Embedding post-doctoral nursing, midwifery and allied professional clinical academic careers in practice: It is possible.

10 February 2021

Guest blog from Professor Julie Sanders, Director of Clinical Research, St Bartholomew’s Hospital, Barts Health NHS Trust and Clinical Professor of Cardiovascular Nursing, Queen Mary University of London, London.

The value of nursing, midwifery and allied professional (NMAP) clinical academic careers to patients, carers, staff and organisations is not under question. We are all singing from the same song-sheet on this already. However, we also all recognise that providing or undertaking a post-doctoral clinical academic career is not straightforward. Generally, there is a lack of structure and clear career progression, a deficit of appropriate joint roles and the administrative challenges these roles produce between healthcare providers and higher education institutions (Baltruks and Callaghan, 2018). Furthermore, this is not a challenge restricted to the UK but is also reported internationally (for example, Klopper and Gasanganwa, 2015, van Oostveen et al., 2017), so there is no ‘off the shelf’ solution available to implement.

Despite this, at my hospital/HEI we wanted to offer an ‘off the shelf’ practical solution that would assist in transparently highlighting and formalising our organisational commitment to provide and support post-doctoral nursing and allied professional (NAP)[1] integrated clinical academic roles. Over the last five years we have successfully supported and embedded pre-doctoral and doctoral NAP clinical academic development, but our ambition is to retain and continue to develop those individuals and build our post-doctoral NAP clinical academic workforce. So, we set about devising and implementing our own ‘off the shelf’ practical offer to all doctorally prepared NAP staff at our hospital.

Our model, recently published (Sanders et al., 2020), is based on providing bespoke, joint NHS-HEI roles (one substantive and one honorary contract to reduce administrative burden), with both clinical and academic objectives and supervision in an area of clinical service need/development. If staff undertake their PhD with us, they do so on a secondment, providing job security, with the aim of having a pre-planned progressive role integrating clinical and academic expertise to return to. Equally, both those who do their PhD with us and those who are recruited to our hospital with a PhD will be offered a minimum of 0.2FTE protected (rostered) research as part of their core job description (not separately funded) to progress their research and post-doctoral plans, with the expectation that for most this will comprise submission of a post-doctoral fellowship application.

Our model was devised to work for us and to date it has been successful with all eligible individuals with or doing a PhD following these framework principles. We think that the model will be beneficial for other organisations, either in whole or in part, as there are features that make it particularly transferable. Firstly, although the development of this framework was led by the clinical organisation, it was devised in partnership with our HEI. There is no reason the HEI couldn’t initiate and start the discussions and collaboration with the clinical organisations. Many hospitals now have NMAP research leads who would be well positioned to start this collaborative partnership, if one doesn’t already exist. Secondly, despite this being an ‘off the shelf’ framework, it is based on developing a bespoke plan for individuals as we couldn’t find a ‘one size fits all’ solution. This provides a considerable scope for amending the content and arrangements of the post-doctoral position to meet individual and organisational circumstances and needs.

Secondly, our model is not reliant on any external funding (for example, the NIHR) and so can be applicable to all four nations of the UK, and those without access to bridging scheme support. This has been ‘funded’ by our hospital and HEI collaboration who recognise and value research in practice and clinical academic career development, through the amendment of the core job description. This close working relationship also determines my fourth point which is that both institutions have agreed to offer full access and support to all research and clinical infrastructure whether the substantial or honorary contract is with the NHS or HEI. One final point is that this has all been established and agreed within an HEI that does not have a nursing/allied professional school. I hope that this is indicative that HEIs with a nursing/allied professional school will be even more engaged (although not sure that is possible due to the support we have had) in establishing post-doctoral clinical academic opportunities.

Our model is by no means perfect but it is a start to transparently progress our post-doctoral clinical academic career opportunities. We intend to review and evaluate as we grow and develop our post-doctoral clinical academic workforce. What had previously been lacking was practical plans and tips for embedding clinical academic careers and hopefully our model has provided some insight into how we have undertaken this challenge. It has been a true delight working on this plan and seeing the excitement and optimism from my team in having this available. They are a constant source of inspiration and I hope this goes some way to supporting them to do great things now and in their future clinical academic careers for many years to come.  If what we have been able to develop can in any way help other organisations and individuals formalise their post-doctoral offers we would be only too pleased and proud.

[1] Allied professional at our organisation refers to all allied health professionals and health care scientists

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