bar at some point in the evening, which seems very sensible.

Here’s the flyer for next week’s event: and what an eclectic bunch us five speakers are! In my slot the aim is to compress a history of mental health care, and a summary of where we are now, into 600 seconds of talking. What fun! For a taster of what I’m planning to say, here’s my summary:

Changing landscapeUntil the middle of the last century most formal mental health care was provided in hospitals. This changed with the emergence of community care. Dr Ben Hannigan, Reader in Mental Health Nursing in the School of Healthcare Sciences, explains how this change came about and discusses the people, policies and practices found within the system now.

Mental Health Nurse Academics UK meets in Preston

Here’s a quick blog post sent from a train, en route from Preston to Cardiff following the Autumn term meeting of MHNAUK. We met at UCLAN, hosted by Joy Duxbury, Mick McKeown and Karen Wright. On the agenda were presentations from Nadeem Gire on tackling digital exclusion, and from Mick McKeown on ‘Democracy and Legitimacy in Mental Health Care’. Mick, as always, was thought-provoking and challenging: follow this link to access downloadable copies of many of his articles.

Sabine Hahn, Peter Wolfensberger and Swiss colleagues were present, with Sabine and Peter giving an overview of the development of mental health nursing and the establishment of the Swiss Academic Society of Psychiatric and Mental Health Nursing. Seamus Watson spoke about public mental health, and what role nurses might play.

In the post-lunch business section of the meeting there were discussions on (amongst other things) the Shape of Caring review, this year’s NPNR conference and plans for 2016, and on a future student mental health nursing conference.