Nursing & Midwifery Research Strategy 2014-2019 April 2014
Acknowledgements NHS Greater Glasgow & Clyde s Nursing & Midwifery Research Strategy working group (see Appendix 1) would like to acknowledge the work carried out by NHS Lothian in creating the NHS Lothian Nursing & Midwifery Research Framework 2010-2015 1. In addition the group would like to acknowledge previous work carried out by the Clinical Trials Unit, NHS Greater Glasgow & Clyde Acute Services during 2006 2. Both these pieces of work were used extensively during the preparation of this framework. The NHS Lothian NMAHP Research Framework has been adapted and is presented, with permission. 2
Content Page 1. Introduction & Context 4 2. Key Aims 5 3. Guiding principles 5 4. Vision 8 5. Conclusion 9 6. Appendix 1 Membership NHS GG&C Nursing & Midwifery 10 Research Strategy short life working group 7. Appendix 2 Suggested action plan to support the framework 12 8. References 17 3
1. Introduction & Context NHS Greater Glasgow and Clyde (NHS GG&C) Nursing & Midwifery Research Strategy aims to support the development, and ensure the sustainability of a NHS GG&C wide Nursing & Midwifery research community of practice. This strategy has been developed from collaboration between NHS GG&C, Research and Development Service; the Glasgow Clinical Research Facility and three principal academic partners: 1. School of Health, Nursing & Midwifery, University of the West of Scotland 2. School of Nursing & Health Care, College of Medical, Veterinary and Life Sciences, University of Glasgow 3. Department of Nursing and Community Health, Glasgow Caledonian University This strategy draws extensively from NHS Lothian s NMAHP research framework which has been adapted to reflect NHS GG&C s local needs and is presented with permission. The findings and recommendations of the review of Research Nurses and Midwives in NHSGG&C have also been incorporated. It sets out the guiding principles that underpin successful collaboration in Nursing & Midwifery research and communicates a vision which will not only strengthen the Nursing & Midwifery contribution to patient outcome through applied research, but will also ensure the development of a vivacious Nursing & Midwifery research culture across NHS GG&C. This strategy pays cognisance to the NHSiS s priorities for healthcare delivery 3 ; NHS Education for Scotland s Clinical Academic Research Careers framework (CACF) & guiding principles 4,5 ; NHS GG&C s corporate objectives; the new Chief Scientists Office (CSO) strategy 6 ; each principal academic partner and the Clinical Research Facilities research strategies, whilst providing the platform for developing capacity, capability and responsibility for Nursing & Midwifery research and evidence based clinical intervention. This strategy recommends developing a continuous improvement plan to ensure the successful implementation of its principles and vision, including identifying criteria for success at five levels: Patient and community level 4
Organisational level (NHS GG&C) Nursing & Midwifery practitioner level Principal academic partnership level Wider research community level This strategy has been developed through NHS GG&C s Nursing & Midwifery research strategy development short life working group, chaired by the Nurse Director of Mental Health Services, with representation from the Clinical Research Facility; Principal academic leads; practice development and Nursing & Midwifery practitioners. Aims The key aims of this strategy are to: Improve patient outcome and efficiency within service delivery by increasing the volume, quality and entrenchment of applied Nursing & Midwifery research Create a culture of inquiry and evidence based Nursing & Midwifery decision making, enhancing the status, profile and contribution of Nursing & Midwifery research across NHS GG&C Support the development of the CACF by enhancing the Nursing & Midwifery research infrastructure Guiding Principles Nursing & Midwifery research within NHS GG&C should be underpinned by the following principles: 1. Applied Research: Patient safety; patient experience; patient flow and outcome; service redesign and equity of access & service delivery are key NHS GG&C priorities which require Nursing & Midwifery professionals to ensure that decision making is evidence informed. Nursing & Midwifery research activity will address these priorities through applied research which leads to improvement in service and patient outcome. 2. Comprehensive & Wide ranging: This strategy supports Nursing & Midwifery research development at 4 levels: 5
Research Leaders: Those Nursing & Midwifery professionals who lead and direct research strategy. They will have a significant role to play in leading programmes of research and creating a Nursing & Midwifery research culture. This will include professionals in Practice development roles; R&D roles; Nursing & Midwifery consultants and Nursing & Midwifery academics. Research Active: Those Nursing & Midwifery professionals working in clinical research and engaged in the inquiry process. This would include Nursing & Midwifery researchers undertaking research as principal investigators or co-applicants. This would also include clinical research nurses or research students. Research Users: All Nursing & Midwifery professionals who are engaged with the evidence base to support and inform their practice Research Enablers: Professionals who actively support and encourage Nursing & Midwifery involvement in research activity through providing guidance on aspects of the research process including training, ethics, managerial support and research governance, for example R&D research facilitators and the Glasgow Clinical Research Facility. This also includes clinical nurse managers, Nursing & Midwifery professional leads and heads of nursing. 3. Collaboration: This strategy builds on the existing relationships between NHS GG&C, HEIs and other research infrastructures supporting research, for example Health Science Scotland (formerly the Scottish Academic Health Science Collaboration (West)). The key priority within this strategy is securing clinical and academic expertise to address important research questions that lead to improved patient care. Where appropriate such expertise may involve collaboration with clinicians and academics outside NHS GG&C; this also extends, where appropriate, to relevant voluntary, charitable and private sector organizations. 4. Mutual benefit: This strategy has been designed to be inclusive, addressing the research priorities of key partners. This includes, for example, developing capacity through collaborative studies and access to subject and methodological expertise. There is a clear recognition that for our academic partners the need to work towards submissions for the Research Excellence Framework (REF) is critical. This framework supports the existing access to R&D infrastructure including expertise within the clinical research facility. 6
5. Integration: NHS GG&C s Nursing & Midwifery Research Strategy supports and strengthens existing partnerships and integration between NHS GG&C R&D office, the three academic partners and NHS Nursing & Midwifery clinicians. Individual research strategy agreements between NHS GG&C and each of the three universities address issues such as access to data and sponsorship. The Clinical Research Facility is regarded as the main conduit for this integration offering support and training for potential investigators. 6. Alignment: This strategy will support alignment of research themes and priorities between NHS GG&C and higher education. Service development plans will be informed by research and provide impetus for focused research questions. This will be achieved through dialogue between key stakeholders (clinicians, managers, Nursing & Midwifery researchers and academics) which will include not only identifying research priorities and activity but also identifying improvement in research outcome dissemination. 7. Building on success: There are existing areas of strength in Nursing & Midwifery research across NHS GG&C that address health priorities, lead to programmes of research and involve collaboration with academic partners. This strategy will build on this success and celebrate research outcomes that lead to improvements in patient care. Emerging researchers and research areas where there is potential for development will be identified and supported. 8. Focus on outcomes and knowledge exchange: The focus on applied research demands that attention is paid to research outcomes in terms of impact on practice and/ or service delivery, publications, dissemination and implementation. There is a need for a review of information systems which capture this activity, including capturing impact on patient outcome. This strategy emphasises the importance of knowledge exchange activities and joint applications which enhance implementation of evidence into practice. 7
Vision 1. Research awareness/ evidence based practice will be explicit in all Nursing & Midwifery roles across NHS GG&C. 2. There will be opportunities for Nursing & Midwifery professionals to pursue a clinical academic career. This includes: Existing doctorally prepared Nursing & Midwifery professionals Nursing & Midwifery consultants Emerging researchers 3. Research activity in GG&C is currently captured by NHS GG&C using a Scottish wide electronic system that should be able to provide information on projects and investigators. Further development of a system will be required to ensure Nursing & Midwifery research activity is fully captured and outcomes of research are made available to raise awareness of research and its impact on Nursing & Midwifery practice in NHS GG&C. 4. There will be appropriate reciprocal arrangements for research active Nursing & Midwifery professionals to have an academic home and academic researchers to have a clinical home in order to strengthen potential collaboration and identification of research priorities and dissemination of research findings. 5. Each directorate/ partnership will have a Nursing & Midwifery research plan that accords with the overall R&D strategy and NHS GG&C service development plans. 6. There will be a clear structure of management, professional support and career development for clinical research Nursing & Midwifery professionals. 7. There will be mechanisms for sharing and supporting Nursing & Midwifery professionals undertaking small-scale projects as part of their practice or academic studies. 8
8. There will be an increase in research activities (such as joint applications for funding, publications, and developing shared agendas) between Nursing and Midwifery in NHS GG&C and academic partners. 9. Nursing & Midwifery researchers in NHS GG&C will play an influential role in shaping policy, and NHS priorities and funding nationally and beyond. 10. NHS GG&C will play a role in the improved performance in the research excellence framework (REF) by the three universities. Conclusion Glasgow has a long established reputation of excellence in research. GG&C and the surrounding conurbation has a population of 2 million with a high prevalence of chronic disease and complex health care requirements. The challenges facing staff delivering health care are also complex, conducting research is therefore essential to improve the care we deliver and continue to develop our professional roles. Nursing & Midwifery professional practice is vital to the delivery of health care in Scotland with Nursing & Midwifery professionals making up the largest component of the NHS workforce. In recent years the Scottish Government in partnership with a range of stakeholders has invested in a number of initiatives to support the embedding of Nursing & Midwifery research and development within clinical practice. The benefits of this investment are being realised, and it is imperative that these are built upon. There is a need to plan for the future research workforce and to do this in such a way that reflects the NHS Career Framework and responds to the recommendations of NHS Education for Scotland to establish Nursing & Midwifery clinical academic career pathways. NHS GG&C is ideally placed to develop and support Nursing & Midwifery careers with 3 university faculties /colleges, an NHS infrastructure within the city available to support researchers and a new state of the art hospital opening in 2015. 9
Appendix 1 Membership NHS GG&C Nursing & Midwifery Research Strategy short life working group Linda Allan, Consultant Nurse Learning Disabilities; NHS Greater Glasgow & Clyde Professor John Atkinson, University of the West of Scotland Mari Brannigan, Director of Nursing, Mental Health Services; NHS Greater Glasgow & Clyde (Chair) Lorraine Forster, Head of Nursing; NHS NHS Greater Glasgow & Clyde Anne Gordon, Assistant Director / Lead Nurse; Glasgow Clinical Research Facility Cathy Holden; Specialist Children Services Manager; NHS Greater Glasgow & Clyde Catriona Kent; Consultant Nurse Psychosocial Interventions; NHS Greater Glasgow & Clyde Grace Lindsay, Lead Nurse - Research, NHS Greater Glasgow & Clyde Toby Mohammed, Head of Practice Development, Acute Services, NHS Greater Glasgow & Clyde Professor Lorraine Smith, University of Glasgow Professor Debbie Tolson, Glasgow Caledonian University 10
Vibrant Nursing & Midwifery research culture within GG&C in which research activity is embedded within routine practice. Usable effective database Increase in studies Increase number of research active Nursing Midwifery professionals recorded on R&D database Clear articulation of Nursing & Midwifery consultants research role. All Nursing & Midwifery consultants have established academic links ACTION PLAN Vision Statement research engagement of the post-holder. Actions Responsibility Measures of success 1. Research Awareness/Evidence Based Practice explicit in all Nursing & Midwifery roles 1. Review of KSF Outlines and PDP templates (in line with CARC s) 2. Production of exemplars of potential PDP objectives and resources to support Heads of profession All KSF outlines/personal Development Plans (PDPs) include a Research component relevant to the level of 3. Review and ongoing dialogue about Nursing & Midwifery research programmes (undergraduate and postgraduate) to ensure alignment with service expectations and explicit link to PDP Undergraduate curricula universally providing solid foundation for students to build future research competency and expertise. 11 2.1 Utilisation of research skills of doctorally prepared Nursing & Midwifery Professionals 2.2 Research Active Nursing & Midwifery Consultants 1. Identification of doctorally prepared Nursing & Midwifery professionals including survey on current research activity, academic links and support needs. 2. Engagement with service leads to identify service priorities, research potential and funding implications 3. Formulation of agreed work plans with ongoing review. 1. Alignment of current research capabilities to CARF Lead Nurses Leads Nursing & Midwifery researchers Nursing & Midwifery Consultants and Professional Leads 2. Identification and establishment of appropriate academic home for individual Nursing & Midwifery consultants.
Vision Statement Actions Responsibility Measures of success Increase in research relevant to practice and impact of research in practice. Named research lead for each directorate/ partnership Interdirectorate/partnership group formed and ACTION PLAN 12 2.3 Emerging generation of researchers 2.4 Joint appointments focussed on research 3. Comprehensive data set on Nursing & Midwifery research and knowledge exchange activity 3. Nursing & Midwifery Consultants have annual research plan which is reviewed with line manager and Lead Practitioner Research. 1. Formal and informal mechanisms to identify new Nursing & Midwifery researchers. 2. Ongoing discussion and support for emerging researchers including linkage to existing research programmes. 3. Where appropriate, inclusion as co-applicants in grant applications. 4. Identification of funding opportunities to support training. 1. Identify current NHS/academic appointments in GG&C 2. Identify the extent to which research is part of existing joint roles 3. Identify potential roles for research development 1. Consultation with Nursing & Midwifery leaders on required dataset 2. Identification of resource requirement and systems to maintain 3. Creation and implementation of dissemination strategies Clinical Nurse Lead Applied Research and Development Clinical and academic leads Clinical Nurse Lead Applied Research and Development Increase in Nursing & Midwifery consultants research activity. Increase in nurses and midwives pursuing clinical academic careers Increase in research activity amongst joint clinical/academic appointees. Comprehensive capture and dissemination of Nursing & Midwifery research activity (publications and conferences) and impact. 4. Reciprocal arrangements for honorary clinical and academic appointments 5. Directorate/ partnerships Nursing & Midwifery research plans 1. Identification of appropriate clinicians and academics. 2. Consultation on appropriate homes and accompanying resources. 3. Negotiation of appropriate contractual arrangements at an individual level. 4. Identification of clear objectives 5. Ongoing evaluation of process and outcomes. 1. Identification of research leads for each directorate/partnership or one per grouping, if appropriate. 2. Establishment of inter-directorate research team to formulate guidelines for directorate/partnerships research plans (including evaluation framework). Nurse Director Head of Schools Research Leads (HEI) Nurses Directorate/CHP Research Leads Lead Nurses
Existence of a robust infrastructure that links research closely with operational management and academic partners Managers and staff at all levels appreciate importance of research and feel engaged with process of integrating systematic enquiry with routine practice and service delivery. Evidence of emergent research culture with increased practitioner involvement and numbers of Research interests/ activities reflected in directorate/partnership Plans & R & D database ACTION PLAN Vision Statement Actions Responsibility Measures of success 3. Establishment of directorate/partnership Nursing & guidance produced Midwifery research groups. 4. Development of individual directorate/partnership research plans that accord with NHS GG&C s strategic priorities identifying short, medium and longer-term goals. Research Leads/Lead Nurses/Nursing & Midwifery Consultants/Clinical Nurse & Other professions/named Academic Link Formation of local Operational Group in each directorate/partnership Each directorate/partnership has its own research plan (congruent with overall R & D strategy) 5. Identification of resources/funding streams to support implementation of research plans. Senior Management Teams/Research Leads/X-Sectoral Partnerships 13 6. Development of new, and consolidation of existing, service partnerships with key partners in the academic, private and voluntary sectors to facilitate priority research activity and implementation.
Vision Statement Actions Responsibility Measures of success Evidence of engagement (where relevant) with private & voluntary sectors to facilitate priority research activity and implementation Increased link between academia and practice. Increased impact of research. Identification of potential Nursing and Midwifery Clinical Academic Research Leaders ACTION PLAN 6. Clinical Research Nurse Structure 1. Establish Clinical Research Nurse Management Group (with representation from Nursing Directorate and CRF) 2. Review support and management arrangements including induction, training, KSF, Royal College of Nursing Competencies. Clinical Nurse Lead Applied Research and Development Increased support for Clinical Research Nurses to develop clinical academic careers 3. Make recommendations for appropriate structure and resource. 14 4. Implement and evaluate recommendations. 7. Smaller scale research studies 1. Agreement of mechanisms to permit identification of candidates employed by NHS GG&C undertaking MSc dissertations or other work-based projects in one of partner HEIs. 2. Identification and dissemination of NHS support mechanisms to complement academic supervision. 3. Development of infrastructure to support dissemination of research topics and findings. 4. Ongoing collaboration between NHS GG&C and partner HEIs to seek funding for opportunities for practitioner-led research Clinical Nurse Lead Applied Research and Development
Improved performance REF focusing on: Grants (esp. with Nursing & Midwifery Professionals as CI) ACTION PLAN Vision Statement Actions Responsibility Measures of success 8. Increase in research activities 1. Ongoing scanning and discussion of research funding opportunities that fit with GG&Cs Nursing & Midwifery research priorities. 2. Identification of appropriate collaborative clinical/academic research teams to respond to calls and conduct research. Clinical Academic Lead Applied Research and Development Increase in Nursing & Midwifery involvement in multidisciplinary research collaborations and as cogrant holders. 9. Influence of Nursing & Midwifery researchers 1. Identify and evaluate existing contribution that Nursing & Midwifery researchers making to local, national and international research and policy forums Clinical Nurse Lead Applied Research and Development Development of Nursing & Midwifery professionals who are acknowledged as national and international experts as a consequence of their research activity. 2. Identify expertise and potential gaps/opportunities to increase participation. 15 10. Performance in Research Excellence Framework 3. Actively promote Nursing & Midwifery researcher involvement in initiatives and bodies that will shape relevant policy / service developments. 1. Collaboratively produce and share information on the REF and REF aims. 2. Produce proforma data gathering forms on REF outputs and impacts Academic leads A document to share Proforma being used 3. Ensure adequate discussion of mechanisms for sharing outputs re the REF Use across institutions of a clear mechanisms for sharing 4. Focus on what it is about the Nursing & Midwifery Research Strategy that will enhance research environment Priorities and monitoring of identified research environment factors
Vision Statement Actions Responsibility Measures of success Publications (esp. with Nursing & Midwifery professionals as 1st author) Knowledge Exchange Impact ACTION PLAN 16
References 1. Nursing & Midwifery (NMAHP) Research Framework 2010-2015. NHS Lothian. Unpublished draft. March 2010 2. Simpson, K. (2006). Research Nurses / Midwives Review. Clinical Trials Unit, NHS Greater Glasgow & Clyde. Unpublished Report. 3. NHS Scotland Quality Strategy Putting People at the Heart of our NHS. (2010). Scottish Government 4. Nursing & Midwifery, Clinical Academic Research Careers Framework. (2009). Version 8 Draft. NHS Education for Scotland. 5. Nursing & Midwifery, Clinical Academic Research Careers Framework, Draft National Principles. (2009). Version 7. NHS Education for Scotland. 6. Chief Scientist Office (2009). Investing in Research, Improving Health. 17