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NIHR CLAHRC Community e-newsletter – Capacity Building in CLAHRCs Issue 61

Welcome to the community e-newsletter for the CLAHRCs, bringing you news from across the thirteen collaborations and the health service research community.

This newsletter looks at the work NIHR CLAHRCs are doing around Capacity Building.

Find out more about the CLAHRC Partnership Programme at: www.clahrcprojects.co.uk/

CLAHRC East Midlands: Matron working towards research ambitions

A senior nurse is fulfilling her academic potential and ensuring research is embedded in frontline clinical practice thanks to a scheme being brought to fruition by NIHR CLAHRC East Midlands.

Louise Bramley, a Practice Development Matron at the Institute of Nursing and Midwifery Care Excellence at Nottingham University Hospitals NHS Trust, is undertaking a post-doctoral fellowship jointly funded by the CLAHRC and Health Education England (HEE) gold awards, having been awarded a PhD in 2016. She is now positioning herself to be a strong contender in the 2018 round of the HEE and NIHR Integrated Clinical Academic (ICA) awards. However, prior to her involvement with the CLAHRC, Louise had never carried out any research. Louise was seconded as one of the original Diffusion Fellows from NIHR CLAHRC Nottinghamshire, Derbyshire and Lincolnshire before it was merged to form NIHR CLAHRC East Midlands. From this experience, she progressed to studying for the NIHR funded MARM and then undertook a PhD.

Without the post-doctoral funding, she would not have been able to dedicate time to prepare for the next stage of her career – working towards producing an application of high quality for the NIHR Clinical Lectureship awards and fulfilling her aspirations to be a senior nurse clinical academic.

Louise is now working with Dr Emma Rowley, the Capacity Development Lead at NIHR CLAHRC East Midlands, to develop an East Midlands-wide network for clinical academics from those aspiring to develop a clinical academic career to those doing it. To join, email emma.rowley@nottingham.ac.uk.

CLAHRC East of England:  Capacity Building in CLAHRCS

The Research Capacity for Dementia Care Research (RCDCP) currently funds 12 PhD students in their research into dementia care, across four CLAHRCs: East of England, Wessex, SW Peninsula & Greater Manchester. This is an initiative from the Department of Health, funded through the CLAHRCs, to increase research capacity for clinically trained health professionals, in particular those with a nursing background.

A key aspect of this initiative is an annual training event, where all students and CLAHRC leads meet to work through topics that are of common interest to the cohort. In particular, we target topics that go beyond standard PhD credits, such as academic pathways, leadership skills and other soft skills that need to be harnessed early in any successful academic.

We have run three of these cross-CLAHRC events to date: 2015, at Cumberland Lodge; 2016, in partnership with the Alzheimer’s Society and the University of Linkoping in Sweden, and our final event will be run in London, later this year.

CLAHRC East of England:  CLAHRC Fellows inform the design and implementation of an innovative youth mental health service in Norfolk

Over a number of years, early intervention clinicians working at Norfolk and Suffolk NHS Foundation trust (NSFT) have undertaken research into design and implementation of youth mental health (MH) services, through a series of 1 year CLAHRC Fellowship projects.

Their research has included: a systematic review finding that young people wanted better access to services, more information, and continuity of care; an examination of referral and contact rates in CAMHS suggesting 14-17year olds were engaging poorly with services at the point of most need and 18year olds had the highest referral rates but the fewest contacts; an iterative consultation process with key NSFT stakeholder groups to examine a ways to better meet service users’ needs; and a 14-25years youth service pilot to explore the impact of extending beyond the 17-18years transition point.

This comprehensive process led to the new 14-25years Norfolk Youth Service being established, representing an innovative example of mental health transformation, comprising a pragmatic, and ‘youth friendly’ service that transcends traditional service boundaries.
A current Fellow from NSFT is continuing the research by reviewing youth mental healthcare service design models in order to assist the future development of Youth mental health services both regionally and nationally. Contact: timothy.clarke@nsft.nhs.uk

CLAHRC East of England:  CLAHRC Fellowship programme

In August 2016, 29 applications for the CLAHRC Fellowship were received from all over the East of England; recruitment included submitting a detailed application form with a proposed research project protocol.

Fourteen applicants were shortlisted for interview, and 12 fellowships were awarded which started in January 2017. The 2017 cohort includes: community palliative care nurse, research clinical psychologist, clinical psychologist, advanced nurse practitioner, research and evaluation lead, consultant in public health, specialist registrar in geriatrics and internal medicine, community matron, a senior clinical pharmacist, research paramedic, clinical psychologist: personality disorder pathway lead and an advanced specialist physiotherapist in stroke rehabilitation.

During the Fellowship year, the fellows’ NHS organisations are funded for one day a week, to release the CLAHRC Fellow to do a research project under the supervision of an experienced PI, participate in an action learning set, and attend one afternoon a month workshop programme. The Fellows will present their projects at a Fellows’ showcase event in December 2017, and will submit a written report in March 2018.

CLAHRC Greater Manchester: Building Research Capacity

Research internships are an important component of research capacity building. To date, CLAHRC Greater Manchester has supported thirteen interns through two cohorts and we plan to deliver a further cohort later in the year. The purpose of the internships is to provide an introduction to research for registered nurses and Allied Health Professionals (AHPs). The internships comprise 30 days over six months and  provide interns with the opportunity,  resources and time to develop key research skills and a piece of work which can be used in service,  following the internship. Internships are effective for career progression, with two of our interns graduating from the intern programme and embarking on an ‘MClinRes’.

Speaking of his experience, Barnaby Rumbold, Registered Mental Health Nurse and former CLAHRC GM Intern (cohort one), said: “The internship has helped me invaluably in a number of ways. From the perspective of skills development, I have been able to work on my academic writing which has improved dramatically. As part of this work, I also presented as part of the Mental Health Research Group at an international conference in Indonesia.”

Dore Young, Musculoskeletal (MSK) Physiotherapist and CLAHRC GM Intern (cohort two), added:One of the most valuable aspects of the internship is being supported in building relationships with a plethora of experts and a network of relevant resources. This has been both inspiring and invaluable for my professional development.”

To support the further progression of nurses and AHPs we have funded six part-time Masters in Clinical Research students. The funding covers their academic fees and 40% backfill to release them from clinical duties. Their clinical roles cover a wide range of areas from Wound Care to End-of-Life Care. To understand the learning processes involved in research utilisation, we are conducting a longitudinal study to examine the experience of interns and Master’s students. For more information, please contact: Carianne.hunt@srft.nhs.uk
CLAHRC North Thames: The CLAHRC North Thames Academy

The CLAHRC North Thames Academy – led by Professor Naomi Fulop, alongside Dr Helen Barratt, Dr Victoria Newton and Anna Head – has three avenues for building capacity across the North Thames area.

Our popular short courses for healthcare and public health staff use real-life examples to equip participants with the skills to implement evidence-based approaches within frontline services. Topics include evaluation, economic evaluation, and a new course for 2017 – Becoming Research Active.

Funded by HEE NCEL, our one-year fellowship scheme provides an excellent opportunity for nurses, AHPs and healthcare scientists considering a clinical academic career to spend four days a week seconded to the CLAHRC working on a research project of their choice.
Our doctoral programme supports PhD students focusing on applied health research, providing a network of expertise and a tailored training programme.

For more on our workshops and training activities, visit our website or email clahrc.academy@ucl.ac.uk.

CLAHRC North West Coast: Capacity Building at CLAHRC NWC

CLAHRC NWC is building research capacity in the North West Coast region by supporting and developing research ideas, projects and individual researchers in its partner organisations.   This is being achieved in a number of ways including support and training for the Partner Priority Programme, a research internship scheme, supporting postgraduate research degrees and furthering career development through the three partner Higher Education Institutions (HEIs).

The Partner Priority Programme aims to build capacity in our NHS and Local Authority Partners by developing evaluation skills of their staff through a process of workshops, masterclasses, training and support.  Each partner in the programme is evaluating initiatives which aim to reduce health inequalities and improve population health and well-being.  In addition to developing evaluation skills, partners are also supporting their staff to undertake a research internship with CLAHRC NWC, developing research ideas that are important to their patients, clients and communities whilst developing valuable research skills.  This includes co-production of Evidence Synthesis (supporting partners to consider research evidence that informs their priorities) and training in Implementation Science.  Through cross-CLAHRC collaboration, training is currently being developed to apply Implementation strategies to project evaluations, and exploring potential barriers to implementation.

CLAHRC NWC has also engaged with a variety of partners to promote the NIHR clinical academic career pathway, in order to identify and support the health care researchers and leaders of the future.

CLAHRC NWC is also supporting over twenty full-time PhD studentships that span its research themes. These projects address health inequalities and support the vision of the CLAHRC NWC.

Read how Anna’s Research explored the relationship between mental toughness and resilience and her findings were fed back to her Local Authority employer.

To see further examples of our students work click here

CLAHRC North West London: Capacity Building at CLAHRC NWL

CLAHRC NWL’s Collaborative Learning and Partnerships (CLP) Cross Cutting Theme builds capacity and capability for the delivery of improvement in complex healthcare systems. We deliver a comprehensive capacity building programme designed to equip NHS staff, patients/carers and researchers with the skills to conduct and implement applied health research to improve care.

Activities range from a diverse doctorate programme, leadership and teaching on 10 MSc programmes and delivery of practical learning to frontline NHS staff and the wider community through quarterly Collaborative Learning events, peer to peer practical learning, an Improvement Leader Fellowship programme, eLearning and bespoke support for over 55 improvement projects.

Our research identified how boundary strategies, such as the tools and methods of the CLAHRC NWL systematic approach can help facilitate dialogue between diverse groups to share the tacit knowledge necessary to translate evidence into practice and achieve improvements in care.

For further information visit the web of CLAHRC NWL

PenCLAHRC: Health Service Modelling Associates

Computer simulation and analysis are key tools in understanding and implementing service redesign and improvement in the NHS. PenCLAHRC’s operational research team, PenCHORD, have developed an innovative approach to increasing operational research capacity in the NHS through their Health Service Modelling Associates (HSMA) programme. Launching in 2016, Associates from six NHS Trusts in the South West worked with PenCHORD mentors to undertake modelling, simulation and analysis projects, which addressed problems specific to their own organisations. The projects have already had a huge impact on service design in these Trusts. Find out more on the HSMA website.

Video: Introducing the HSMA programme

PenCLAHRC: Helping healthcare professionals make sense of evidence

Healthcare professionals who are able to use research to inform their decisions can provide the best possible care to their patients. Workshops supported by PenCLAHRC are achieving just that – giving health care providers, as well as patients and members of the public, the tools by which they can interpret and make sense of research evidence. Find out more on the Making Sense of Evidence webpage.

Video: Introducing the Making Sense of Evidence training

PenCLAHRC: Extending evidence-based practice outside of healthcare

Taking lessons from the use of evidence-based practice in healthcare, this HEFCE-funded project worked with Devon and Cornwall Police to help them use research knowledge to develop and improve services. The Exeter Policing, Evidence and Research Translation (ExPERT) project also aims to create sustainable training programmes and meaningful research collaborations between the police force and Higher Education institutions. To find out more, visit the ExPERT project website.

Video: Introducing the ExPERT project

PenCLAHRC: Helping healthcare professionals make sense of evidence

Healthcare professionals who are able to use research to inform their decisions can provide the best possible care to their patients. Workshops supported by PenCLAHRC are achieving just that – giving health care providers, as well as patients and members of the public, the tools by which they can interpret and make sense of research evidence. Find out more on the Making Sense of Evidence webpage.

Video: Introducing the Making Sense of Evidence training
CLAHRC West: More than 500 people trained in CLAHRC West’s capacity building programme

CLAHRC West’s training programme, which has been running since May 2015, has now trained more than 500 people and delivered 44 training events, across a range of NHS, local authority and voluntary sector organisations. CLAHRC West are working to build a culture of evidence informed healthcare and evaluation across the region, and even further afield. One of the main ways they do this is through their capacity building and training programme.

People from a range of disciplines and backgrounds have attended, including clinical staff from medical, nursing and allied health backgrounds, public health staff, academics and managers and commissioners of NHS services.

Find out more

CLAHRC West: Introducing CLAHRC West’s new Post-Doc Nurse Fellow

Dr Nikki Cotterill has recently joined CLAHRC West as Post-Doc Nurse Fellow, a joint post with the University of the West of England’s Centre for Health and Clinical Research (CHCR). Her area of expertise is continence. Here she tells us a bit about her career history and what she will be working on.
CLAHRC West: Building public health evidence skills in local authorities

The CLAHRC West training team ran a new training course in Swindon for local authorities during May, called ‘Understanding evidence for local authorities’. Specially designed for people working in council departments outside public health, the course was attended by staff from planning, housing and environmental health teams.

The decisions these kinds of teams make have the potential to impact on the health of the communities they serve. But traditionally they aren’t trained in the critical use of research evidence. It can be hard to engage these groups with this kind of training in research evidence, as they may not appreciate the direct relevance to their jobs. Councils are under increasing pressure so this may also be a barrier to taking up training.

However, with eight attendees from as far afield as Bournemouth, the CLAHRC West training team were delighted with the response to this new course.

Find out more on the CLAHRC West website

CLAHRC West: Creating a communications culture in the West

CLAHRC West’s Communications Manager Zoe Trinder-Widdess describes her work to build a culture of good quality communications in the health sector in the West.

Find out more

CLAHRC West Midlands: Capacity Buidling

The West Midlands Patient Safety Collaborative (WMPSC) joined together with the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care West Midlands (CLAHRC WM) and Warwick Business School to hold a ‘Nudgeathon’ in March 2017.

This unique event for the first time brought together NHS professionals, patient representatives and behavioural science students to look at the application of ‘nudge’ theory to solve ‘real world’ healthcare issues – in this instance one of the priority areas for the WMPSC – improving the diagnosis and treatment of atrial fibrillation.

Nudge theory and behavioural science is widely used across all sectors of industry. The attraction of nudge theory is that interventions tend to be low cost, scaleable and can be combined with other nudges to create a number of layers and this approach is ideally suited to tackling complex problems in complex environments such as health. One of the ideas behind the event was to deliberately encourage new and novel approaches brought by the students to solving a health related issue, whilst NHS professionals could offer clinical and organisational expertise and ensure that any solutions offered could realistically be introduced.

Many of the ideas generated from the event are now being developed further with the Patient Safety Collaborative, with the aim that these will then be adopted and scaled up by the West Midlands Academic Health Science Network. There was great enthusiasm for the event with many of the NHS staff now seeking to apply behavioural science approaches to their own areas of practice or influence and build organisational capacity around this.

For more information please contact Paul Bird (P.Bird.1@warwick.ac.uk) Head of Programmes, CLAHRC WM

CLAHRC Yorkshire & Humber: CLAHRC YH working with AHP professional bodies

The mapping exercise undertaken for the CLAHRC Directors (Cooke et al 2016 http://clahrc-yh.nihr.ac.uk/capacity-building/national-and-international ) recommended that CLAHRCs should work with professional bodies to promote research and knowledge mobilisation for nurses, midwives and applied health professionals (NMAHPs). The CLAHRC YH has worked with a number of such bodies in the last year. Two examples working with AHPs are:

  • Council Allied Health Professional Research (CAHPR): We have supported the development of two sub-regional groups in CAHPR. At the inaugural event of the SY CAHPR, speakers described their career in research, and 4/5 speakers highlighted how CLAHRC has helped in this regard. Mechanisms such as secondments, fellowships and capacity development funds have helped.  Joint projects with academic partners were  also cited as helpful approaches undertaken by CLAHRC.
  • Joint work with CAHPR includes post-doctoral fellowships. Two successful candidates are currently on their placement with us. Another secondment is about to be launched aimed at developing a research competencies framework for research active AHPs.
  • Chartered Society of Physiotherapists (CSP): The Translating Knowledge to Action team in CLAHRC YH, and the NICE implementation Fellow based in the CSP are working with the Musculoskeletal Outpatient Physiotherapy Services at Doncaster Royal Infirmary to implement the NICE obesity guidelines. This is part of the CSP resource called Inspire which aims to support implementation of NICE guidelines relevant for physiotherapists. Using a participatory and co-productive approach to knowledge mobilisation, patients and clinicians with experience of this pathway are working together to create contextually sensitive interventions to improve staff and patient satisfaction around weight management.  The aim of this work is to provide an example of how Inspire can be used to promote evidence use in practice.  The project was funded by the CSP with a local research champion having time to co-ordinate the project in Doncaster.

CLAHRC Yorkshire & Humber: Developing pathways for clinical academic careers for practitioners: The paternoster model supported by ‘learning by doing’.

Our mapping exercise of support that the CLAHRC community provide for nurses, midwives and applied health professionals  (NMAHP)  http://clahrc-yh.nihr.ac.uk/capacity-building/national-and-international) found that ‘learning by doing’ opportunities are widely offered by the CLAHRC community. They include short-term CLAHRC fellowships, internships, secondment opportunities and grant/ fellowship preparation awards. Such activities offer protected time away from the clinical environment, but do not contribute to formal training or qualifications. Nevertheless they provide important ‘next step’ capacity opportunities at recognised ‘pinch points’ in the formal training pathway. They include openings at pre-masters, post masters and post PhD levels of experience. As such they provide an important element of the clinical-academic pathways for NMAHPs, and recognise that rather than an escalator pathway for career progression, the model works more like a paternoster.  A paternoster is a continuously moving lift consisting of a series of linked compartments without doors. One has to prepare to get into the compartment when it arrives at the level that you are on. Such ‘learning by doing’ opportunities offer such preparation, application of previous learning, and confidence building to step back onto the upwards pathway.

We offer such opportunities for NMAHPs in CLAHRC YH. These are undertaken in collaboration with other parts of the NIHR infrastructure. In line with the paternoster model, we aim to support applied research that is informed by clinical practice, and directly useful for the practitioner to enhance their CV, and to the work environment. We also work with their clinical managers to enable this. We are currently evaluating this initiative, but initial findings are hopeful in terms of publications outputs, examples of impacts on local practice, career progression and research culture.

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