Tag: research capacity

Research capacity building in Wales

The Nursing and Midwifery Council (NMC) here in the UK tells us that, at the end of March 2014, there were 680,858 nurses and midwives on the register. The Health and Care Professions Council (HCPC), which regulates 16 different professions, tells us that on the same date approximately 322,000 individuals were registered. Adding these numbers together gives a total in excess of one million. That’s an awful lot of registrants. Only a small number of these, however, are directly engaged in research to inform current and future practice and fewer still have had opportunities to become fully independent investigators. As the Shape of Caring review puts it with regard to nursing:

It is currently estimated that 0.1 per cent of the nursing workforce in England are professors of nursing: an indication that there are simply inadequate numbers for the task of leading research and evidence-based practice. Many of these academics will retire in the next 10 to 15 years.

Given this mismatch, efforts to grow research are immensely important. Leading the way in this part of the UK is the RCBC Wales scheme, which:

[…] was established in order to increase the research capacity of nursing, midwifery and allied health professions in Wales and to contribute toward the development of clinical academic roles.

I was fortunate enough to be awarded an RCBC Wales post-doctoral research fellowship in 2006. In the last few weeks three Cardiff-based colleagues have been successful in securing the same in the most recent round of applications: Dr Jessica Baillie, Dr Lucie Warren and Dr Liba Sheeran. Jess is a nurse who will be researching the experiences of people who develop peritonitis as a result of peritoneal dialysis, Lucie is a midwife who will be investigating an intervention to improve the diet and physical activity of pregnant women, and Liba is a physiotherapist who is exploring how smartphone technology can help people recovering from back pain. Congratulations to all three.

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.

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.

 

Reviewing health and social care research in Wales (reprise)

Time this morning, before I head off for a second day of MMI-ing, to draw attention to revised restructuring proposals from (and for) the National Institute for Social Care and Health Research here in Wales. I’ve written about the NISCHR review in this earlier post, and this latest document is the version which has gone out for external peer review.

I’m pleased to see that NISCHR proposes a continuation of its support for research capacity building in nursing and the allied health professions. Here’s a snip from the new document:

Research Capacity Building Collaboration (RCBC) – RCBC was established in 2006 as a collaboration between six universities in Wales to increase research capacity in nursing/midwifery and the allied health professions in Wales. It does this through a number of funding schemes including PhD Studentships and Post-doctoral Fellowships.
v. It is proposed that a new specification is developed for an application for renewal of RCBC/ a new initiative to increase research capacity in nursing/midwifery and the allied health professions in Wales.

For those not familiar with the RCBC scheme I recommend a visit to this website.

Elsewhere, I see that NISCHR proposes pressing ahead with its plans to close the gap between its funded Registered Research Groups, Biomedical Research Centres and Biomedical Research Units. It says:

There is a need to further integrate the functions of the BRC, BRUs and RRGs into the NISCHR infrastructure and to provide clear objectives and indicators to ensure NISCHR funding makes a real difference and contributes to future outcomes. There is also a need to avoid duplication and address the perception of NISCHR’s infrastructure being unnecessarily complicated.
b. It is proposed to create new entities known as NISCHR Centres and Units. These will replace BRCs, BRUs and RRGs and become central pillars of the NISCHR infrastructure to create a more streamlined and integrated structure, improve cost-effectiveness and foster collaboration across sectors to facilitate translation.
c. It is proposed that NISCHR Centres will have responsibility for portfolio development and delivery in their areas across the translational spectrum, in collaboration with other elements of the infrastructure. In some instances they may also provide elements of infrastructure support themselves.
d. It is proposed that NISCHR Units will be smaller entities than NISCHR Centres and focus on specific points of the translational spectrum, specific activities, or represent emerging areas of research strength with aspirations to become NISCHR Centres in the future.
e. It is proposed that a competition is held for NISCHR Centres and Units; the existing BRC, BRUs and RRGs will be able to apply and be encouraged to consider how best to augment existing functions and strengths to become more integrated entities in the future. They may also incorporate the functions of other elements of the existing infrastructure. The NISCHR Centres and Units will have a Director, Operational Manager and Leads for specific specialties/areas. They will be multi-professional and multidisciplinary, including Public and Patient, NHS, HEI, Industry and Social Care representation as appropriate.

This is a significant, if not unexpected, proposal. As future arrangements begin to become clearer I’ll be looking for ways to make sure that research into mental health systems and services continues to be supported. Plenty to think about, then, as I head for the train.

Doughnut meetings

My esteemed colleague Professor Jane Hopkinson facilitates a Wednesday lunchtime research drop-in, to which people in the School of Healthcare Sciences at Cardiff University are invited. Affectionately known as doughnut meetings (see photo of today’s goodies attached), these provide a loosely-structured, supportive, space for the sharing of ideas and experiences. The gatherings are really very good: informal, but always informed. I make a point of getting along when I can.

Typically those who meet up get to propose themes for future meetings. This afternoon’s topic was ‘research and evaluation’, and more particularly the distinctions between the two. People involved in health services research (or indeed, health services evaluation) will know how important this differentiation is for NHS governance and approval purposes. Projects classified as ‘research’ require independent NHS research ethics committee (REC) approval. Projects classified as ‘evaluation’ do not. The NHS Health Research Authority provides guidance to help people work out what type of project it is that they are proposing, but in my experience making these determinations remains a wholly inexact science.

I have also learned that a project can be ‘evaluation’ in one context (e.g., for NHS research governance and ethics review) and ‘research’ in another (e.g., for academic progression and award purposes). My own PhD was designed, part-funded through open competition, completed and examined as ‘research’: what else could it possibly have been, as a research degree? But it was also categorised as something else when I offered it up for NHS REC approval, as I’ve written about here and (at length) in this paper.

So there we have it. Potentially all rather confusing, and certainly enough to make me want to eat a doughnut.

Reviewing health and social care research in Wales

Here in Wales, a month or so ago the National Institute for Social Care and Health Research (NISCHR) published a document outlining ideas for its restructuring, and opened a discussion on how research should be prioritised, organised and supported in the future. NISCHR says that it:

[…] proposes to engage its stakeholders, including patients, the public, the NHS, social care organisations, universities, industry, the third sector and other government departments to review the infrastructure and programmes it currently funds and help determine what changes should be made.

Now, details of a series of open meetings have appeared. I’ve registered for the November 29th meeting taking place at the Cardiff City Stadium. I will also be offering up some ideas for the School of Healthcare Sciences’ collective response.

A number of things are currently brought together under the NISCHR umbrella. Funding is provided for national-level registered research groups (RRGs), regionally based academic health science collaborations (or partnerships) and a biomedical research centre and series of biomedical research units. Social care research is assisted through capacity-building funding. Support is also provided for Involving People, and for all-Wales training in research governance and related matters. Studies on the NISCHR portfolio are eligible for funded, in-the-field, help via a network of clinical studies officers and research nurses. NISCHR also oversees approval processes for NHS research, funds a number of trials units and has (this year) launched a faculty. There is also the small matter of NISCHR’s competitive funding schemes, which provide project-by-project support for high-quality studies of importance to health and social care in Wales.

Given all of this, NISCHR’s review is, I think, an important process to be contributing to. One of the NISCHR schemes mentioned in the review document is the Research Capacity Building Collaboration for Nursing and Allied Health Professionals (RCBC Wales). This has been an excellent initiative, entirely delivering (so far as I can tell) on its ambitions to develop capacity. As such, it deserves to be continued (and better still, expanded). I have to declare an interest here, of course, being an alumni of the RCBC Wales scheme having secured a postdoctoral fellowship in 2006. This was the funding which allowed me to investigate the establishment, work and wider system impact of crisis resolution and home treatment services, as I’ve variously blogged about in the past here, here and here.

The NISCHR document also draws attention to the use of Welsh health and social care research funds to support NIHR NETSCC Programmes. This paves the way for researchers in Wales to apply, on an equal footing to colleagues in England, for support from the HS&DR Programme, the HTA Programme and others. This mechanism facilitates cross-UK collaboration, which has to be a good thing. It is only through this support that Wales-based colleagues and I have been able to work on the COCAPP and RiSC projects.

I also see mention by NISCHR of an ongoing review of the operation of R&D offices, and in this regard I hope that a way is found to further rationalise approval and governance processes. The NHS research passport system could be better (it’s not really much of a ‘passport’ at all), and there are variations still in the ways different R&D offices process applications.

It is also clear that NISCHR is considering the level and type of support it offers to its all-Wales RRGs, and the connections these might have with biomedical research centres and biomedical research units working in overlapping areas. NISCHR is, if I understand this correctly, thinking through how organisations like the Mental Health Research Network Cymru and the National Centre for Mental Health might relate.

So, there we have it: evidence that changes to health and social care research organisation and funding in Wales are on the cards, with plenty of time remaining for people with an interest to get involved in shaping future arrangements.

Research and mental health nursing

Over on the Mental Health Nurse Academics UK blog, the group’s chair Dr Michael Coffey writes:

The Research Excellence Framework (REF) looms large for many of us. This is part of the regular round of judging of peer-reviewed research publications on which the UK government bases its decisions on distribution of institutional research funding. Decisions within Higher Education Institutions are being made around now on who is considered returnable and then whether it is strategically advantageous to submit these researchers in the exercise. For individual research careers these decisions weigh heavy. For the profession of mental health nursing there may be wider implications. Previous research assessment exercises have seen more and more evidence of mental health nurses being returned. This has undoubtedly led to an improved profile within individual universities and recognition of the contribution of research to improving the experience of people using mental health services.  There remain significant opportunities for mental health nurse researchers to contribute and bring to bear a professional view on what needs researching and how this should be conducted. We will have to wait until 2014 for an idea of what the landscape will look like in relation to mental health nursing. One thing for sure is that we need a highly engaged mental health nurse academic workforce to continue to provide high quality education and research. By doing this we can make a meaningful contribution to the development of mental health care both here in the UK and beyond.

Nursing certainly did do well in the UK’s last Research Assessment Exercise, the precursor to the REF to which Michael refers in his post. Results for all higher education institutions submitting to Unit of Assessment (UoA) 11 (Nursing and Midwifery) in RAE 2008 can be found here. In his subject overview report for UoA11, Professor Hugh McKenna of Ulster University ended with this:

In conclusion, the sub-panel members were very impressed with most of the submissions they reviewed and with the pervasive pattern of world-leading and internationally excellent research. There are many models of good practice from which developing research groupings can learn in terms of research activities, outputs, environment and esteem. It is clear that investment by Governments, funding bodies and universities has increased research capacity and developed research leaders capable of undertaking nursing and midwifery research that is internationally excellent and world leading. These funding streams need to be sustained and enhanced if the upward trajectory and momentum are to continue and if the quality differentials between the strongest and weakest departments are to be addressed.

And, when the results from the last RAE were published in December 2008, The Guardian ran an article titled Nursing research takes its place on world stage. Here it said:

Nursing, for many years medicine’s poor relation, has come of age in the 2008 research assessment exercise (RAE). Academics in the field can justifiably claim to be world-leading in terms of research. Nursing and midwifery was among the subjects with the most highly rated research in the results published today.

Heady stuff indeed, and testimony to years of hard work, strategy, and capacity-building investment. All this does, though, seem an awful long time ago. As Michael reminds us in his MHNAUK post, attention has long since turned to preparations and prospects for REF 2014.

I have written about nursing and the Research Excellence Framework 2014 on this site before, drawing attention to the workload facing members of UoA A3 (Allied Health Professions, Dentistry, Nursing and Pharmacy) and to the challenges of demonstrating and assessing ‘impact’. So, as we hurtle towards the deadline for REF submission, in what shape does UK mental health nursing research find itself?

Readers of this blog will know that this is a question that MHNAUK is also asking, and is seeking an answer to in organised fashion. Professor Len Bowers led a discussion on this at the MHNAUK meeting held in Cardiff last March. When the group reconvened in Liverpool in June, Dr Fiona Nolan asked members for items to include in her planned survey of research activity and capacity.

Whilst we await findings from Fiona’s project in the first instance, my personal view is that there is much to celebrate in mental health nursing research but also room for development. A small number of universities are home to strong and established research groups. Leaders of these have built national and international collaborations across disciplinary and institutional boundaries. They have laboured to secure funding in open competition and to complete and publish studies with real implications for policy, services, education and practice. This is excellent progress, and I think we now need more of this type of activity across more universities. This means people (and I include myself here) extending their ambition, and perhaps being a little bolder. As an example, early next year the European Union’s Horizon 2020 research and innovation programme invites a first round of applications for funding. How excellent it would be for mental health nurses in the UK to be leading, and collaborating on, high-quality bids submitted there.

My more general reading of the field is that, in many universities, mental health nurse researchers are thinly spread. I’ll bet that in most of the sixty-plus universities represented at MHNAUK the number of people predominantly involved in teaching far outstrips the number predominantly engaged in research. Teaching is important – really important – but the lone researcher in a team of teachers is in a tough place indeed. As I cast an eye around the departments I am most familiar with I also wonder where the younger mental health nurse researchers are. How many mental health nurses in their 20s are studying for PhDs? If the answer is ‘not many’, then what should we collectively be doing to make research a viable, and attractive, career proposition for nurses at the start of their careers? How might we nurture a future generation of mental health nursing clinical academics?

Anyway: all is speculation until we have some evidence. The MHNAUK survey, I anticipate, will paint a more rounded and complete picture of the true state of research activity and capacity than will the Research Excellence Framework. The REF, being what it is, is subject to all sorts of inter- and intra-institutional politicking and will produce only a partial view of what’s really going on.