The Leeds Teaching Hospitals

NHS Trust

n

Clinical Research Careers for the Non-Medical Professions

Strategy 2018-2021

Research Innovation

&

Changing the future of healthcare

2

Fair

Who is this strategy for?This three year (2018 - 2021) strategy is for Leeds Teaching Hospitals NHS Trust (LTHT) non-medical staff. It has been developed jointly with staff, patients, carers and local university partners, and is aligned with the Trust’s Research and Innovation strategy (2015-2020). The Trust’s goal ‘to be an outstanding research and education organisation’ is at the heart of the strategy and specifically to support clinical research careers.

What is the national and local picture?Research active Trusts directly improve outcomes and the care of patients (Boaz et al., 2015). Historically, practice based research has more commonly been developed by medical

practitioners, with non-medical professionals predominantly supporting research delivery (UK Clinical Research Collaboration, 2007).

The Health Education England (HEE) R&I strategy identifies the importance of a workforce that embraces R&I as being central to improving the quality of care and patient experience (HEE, 2013). The Shape of Caring review also recognises the value of registered nurses who successfully combine a clinical and academic career (Willis, 2015).

“Broad research awareness and the ability to engage in critical inquiry and the ability to adopt ‘curiosity’ in all that we do are essential features of our future workforce and underpin our ability to advance patient care safely and effectively.”

(Willis, 2015)

Clinical Research Careers (non-medical) - The Leeds Way

Patient-centred EmpoweredAccountable Collaborative

Research VisionTo be a centre of excellence for applied health research and clinical academic careers driving high quality care.

4 3

43

• Agreement in Principle (between the UoL and LTHT) regarding an amendment to the Memorandum of Understanding to safe guard employment terms and conditions for medical clinical academic careers (CAC), will be applied to all professions.

• Development of a Clinical Research Career Pathway to help managers, clinicians and academics navigate a Clinical Research Career.

• A range of research education, training and leadership opportunities have been created.

DefinitionA research-focused clinician academic is a nurse, midwife or allied health professional who engages concurrently in clinical practice and research and provides clinical and research leadership in the pursuit of innovation and delivery of excellent evidence-based healthcare. A central feature of the research they do informs and improves the effectiveness, quality and safety of patient care. Clinical academics focus on building a research-led care environment for patients and challenge existing practice as well as working within and contributing to a research rich environment leading the way towards achieving excellence in patient outcome and healthcare. The substantive contract of employment may be held by a healthcare provider or a Higher Education Institution. Honorary contracts should be held with the non-substantive host.

AUKUH Clinical Academic Careers Group, February 2012

Where are we now?Similar to other Trusts, LTHT has a limited number of non-medical professionals who are initiating, developing and undertaking their own clinical research. In a few areas of the Trust (aligned to the University of Leeds (UoL)), progress has been made in developing non-medical staff and creating research career opportunities. However, the lack of infrastructure and resource has limited LTHT’s ability to develop and engage broader groups in research.

Likewise, in a number of areas of the Trust the research delivery workforce is well trained and competent. However, additional training and development opportunities are required to create a resilient and competent workforce across all areas.

Additionally, research delivery opportunities have not always been visible to those wishing to develop a clinical academic career. Increasing access to these opportunities would be a significant enabler for those wishing to pursue a clinical academic career.

Over the past 36 months, significant progress has been made:

• In 2015 a Head of Nursing for R&I was appointed to lead the development of clinical research careers.

• A Research Leadership Group (non-medical) was established in 2015 to strengthen links with university partners and drive forward the research agenda.

• A positive research culture for all staff groups.

• Improved awareness and access to research career opportunities (research delivery and clinical academic training) and related roles have also increased.

5

Clinical Research Career Pathway (CRCP)

Identify other opportunities to contribute to research culture

No

Yes

Yes

No

Identify Talent

Build and Sustain

Support Potential

Supporting the delivery of research

Integration of research into clinical

practice

Personal clinical academic career

Identify research delivery role

Review of role

Agree and implement clinical

academic work plan

Link with researchers to identify research

delivery opportunities

Implementing research to

demonstrate service improvement

Implement Employment Contract

(LTHT/UoL Clinical Academic Post)

Consider future opportunities

Consider future opportunities

Continue to develop clinical academic capacity

Enable and advise, including review of

job role

Identification of resource,

opportunity, role and level

Preparation for opportunity,

connecting with research networks

and links

Signpost people to the right places

Provide opportunities to get involved in research

Joint decision to

pursue research within clinical practice

Identify talent and motivation, discuss with line manager

Securing resource and/or organisational

support

Coaching/mentorship ensuring ongoing managerial support, education, training and clinical development

6

Our challenges are:• The implementation and evaluation of the

LTHT Clinical Research Career Pathway (CRCP) and development of clinical academic career routes

• Creating a culture and environment where the participation in research for patients, staff and the wider community is valued, encouraged and facilitated

• Identifying and developing staff with the talent, ability and drive to pursue a research career

• Establishing sustainable funding resources

This strategy sets out our vision, direction of travel and four main aims for the next three years with clear objectives that will be flexibly applied and measured through pre-defined metrics.

Our strengths are:• Support of the LTHT Board

• Strong partnerships with our local HEI’s

• Considerable success in securing external funding and career development fellowships for non-medical staff

• Close collaborations with our medical and scientific colleagues

• Strong clinical expertise

• Access to local and national expertise for both research delivery and clinical academic career development

• Strong engagement in the research agenda by patient groups

7

8

Strategic aims and objectives

“I’d like to have research as part of my job and use research to make a difference to patient care, but I don’t know whether there are any opportunities”

AIM

ON

E Aim: Implement and evaluate the LTHT Clinical Research Career Pathway (CRCP) and develop clinical academic career routes

KPI: Number of joint clinical academic posts with our university partners

Objectives: 1.1 Implement and evaluate the LTHT Clinical Research Career Pathway through engaging with staff and managers and incorporating into the appraisal system

1.2 Develop clinical research career opportunities for staff

1.3 Improve integration between the Trust and local university partners

“I’d like others to understand, value and support my research role more fully and for them to be aware of the benefits to patient care”

AIM

TW

O Aim: Create a culture and environment that values, encourages and facilitates the participation in research for patients, staff and the wider community

KPI: Number of peer review publications with non-medical professionals as authors

Objectives: 2.1 Increase managers commitment to supporting clinical academic pathways while balancing clinical provision

2.2 Increase the number of non-medics as Chief Investigators (CI) and Principal Investigators (PI)

2.3 Increase the number of staff submitting academic abstracts and publishing their work

9

“With support and training I know I can make a greater difference to patient care through becoming a researcher whilst staying in practice”

AIM

TH

REE Aim: Identify and develop staff with the talent, ability and drive to pursue

a research career and reach their full potential

KPI: Number of staff applying to a range of internal and external fellowships and number of research appointments (i.e. Clinical Academic Fellow, Honorary Clinical Associate Professor, Clinical Professor)

Objectives: 3.1 Create and sign post research opportunities for staff and managers, thereby enabling managers to identify talent

3.2 Build research capability across the non-medical professions tracking staff career trajectories

3.3 Develop staff to drive research initiatives

3.4 By 2020 establish a range of key research appointments, including externally awarded and jointly created with university partners

“I need the time to do research”

AIM

FO

UR Aim: Establish sustainable funding resources

KPI: Increase by £60K the annual NMAHP budget ring fenced for non-medical CAC and research delivery career development

Objectives: 4.1 Establish the size of the required budget to establish and maintain the infrastructure to develop non-medical clinical academic career and research delivery careers

4.2 Target priority funding schemes/sources and match staff to opportunities

4.3 Target internal funding streams to create and maintain infrastructure, training and support for staff

4.4 Target external collaborative financial solutions for infrastructure, training and CAC support

10

Delivering the strategyDelivery of the strategy is detailed in the three year strategic plan, which outlines the actions, measures and targets for each objective; progress against each year 2018 to end 2021 is also monitored.

ReferencesBoaz, A., Hanney, S., Jones, T. & Soper, B. (2015) Does the engagement of clinicians and organisations in research improve healthcare performance: a three-stage review. BMJ Open, 5.

Health Education England (HEE) (2013) Research & Innovation strategy (2013-2018). https://hee.nhs.uk/our-work/research-learning-innovation/research-innovation-strategy. Accessed: 09/06/2017

Willis, GP. (2015) Raising the Bar. Shape of Caring: A Review of the Future Education and Training of Registered Nurses and Care Assistants. Health Education England, London. www.hee.nhs.uk/sites/default/files/documents/2348-Shape-of-caring-review-FINAL_0.pdf. Accessed: 09/06/2017

UK Clinical Research Collaboration (2007) Developing the Best Research Professionals. Report of the UKCRC Sub-Committee for Nurses in Clinical Research. www.ukcrc.org/reports. Accessed: 09/06/2017

AUKUH Clinical Academic Careers Group (2012) What is a clinical academic? www.aukuh.org.uk/index.php/affiliate-groups/nmahps/clinical-academic-nmahps. Accessed: 12/10/2017

Research and Innovation (2015) Leeds Teaching Hospitals Research and Innovation strategy. www.leedsth.nhs.uk/assets/Uploads/RI-Strategy.pdf

Resources• Research Capacity Building Framework. Cooke, J.

(2005) A framework to evaluate research capacity building in health care. BMC Family Practice. 6(1), pp.1-11

• NIHR booklet Building a Research Career. NIHR (2015a). Building a Research Career: A guide for aspiring clinical academics (excluding doctors and dentists) and their managers. [Leaflet]. www.cancerbrc.org/news-events/news/building-research-career-guide-aspiring-clinical-academics-and-their-managers

• Association of UK University Hospitals (AUKUH) Clinical Academic training pathway for NMAHP. Finley, V. (2012) A Strategy for Developing Clinical Academic Researchers within Nursing, Midwifery and the Allied Health Professions. www.gov.uk/government/publications/developing-the-role-of-the-clinical-academic-researcher-in-the-nursing-midwifery-and-allied-health-professions

• The clinical academic pathway capability framework. Westwood, G. and Richardson, A. (for AUKUH) (April 2014) http://aukuh.org.uk/index.php/component/docman/doc_download/151-aukuh-clinical-academic-careers-capability-framework-may-2014

• Transforming healthcare through clinical academic roles in nursing, midwifery and allied health professions: A practical resource for healthcare provider organisations. AUKUH (2016)www.medschools.ac.uk/SiteCollection Documents/Transforming-Healthcare.pdf

• The Association of UK University Hospitals (AUKUH). www.aukuh.org.uk/index.php/affiliate-groups/20-nmahps/128-clinical-academic-careers-pathway-capability-framework

• NIHR. www.nihr.ac.uk/funding-and-support/funding-for-training-and-career-development/training-programmes/nihr-hee-ica-programme

11

Appendix - Strategy Plan

Aim 1: Implement and evaluate the LTHT Clinical Research Career Pathway (CRCP) and develop clinical academic career routes

KPI: Number of joint clinical academic posts with our University partners

Objectives Actions/Measures Target

18 19 20

1.1Implement and evaluate the LTHT clinical research career pathway (CRCP) through engaging with staff and managers and incorporating into the appraisal system

Publish an agreed implementation plan December 2017

Numbers of staff citing the use of the pathway (through an annual research culture survey)

N/A 5 10

Staff using the CRCP as part of their appraisal

N/A 20 30

1.2 Develop clinical research career opportunities for staff

Number of joint clinical academic roles 2 2 2

1.3 Improve integration between the Trust and local university partners

An adapted MoU between UoL and LTHT applied in practice

TBC by UoL HR

Recruitment of a PhD student through the CLAHRC doctoral partnership scheme

N/A 1 UoL 1 LB

Expression of interest created as part of the national trailblazer group to develop a level 8 (PhD) apprenticeship clinical academic fellow (non-medical)

End March 2018

12

Aim 2: Create a culture and environment that values, encourages and facilitates the participation in research for patients, staff and the wider community

KPI: Number of peer review publications with non-medical professionals as authors

Objectives Actions/Measures Target

18 19 20

2.1Increase managers commitment to supporting clinical academic pathways while balancing clinical provision

Publish NHS Managers Research Tool kit End March 2018

Number of responses to the annual research culture staff survey

N/A 100 170

Number of information/education events with managers

2 3 4

Number of staff research awards (includes shortlisted)

2 3 4

Number of research case studies shared on the non-medical R&I intranet page

3 4 5

2.2 Increase the number of non-medics as Chief Investigators (CI) and Principal Investigators (PI)

Number of non-medical: PI’s CI’s

34

56

78

Number of clinical academics submitting grants: 1) as co-applicant 2) as lead

21

21

41

2.3 Increase the number of staff submitting academic abstracts and publishing their work

Ability to track publications End March 2018

Increased numbers of published articles 5 10 30

Annual increase (%) of abstracts submitted to the LTHT NMAHP annual conference 1) Clinical 2) Research

10%5%

10%5%

10%5%

13

Aim 3: Identify and develop staff with the talent, ability and drive to pursue a research career and reach their full potential

KPI: Number of staff applying to a range of internal and external fellowships and number of research appointments (i.e. Clinical Academic Fellow, Honorary Clinical Associate Professor, Clinical Professor)

Objectives Actions/Measures Target

18 19 20

3.1Create and sign post research opportunities for staff and managers, thereby enabling managers to identify talent

Number of abstracts submitted to NMAHP conference 100 120 140Attendance numbers at research support group meetings (mean)

4 6 10

Working with university partners to identify talented undergraduates who may wish to pursue a research career

1 2 3

Number of staff aware of NIHR Integrated Workforce Framework (IWF)

Number of staff using the IWF at appraisal

30

N/A

60

20

100

40

3.2 Build research capability across the non-medical professions tracking staff career trajectories

Number of annual funding applications

1) MRes2) PhD3) NIHR Clinical Lectureships

410

521

631

Develop band 7 team leader training program June 2018

Number of newly developed research delivery education schemes

1 1 1

Number of band 6/7 research delivery staff undertaking leadership training

2 4 4

3.3 Develop staff to drive research initiatives

Number of staff (who require it) have access to appropriate clinical academic support and mentorship/coaching

3 5 7

Number of staff accessing

1) Research skills training courses2) Collaborative research opportunities

11

12

13

3.4 By 2020 establish a range of key research appointments, including externally awarded and jointly created with university partners

Clinical Academic Professor (non-medical) 0 0 1

Honorary Clinical Associate Professors (HCAP) (new non-medical)

2 2 2

NIHR Senior Clinical Lecturers 0 0 1

Renewal of existing NIHR Senior Investigators Renewal date

Support further NIHR Senior Investigators 0 1 1

14

Aim 4: Establish sustainable funding resources

KPI: Increase by £60K the annual NMAHP budget ring fenced for non-medical CAC and research delivery career development

Objectives Actions/Measures Target

18 19 20

4.1 Establish the size of the required budget to establish and maintain the infrastructure to develop NMAHP CAC and research delivery careers

Working with finance and R&I colleagues identify costs associated with CAC’s:

1) Joint posts

2) Training

3) other infrastructure

Identify required

overarching budget by end March 2018

4.2 Target priority funding schemes/sources and match staff to opportunities

Identify, signpost and support staff to submit internal and external funding applications

1) Number of staff applying across a range of funding awards

2) Number of staff successfully awarded

3) Non-medically led NIHR Programme grants

10

5

1

12

6

1

13

7

1

4.3 Target internal funding streams to create and maintain infrastructure, training and support for staff

Establish internal sustainable financial support for CAC’s

December 2018

4.4 Target external collaborative financial solutions for infrastructure, training and CAC support

Establish collaborative CAC financial solutions with our university partners

December 2018

Published by Nursing Innovation & ResearchThe Leeds Teaching Hospitals NHS TrustOctober 2017 MID Code: 20170904_009/NR