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Professor signals 'tipping point' for nurse and midwife research

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The historical under-representation of nurses and midwives in health research roles is at “tipping point” in the right direction, a leading professor has told Nursing Times.

Debbie Carrick-Sen, a Florence Nightingale Foundation clinical professor of nursing and midwifery research based in Birmingham, said these professions were “hugely valuable” to the research agenda and needed to have “equal access” to opportunities.

“Nursing and midwifery make a very valuable contribution towards this research agenda”

Debbie Carrick-Sen

Professor Carrick-Sen spoke exclusively to Nursing Times during the launch of the National Institute for Health Research (NIHR) Academy at the Barbican Centre in London on Thursday.

The academy has been launched by NIHR to “future-proof the nation’s research workforce”, leaders said.

A key aim of the scheme is to attract professional groups who are not as engaged in research currently, including nurses, pharmacists and social scientists, and to break down barriers to career progression. 

The academy will feature six new virtual “incubators” to increase research in previously neglected areas including nursing and midwifery, primary care, public health, social care, health data science, and emergency care.

“Organisations that are research intensive make a huge difference in terms of patient outcomes and experience”

Debbie Carrick-Sen

It will also upskill the current academic workforce in emerging fields such as bioinformatics and data science.

In an interview with Nursing Times, Professor Carrick-Sen spoke about the importance of the venture for the nursing and midwifery professions.

“If you look back in history we know that organisations that are research intensive make a huge difference in terms of patient outcomes and experience,” said the professor, who is on the NIHR nurse, midwife and allied health professional clinical academic doctorate award panel.

“Patients themselves who are involved in research report more frequent monitoring and contact with health professionals, so report having a high-quality experience and being more satisfied,” she said.

“Nursing and midwifery make a very valuable contribution towards this research agenda, but we know compared to our medical colleagues where 15% are senior clinical academics, this compares to 0.01% of nurses, midwives and AHPs who are senior clinical academics – so this is a huge gap,” she noted.

Professor Carrick-Sen said there had been a number of successful initiatives in the last decade to tackle this gap, including the development of a dedicated research training award scheme for non-medical professionals by the NIHR and Health Education England. However, she added that “inequalities still exist”.

For example, she said AHP applicants tended to be more successful than nurses and midwives, particularly physiotherapists, who were four times more likely than a nurse to win research grants.

“We are at tipping point and that the development of nurse and midwifery clinical academic roles are firmly here to stay”

Debbie Carrick-Sen

Professor Carrick-Sen said one of the key reasons for this disparity was likely to be because AHPs had more autonomy over their work schedule, so could dedicate more time to creating a stand-out application.

She suggested that nurses and midwives were generally not as confident in the interview part of the assessment process.

“We know from local experience they often need two or three mock interviews,” said Professor Carrick-Sen, who also cited workload pressures as a barrier.

The NIHR Academy was going to be “instrumental” in redressing the balance and, in particular, the midwifery and nursing incubator would be “really important” in this ambition,” she told Nursing Times.

“The purpose of it is to address that gap and to nurture and support nurses and midwives to develop and submit high quality applications for competitive funding like the NIHR to enable one, to undertake important research in this area, and two, to develop nurse and midwife research leaders of the future,” she said.

She added: “The incubator will be a virtual entity and will within it have a number of innovative activities that will nurture, support and mentor both existing nurse and midwifery clinical academics, as well as those new that are maybe working in clinical practice that would be interested in clinical academic roles.”

Professor Carrick-Sen qualified as a nurse in 1985 and as a midwife two years later. She is now a clinical academic herself, spending half of her time at Heartlands Hospital and the other half at the University of Birmingham.

“The training component is already there and will be further enhanced by the incubator”

Debbie Carrick-Sen

She highlighted that one of the problems historically had been that people who obtained research qualifications left the NHS to join universities.

Over the last 10 years, she has led on a number of initiatives to try and help NHS organisations develop and retain clinical academics, including spearheading the AUKUH National NMAHP Clinical Academic Role Implementation Network.

The network was launched 15 months ago with 29 trusts and Professor Carrick-Sen said the progress made already had been “immense”.

“I personally feel we are at tipping point and that the development of nurse and midwifery clinical academic roles are firmly here to stay,” she stated.

Florence Nightingale Foundation

Professor Debbie Carrick-Sen

Debbie Carrick-Sen

“There are still gaps that need to be filled and some of them focus on embedding and sustaining roles within the NHS setting, however the training component is already there and will be further enhanced by the incubator,” she said.

She added: “Nurses and midwives make a hugely important contribution to this agenda…they are one of the professions that are most focused on patient experience and patient outcomes and really care about it.

“I really feel like we need to care about the profession more than we are to enable them to have equal access to all these opportunities,” said Professor Carrick-Sen.

The government-backed NIHR is the largest funder of health research training in the UK and invests more than £130m a year in training and career development.

It gives out research grants from pre-doctoral level to research professorships and senior investigator awards and offers access to leadership and mentorship support.

Lord O’Shaughnessy, parliamentary under secretary of state for health, also attended the NIHR Academy launch event.

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