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SoWhoCaresAnyway E14 Igniting Curiosity · SoWhoCaresAnyway

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Hello and welcome to So Who Cares Anyway, the podcast that shares learning, innovation and ideas from the world of health and social care and beyond.
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My name is Ruth Germain and I'm inviting you to join me each week with my inspirational guests to hear about who cares.
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To join me each week to find out, so who cares.
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Anyway, to find out more about me, who I am and what I do, please head over to my website, www.reflectiveruthconsultancy.com,
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where you can also catch up with previous episodes and read my blogs.
Hello and welcome to this next episode or so.
Who cares? Anyway, and today it's my, pleasure to introduce you to Claire Peg.
I've known Claire about two or three years now, and, we first met when I was doing some work in the, integrated care building, advanced practice, and I set up a platform for people that were working at that advanced level across Kenter midway to link together and learn together.
And I had a section on there, which was around research.
And at that point, the people that had been leading it for me had.
Left because the idea was that this was self-led by people either working in the system, or working in the area.
So Claire had taken on a role, at the time and agreed to lead that research section for me.
And it's gone from strength to strength.
So before we talk about that, I'm just gonna ask you to introduce yourself please.
Certainly.
Thank you Ruth, and thank you for having me on your podcast.
So, as you said, my name's Claire Peg and I have a couple of hats.
So the National Institute of Health and Care Research is.
Almost like the research arm of the NHS and it's undergone a little bit of a transition recently, so it was called the Clinical Research Network.
It's now transitioned to the Research Delivery Network and under the Research Delivery network.
I have a couple of roles.
So I'm the health and Care director for nurses, midwives, and AHPs.
So this is brand new role in the new RDN and.
It's as a result of lots of conversations where they felt that there wasn't so much of an equality for nurses, midwives, and hps for our M maps to do research as it was for our medics.
So in the old world, in the clinical research network.
There was a clinical director, but there was no representation for the M maps.
So in the new world, it was felt very much that actually there needs to be a platform, there needs to be a senior leader in that space.
And actually that they're equal.
So the M MAP director doesn't report into the medic.
They both come, at an equal playing field.
So that took a lot of, conversations, I believe, and a lot of discussion, but.
For me and for a lot of the M maps that I represent, that's really important that we've been given that platform that we've been seen as important as the medics when it comes to research.
So that's one of my jobs.
I do that two days a week.
Then the other role that I do with, the RDN is I am.
A joint.
Sorry, Claire, before you move on, I'm just gonna ask you if you'll clarify RDN and then Max again, so the RDN is the research Delivery Network.
And when we talk about M maps, that's our nurses, midwives, and AHPs.
Which you did say, but I thought people might have missed Thank you.
That's fine.
That's the trouble.
They roll off your tongue after a while, don't they? You don't hear them so much in your own brain.
So as part of the, research delivery network, I am a joint role with, my colleague and we are the workforce and people, senior manager.
So within that particular role, it's very much about that growing the.
The skillset, of those that are working within the research delivery field, and those that are potentially gonna want to step into some of that academic stuff.
We don't do a lot of that academic, it's more the case of we will signpost, because we are very much that research delivery network.
So what's quite handy is that I've got those two days.
The M Map director, which is all about kind of building capacity, capability and really encouraging M Maps to do their own research.
And then actually as the workforce and people, senior manager, I've got a little bit more of an operational feel of it, and actually I can start to make some of that stuff happen, which is ideal and it's a really good match in my brain and it works well, for me anyway.
And then.
One day a week.
I also now work for NHS England, and that is as their, program lead for research.
And it's around delivering what people would've heard as the sort tool, which is the self-assessment organizational readiness tool.
So this was published about a year ago from NHS England, and it's all around ensuring.
And understanding how an organization can assess how ready they are to deliver research from an Nmap perspective.
Again, so really focusing on this nursing midwifery and a HP role.
So yeah, they're my roles at the moment.
Thank you, Claire.
And there's lots of changes, so Yeah, I can imagine it really affects it.
I wonder if you'd, just tell me though, Claire, obviously you're a nurse by background.
If you just give a brief bit of your background so people can understand a little bit more about who you are, but particularly to start to talk about how that took you to that research area, because obviously you are quite embedded in that research now.
What was your journey and what took you that way? Interesting, I never really thought about nursing in any way, shape or form.
In fact, I was actually, I had, a place at university to do religious studies and theology, as a degree.
But okay, there was that element of I don't really know what I'm gonna do with that.
That's great that this is something I'm interested in, but actually what am I gonna do? And the thought of going to university and all of that debt and not really knowing what to do with it.
And my boyfriend at the time, who's now my husband, we've been together since.
I was 16.
He was said, why don't you consider nursing? And I was like, not nursing.
Anyway best friend at school, her mum was a nurse and she said, oh, let me take you out.
And I went and did some community nursing with her and absolutely loved it.
So I then put in an application to, to do nursing.
So that's where it started.
And when I was training.
I fell in love with intensive care, literally fell in love with it.
It was the place where I felt so comfortable.
I felt so.
Pushed in a sense of understanding conditions and all of that kind of stuff.
It was such a supportive environment and I loved it.
And my mentor there said, why don't you work here when you qualify? Why don't you go and speak to the matron? So I did, and I just said, I really would like to work here when I qualified.
And she said, that's fine, but could you do six months elsewhere? So I did six months on, on a respiratory ward and I hated it.
Absolutely hated it.
And so I was so relieved when that six months was over and I went to intensive care and I remember very much being with one of the nurses there and.
Probably one of my first sort of shifts and the patient was really acutely unwell.
They were ventilated, they were on hemofiltration, they were on, a big sort of rotating bed that we had at the time.
They were on so many different infusions.
And I remember working with the nurse and she was like, yeah, it's another pneumonia.
And he was thinking.
Oh yeah.
Gosh to feel so comfortable in that environment, I was still like, rabbit in headlights to be so comfortable in that environment that she was like, yeah it's just another pneumonia.
I was like, oh, wow.
To ever get to that point.
What's that gonna feel like? And.
I suppose it was seven or eight years down the line or less than that, but you start to go, oh yeah, it's just another pneumonia.
You start to feel really comfortable and understanding.
But I think the thing that I was really concerned about was I never wanted to almost come to that compassion fatigue, I didn't want to just become yeah, it's just another pneumonia.
I didn't want to become so numb to the fact that what people were going through was horrific and, so I think after a while when I started to get really comfortable in that environment, I started to look for something else.
And so the Intensive Care National Audit Research Center had a couple of projects and there was some funding behind that.
And so they asked if there was anybody that would be interested in applying for the role as critical care research nurse and.
I thought I could give this a go.
I can see what happens.
So I applied for the role.
I was successful at the role or successful in the application of the role.
And yeah, I absolutely loved it.
And I think looking back on that.
Role.
You know how everybody looks back at a job and goes, oh yeah, that was my favorite job.
I think looking back, that's probably been my absolute favorite job.
If I could choose to go back to any job, that would be it.
We did studies into sepsis.
This was before the sepsis six was really known about.
We did studies into different types of ventilation, different types of feeding delirium all.
Just all sorts of stuff.
I really loved it and as part of that role, I learned how to deliver good clinical practice.
Good clinical practice or GCP training is one of the things that researchers are asked to do when it comes to undertaking research and ensuring that we support our participants to, step into a research project.
And so it was quite a comprehensive training program.
And you have to learn an awful lot around the history of where things have come from and why it is that we do what we do.
And it goes back an awful long way.
But as part of this, it meant that I was going out and about teaching various different people how to undertake a good clinical practice.
And one of the places that I went to was, and a community organization and we had lots of conversations and they said, oh, we really need somebody to come in and support the development of research within our organization.
'cause we don't really have a huge amount.
They put a job out.
I applied for that and I went into a leadership space and I did that for a couple of years.
And don't get me wrong, I absolutely loved it.
I really enjoyed it.
But there was something about the pull of the hospital that I really missed.
I.
So when a role came up to be the lead nurse in an acute organization for research, then I applied for that and I did that for five, six years.
And that was leading on the research that happened in a multiple different portfolios.
So everything from hematology, oncology, ophthalmology.
So it was all sorts of different specialisms and there was quite a big team and we had the COVID pandemic during that time, so we had to lead on really kind of complex studies that looked at treatments for Covid.
And we did vaccine study as well.
So that was quite hairy.
That was definitely something I'm.
Don't want to repeat, if I'm honest.
Okay.
But I, there's so much learning from it, so much learning, but the stress was just epic and, yes, I did that.
And then the Clinical research network, they were looking for a role as regional chief research nurse, and they said this is the first sort of strategic post that they're gonna have.
And so I applied for that.
I did that for a couple of days and then took on their role of as workforce leaders, for three days to do that.
And then I've stepped into the roles that I've done now.
So yeah, it's definitely been interesting and.
If you were to take me back to my newly qualified self and say, where do you think you would see yourself in 20 odd years time? This is definitely not where I would've seen myself.
So it's happened very organically and i've always been driven by doing a job that I really feel needs to be done.
So with this particular role, you're thinking, yeah, do you know what this is a role that I could undertake.
I absolutely believe that this role is really important and it needs to be done.
And so I think that's what it is, that's these opportunities have come by.
And I've looked at them and gone, yeah, do you know what This absolutely needs to be done and this is what I need to, what I could potentially apply for.
Wow.
So thank you.
And you've given a good history there, but what, in that you've really spoken about some really important things and the first bit that I really picked up was around that compassion fatigue.
So there was a part of you that wanted to become comfortable.
Because I think we all do.
Somebody comes to see us or we are looking after somebody, there's somebody in our care as nurses, and we want to feel comfortable that we know what the right thing is to do for them and that we can manage that and do that.
Without that, think of what do I need to do and should I ask somebody or do I need to get help and will I cope and will it be okay? So there's a lot of pressure on you in a way.
So that comfortable feeling is something that sort of almost strive for.
But at the same time, and I recognize this 'cause I can remember saying to my dad the day that I don't feel any compassionate to be the day that I leave nursing.
Yeah.
Because actually that compassion is really important because this is something that's happening to somebody.
This is somebody's life and it's really important that we are compassionate and we understand that and think about how that feels for them, their family, and everybody else.
And I find it interesting 'cause I wanted to understand what led you into research And it's almost that.
Because you felt not that you had compassion for fatigue, I'm sure Claire, but because you were aware that was potentially there when you became comfortable, that led you into research so that you started to question and in questioning that kept you from having that, compassion fatigue maybe.
Yeah, and what I'm thinking is, I think for those people that are working out there, there's always this thing about advanced practice consultancy practice, and we should be working across the four pillars of that practice.
And one of those, I won't go to say this now 'cause it takes us down a different route, but one of those is research.
And people aren't always afforded time to do research within their clinical roles.
But actually this demonstrates a really important point as to why people need time.
Trying to take research, whatever that research might be.
Obviously it needs to have some sort of importance behind it, but you've really demonstrated that in a way that I think shows why we need to be doing research and given time to stop and think and question is this the right thing? Yeah, absolutely.
And it doesn't happen enough, which is a real shame.
And what would be.
Gold standard treatment, and not treatment, but what would be gold standard is that actually it's not just those that step into research roles that have time aside for research.
It's not just those that have the fourth pillar of their practice with time aside for research.
That always happens, but we know.
But wouldn't it be lovely if actually as part of your journey from a, from an M map, so nurses, midwives, and all AHPs, that actually they're not rostered a hundred percent clinical from the outset.
So you've actually got bound five nurses that are fresh out of university that understand some of the, up and coming stuff that have actually got time aside to start to see things and what we've got with our brand new nurses and.
Other healthcare professionals is that they're able to come at things with a degree of naivety, which I is actually a really positive thing because you can come in and go, I don't understand why this works like this.
And when you've been in that, when you've been looking after you only your patients for seven years and you do this, and you do that, and you do that and you, because that's how you've always done it.
If you've got somebody that's coming in with that culture of that curiosity in their brain going, but why are we doing that and why are we doing this, then you've got such an opportunity to start really beginning to question actually what it is that we are doing and why it is that we are doing what it is that we do.
And I think sometimes we don't appreciate necessarily that.
Inquisitive mind and that fresh learning, that fresh understanding.
I remember doing something at university when I was doing my intensive care course, and it was a fairly new score in system that they'd brought out that was gonna look at whether or not a patient needed to be hemo filtered as part of their treatment and.
I'd got this score and I was like, oh, this is amazing.
Like this work, this works really well.
And I remember so, so clearly looking after a patient in bed, one who was deteriorated and thinking.
I'd been in post for quite a while now.
So you, you get used to picking up and knowing what's happening with your patients physiologically, and I'm thinking this patient's gonna end up needing to be filtered.
Absolutely.
They're gonna need to be filtered.
And I had this scoring system and actually this scoring system backed up what.
I thought that actually we need to be getting on top of this because if we start filtering this patient now, then you know we are gonna actually improve their outcomes.
I remember bringing it up to the consultant and said, look, we've got this score and this, that, and the other.
And then, and they went, oh yeah, that's great.
No, we don't need to filter them at the moment.
And do you know what? It was about 48 hours later what happened? They had to go on the filter.
He was just thinking, oh, I was so frustrated because you're thinking we've got that evidence there.
So again, that's part of that research, isn't it? It's that knowledge mobilization, you've got that knowledge, but we are not able to mobilize it because there's barriers in a way.
There's people that don't necessarily understand that.
So yeah, time aside for research is, it's imperative.
It really is.
Yeah, absolutely.
And I really like that bit that you were talking about, that inquisitive.
Of, people that are new and thinking, and you say you've been in post for quite a while, but you were still quite relatively new.
And actually because of that probably is why that.
Knowledge that you had wasn't seen by everybody else.
And actually it just needs to be part of everybody's business almost so that people are going, oh, okay.
And it's accepted that somebody's new or relatively new to an area or whatever their role.
Because I think probably, I think things have changed now, but I know certainly from my own career, if I spoke to a consultant and suggested something, it would be.
But the consultant will make that final decision and knows best, and I think we've moved on from that quite a bit, that it's more of teams working together, but there was that side to it.
I think it's really important that people talk together I just, before we move on, I just wanna say it really links in as well, I dunno if you've particularly listened to this one, Claire.
I know you've listened to some of them, but it really links in with Rebecca Myers who was talking about the emotional labor of work and how we need to recognize that.
And actually, really what you're talking about, there was that sort of emotional labor that you wanted to get to that comfort area, but actually you found a way round of doing that so that you.
Still felt comfortable, but you didn't get that compassion fatigue, which we often see, when work is so emotional as well, because it's just a way of coping really, isn't it? Yeah.
To be fair.
So I'm gonna move on now to what you're doing now.
So what is it that you are doing in your role, to support research.
And I suppose as you're talking about that, one of the things I'm thinking is why.
We've got a bit here about why it's important, we've, or quite a big bit really, but there's probably other reasons about why research is important.
So I wonder if you talk a little bit about that and then that might help to talk about what it is that you're doing because you are be explaining why at the same time, very long-winded question.
Sorry.
No, it's fine.
I tend to do that.
I suppose what.
People don't necessarily realize.
And I think looking at the history of the NHS and how it's always worked is that research has always predominantly been done by medics.
It's always been done by our doctors.
And that's great because we've got new treatments, we've got new therapies, we've got lots of stuff that's happened over the years that has been led by doctors and I think.
There's now this.
Light has been shone on the fact that it isn't just doctors and we need to be thinking about our M maps, and there's real evidence there that actually shows that nurses and midwives and AHPs that deliver their own research, that ask those questions, that develop that culture of curiosity, they actually really influence and shape the nursing profession.
It can.
Inform, it underpins policies, it shows that there's improvement in healthcare performance.
It actually improves patient outcomes.
You look at it starts to challenge some of that status quo.
And this isn't just me saying that this is what it does.
There's evidence, it's documented, there are references that I can give you that, that show all of that.
And it's so it's there.
And I think one of the biggest things that.
It probably frustrates me, I think the most is that there's a real significant association between clinical research, activity, academic outcomes, and reduced patient mortality.
And for those that have heard me speak at various different conferences and things, one of the things that I often go back to is we know that good hand hygiene.
Has an impact on patient mortality.
So we do that and we know that good pressure area care has an impact on patient mortality, so we make sure that we do that.
But yet as nurses and midwives, it's evidence there that the research we do impacts patient mortality, and yet we still see as somebody else's business still somebody else's job to do that.
And I think this is where we need to start turning research on its head.
The conversations that I've had with M Maps is they have questions.
They want to know the answers to these various different things.
Some of the CNSs that I've spoken to, for example, that, that work in breast care, they've had.
Numerous examples where they're going, but we could do this as a treatment to maybe reduce pain or we could do this, or we could do that.
And I've been reading about this and perhaps, so the questions are there.
It's just about offering that platform, that development opportunity to step into that space and rec trying to get our senior leaders, our chief nurses, our divisional leaders, to recognize that this is an important thing to be able to.
Offer that to their staff.
So to, rather than putting barriers in place and saying we need you to work clinically a hundred percent of the time, we know that actually releasing our M maps to do something else means that there's better retention and recruitment rates as well.
Those that are working in research, positive cultures actually have better recruitment.
So it's so much holistically, I suppose beneficial than just necessarily the research outcomes, but it's sometimes frustrating that is not always seen.
Yeah, and I think it is that thing that there's so much clinical work to be done and so often, and people have talked about this a lot, particularly during Covid and even after, but I think it's always been the case that, there's clinical work to be done.
So all the other is a almost a nice to have.
Yeah, all those other things, but actually they're not a nice to have.
They're a necessity.
And the only way to relieve pressure on the system is to have that leadership and that education and that research for everybody from the word go, that people have time to do those other things.
Because without that, we're just doing the same things all the time.
Rather than saying what else can I do? And I really like that you've talked about that, people have questions and there is something, I find myself, if I look back and I'm not a researcher at all as when I look back and I think about research was, it felt a little bit mystical.
And it wasn't just that I thought other people would do it.
There was something about it that felt a bit scary.
But actually is about asking inquiring questions and then knowing who there is out there to help you support that, which is where it's nice that there's people like you.
To be able to do that.
Yeah.
And I think that's definitely a term that we come across.
The whole myth busting of what research actually is.
There's we witnessed it very early on that, the easy use of acronyms and all of a sudden these words are banded around, oh, we're gonna have clinical academics, we're gonna have fellowships, we're gonna have internships, we're gonna, and these are all words that are not always familiar within the M map space.
Yes, they're a little bit more familiar when it comes to medics, but not necessarily for M maps.
And I think sometimes just a language that's used within the research sphere can be a little bit off putting and.
I think as well, there's often this, I've been told numerous times or I couldn't be a research nurse.
I'm not clever enough.
And I think hang on a minute.
There is nothing about being clever.
It's just about having that curiosity.
It's about asking the right questions.
It's about wanting to know.
The answers, I don't necessarily think it's anything about being clever.
If you are clever enough to become a nurse midwife or an a HP, then you are clever enough to ask a question and to find the answer to that.
So it's just all about, okay, so how can we make this work? And what's out there to support that development.
Yeah.
And that keeps it being in that mythical space.
So one of the things that I asked you earlier on was, so what is it that you are.
Doing at the moment.
So what's happening that you are doing to help to support those nurses with wives and adult health professionals to, to go into that world of research and to have time to do that? So I think a lot of it is around that advocation.
So making sure that I'm an advocate for the M maps in the right spaces.
So various different meetings and things that I attend quite historically are always medical based.
I will make sure that I'm in that space and I'm going, actually we need to make sure we're using the right language here because if you keep talking about medics, then you are ostracizing a massive amount of the workforce that could be stepping into this space.
So if you're not even getting the language right, then actually those opportunities are not gonna follow.
So working for the National Institute of Health and Care Research varies very much.
There's a national nursing, midwifery and allied health professional.
Team, as it were.
So it's very always been very much a nursing and midwifery team.
And they've now appointed associate director for a HP.
So they all work together in one particular office.
And what tends to happen is there's a lot of these opportunities that come out that are all development opportunities and part of my role, and there's.
There's 12 of us across the nation.
So we've got our central kind of team as it were.
And because we are a network, there's one of us based in each of the regions.
There's 12 regions, there's 12 of us, and our roles are very much a case of right, what opportunities are there and how can we make sure that they are offered out to those that are in the right spaces.
So actually there's equitability of access to those opportunities.
So when we are thinking around those, it's around.
Opportunities to potentially step into to a master's, opportunities to step into a PhD, to be able to start to push and pull together what your own academic question and your own academic career could look like.
But alongside that, it's about recognizing that there really needs to be solid leadership in that space for research.
Research needs to have advocacy in as many places as it possibly can.
So there's.
Lots of different leadership opportunities.
So we have a senior research leadership program, which is for our nurses and midwives, and for the first time, hence, sorry, in Sussex, we have got three senior research leaders that have just been appointed and we haven't had any for the last couple years.
So super excited to see what this is gonna look like in that space.
They get two days a week allocated.
Backfield for three years to grow capacity capability for research in their settings and across the region.
So I'm gonna be working really closely with these guys to see what we can start to do and how instrumental we can be across the region collectively.
So from an a HP perspective, there's a similar program that has just been launched.
It's called the Developing Research Leaders.
And again, this is for AHPs to step into, to start to build capacity and capabil.
Ability specifically for AHPs and their game within their region and their organization.
And then we've got new things around social care.
So the National Institute of Health and Care Research, it was very much felt like the and care was just that added extra.
So as part of that transition, there's been a real acknowledgement that we need to start thinking about.
Research in the wider health and care setting.
So we are not just focusing on our patients that are coming in through the doors in a e and that are rocking up into our outpatient clinics.
We need to be thinking around, okay, so what does it look like for our schools? What does it look like for our prisons? How can we work with those? If Domiciliary care, how can we support our social care nurses? How can we start to think around, homeless services and refugees and prisons, like how can we start to expand what it is that we are doing so it's not just focused on that very small amount.
It's 10% of people that enter the hospital.
90% of our population are treated within primary care and they the wider health and care settings.
We need to be focusing our efforts in where some of those populations are.
And I think as part of the government's move to bring that focus from hospital to community, that again is very aligned with what we are doing from an N-I-H-A-N-I-H-R perspective in making sure that we've got those wider health and care settings.
So I suppose some of that work is myself stepping into those spaces and.
Advocating again for research.
So I'm part of the social care nursing advisory council for the Southeast.
So yes, I'm not a social care nurse by background.
I do not say that I know everything with regards to social care nursing.
I really don't.
I'm very naive in that space, but we've got a social care nurse who is leading nationally in that space and so I'm able to take some of those conversations I have with her and bring them into our local space.
So I think a lot of it is around that.
Yes, I think that's massive, Claire.
Because what you're talking about there is extending research from medical research and it was something I was gonna come onto as well to ask you about to that, to other research because.
We tend to think of research.
It's about this procedure or that medicine, or traditionally it's talked about in that way.
But actually what you're talking about here is extending it to other groups, whether they be nurses working in social care, or whether they be our allied health professionals.
And there's probably people listening that are thinking who are allied? Professionals.
I'm not gonna say them all, people know some of them sort of paramedics, occupational therapists, physios.
But it goes all the way through to things like to drama therapists.
Yeah.
And art therapy actually.
So the questions they come up with are surely gonna be quite different to the questions that a medic or a nurse might come up with.
And the setting that people work in will make different questions.
And all of those things are about.
Not only providing better care, but actually thinking about how do we make things different for this group of people? You talked about homelessness, so sometimes that might be a very different question about how we support those people to live well or something like that.
So I dunno if you've noticed a difference in the type of questions that people are coming forwards with.
What's.
Useful is having some of those opportunities to hand so that when people do have a question, it's about going right.
This would be the right opportunity for you with that particular question, and I.
So I think understanding the lay of the land when it comes to the infrastructure that's out there and the different opportunities and the other different bodies that could potentially help.
So that, yes, if somebody does come to a, forward with a question for homelessness, I've really.
Wouldn't have a clue, but I know exactly where I can signpost you to, and I know those people that I can link you in with.
So I think sometimes it's not necessarily knowing and understanding the remit in which people are coming forward with those particular questions, but perhaps understanding the infrastructure that supports it and the opportunities to make sure that they're in the right space.
So how are you working to make sure that those people are.
That when they have their questions, that they think of that as research, because I think that's one of the things that you talking about earlier on.
I've got a question, why don't we do this? And why don't we do that, but actually think, oh, this could be research.
This might be research.
And then to actually think about, oh, actually this is how I can take that forwards without feeling overwhelmed and daunted, which is what we spoke about earlier on.
Thinking around those, that step into some of the master's spaces that, they've done their degree and then potentially they're gonna go ahead and do masters.
And I think this comes onto nicely for our acps, really for our advancing clinical practitioners is as part of post-graduate training, potentially people will do a dissertation and that will either be.
Are there a quality improvement project? It could be an audit, it could be some sort of research.
Some people do a bit of a literature review just to find out what's out there and just see what does literature say and what should I be implementing within my particular service.
And I think these are done as routine in the sense of dissertations are very much done and you have to do that in order to get your qualification and what.
I've come across and what seems to happen quite a lot is that people will do a dissertation and then that's it.
It's just parked, it's put on the shelf.
Yeah.
And.
One of the things that I've been working with some of those universities to do is actually just think about that almost dissertation dissemination.
So rather than it sitting on the shelf, but how can we start to showcase some of that work that's happened? So some of it may not be researched, so technically it may not fit under what my umbrella would be, but.
Quite often you need a quality improvement project or you need an audit as a starting point to go hang on a minute, let's have a look.
If we do this, is this gonna lead to this within that service, that would potentially be a quality improvement project, but.
When you start to think, okay, what are the outcomes of this? That's when you start to build some of those research questions.
So I think some of those conversations around just encouraging people to think a little bit bigger.
And say okay, so you've done this, your dissertation is up there on the shelf, but how can we learn from that? And how can we start to expand that? How can you start to showcase the stuff that you've learned? Because if you've found out that a, b, E equals C, then actually that's gonna be useful for somebody else because you're not the only person that's working in that space.
And I think that kind of leads us onto the community of practice really that.
We'd developed from an advancing clinical prac practitioner space.
And I think, like you were saying, Ruth, at the very beginning, that this was something that you had you envisaged and you wanted to happen.
And it was something that I'd, I suppose it was a vision that I'd had when I was working in my previous.
Role and I'd started to work with the acps in that space, within that organization.
So then stepping into something that was regional focused, you just think this would be amazing to pull together a community of practice for advancing clinical practitioners, trainees, those that are training, those that are actually advanced that are.
Kind of qualified is what they would say advanced, and those that are consultant level, but actually as well, even those that are working in that advanced space that may not have gone through the.
I suppose what we would now, say the kind of standardized route because roll the clock back sort of five, 10 years really.
And there really wasn't that sort of standardized approach.
And there was a lot of people that were working in what would say, advanced roles who were very advanced, but not having undergone necessarily that particular training program.
So it was about making sure we don't ostracize those, but actually we bring in some of that knowledge and expertise and skills within that group.
So I suppose the A CP Community of Practice was birthed about a year ago, and I would say now there's about 250 acps that we have got signed up across in Sussex, and we've got a few that are from outside as well.
And wow, this particular community is.
All about focusing specifically on that research pillar.
So what does that research pillar look like for our acps? And so we have an hour meeting once a quarter, so it's not overly draining on time and stuff.
We're very mindful of that.
And we did a little bit of work beforehand to make sure that we were gonna get people on the right days, the right times and that kind of stuff.
So we didn't go in going, this is what we want.
For you, we very much went in and gone, right? We need you to come alongside us and think about how we could design this.
We don't wanna do it to you, we wanna do it with you.
We wanna be able to part of that kind of supportive role.
And so there's a steering group that we've got and we look at.
What we've got coming up.
We look at planning our meetings and I suppose one of the things that came through was about making sure there was an understanding for that multi-professional research practice-based capabilities framework, which there is no acronym for that.
And I almost wish there was 'cause it's so long.
It's quite long.
It is.
But this was a piece of work that was published by NHS England in February last year.
And it looks very much a case of we know that our acps have to work to their fourth pillar of practice.
That's great, but what does this fourth pillar actually mean? What does it mean to be research active in the a CP space? And so this capabilities framework was published and there's eight interrelated non-hierarchical domains, and it's all centered around transforming care and patient services.
And these.
Interrelated and non-hierarchical domains are focused on things like research delivery, knowledge mobilization, research leadership, so actually the stuff that we've already talked about, these are part of what that framework looks like, and it's about the.
Breaking it down to go right.
Actually, if you are coming in at an enhanced or at advanced level, sorry.
When you are working in this space, this is what we expect that you will be doing in order to meet your fourth pillar of practice.
And there's a lot there.
There is a lot there.
So it's a case of.
There's no expectation that somebody is going to be advanced necessarily within all of those eight interrelated domains because there's gonna be elements of it that you are actually gonna be really good at and maybe elements of it.
That you think, actually I need a little bit of further development.
So as part of that, this framework can be used for appraisals, it can be used for kind of development conversations.
It can be used for making sure you've got the right people coming into that space for training as well.
So the whole thing is about ensuring that there's that robustness to what it is that you are doing.
So it's not just, reading the latest article on a Friday night, it's about actually how am I bringing this into my practice? How am I really developing that research pillar? So as part of the community practice, we have a look at this particular framework.
And then we'll also make sure that there's an opportunity for somebody to showcase some of the work that they're doing.
So we've had lots of examples.
In the last sort of year of some really good practice and people that are doing exactly what the evidence says, where they're actually informing an underpinning policy, we've seen that in the community of practice, which is brilliant.
And then also we come across some collaborative pieces of work.
So we'll say is anybody doing a piece of work? And you need colleagues on board.
So someone might present and say, yeah, do you know I'm doing this and I really need this, that, and the other from you guys.
And.
People will potentially come forward.
And then again, it's a bit of a platform.
In the role thinking of what's happening nationally from the nursing midwifery office, those opportunities do not always translate to those that are working.
Out clinically, but actually having this community of practice, I'm able to bring those opportunities that we've got and go, Hey, this is now what we've got.
We've got these social care internships or social care fellowships, so we've got these local authority, this, that and the other.
I'm able to use that platform to make sure that those that potentially want to develop can hear about it.
That's brilliant, Claire.
And I think it is just that thing of having people together and then being able to talk and be able to support them.
And take away that myth that's behind it all.
And I think the thing about the and I'm not even gonna, you said it would be nice if I had an acronym about the framework that you were just saying about.
I think what's useful is not only is it there and paints a picture for people of what they might be doing.
'cause sometimes people, we think, what do I need to do in that area? It's actually written, but also from that point of view of being able to go back and we spoke earlier on about how people are pa into just doing that clinical focus work.
Because that's what needs to happen.
But actually they can say I need to be doing this as well because I am working at this level, so this is something else that gives people that evidence to be able to say, that's something else that I need to do, and talk about why that's important to give them that time.
So I'm really aware of time Claire, and yeah, I've got lots of other questions for you, but they can probably last for another day and another time.
But I think you've given us a massive insight here into research, why it's important and your passion as to why you took it forward.
So before we finish, I just want to ask firstly, is there anything else that you were bursting to say that perhaps I haven't asked you about? And after that, have you got any key points that you think these are the key things that I want people to take away from today? I suppose the only thing that we've not necessarily touched on so much is the self-assessment organizational readiness tool.
So it was another document that was published by NHS England, and I think it's a real.
Ideal time to start looking at this document.
There's 44 different statements, and actually as an organization, benchmark yourself as to where you are.
So the idea being is that it's an organizational thing, so it's supposed to be very much driven by exec teams, potentially led by those that are in the research space, but not necessarily.
And there are examples where it's been used for teams.
So I would just say that if you have the opportunity to have a look at the sort tool to see what that looks like and potentially think around, okay, so is this something that we're good at? Is this something that we need to recognize, that we need to develop? And actually what are the developing opportunities in order to be able to help, I think.
From the organizations that I cover in the role with NHS England, there's a real mixed bag as to what's happened with people that have completed it.
As in organizations? Yes.
So there's some that have done it and they're pulling together like an implementation plan, and they recognize that these are the areas that they need to kind of fulfill and this is what it's gonna look like.
I think one of the biggest things to say is it's really important that as an organization you decide how best it would work for your organization.
So I have yet to come across an organization that has run it exactly the same as another one.
Everybody's taken it and gone, this is what we need and this is how we're going to.
Potentially run it.
And I think that's because infrastructure's different.
Leaders are different and there's lots of different ways in which that can potentially be done, but I think it's just really important to map outputs from it and then recognize how you can step into some of those spaces from a development perspective.
So yeah, I think that's probably the only other thing that I would add, if that's okay.
Ruth? That's perfect.
And that really fits in with what we were saying just now.
So I think it's a really useful tool.
Thank you.
But just thinking about what you said, key points and I just think.
My biggest key point is to say that actually research doesn't need to be this mystical thing.
It doesn't need to be this layer of, oh, that's what the clever people do, or that's what the academics do.
There's elements of being able to get involved in research in wherever you're working.
So if you are an M map there's a whole portfolio of studies that you could potentially deliver within your organization, and that doesn't need you to gone down an academic route.
It needs you to have common sense and an understanding of actually how could we support this? There's often that thought that research nurses are not nurses in the sense of they, oh they don't do nursing nurse stuff, and you're thinking no, actually, as a research nurse.
I was seeing my patients, I was following them up in clinics, I was looking at their holistic care.
It's a different type of nursing, but don't take away the fact that's nursing, because it's still nursing.
And so I think it's really important that people recognize that research nurses can really bring something into a space and actually.
As those that are working clinically, there is easily those opportunities to go how can I support research and how can I do that within the field that I'm working in? So don't let research be mystic and this kind of cloud that you can't quite access if you are.
Questioning constantly.
Then research is for you.
And actually, do you know what? One of the things I came across a few months ago when I was sorting out some stuff was my leaving book from school, and my science teacher had written in there, Claire, I'll always remember you as the person that asked the easiest questions, but that always had the hardest answers.
He said, you always ask the questions that nobody else ever did, and you're just thinking.
Gosh.
So I was already irritating my science teachers with this culture of always wanting to find out, and I think that's what it is.
That's exactly what it is.
It's about bringing that into a space of where you are constantly working.
How can you encourage your teams and how can you go, should we be delivering this? Is there something else? How can we make it happen? That's wonderful.
Thank you, Claire.
And it is really nice to hear about how you were that curious mind from quite young and that you've just taken it through your career and now you're just supporting other people to do the same and to ask those questions and find the answers.
So thank you so much for joining me today.
I've really appreciated it and enjoyed it.
No worries.
Thank you for having me, Ruth.
It's been a pleasure.
You're more than welcome.
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