Category: Education

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.

Studying for a PhD in the School of Healthcare Sciences

PhD2Here in the School of Healthcare Sciences at Cardiff University we’ve continued to think about how best to appeal to potential PhD students, and to simultaneously develop research capacity across nursing, midwifery and the allied health professions. A change which we’ve recently made is to invite applicants for postgraduate research study to make clear how their developing plans fit with the research already going on in at least one of the School’s research themes. To help in this process we’re now advertising areas for future PhD study, closely aligned to the substantive and methodological expertise already found in the School. This makes lots of sense, and will help us to grow research in programmatic fashion and ensure students are appropriately supervised.

The place to go for the current list of topics/areas is here, where under the Workforce, Innovation and Improvement theme you’ll find this:

The use of in-depth qualitative methods to examine mental health systems. Specifically, projects investigating aspects of policy; service organisation and delivery; work, roles and values and user and carer experiences.

That’s the kind of PhD I’m primarily interested in supervising. For an example of what a completed one looks like, then follow this link to the full text of Dr Mohammad Marie’s freshly minted thesis titled, Resilience of Nurses who work in Community Mental Health Workplaces in West Bank-Palestine.

Research in the School of Healthcare Sciences

In February 2015, in the School of Healthcare Sciences at Cardiff University we launched our new research strategy. The School’s main research webpage can be found here, and for the nuts-and-bolts of our four research themes the links to follow are these:

Meanwhile, in the very near future the School (including its researchers) will be occupying additional floors at our base in Eastgate House. This, for those who know Cardiff, is a building situated at the junction of Newport and City Roads. My office, I think, will move: giving me fine views over the city and beyond.

Here are some photos of the 12th floor, as previously shared via a Tweet:

It is very welcome that we will soon have these new facilities available to us, with the rooms in the photos being used mainly by PhD and Professional Doctorate students.

Which brings me neatly to…

Other interesting developments in the School on the postgraduate research student front are plans to recruit very pro-actively. Research theme members have been busy generating topics for doctoral study, which reflect existing areas of substantive and methodological expertise and where capacity to supervise is known to exist. We’ll be advertising these soon, and inviting potential students to tell us how their plans align. The aim, obviously, is that we grow research in programmatic style by building on established and emerging lines of enquiry. For anyone interested, I’m looking to supervise people who want to use in-depth qualitative methods to examine mental health systems (no surprises there, then!). Specifically, this means projects investigating aspects of: policy; service organisation and delivery; work, roles and values; and user and carer experiences.

Other postdoctoral news includes Mohammad Marie‘s (that’s Dr Mohammad Marie’s) successful defence of his thesis at viva last month. Well done! Mohammad has been supervised by Aled Jones and me, and the title of his thesis is Resilience of nurses who work in community mental health workplaces in West Bank, Palestine. Next up for him are papers for publication: and jolly interesting they’ll be, too.

The shape of nursing (reprise)

York, March 10th 2015
York, March 10th 2015
Yesterday I joined other members of Mental Health Nurse Academics UK at the University of York, for what turned out to be a particularly lively spring term meeting. 

We were treated to two high-quality local presentations in the morning: from Simon Gilbody on smoking cessation interventions for people using mental health services, and from Jerome Wright on developing community mental health in Malawi. 

In the early afternoon David Sallah from Health Education England (HEE) took the floor to talk about the Shape of Caring review, the final report from which is due to be published later this week. From David’s presentation it is evident that HEE will be making a case for a significant shake-up to the way nurses are prepared. 

MHNAUK members in York were concerned with what they heard. Uppermost for many was a concern that HEE’s wish for future student nurses to commence their courses with two years of Project 2000-style generalist preparation will erode the time available for mental health-specific learning. People were also struck by the apparent lack of a clear evidence base for change. It is, after all, only a handful of years since the Nursing and Midwifery Council introduced its current standards for education, and curricula up and down the country were rewritten in response. In the absence of robust evaluations of what we already have, are we really sure we know what needs fixing in nurse preparation? 

The Shape of Caring review is sponsored by a body with authority in England only, but I am under no illusions that any changes flowing from it will be felt equally here in Wales. David Sallah mentioned cross-UK talks as having already opened. As people observed yesterday, however, any changes to nursing education recommended at this point may be lost following a general election where greater priorities occupy the time of a newly formed government. 

Meanwhile, and with a firm eye on the forthcoming election, the Council of Deans of Health has been busy making a case for health higher education and research in its new publication Beyond Crisis. This has three main messages, addressing: workforce planning; building on the talents of the current workforce; and investing in research. Amongst other things the Council is asking for proper forward planning to avoid cycles of boom and bust, opening up opportunities for continuous professional development and protecting and advancing research. It is also suggesting that new ways of financially supporting health professional education should be looked at, including models where contributions are made by students and employers.

The shape of nursing?

Congratulations to Steven Pryjmachuk on his pre-Christmas election as Vice Chair, and Chair-elect, for Mental Health Nurse Academics UK. Steven works with Joy Duxbury throughout 2015 and 2016, and becomes Chair for the two years following.

During the December 2014 MHNAUK election, for which I acted as returning officer, news seeped out that Health Education England’s Shape of Caring review (led by Lord Willis) was weighing up the future of UK nursing’s four fields (mental health, adult, child, learning disability). Michael Coffey, in his last month as MHNAUK Chair, led this response sent to the Health Service Journal:

Michael Coffey
Chair of MHNAUK

11th December 2014

Dear Sir

Shaun Lintern writes in the Health Service Journal (11th December 2015) that Lord Willis, chair of the Shape of Caring review envisages changes to nurse education that would see the loss of the current branches of nursing. One of those fields is mental health nursing. Those who practise in this area provide skilled compassionate care to some of the most marginalised and stigmatised people in society. We write on behalf of Mental Health Nurse Academics UK a group consisting of representatives of 65 Higher Education Institutions providing education and research in mental health nursing. As people long experienced in this field we are disappointed though not surprised to read your article presenting these views on the future of nurse education. We are disappointed because the evidence for the changes that Lord Willis claims are needed is largely non-existent. We are not surprised because we have been here before and can see that despite claims to the contrary, there is no evidence that this future for nurse education will deliver what it promises.

Nurses account for the highest number of professionals providing mental health care; the median average number of nurses per 100,000 of the population working in mental health is 5.8, more than all other professionals combined (WHO, 2011), making mental health nurses pivotal to the delivery of the WHO action plan. None of this is likely with a generic curriculum.

To be clear “the greater element of generalism” (which presumably means adult nursing) has been tried previously in the UK and found wanting. Internationally generalism has failed to deliver better care for people with mental health problems. The effect will be to dilute mental health nursing when there is increasing evidence that specialist knowledge, values and skills are required in the care of people with a range of long-term conditions and dementia. We remain unclear from your article what precisely is being proposed though our favoured suggestion would be for nurses to spend two years rigorously learning how to interact with people in compassionate ways that promote dignity and respect (core mental health nursing skills if you will) before launching themselves into the cold clinical world of high technology nursing.

The evidence from abroad and from evaluations here in the UK of the previous version of generalist frontloaded training (Project 2000; Robinson and Griffith 2007) show clearly that mental health nursing as a specialism suffered from a minimal focus on mental health in curricula and a depletion of mental health skills across the workforce. The strengthening of the mental health ‘field specific’ elements within the 2010 NMC standards reflected positive differences in areas such as language, the co–production of care and inter–professional practice. Any move to generic, or general (adult?) nurse ‘training’ as a start point for all will inevitably lead to a different set of values underpinning mental health nursing practice over time.

The expectation that the training of mental health nursing skills will be picked up and delivered in the workplace is without foundation despite the numerous examples to do this. The result will be that in an era of claims of parity of esteem people who use services will effectively be deprived of specialist trained nurses. Moreover, there is no evidence that current models of training are not fit for purpose or that a focus on generalist nursing skills will adequately address the needs of people with complex and enduring mental health difficulties.

The longer term effect of this approach is clear to see from countries who have moved down this road ahead of us, depleted services provided by unskilled workers, extra costs for employers in re-training and educating a workforce not fit for practice, difficulty in securing sufficient qualified staff to provide evidence based mental health care and longer term the stripping away of a set of skills in higher education that are unlikely to be replaced.

We don’t know what advice Lord Willis has taken to come to his view. Our worry though is that already the language being used here is designed to undermine professional skills that have been long in the making. For example, the unhelpful rhetoric embodied in the use of the term “silo” downplays specialist skills for the purposes of promoting something far less specific like “flexibility”. It is a largely hollow rhetoric and is never heard in relation to cardiologists, neurosurgeons or diabetes nurses. It seems that the pressure for change then is not one premised on the needs of people using healthcare services nor one based on the evidence of what works but driven by other factors that choose to position specialist nursing skills (and by corollary those who need these skills) as having little value.

We also note that any modification to the NMC’s standards for pre-registration nursing education and to the four fields driven by the Shape of Caring review will be felt across all parts of the UK. As an HEE-sponsored Review we are concerned that voices from parts of the UK other than England will not have opportunities to be heard.

We readily acknowledge that the full report is not yet due but wish to advance the notion of such a review democratically reflecting the voices of nurses and the people who use their services. In this regard we have been disappointed at the absence of any real attempt by the review to engage with our group specifically and have questions about the level of engagement with mental health service users more generally.

Yours Sincerely

Dr Michael Coffey
Chair of Mental Health Nurse Academics UK
Swansea University

Professor Joy Duxbury
Chair-elect of Mental Health Nurse Academics UK
University of Central Lancashire

Professor Len Bowers
Institute of Psychiatry
Kings College London

Professor Patrick Callaghan
Nottingham University

Professor Alan Simpson
City University London

Professor John Playle
University of Huddersfield

Professor Steven Pryjmachuk
University of Manchester

Professor Hugh McKenna
University of Ulster

Professor Doug Macinnes
University of Canterbury

Professor Karina Lovell
University of Manchester

Professor Geoff Dickens
Abertay University

Dr Ben Hannigan
Cardiff University

Dr Liz Hughes
University of York

Dr John Baker
University of Manchester

Dr Mick McKeown and Dr Karen Wright
University of Central Lancashire

Dr Robin Ion and Emma Lamont
Abertay University

Dr Sue McAndrew
University of Salford

Dr Andy Mercer
Bournemouth University

Dr Naomi Sharples
University of Chester

Dr Majorie Lloyd
Bangor University

Around this time there was some debate, via email, amongst MHNAUK members centring on the kind of nurses people felt were needed for the future and how they might best be prepared for practice. Important differences in view were freely expressed. Not all who are associated with MNHAUK are in favour of the retention of mental health nursing as a pre-registration field, for example, though my reading of the flow of pre-Christmas exchanges is that most are. Joy Duxbury and Steven Pryjmachuk, I suspect, will be returning to some of this debate during their tenures.

December catch-up

Competing priorities have kept me away from this site in recent weeks. There’s been work to do on COCAPP, which is close to the finish line, and doctoral students’ drafts to read and comment on (before imminent thesis submission, in one case). I’ve also been reading a thesis ahead of a PhD examination I’m involved in at the end of the coming week. So if this catch-up post feels a little bitty, then that’s because it is: there’s been lots happening that I want to comment on.

First up is the RiSC study, which I’ve mentioned here plenty of times before. In the last ten or so days the NIHR has published a first look summary of our aims, methods and findings. This is a precursor to the publication of our whole report, which is now post-peer review. Sometime in the new year we’ll be reconvening as a research team to plan our next project.

In October I made the short trip to the University of South Wales to hear Professor Linda Aiken from the University of Pennsylvania deliver this year’s RCN Winifred Raphael Lecture. Professor Aiken spoke on Quality nursing care: what makes a difference?, drawing on findings from the RN4Cast study and more. As promised, the RCN Research Society has now uploaded its video of the event for the world to see. It’s well worth watching.

News on the Mental Health Nurse Academics UK front includes an election, which we are now midway through, for the group’s next Vice Chair and Chair Elect. I’m overseeing this process (as I’ve done twice before), and will be in a position to announce the successful nominee on December 15th. One of the things that MHNAUK does is to work with the RCN to run the annual NPNR conference, and I’m very pleased to have had the chance to join the NPNR scientific and organising committee for a three year stint. More to follow on that front in the future, including details of next year’s event as they emerge.

Elsewhere I read that the Shape of Caring review, chaired by Lord Willis, is looking at the UK practice of preparing new nurses, at the point of registration, for work in one of four fields (mental health, adult, child and learning disability). This is something to keep a close eye on, with reports from last month’s Chief Nursing Officer Summit in England suggesting that the fields may be on their way out. For a useful, balanced, review in this area I refer the reader to the 2008 King’s College London Policy+ paper Educating students for mental health nursing practice: has the UK got it right? and, for a longer read, to Approaches to specialist training at pre-registration level: an international comparison.

Building research capacity

Last night I enjoyed an evening event in Cardiff with other past, and present, members of the RCBC (Research Capacity Building Collaboration) Wales Community of Scholars. This is a collaborative venture supported by higher education institutions, with funds now coming from NISCHR. Since coming into being in 2006 the RCBC programme has sought to develop research capacity across nursing, midwifery and the allied health professions. I’ve written about the scheme on this blog before (see here and here), and am personally grateful for the support I received as an RCBC Post-Doctoral Fellow which enabled me to complete my study into the work and system impact of crisis resolution and home treatment teams. For more on what I found in that project, check out these green open access articles saved in Cardiff University’s ORCA repository:

Hannigan B. and Coffey M. (2011) Where the wicked problems are: the case of mental health. Health Policy 101 (3) 220-227

Hannigan B. (2014) ‘There’s a lot of tasks that can be done by any’: findings from an ethnographic study into work and organisation in UK community crisis resolution and home treatment services. Health: an Interdisciplinary Journal for the Social Study of Health, Illness and Medicine 18 (4) 406-421

Hannigan B. and Evans N. (2013) Critical junctures in health and social care: service user experiences, work and system connections. Social Theory & Health 11 (4) 428-444

Hannigan B. (2013) Connections and consequences in complex systems: insights from a case study of the emergence and local impact of crisis resolution and home treatment services. Social Science & Medicine 93 212-219

Last night began with a talk from Tina Donnelly, Director of RCN Wales and Commanding Officer of the 203 Welsh Field Hospital. In introducing Tina, RCBC Grant Holder Professor Donna Mead (from the University of South Wales) shared the news that the RCBC scheme has received confirmation from NISCHR of continued funding. That’s good, and means we can look forward to more doctoral (and hopefully, post-doctoral) opportunities in the coming months and years.


New academic year post

University departments for the health professions, like Cardiff University’s School of Healthcare Sciences, have long academic years. We welcome intakes of new pre-registration undergraduate nurses every September, which is a time when students of many other disciplines are still enjoying the tail end of their summer holidays. In September we also welcome back existing students, and this afternoon – assuming I can navigate across Cardiff and its NATO summit-encircling ring of steel – I’m off to the School’s University Hospital of Wales (UHW) campus to meet a group of third year undergraduates to talk about the ethical aspects of nursing and healthcare research.

More generally, I start the 2014-15 academic year as incoming Co-Director of Postgraduate Research in the School, sharing this work with my esteemed colleague Dr Tina Gambling. Currently in the School of Healthcare Sciences we have almost 80 students studying for either the degree of PhD or the Professional Doctorate in Advanced Healthcare Practice (DAHP). The student group is a rich and varied one, and includes many who have made significant commitments to leave their homes (and often, their families) in other parts of the world to live and study in Cardiff. An example is Mohammad Marie, who I have written about on this site before.

In the case of new, or intending, postgraduate research students in the School some helpful advice is: keep an eye on the School’s website. We’re in the process of launching a new research strategy with distinct themes, and our aim is to recruit new PhD and Professional Doctorate students whose interests are clearly aligned with these. Research theme groups will, we’re all hoping, become communities of scholars drawing in researchers with all levels of experience: including those just starting out, and those who are internationally regarded.

Academics and social media

Time this evening to give a quick plug to Deborah Lupton’s Survey on academics’ use of social media. I spotted the online questionnaire when it first appeared, and was pleased to take part. Now, some months later, Deborah has published her results. Here’s the abstract from the main report, reproduced in its entirety:

This report outlines findings from an international online survey of 711 academics about their use of social media as part of their work conducted in January 2014. The survey sought to identify the tools that the respondents used, those they found most useful and the benefits and the drawbacks of using social media as a university faculty member or postgraduate student. The results offer insights into the sophisticated and strategic ways in which some academics are using social media and the many benefits they have experienced for their academic work. These benefits included connecting and establishing networks not only with other academics but also people or groups outside universities, promoting openness and sharing of information, publicising and development of research and giving and receiving support. While the majority of the respondents were very positive about using social media, they also expressed a range of concerns. These included issues of privacy and the blurring of boundaries between personal and professional use, the risk of jeopardising their career through injudicious use of social media, lack of credibility, the quality of the content they posted, time pressures, social media use becoming an obligation, becoming a target of attack, too much self-promotion by others, possible plagiarism of their ideas and the commercialisation of content and copyright issues. The report ends by contextualising the findings within the broader social and political environment and outlining areas for future research.

The report makes for an interesting read. For those looking for a condensed-but-longer-than-an-abstract version, follow this link for Prof Lupton’s accompanying piece for The Conversation website.

2014 Skellern Lecture, JMPHN Lifetime Achievement Award and MHNAUK meet-up

Last week brought a trip to London for a series of events: a COCAPP update on framework analysis; a COCAPP project advisory group meeting; the 2014 Skellern Lecture and the Journal of Psychiatric and Mental Health Nursing Lifetime Achievement Award; and this term’s meeting of Mental Health Nurse Academics UK.

Gary Winship, who does an excellent job organising the Skellern and JPMHN events, wrote this piece on the MHNAUK blog ahead of the lectures taking place at the Institute of Psychiatry. He wrote how Professor Joy Duxbury in her Skellern Lecture:

…will endeavour to balance the evident need for improved compassionate based care against a backdrop of risk aversion [and will place] a particular focus on coercive practices, more specifically restraint in mental health settings.

And that was exactly what Joy did on the night. She lined up, and tackled, the reasons mental health nurses give for using physical restraint and using video evidence drew her audience’s attention to what can go wrong. This includes patient deaths, something which the national charity Mind has been campaigning about since last year (see this post from June 2013) and which has helped drive the Department of Health’s guidance on positive and proactive care.

Professor Hugh McKenna took a break from his REF duties as Chair of the Allied Health Professions, Dentistry, Nursing and Pharmacy sub-panel to receive this year’s JPMHN Lifetime Achievement Award. Here’s Gary Winship’s preamble from the MHNAUK site:

Professor McKenna has a long and illustrious career. He was appointed an International Fellow of the American Academy of Nursing in 2013 which is an accolade accorded to very few people outside the USA. He was made an Honorary Fellow of the Royal College of Surgeons in Ireland (1999), Fellow of the Royal College of Nursing (2003) and Fellow of the European Academy of Nursing Science (2003). In 2008, Professor McKenna received a CBE for contributions to health care and the community, and in the same year he was appointed to Chair the Nursing Panel in the 2008 Research Assessment Exercise.

Hugh delivered a personable, good-humoured, lecture which also contained some important messages for nurses aiming to build programmes of research. These included the importance of working collaboratively and across disciplinary boundaries, aiming high, and getting funding. These are all things which Hugh has excelled at in his own career, though he was far too modest to draw explicit attention to this himself. Many congratulations both to him and to Joy: two recipients very worthy of their awards.

Following events on June 11th, the 12th brought the final meet-up in the current academic year of Mental Health Nurse Academics UK, convened on this occasion at London South Bank University. The morning was devoted to these presentations:

Colin Gale, Archivist, Bethlem Museum of the Mind
As if to, drive me mad: an Edwardian’s experience of sedatives and the asylum

Tony Leiba, Emeritus Professor, LSBU
Lessons of social inclusion through policy

Tommy Dickinson, Lecturer, Manchester University
‘Curing Queers’: giving a voice to former patients who received treatments for their ‘sexual deviations’, 1935-1974

The afternoon saw MHNAUK members get down to business. This included a discussion, led by Andy Mercer, on how best to influence the latest round of nursing reviews including the Shape of Caring and The Lancet Commission on UK Nursing. Elsewhere on the agenda were updates on this year’s Network for Psychiatric Nursing Research conference, MHNAUK’s in-progress position paper on physical health and well-being (led by Patricia Ryan-Allen and Jacquie White) and possible journal affiliations.