4 Where’s the starting point? Benefits of the JobThe conduct of research to international standardsTravelling to investigator meetings and conferences nationally and internationallyEating at good restaurants to discuss the research project/s and to networkNo shift workDrawbacks of the JobDrowning in a sea of research jargonFrequently working in isolationOther nurses view the CRN as a data collectorShort term contractsSometimes have to arrange holidays around studies in progress
5 Historically Worked in isolation from their professional colleagues Convenient whilst raising a family, not having to work weekends and eveningsMere data collectorsShort term contractsLack of line management supportInvisible to trust personnel systemsExtended and specialised role
6 Biomedical Research Centres BirminghamAberdeenManchesterEdinburghCambridgeGlasgowSouthamptonInvernessNewcastleTayside DundeeLondonBelfastMcMichael CentreDublinUCLHGalwaySomers GOSHCorkGuy’s & St Thomas’CardiffHull YorkManchester Children’sSheffieldSheffield Children’sBirmingham Children’sOxfordPeninsulaBrightonSurreyClinical Research FacilitiesBiomedical Research CentresAberdeenDundeeGlasgowEdinburghNewcastleManchesterLiverpoolCambridgeOxfordLondonGreat Ormond StGuy’s & St Thomas’ImperialMoorfieldsRoyal MarsdenUCLInvernessAberdeenDundeeGlasgowEdinburghNewcastleBelfastGalwayYorkDublinHullManchesterLeedsLiverpoolSheffieldBiomedical Research UnitsNottinghamLeedsLiverpoolSheffieldNottinghamLeicesterBirminghamOxfordBristolLondonRoyal BromptonBartsSouthamptonExperimental Cancer Medicine CentresCorkBirminghamLeicesterEdinburghGlasgowBirminghamBelfastCambridgeNewcastleOxfordLeedsLondonManchesterBartsLiverpoolICRSheffieldImperialLeicesterKCLUCLSouthamptonCambridgeOxfordCardiffBristolLondonSurreySouthamptonPeninsulaBrighton
7 NIHR Clinical Research Networks NIHR Dementias & Neurodegenerative Diseases Research NetworkNIHR Diabetes Research NetworkNIHR Medicines for Children Research NetworkNIHR Mental Health Research NetworkNIHR National Cancer Research NetworkNIHR Primary Care Research NetworkNIHR Stroke Research NetworkNIHR Comprehensive Clinical Research Network
9 Clinical Research Nurses Newcastleyear n100%Increase over 3 years
10 Similar Picture Across the Country AHP/STUDY COORDINATORSCambridge 26Sheffield 21Manchester 13Norfolk & Norwich 8NUMBERS INCREASINGYEAR ON YEARNURSESCambridge 148Sheffield 173Manchester 168Norfolk & Norwich 56Newcastle 180Birmingham 87 (Trust)Scotland 411Large body of nurses being employed with little or no strategic thinking of how to develop group of individuals.However as critical mass emerges, solutions to concerns or problems are developing2012/1310,000
11 Changes since 2001National:- including Developing the Best Research Professionals (Finch) 2007, Competency document – version 2, Training – GCP, Informed Consent, new roles emergingNetworks:- Induction Portfolios, local training, information sharing - UKCRF Network –Trust:- Lead Nurse Appointments, Local Training
14 Advanced Practitioner The definition used widely by the DOH outlines that an advanced practitioner is a clinically autonomous practitioner, defines the scope of practice of others and continuously develops clinical practice within a defined field.• Experienced non-medical registered professional who has developed his or her knowledge to a very high standard in a specific and often high level of practice. This high standard is such that not only is the individual the expert in the base domain:-but can also accept the full responsibilities for providing those services hitherto supplied by others, in defined circumstances.(J. Sargent 2003)
15 Core Characteristics of Advanced Practice Work across organisations and different agenciesProvide advanced levels of practice, knowledge and skillsClinical focus - Clinically autonomous.Empowered to make high-level decisions.Be self directed, manage risk, have high levels of communication skills and be a member of a wider clinical/ service team.In many cases the person will have their own patient/client caseload with decision making responsibilitiesIn many cases manage medications including assessment, review and prescribing.Undertake a physical examination and history taking, diagnosis and plan care and treatment.
16 Advanced Practice in Manchester Modernising workforceEuropean working time directivePatient centred seamless carePARTNERSHIP 2004Strategic Health Authority13 Acute andMental health TrustsUniversity of Bolton (primary care)University of Salford (acute)
17 Advanced Practice in Manchester Greater Manchester SHA initiative – Delivering the WorkforceAdvanced and Assistant PractitionersNeed identified by Trust, application to GMSHETrainee roles commissioned and funded through GMSHASupported by an education programme
18 Application Process Rigorous process Trust and WTCRF commitment to the roleDetailed proposal form submitted to SHADecision to support application sits with SHA
19 The Proposal Executive sign off Role description Reason for developing roleNeeds analysisSkills and competenciesFacilitation of WBLIdentification of mentor/assessor/line managerSafety, effectiveness. governanceFunding arrangements and sustainabilityOrganisational track record
20 The Role - OverviewTo develop advanced knowledge and skills in the identified theme areas and assist both new and established investigators to efficiently carry out their studies and enable them to achieve study targets by providing continuity of service.In partnership with the Clinical team manager provide clinical leadership to the team of nurses, focusing on enhanced practice developmentTo develop nurse led research and support the development of clinical academic roles.
21 The Role - Expectations Lead on participant care for the duration of a study, including assessment for inclusion in a study, medical history taking, medical examinations, management of drug infusions, prescribing and reviewing and refining participant care throughout the studyProvide medical cover for identified cardiovascular and paediatric studiesUndertake informed consent for Clinical Trials of Investigational Medicinal Products
22 Demonstrate enhanced clinical skills including arterial bloods, biopsies, management of central lines, minor surgical procedures, ultrasound in the vascular system, management of anaphylaxis, pulse wave analysis, analysis and decisions relating to test resultsLead on the development of nurse led research and enhanced clinical practiceProvide advice and guidance to PI’s on study efficacy and safetyParticipate in the development and testing of new devices and approaches to health care for patient benefit
23 MSc - Programme 2 years (part time) 45 weeks per year (3 semesters). 2 learning days per week.Thursdays taught day.Thursdays and some Fridays sem 1 and 2Attendance at University greatly reduced year 2. - WBLSecond day student choice for clinical/work based needs.90 days per year clinical application.
24 University of Salford, MSc Advanced practice (Health and Social Care Pathway)Programme OverviewSemester 1Semester 2Semester 3CreditsYear 1Principles of Advanced Practice (30)Application of Life Sciences (30)Contextualising Advanced practice (30)90PortfolioIndividual Learning PathwayTripartite Agreement core and bespoke skillsOrganisational pathway analysisYear 2Research Methods(30)AP1: Practitioner competence (30)AP2: Clinical Reasoning (30)
25 Portfolio of Evidence Year 1 Job descriptionIndividual Learning PathwayClinical Skills Learning AgreementBespoke Skills identified and agreedObjective and subjective evidence for sub elements of the Elements of Advanced PracticeAchievement of skills at level 2 on Taxonomy of AchievementOrganisational pathway analysis360 degree feedback
26 Portfolio of Evidence Year 2 Cases (formative and summative)Triangulated evidence for many sub-element of Elements of Advanced PracticeCompleted skills log (core and bespoke) at level 2 and 340 case assessmentsCompletion of Individual Learning Pathway180 credits at level M
27 Programme Support Mentors Stay with student for 2 years Understand programme and learning requirementsAdvocate in Trust on behalf of studentAssessorsObjective judgement on performance throughout 2 yearsMay delegate some work to supervisors of appropriate standing
28 Programme Support Trust Mentor Line Manager Assessors Supervisors UniversityPersonal TutorAcademic SupervisorProgramme leadStudent LifeLearning Facilitator
29 Where are we now Successful SHA application – 2 posts Successfully recruited through internal secondment – band 7 in training, 8a once qualifiedSteering group in place2 trainees commenced Sept 2011