1. Janet Hanley R&D Manager NHS Lothian

2. Why? Universities 2001 RAE- NMAHP subject groups did badly Compared with other subjects NMAHP departments had high teaching loads, little time for research and few senior academic posts NHS 1980s onwards committed to evidenced based care From late 1990s onwards increasingly organised in approach to clinical research Became obvious that research activity/ output very unbalanced with little research activity/ evidence to support some aspects of clinical care (NMAHPs, primary care, health service delivery)

3. Why clinical/ academic careers? Why does the NHS not just commission clinical research from Universities? Clinical research agenda is largely developed from the bottom up Effective clinical research studies bring together good science creative thinking Knowledge of how things work in a clinical context the ability to be enterprising within a large organisation The evidence is that this is easier to achieve when there are some individuals working across clinical academic boundaries over sustained periods More interesting jobs

4. What has been happening? 1994 – The CSO Nursing Research Initiative (now NMAHP research unit) 2002 – Choices and Challenges 2004 – AHP Research and Development Action Plan 2004 - The Research Training Scheme 6 post-docs and 6 PhD students 2004 – NMAHP Research Consortia 2004 – UKRC – Walport Report – Research Career Pathways for doctors and dentists in training 2007 – SCREDS – Research Career Pathways for medical staff 2007 – UKCRC – Finch report - recommends Nursing Research Career Pathways – funded in England 2008 – The Advanced Practice Tookit (SGHD) 2008 – RAE Results 2008/9 – Lothian CARC drafted and shared with NES 2009 – NMAHP Leaders Day focussing on NMAHP Research and Development 2009 – NMAHP Clinical Academic Career Pathway Consultation Events May 2010 Lothian CARC launched October 2010 National NMAHP clinical academic career framework

5. Lothian CARC scheme Informal collaboration to draft proposal for implementation of the Finch report recommendations in Lothian. Working group led by James Law and Andy Peters Approached NES with draft in October 2008 NHS Lothian R&D agreed 50% funding in 2009 NES and the 3 university partners agreed remaining funding Scheme formally adopted by NHS Lothian in 2010 and launched in May

6. Support Worker – level 1 Practitioner – level 5 Assistant Practitioner – level 4 Senior Healthcare Support Worker – level 3 Healthcare Support Worker - level 2 More Senior Staff – level 9 Consultant Practitioner – level 8 Advanced Practitioner – level 7 Senior Practitioner – level 6 Career Framework for Health

7. Lothian CARC Features Four levels relating to career framework for health Masters (level 5) PhD student (level 6) Post doctoral (level 7) Advanced (levels 8 & 9) Only levels 6 & 7 included within current funding as time limited training posts Embedded within the clinical services and academic departments, who must work in partnership Some funding for independent evaluation

8. Demonstration sites 3 demonstration sites Partnership between a clinical area, a partner academic department and potentially others Each demonstration site will get funding for one senior practitioner (PhD student – 5 years) one advanced practitioner (post doctoral – 3 years in first instance) Both will be 50% academic, 50% clinical Funding 50% clinical service, 50% CARC scheme NHS contracts and appropriate academic status within partner institutions

9. Progress 1 demonstration site appointed (ICU/ U of E) Second call for applications closes tomorrow Issues/ opportunities Some interesting partnerships developing – some at too early a stage for this call Some clinical research interests are not within the priorities of any of the partner academic departments and vice versa The NHS Lothian recruitment freeze has limited the pool of candidates to existing NHS Lothian staff at the present time, so the potential for the scheme to attract in talent cannot be explored.

10. Challenges Pressure for these 3 demonstration sites to be successful REF Nurturing other partnerships Financial climate NHS support funding vs FEC Sustainability – although there is a national framework there will not be a national scheme How do we develop posts for career development? (levels 8&9/ permanent posts?)

11. Thank you Additional slides for discussion if required NIHR multi-professional career pathway Draft Scottish NMAHP career pathway Steering group

12. Steering Group Andy Peters Juliet MacArthur Janet Hanley Pam Smith Shona Cameron Catriona Kennedy The programme is managed through the Edinburgh Health Services Research Unit www.HSRU.ed.ac.ukwww.HSRU.ed.ac.uk

13. Doctors and Dentists NIHR Integrated Academic Training All Professions NIHR Fellowships Nurses, Midwives, Allied Health Professionals Clinical Academic Training NIHR Clinical Lectureship NIHR Clinician Scientist Award Masters Health Economics, Masters in Med. Statistics. NIHR Doctoral Research Fellowship NIHR Post- Doctoral Fellowship NIHR Career Development Fellowship NIHR Senior Research Fellowship NIHR/CNO Masters in Clinical Research NIHR/CNO Clinical Doctoral Research Fellowships Level of Award Other Awards -------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------- Senior/ Pre-Chair -------------------------------------------------------------------------------------------------------------------------------- NIHR Research Career Pathways Senior Post-Doc Early Post-Doc Doctoral Pre-Doctoral/ Masters Undergraduate NIHR/CNO/HEFCE Senior Academic Clinical Lecturer In-Practice Fellowships and NIHR Academic Clinical Fellowships NIHR/CNO Clinical Lectureships CSO Health Care Scientist Doctoral Fellowship CSO Health Care Scientist PostDoctoral Fellowship