A Research Portfolio: Transformational change by nursing, midwifery and care staff across health and care.

This is the peer reviewed version of the following article: Finnegan, A. P. & Aitkenhead, S. (2020). A Research Portfolio: Transformational change by nursing, midwifery and care staff across health and care. Journal of Advanced Nursing, 76, 7-8., which has been published in final form at 10.1111/jan.14228. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.It is widely accepted that nursing research is paramount to help address the challenges facing the international nursing workforce in caring for a growing and ageing population. Nursing, midwifery and care staff make up the largest proportion of the workforce across the NHS. In the UK, there are over 693,000 registered nurses and midwives (Nursing and Midwifery Council, 2018), all striving to prevent and tackle health inequalities and improve the care experience for patients, individuals and populations. The role that nursing, midwifery and care staff play should not be underestimated and specifically in this editorial, we describe a new research portfolio which signposts to examples of nursing, midwifery and care staff led research to demonstrate the significant academic contribution of these professions to transformational change across the health and care system. The Research Portfolio (NHS England, 2019a) showcases examples of research studies that demonstrate leadership in research and practice, all aligned to the key priorities outlined in the NHS Long Term Plan (LTP) (NHS England, 2019b). Evidence underpins so much of what we do and there is a huge opportunity to quantifiably demonstrate the contribution staff bring to the LTP, harnessing intelligence in closing gaps and addressing unwarranted variation in health and care

Implementing a strategic plan for child health: a Sydney case study

Aim: The aim of this paper is to describe the implementation of a strategic plan, ‘Health Gain for Children and Youth of Central Sydney”, over a 10 year period to December 2005. Methods: Descriptive information was obtained from the records and minutes of all relevant committees, interviews with key workers who were involved with the committees, managers and senior health professionals, and from the involvement of the authors throughout the process of the implementation. Results: An implementation steering committee was established to oversee the implementation of the plan. Rather than adopting a uniform approach to assigning responsibility for the implementation of each strategy in the plan or developing specific costs and time frames for each strategy, a more pragmatic, flexible and opportunistic approach was taken. Most of the plan’s strategies were implemented over a 7 year time frame using a combination of service reorientation and implementation of new programs, some of which were funded from sources not anticipated during the development of the plan. Implementation required a dedicated driver, commitment at senior level and participation by many staff at many levels. Outcomes, monitored through data collected at 5 year intervals, revealed positive trends in a number of child and youth health indicators. Conclusions: The successful implementation of the strategic plan required pragmatism, flexibility, opportunism and the commitment and involvement of staff at all organisational levels. . It is envisaged that this approach provides a firm base for future evidence based developments to benefit the health and well being of children, youth and their families and reduce health inequities

Managing a sustainable, low carbon supply chain in the English National Health Service: The views of senior managers.

Objectives:In an effort to reduce costs and respond to climate change, health care providers (Trusts) in England have started to change how they purchase goods and services. Many factors, both internal and external, affect the supply chain. Our aim was to identify those factors, so as to maintain future supply and business continuity in health and social care.Methods:Qualitative interviews with 20 senior managers from private and public sector health service providers and social care providers in south west England. Interviews were recorded, transcribed and thematically analysed.Results:There were four areas of concern: contradictions with government legislation which caused confusion about how best to deliver sustainable solutions; procurement was unclear and created multiple approaches to purchasing bulk items at low cost; internal organizational systems needed to be reconsidered to embed sustainability; and embedding sustainability requires a review of organizational systems. There are examples of sustainability solutions throughout the National Health Service (NHS) but the response continues to be patchy. More research is needed into why some Trusts and some staff do not recognize the benefits of a core approach or find the systems unable to respond.Conclusions:The NHS is one of the major purchasers of goods and services in England and is therefore in an excellent position to encourage sustainable resource management, manufacturing, use and disposal

Roles and responsibilities in integrated care for dementia.

PURPOSE Effective integrated healthcare systems require capable, trained workforces with leadership, shared governance and co-ordination. This study aimed to provide additional understanding of roles and responsibilities in relation to integrated care from the perspective of massive open online course (MOOC) participants. METHODOLOGY MOOC discussion board posts were analysed using Framework analysis consisting of transcription, familiarisation, coding, developing an analytical framework and application of the framework. FINDINGS Boundaries and key issues surrounding roles and responsibilities were highlighted and participants suggested a number of enablers that could remove barriers, thereby enhancing integrated care. ORIGINALITY/VALUE Enablers included introduction of shared communication and IT systems to support continuity of care. Awareness and understanding of dementia was seen as crucial to promote person centred care and care planning. The roles of education in, and experience of, dementia care were highlighted. Barriers affecting the roles and responsibility professionals exercise include funding, role conflicts, time constraints and time-consuming paperwork.N/

When a workforce strategy won't work : critique on current policy direction in England, UK

“The final, definitive version of this article has been published in the Journal, Journal of Intellectual Disabilities: JOID, Vol.14 Issue 4, 2010, Copyright SAGE Publications Ltd on SAGE Journals Online: http://online.sagepub.com/ "This editorial is based on findings from a regional review of educational commissioning, and workforce issues for one Strategic Health Authority in England. Known as the ‘Valued People Project’ (VPP) it commenced in May 2008 and was undertaken in response to expressed concerns by regional key stakeholders regarding education commissioning specifically of pre-registration learning disability nursing, and the contribution of the specialist learning disability health workforce more generally (Gates, 2009). This work was also undertaken as a consequence of the scale and cumulative effect of changes to education, workforce, professional regulation and central health and social care policy that has affected people with learning disabilities, and the services and personnel that support them.Peer reviewedFinal Accepted Versio

Comparison of sociodemographic and health-related characteristics of UK Biobank participants with the general population

UK Biobank is a population-based cohort of 500,000 participants recruited between 2006 and 2010. Approximately 9.2 million individuals aged 40-69 years who lived within 25 miles of the 22 assessment centres in England, Wales and Scotland were invited, and 5.4% participated in the baseline assessment. The representativeness of the UK Biobank cohort was investigated by comparing demographic characteristics between non-responders and responders. Sociodemographic, physical, lifestyle and health-related characteristics of the cohort were compared with nationally representative data sources. UK Biobank participants were more likely to be older, women and to live in less socioeconomically deprived areas than non-participants. Compared with the general population, participants were less likely to be obese, smoke, drink alcohol on a daily basis and had fewer self-reported health outcomes. Rates of all-cause mortality and total cancer incidence (at age 70-74 years) were 46.2% and 11.8% lower in men, and 55.5% and 18.1% lower in women, respectively, than the general population of the same age. UK Biobank is not representative of the sampling population, with evidence of a ‘healthy volunteer’ selection bias. Nonetheless, the valid assessment of exposure-disease relationships may be widely generalizable and does not require participants to be representative of the population at large

Child Abuse and Neglect in American Indian/Alaska Native Communities and the Role of the Indian Health Service

This report is the first study to provide national information regarding the incidence of child abuse or neglect in Indian communities. It also provides comprehensive assessments of the effectiveness of Indian Health Service (IHS) and tribal policies, procedures, and personnel in the recognition and treatment of child abuse and neglect. The report also designs an intervention program flexible enough to be used by American Indian and Alaska Native AI/AN communities across the country. The project described in the report was conducted in three phases. Each phase contained several distinct, but interrelated, components. Phase I included a review of IHS policy and procedures on child abuse and neglect, and a survey and on-site data collection regarding the incidence of child abuse and neglect. Phase II included evaluation of the data obtained in Phase I,additional research and on-site assessments, and the development of a model intervention program. Phase III involved surveying tribal service providers, implementing the model program (New Beginnings) at a pilot site, and disseminating information about this project to Indian communities. The report also discusses the role of IHS in addressing issues of child maltreatment and makes recommendations about how IHS can better fulfill its responsibilities in this area. The report concludes that IHS should promote individual, family, and community wellness; identify families at-risk and provide needed services and links to community resources; and provideadequate treatment and services for identified cases. The report includes an eleven page executive summary

A UK student survey investigating the effects of consuming alcohol mixed with energy drinks on overall alcohol consumption and alcohol-related negative consequences

© 2016 The Authors Previous research reported positive associations between alcohol mixed with energy drink (AMED) consumption and overall alcohol consumption. However, results were largely based on between-subjects comparisons comparing AMED consumers with alcohol-only (AO) consumers, and therefore cannot sufficiently control for differences in personal characteristics between these groups. In order to determine whether AMED consumers drink more alcohol on occasions they consume AMED compared to those when they drink AO additional within-subjects comparisons are required. Therefore, this UK student survey assessed both alcohol consumption and alcohol-related negative consequences when consumed alone and when mixed with energy drinks, using a within-subject design. A total of 1873 students completed the survey, including 732 who consumed AMED. It was found that AMED consumers drank significantly less alcohol when they consumed AMED compared to when they drank AO (

New investments in primary care in Australia

There is a crisis in primary care health workforce shortages in Australia. Its government has attempted to fix this by role-substitution (replacing medical work with nursing instead). This was not completely successful. Obstacles included entrenched social roles (leading to doctors 'checking' their nurse role-substituted work) and structures (nurses subservient to doctors) - both exacerbated by primary care doctors' ageing demographic; doctors owning their own practices; doctors feeling themselves to have primary responsibility for the care delivered; and greater attraction towards independence that may have selected doctors into primary care in the first place

Finding the Forgotten: Motivating Military Veterans to Register with a Primary Healthcare Practice

This is a pre-copyedited, author-produced PDF of an article accepted for publication in Military Medicine following peer review. The version of record Finnegan A, Jackson, R & Simpson, R (2018 - in press) Finding the Forgotten: Motivating Military Veterans to Register with a Primary Healthcare. Military Medicine is available online at: https://doi.org/10.1093/milmed/usy086Introduction: In the UK, primary healthcare practices choose from a series of Read codes to detail certain characteristics onto a patient's medical documentation. One of these codes is for military veterans indicating a history relating to military service. However, veterans are poor at seeking help, with research indicating that this code is only applied in 7.9% of cases. Clinical staff have a clear role in motivating veterans to declare their ex-Forces status or register with a primary healthcare center. The aim of this study was to motivate veterans to notify primary healthcare staff of their armed forces status or register with a general practitioner, and to improve primary healthcare staff's understanding of veterans' health and social care issues. Materials and Methods: Data were provided by four primary healthcare centers' containing 40,470 patients in Lancashire, England during 2017. Pre- and post-patient medical record Read Code searches were conducted either side of a 6-wk intervention period centered on an advertising campaign. The data identified those veterans with the military specific Read code attached to their medical record and their age, gender, marital status and mental health disorders. Further information was gathered from interviews with eight members of staff, some of whom had completed an e-learning veteran healthcare academic module. The study was approved by the University of Chester's Research Ethics Committee. Results: The pre-intervention search indicated that 8.7% (N = 180) of veterans were registered and had the correct military specific code applied to their medical record. Post-intervention, this figure increased by nearly 200% to N = 537. Mental health disorders were present in 28% (N = 152) of cases, including 15% (N = 78) with depression. Interviews revealed the primary healthcare staff's interpretation of the factors that motivated patients to declare their ex-Forces status and the key areas for development. Conclusion: The primary healthcare staff took ownership and responsibility for this initiative. They were creative in introducing new ways of engaging with the local armed forces community. Many veterans' and staff were unaware of veterans' entitlement to priority medical services, or the wider provisions available to them. It is probable that veterans declaring their military status within primary healthcare, or registering with a general practitioner for the first time is likely to increase. Another review will be undertaken after 12 mo, which will provide a better indication of success. There remains however an ongoing need to reach out to those veterans who never access a primary healthcare practice. This paper adds to the limited international empirical evidence undertaken to explore help-seeking behavior in an armed forces community. The positive outcomes of increased awareness and staff commitment provide a template for improvement across the UK, and will potentially stimulate similar initiatives with international colleagues