Clinical Academic Research Careers Scheme for Nurses, Midwives and Allied Health Professionals (NMAHPs) in Lothian.


When did you first introduce the innovation?

More than 24 months ago

Please describe the innovation you have developed

In recent years the Scottish Government, in partnership with NHS Education for Scotland (NES), the Scottish Funding Council and the Health Foundation, has invested in a number of initiatives to support the embedding of NMAHP research and development within clinical practice. This has included the establishment of the national Chief Scientist Office (CSO) NMAHP Research Unit, the NMAHP Research Training Scheme and the NMAHP Research Consortia. Whilst the benefits of this investment are being realised there is a continuing need for development of sustainable career pathways to support the future research workforce within the context of the National Guidance for Clinical Academic Research Careers for Nurses, Midwives and Allied Health Professions in Scotland (NES, 2012). The CARC scheme was developed to address this need.

What prompted you to develop this innovation?

The benefits of the Scheme include defined research outputs from NMAHP practitioners in terms of research training, career development and succession planning, grant income generation, completion of relevant clinical research studies, publications, and evidence-based impact on clinical service delivery. The CARC scheme also serves to further a culture of enquiry and research-mindedness within the NMAHP professions.

In your view, what is it about this innovation that makes it different/important?

The CARC scheme has used the research expertise in NHS Lothian and the three partner higher education institutions to bring together researchers who are supported to research areas of clinical interest with support from all partners and research and development departments. The scheme therefore promotes collaborative working.

To what extent does your innovation make use of existing approaches, resources or technologies?

Main Features of the Scheme

  • 8 clinical research appointments at senior and advanced practitioner levels across 4 clinical demonstration sites (Critical Care, Substance Misuse, Weight Management/Telehealth, Dementia).
  • Funded clinical research training relevant to both career stages (i.e. PhD and Post-doctoral Research Fellow).
  • Defined allocation of clinical and research time embedded within clinical service setting.
  • Team organisation of the demonstration sites with clear operational line management, academic supervision and support arrangements.
  • Clinical demonstration sites selected in relation to strategic research priorities, local service plans and supportive infrastructure especially the existence of well-established, active and successful research groups (of whatever professional mix).
  • Principle of separation of funding stream for research from clinical budgets (clinical parts of posts are already establishment and funded from current general budgets therefore incurring no additional cost to NHS Lothian).

To what degree has this innovation led to changes in education or clinical practice?

The scheme has been ‘live’ since January 2011 when the first of four demonstration sites (a collaboration between the Critical Care Directorate of NHS Lothian and the University of Edinburgh) became operational. A successful bid by the Substance Misuse Directorate, Edinburgh Napier University, and the University of Edinburgh established the second demonstration site in December 2011. The third site, focusing on Weight Management and Telehealth interventions, started in November 2013 and is a collaboration between NHS Lothian, Queen Margaret University, Edinburgh Napier University, and the Edinburgh Tommy’s Centre. A fourth site in Dementia started in February 2014; this site has a slightly different funding model, being a collaboration between NHS Lothian, the University of Edinburgh and Alzheimer Scotland.

As of February 2015 six nurses and two dietitians have been employed in 0.5WTE CARC posts on secondment or fixed term contracts – three Advanced Practitioners (post-doctoral) for three years and five Senior Practitioners (PhD study) for five years. Negotiations to develop two further sites in the areas of Midwifery and Accident and Emergency Care are in progress.

Progress of both the Critical Care and Substance Misuse sites has been very good. The post-holders in the Critical Care site have developed their research networks both nationally and internationally and presented at conferences. Their research focuses on person-centred service development and redesign to improve the psychosocial recovery of patients who have experienced critical illness. Dr. Pam Ramsay has achieved journal publications, been awarded grants to further develop the research programme, and has recently secured a 3 year Research Re-engagement Fellowship funded by the Chief Nursing Officer of Scotland to further sustain her post-doctoral development and research programme.

The Substance Misuse site is younger but Dr. Anne Whittaker has made progress in securing a grant to study healthcare provision for Neonatal Abstinence Syndrome babies, achieving several peer-reviewed journal publications, and, with an international team of collaborators, was recently successful in obtaining a grant from CSO of c.£160,000 to trial Behavioural Couples Therapy with substance misusers. Anne Whittaker has also secured a Senior Lecturer/Reader post at Edinburgh Napier University to sustain her post-doctoral research career on completion of her CARC post.

The Weight Management and Dementia sites are relatively new, having appointed postholders to part-time PhD and post-doctoral study within the past year or so and are currently formulating the fine details of their research programmes. Postholders in all sites have accessed learning opportunities to further their research skills and knowledge, and are ensuring that their research activity is integrated within the clinical service to optimise impact.

What evidence do you have of the impact of the innovation?

Summary of the Scheme disseminated to all Nurse, AHP, Research & Development (R&D) Directors, and Heads of NMAHP university departments in Scotland.

Annual reports to senior NMAHP and R&D and Deans/Heads of Schools locally as part of the Steering Group process.

Presentations at national conferences in Scotland and the United Kingdom e.g. Royal College of Nursing Research Conference.

To what degree has the innovation been disseminated in your organisation or elsewhere?

Presentation to Association of University Hospitals UK Conference this autumn to contribute to the development of a national ‘CARC Implementation Tool’.

The Operational Management Group which oversees the scheme plan to publish information about development of the scheme, the lessons learned and the impact of it in peer reviewed healthcare journals.

Please provide details of any plans you have to disseminate the innovation in the future.

In Lothian we have developed a partnership model for the development of a clinical academic research career pathway; the Lothian Clinical Academic Research Careers (CARC) Scheme for NMAHPs. The scheme is firmly embedded within clinical practice (NHS Lothian), whilst involving full collaboration with academic partners (the University of Edinburgh, Edinburgh Napier University, Queen Margaret University Edinburgh and NHS Education for Scotland) as well as involving the voluntary sector (e.g. Alzheimer Scotland) and places an emphasis on supervision and training.