Tag: School of Healthcare Sciences

Safe staffing (again)

safe staffingJust over a year ago I posted a short piece on this site on safe staffing, particularly noting the work of Shaun Lintern and John Baker in alerting people to the importance of this in the mental health nursing context. Since then, the Nurse Staffing Levels (Wales) Act 2016 has passed into law, and the Welsh Government has opened this consultation on its draft statutory guidance for Local Health Boards and NHS Trusts. My colleague Aled Jones is coordinating a School of Healthcare Sciences response.

Here in Wales, the duty to calculate nurse staffing levels is currently limited to adult acute medical and surgical inpatient wards. In each NHS organisation with responsibilities in these fields, the Government’s draft document refers to the appointment of a ‘designated person’ with the job of calculating nurse staffing levels using three elements:

  • professional judgement;
  • use of an evidence-based workforce planning tool; and
  • a consideration of the extent to which patients’ wellbeing is sensitive to nursing care.

Making these calculations, I can only imagine, will be a mighty challenging task requiring in-depth understanding of individual wards, the characteristics of patients admitted, and use of a tool which has (so far as I understand it) yet to be finalised.

Meanwhile, via John Baker I learn today of this new publication by NHS Improvement on safe, sustainable and productive staffing in mental health services. This is not about safe nursing staffing, but is about interprofessional staffing in specialist mental health services. Here I read of expectations around right staff, right skills and right place, right time and also spot a rapid review of the relevant literature. This begins with the understated observation that, ‘the issue of safe and sustainable staffing in mental health is complex and research is lacking’. I should say so. The time is ripe, I think, for some serious independent studies in this area.

 

Reflections on #AfterWhitchurch

Further to my last post looking ahead to #AfterWhitchurch, here now are my reflections on the event as it happened as also recorded on the Cardiff University mental health blog. I’ve selected some photos, too.

The closure of Whitchurch Hospital to inpatients in spring 2016 provided the backdrop for #AfterWhitchurch, a collaborative Economic and Social Research Council (ESRC)/Cardiff University Festival of Social Science event focusing on the changing system of mental health care hosted at Cardiff’s Chapter Arts on November 10th 2016.

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Whitchurch Hospital opened as the Cardiff City Mental Hospital in 1908, the image below being the first entry on the first page of the hospital’s visitors book.

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Members of the hospital’s Historical Society were on hand with objects, documents and photographs from their archive. Artist and director Elaine Paton presented and talked about her work with Moment(o)s of Leaving, a multimedia performance produced to mark the occasion of the hospital’s closure. Audiorecorded interviews, created for Momento(s) of Leaving by artist/curator and researcher Julia Thomas, recounted staff members’ reflections on leaving Whitchurch and their thoughts for the future.

Chaired by Norman Young from Cardiff and Vale University Health Board, School of Healthcare Sciences and service user researchers discussed how mental health care has shifted from hospital to the community, and shared reflections from research into the organisation of services, the work and experiences of service users and staff and the provision and evaluation of novel psychological interventions.

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Ben Hannigan talked about using in-depth case methods to understand mental health services at different levels of organisation, and Nicola Evans discussed her research into the mental health of children and young people. Dean Whybrow drew on 18 years of experience in the Royal Navy to describe how mental health support and interventions is provided in the military. Alan Meudell shared his reflections on being a service user researcher, and Bethan Edwards spoke of her dual identity as an occupational therapy researcher investigating care for older people with dementia and as a service user researcher. Stimulating and informed questions from the floor challenged the panel to think about stigma, the impact of research on changing practice and services offering respite and asylum.

#AfterWhitchurch

On the evening of Thursday November 10th at Chapter in Cardiff, as part of Cardiff University‘s contribution to this year’s ESRC Festival of Social Science, I’ll be joining friends from the School of Healthcare Sciences, the Whitchurch Hospital Historical Society, the service user community, the National Centre for Mental Health and the world of community arts for an evening reflecting on the changing mental health system. The event is free to members of the public, and further details (and a link for ordering tickets) can be found on our #AfterWhitchurch page.

For a snippet, here’s what we’re planning:

Whitchurch Hospital opened as the Cardiff City Mental Hospital in 1908. The transfer of its last inpatients to new purpose-built facilities in April 2016 provides a backdrop for an event reflecting on the changing shape of mental health care. In conjunction with the Whitchurch Hospital Historical Society and the National Centre for Mental Health, we will invite our public audience to review care as it used to be and care as it is now. We will draw on current Cardiff University mental health services research and use a range of historical and artistic media to maximise participation and provide variety.

Spread the word!

Cumulative insights

Not for the first time, I’ve attempted to produce some cumulative insights from the past and present mental health research studies I’ve had the opportunity to work on. These include my PhD investigation into work and roles in community mental health care, my post-doctoral study of crisis services, and more recent projects which Alan Simpson, Michael Coffey or I have led on.

The prompt, on this occasion, has been the chance to give a presentation at a School of Healthcare Sciences research seminar taking place this afternoon. For anyone interested, here is the PowerPoint I used. I opened with some general comments on the need for mental health research, and on the funding landscape. I then had some things to say about theory, design and methods. Many of the individual slides have hyperlinks to green open access publications:

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.

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.

Mental Health Nurse Academics UK meets in Nottingham

I was unable to make Thursday evening’s Skellern Lecture and Journal of Psychiatric and Mental Health Nursing Lifetime Achievement event hosted by Patrick Callaghan at Nottingham University. My congratulations to Ian Norman and to Marion Janner, this year’s very worthy award winners. As it happens, Ian was one of my PhD examiners. My following of Thursday’s proceedings from afar, via Twitter, tells me I missed a treat.

I was, however, able to make the trip to Nottingham for Friday’s summer term meeting of Mental Health Nurse Academics UK (MHNAUK). This was held in the new, and rather impressive, Institute of Mental Health building:

Here’s a picture I took of the sculpture, titled House for a Gordian Knot, displayed at the entrance to the Institute’s main building:

We had three local presentations. First up was  Paul Crawford, who gave a broad overview of the Creative Practice as Mutual Recovery research programme which he leads, followed by Andrew Grundy giving an account of qualitative findings from the Enhancing the Quality of User Involved Care Planning in Mental Health Services (EQUIP) study. EQUIP is an important, NIHR-funded, programme of work which (along with COCAPP and COCAPP-A) is producing evidence of how care planning is being done and how it might be improved. Here’s a photo, taken and shared by Karen Wright, of one of Andrew’s final slides outlining steps to successful user involvement in this process:

Tim Carter talked us through his freshly-minted mixed methods PhD, in which he investigated the use of a preferred-intensity exercise programme for young people with depression. I thought this to be a very well-designed study, which generated considerable discussion around the active ingredients of the intervention and plans for a future follow-up.

Elsewhere Lawrie Elliott, editor of the Journal of Psychiatric and Mental Health Nursing, was welcomed by the group to give an update on developments at the journal in his first year at the helm. I really liked what I heard, and said as much in our discussion. Quality of papers, and relevance to mental health nursing, are being prioritised. Word limits have been increased to allow for more in-depth analysis in accepted articles. To extend its reach the journal now has a Twitter account, which can be followed by clicking the following link:

Ben Thomas from the Department of Health opened a discussion on the future of the Student Mental Health Nursing Conference, the inaugural event having taken place at the O2 Arena in London in February this year. As I understand it, much of the organising was done by staff and students at Greenwich University: well done, them. A group of MHNAUK members representing different universities has agreed to collaborate to keep this initiative going, and with a view to turning it into a cross-UK, rather than an England-only, opportunity.

Following David Sallah’s meeting with MHNAUK in York in March 2015, Joy Duxbury and Steven Pryjmachuk chaired a discussion on the current status of the Shape of Caring review. Since returning from Nottingham I have found that Health Education England is planning to sound out opinion through a series of events running into the autumn. Details are to follow.

Thanks particularly to John Baker, in the weeks leading up to this latest meeting MHNAUK published a response strongly criticising the announcement that the National Institute for Health and Care Excellence (NICE) was ending its work in the area of safe staffing. This decision, defended two days ago by Jane Cummings (Chief Nursing Officer at NHS England), has also been challenged by others including Sir Robert Francis and now the Council of Deans of Health. The Safe Staffing Alliance campaigns in this area, and MHNAUK will continue to make a contribution via a further response the outline of which was agreed in Nottingham. As a reminder of some of the key evidence supporting the importance of registered, graduate, nurses for quality and safety follow this link to an earlier post on this site and this link to a recording of Linda Aiken delivering the Winifred Raphael Memorial Lecture at the University of South Wales on October 1st 2014. And, for those interested in how #safestaffing is shaping up differently across the countries of the UK, follow this link for a record of the progress of the Safe Nurse Staffing Levels (Wales) Bill through the National Assembly for Wales. Following this link brings you to a report reviewing the evidence, commissioned by the Welsh Government and produced by a team led by Aled Jones in the Cardiff School of Healthcare Sciences.

Fiona Nolan shared progress on her survey of mental health nursing research interests and expertise in UK higher education institutions. And, finally, on behalf of the organising and scientific committee Russell Ashmore, Laoise Renwick and I took the chance to update MHNAUK members on progress for the 21st International Network for Psychiatric Nursing Research conference.

#NPNR2015 takes place at the Manchester Conference Centre on Thursday 17th and Friday 18th September 2015. We think the programme is shaping up perfectly, with keynote speakers including England’s National Clinical Director for Mental Health Dr Geraldine Strathdee, Prof Shôn Lewis from the University of Manchester, Mark Brown who ran One in Four magazine and is now involved with The New Mental Health, and André Tomlin who runs The Mental Elf service. We have symposia, workshops and concurrent sessions with papers accepted from presenters around the world, a walking poster tour and the opportunity for fringe events. Make your booking now!

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.

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.