Review: Implementing clinical academic careers in nursing: an exemplar of a large healthcare organisation in the United Kingdom

The paper highlights some of the key issues that have impacted upon the advancement of the clinical academic role for nursing in clinical practice in England. The case studies capture many of the drivers as well as some of the inhibitory factors at play here. It is commendable that Sheffield Teaching Hospital chose to invest in research leadership in nursing, appointing a Professor of Nursing, as well as supporting the nurse consultants to develop and expand the research component of their roles. This paper provides ideas for other Trusts that want to get involved to support these key roles. Exemplars from Scotland, such as those included in the report produced in 2010 titled Clinical academic (research) careers scheme for nurses, midwives and allied health professionals in NHS Lothian (http://www.ed.ac.uk/files/imports/fileManager/NHS%20Lothian%20NMAHP%20Clinical%20Academic%20Research%20Careers%20Scheme%20FINAL.pdf), which were established at around the same time as Sheffield appointed its Professor of Nursing, echo the challenges presented here. It is interesting to see how other professions view clinical academics. For example, in medicine, clinical academics are accepted as the norm and yet, for nursing and other health professionals, a much tougher battle for clinical academic contracts is being fought.

In the UK, when nursing entered higher education, in my opinion the profession did itself few favours when, as part of the process, it adopted the standard academic pathways, rather than align itself to the clinical route that medicine had created and adopted so successfully. This activity diminished the clinical component of nursing within academic circles and since then it has been hard to break into the clinical academic pathway in a consistent way. Frameworks such as that provided by Joyce Kenkre and David Fox (2001) and the HEE/NIHR (NIHR/HEE ICA HEE/NIHR, 2015) are useful but they do not have any mandate for implementation. The collection of papers edited by Juliet MacArthur (2015) provides a very useful resource for those interested in developing a clinical academic career. Most recently, the AUKUH, in 2016, launched a guide as a resource for healthcare provider organisations to developing, supporting and sustaining research-focused clinical academic roles in nursing, midwifery and allied health professions (AUKUH Clinical Academic Roles Development Group, 2016).

The financial support to advance research training expertise has been welcomed but the number of internships, fellowships and grants awarded is relatively small, with the competition being very strong. The paper highlights the concern that Trusts in England do not fully recognise the contributions that research leadership and research engagement bring to advancing clinical care delivery. In the quest to balance the books, Trusts appear to be reluctant to invest in this way, which is sad to see.

The framework developed and implemented by Sheffield Teaching Hospitals NHS Foundation Trust is one that others could use. However, one weakness of the paper is the lack of evaluation data. Given that the programme was introduced over 10 years ago, what is now needed is a formal evaluation of the impact of the programme on research capability and capacity, as well as determining how the culture has changed over this time to facilitate a more research aware environment among nurses, midwives and other health professionals. Other organisations have implemented similar models and it is now timely to have some capture of the wider picture. We need to know the extent to which Higher Education Institutions and Trusts are collaborating, the models favoured and the local impact on services.