Transcript AHP careers and development - Allied Health Professions

AHP research:
excellent opportunities
in challenging times
Dr Angela Green
Lead Clinical Research Therapist
Hull and East Yorkshire Hospitals NHS Trust &
NIHR NEYNL comprehensive local research
network
How important is
research to the NHS?
DH Equity and excellence: Liberating the NHS (July 2010)
3.16 The Government is committed to the promotion and conduct of research as a
core NHS role. Research is vital in providing the new knowledge needed to
improve health outcomes and reduce inequalities. Research is even more
important when resources are under pressure – it identifies new ways of
preventing, diagnosing and treating disease.
•There will always be
a need for new
evidence to support or
challenge practice
• Future research priorities
may have to focus on
improving productivity, cost
effectiveness and meeting
targets e.g. reducing
likelihood of readmission
within 30 days of discharge
Why research is important
for your organisation
Since
2010 every NHS Trust has been required
to publish an annual Quality Account which is
available to the public. This includes a statement
of the number of patients who were recruited to
participate in research approved by a research
ethics committee during that period.
Why research is important
for your organisation
Using
this data,
the Guardian
newspaper and
National Institute for
Health Research
published a
research activity
league table on 2nd
December 2011.
N.B. This illustrated
participation in
NIHR portfolio
studies only.
Organisation
Position in
table
Number of
NIHR
studies
2010/2011
Number of
patients
recruited
2010/2011
Central
Manchester
University
Hospitals
11
204
4635
The Christie NHS
Foundation Trust
21
136
1301
Salford Royal
NHS Foundation
Trust
31
111
3167
University
Hospital of South
Manchester NHS
Foundation Trust
42
86
21,476
Unplaced
0
0
North West
Ambulance
Service
How research can benefit
AHP services
Knowledge is valued since, if applied, it has the potential to
improve the human condition. If an organisation only
undertakes established procedures, it is simply a ‘provider’
among many providers. An organisation that undertakes
research and development has the capacity to potentially
offer unique care, and, more importantly, is seen to have
the drive to do so. Consequently, it moves into a different
‘league’. Being in this ‘league’ makes it easier to attract,
recruit, retain and develop staff, and effects how the
population, commissioners and other providers feel about
the organisation: it becomes a source of local pride.
(HEYHT Research and Development Strategy 2009-2012).
Clinical research - Lows!
You realise that there are a lack of validated
outcome measures to use in your study
You discover just how much it costs to order
articles through your medical library!
Mastering the IRAS (ethics) and R & D forms
Discovering that you need MHRA approval
Your equipment supplier ceases trading!
Your grant application is rejected
Your application gets lost in a bureaucratic
black hole
Your supply of eligible patients disappear
Staff leave/ rotate or become to busy to
participate.
Data analysis reveals no difference… or
worse!
Etc……..
Clinical research – Highs!
Discovering that other people value your
idea
Discovering that your clinical research
question will address a gap in research
evidence
Securing your managers approval
Successfully obtaining funding to support
your project
Receiving a favourable opinion from the
research ethics committee
Recruiting your first few patients
Discovering that your data supports what
you suspected, or suggests something far
more exciting!
Having a paper accepted by a peerreviewed publication
Research in nursing and the allied health professions.
Report of the Task Group 3 to HEFCE and the
Department of Health. Bristol: HEFCE; 2001.
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underfunding relative to comparable
professions
underfunding relative to the size of the
professions
Funding skewed towards short-term projects
There was a need to support career
development and research opportunities for
health professions researchers, teacher
researchers and clinician-researchers
Barriers to AHP research
in the North West
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Nurses and AHPs from 54 North West region NHS
organisations and 8 HEIs were either interviewed or
completed an electronic survey.
Barriers identified:
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Lack of time
lack of funding
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To backfill posts
For education and training
To support research projects
Lack of practical support.
Organisational culture focussed on achieving targets and service
delivery
Lack of any clear career structure
( Pidd, H.; Tinston, C. (2009) Non medical research and development workforce scoping
exercise).
Breaking into research
study day, York 2010
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Attitudinal
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Resources
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Lack of management support
Negativity from colleagues
Tradition – research is not a major component of AHP job
descriptions
Lack of confidence to develop ideas
Time to develop idea
Access to relevant IT software and hardware and desk space!
Lack of appropriately skilled staff to backfill posts.
Process
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Work in silos – lack peer support
Put off by the time taken to go through governance and ethics
Solutions: Time
Impact assessment: research geared
towards key service priorities
 Directory of AHPs willing to be involved in
research
 Increased investment in joint academia/
NHS funded clinical research posts.
 Research Secondments with NIHR or
HEIs
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Solutions:
Partial Involvement
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Identification of clinically relevant research questions for HEI
projects
Involvement in study design & grant applications as part of a
stakeholder group/ expert panel
Participation in portfolio studies
Involvement in study set up/gaining permissions
Identification of suitable patients for studies
Recruitment to studies
Providing interventions under study – portfolio projects
Data collection/outcome measures
Dissemination of results: Journal club or in service training
sessions
Implementation of research evidence – service development
Portfolio Studies ?
Research proposals which have been successful in
open, national competitions and been subject to
independent peer review i.e. high quality, studies.
NIHR portfolio studies have automatic access to
NHS support costs
Include multi-centre and single centre studies
Include commercial and non-commercial studies
Benefits of participating in portfolio
research studies
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Chance to collaborate with leading
researchers in your specialist area;
Possibility of training and/or use of novel
assessment tools, outcome measures or
interventions;
your assistance will help ensure the success
of much needed, high quality AHP research
projects which provide the evidence to support
or challenge what we do.
Experience of the research process
CLRN support costs should be paid to your
department to support the time that you devote
to the study, plus support infrastructure to help
get the process underway
Accessing the
UKCRN portfolio
database
http://public.ukcrn.org.uk/search/
Spoilt for choice?
Spoilt for choice?
Primary care study
of interest to manual
therapists and those
trained to administer
acupuncture.
Career structure:
clinical researcher posts
In May 2005,
NHS employers. org
incorporated five
generic therapy
research job profiles
on the Agenda for
Change/ KSF register
AfCmin
AfCmax
6
6
7
7
7
7
8a
8a
Clinical Researcher
8b
8d
AHP Consultant
8b
9
Clinical Researcher
Clinical Researcher
Specialist
Practice Education
Facilitator
Clinical Researcher
Principal
http://www.nhsemployers.org/
NIHR Research Career Pathways
Other Awards
Doctors and Dentists
NIHR Integrated Academic
Training
All Professions
NIHR Fellowships
NIHR Senior
Research
Fellowship
Nurses, Midwives, Allied Health
Professionals
Clinical Academic Training
Level of Award
NIHR/CNO/HEFCE
Senior Academic
Clinical Lecturer
Senior/
Pre-Chair
-------------------------------------------------------------------------------------------------------------------------------NIHR Clinician
Scientist Award
Senior
Post-Doc
NIHR Career
Development
Fellowship
NIHR/CNO
Clinical
-------------------------------------------------------------------------------------------------------------------------------Lectureships
CSO Health
NIHR PostCare Scientist
NIHR Clinical
Early Post-Doc
PostDoctoral
Doctoral
Lectureship
Fellowship
Fellowship
-----------------------------------------------------------------------------------------------------------------------------CSO Health
Care Scientist
Doctoral
Fellowship
NIHR Doctoral
Research
Fellowship
NIHR/CNO Clinical
Doctoral Research
Fellowships
Doctoral
------------------------------------------------------------------------------------------------------------------------------Masters Health
Economics,
Masters in Med.
Statistics.
In-Practice Fellowships
and NIHR Academic
Clinical Fellowships
NIHR/CNO
Masters in Clinical
Research
Pre-Doctoral/
Masters
-------------------------------------------------------------------------------------------------------------------------------Undergraduate
Other organisations offering
fellowships to AHPs
http://www.rdinfo.org.uk/
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Arthritis Research UK
Diabetes UK
Fight for Sight
Medical Research Council
Parkinsons UK
Public Health agency Northern Ireland
Stroke association
Wellcome Trust
Funding
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To support research projects:
NIHR funding streams (e.g. research for patient benefit; Health
services and delivery research programme etc)
Professional body research funding
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For education and development
NIHR and some research and development organisations provide
free research training e.g. Good clinical practice (GCP training)
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For backfilling posts
Clinical research networks and CLRNs provide service support costs
to pay for involvement in portfolio studies over and above what is
considered usual care. Where there is the potential to be involved in
a number of studies, the NIHR has supported research AHP posts.
Support with your
own project
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Organisational R & D department or consortium
Regional AHP research forum
Professional society
NIHR networks
6 Topic Specific Networks (Cancer, Stroke, Medicines for
Children, Mental Health, Dendron, Diabetes)
A Primary Care Research Network
25 Comprehensive Local Research Networks
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National and local Specialty Groups
RDinfo website (http://www.rdinfo.org.uk/)
Research design service
Research design service for North West
Based at Lancaster University
[email protected].
Telephone: 01524 593209
You may contact the RDS at any stage of your proposal
development, but it is preferable to contact us at an
early stage to discuss your ideas.
Making research
easier ?
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In December 2011, the Government established a Health Research Authority whose
purpose is to co-operate with others to combine and streamline the current approval
system and promote consistent, proportionate standards for compliance and
inspection. It will reduce the regulatory burden on research-active businesses,
universities and the NHS, and improve the efficiency and robustness of decisions
about research projects.
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The NIHR is also developing research support services to simplify approvals and
permissions, and is working towards unified knowledge management systems for the
NIHR and its partners.
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Key points include:
wherever possible, researchers will complete procedures and input data once for
multiple uses
researchers have free access to expert advice and information about regulatory
approvals, permissions and good practice
systems are being strengthened to ensure more effective dissemination of outcomes
of research
All organisations in England that provide care, fund research, employ researchers or
review or regulate research will be eligible to use the new systems.
In conclusion:
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Research is a Government priority
In such financially constrained times, research is a
vehicle which will enable AHPs to demonstrate the
value that we bring in enhancing hospital discharge
and prevention of admission
There are a number of different sources of help and
advice for novel researchers, but it is advisable to be
proactive and seek help early in the process.
Interdisciplinary Collaboration and strong PPI links
are the key to successful research funding bids.
If you don’t fancy being a research lead, there are
many other opportunities which exist to influence
future research and practice
Thank you
for listening.
Hull Fair
Humber Bridge