Phase 1 Evaluation of Lothian’s Nursing, Midwifery and Allied Health Professions (NMAHP) Clinical Academic Research Careers (CARC) Scheme.

The Clinical Academic Research Careers (CARC) Scheme for Nurses, Midwives and Allied Health Professionals (NMAHPs) in Lothian was launched in 2010, as part of the NHS Lothian NMAHP Research Framework. It is funded and managed by a partnership between NHS Lothian, NHS Education for Scotland (NES), University of Edinburgh, Edinburgh Napier University and Queen Margaret University.
Aim: To assess the processes involved in setting up and managing the scheme and progress and achievements to date.
Method: A mixed method approach was used which included a document review; a questionnaire completed by four post-holders; a questionnaire sent to R&D and NMAHP Directors across NHS Scotland (43% response rate); and semi-structured interviews with key stakeholders. A total of 27 interviews were conducted with post-holders (4); steering group members (8); management group members (6); demonstration site staff (8) and one external stakeholder.
Results: Outcome measures
Two demonstration sites had been funded to date, with progress being made in terms of conducting research studies, applying for additional research funding, dissemination and training. It was considered to be too early to have achieved any measurable impact on practice. At NMAHPs Director level, there is limited awareness of Clinical Academic Career schemes across NHS Scotland or of the NHS Lothian CARC Scheme.
Post holder views
Post-holders felt well supported by academic and clinical staff, and they welcomed having dedicated time to conduct research, along with opportunities for research training and personal development. Working under the ‘CARC’ identity was seen to be valuable. However, the degree of integration between the clinical and research roles was sometimes less than expected. Challenges faced included managing time between clinical and academic roles; negotiating the different systems of the partner organisations; securing backfill for their clinical role; and having limited influence on the direction of research.
Stakeholder views
There was overall support for the CARC scheme, with on-going commitment to the programme from all strategic leads. The Scheme facilitated stronger relationships between partner organisations, supported research focused on practice development, and provided a basis upon which to build clinical academic pathways for NMAHPs and support further research capacity and capability. There was some frustration at the length of time it had taken to get the scheme operational, and aligning the priorities of the academic partners with NHS Lothian in some areas. Selection of post-holders had been a challenge, with a limited pool of suitably qualified NMAHPs within Lothian; it was recognised that more flexible approach to recruitment, along with a rigorous selection process, would attract the best candidates to the CARC posts. However, the Scheme has demonstrated enough flexibility within the model for it to be applied in different settings.
Considerations for Future Development: Sustainability was seen to be a significant risk to the scheme, in terms of maintaining activity and building on the achievements made to date. Suggested considerations for future development included:
• Agreeing a plan of sustainability including identification of potential new CARC sites;
• Wider publicity, and dissemination of achievements and lessons learnt;
• More flexibility in recruitment, including wider advertisement of CARC posts within NHS Lothian, and elsewhere;
• Greater alignment with other elements of the clinical academic career pathway and integrating with other degree options;
• Simplifying administrative processes, for example by facilitating the adoption of the CARC model in other clinical areas.
Further evaluation, at the end of the current funding period will be useful to assess achievements against outcome measures.