Clinical Academic

Career Pathways: A

Trust Perspective

Dr Sarah Williams

Associate Director of Research & Clinical

Effectiveness

Clinical Academic Posts….

The Vision

● Clinician first

● Academic skills and links

● Evidence & measurement

● Relevant, appropriate research

and quality improvement skills

● Training & Workforce

Development

● Partnership working – 2 way

● Better care… more research… not

necessarily linked to accruals

● Solent part of founding group in Wessex with UHS, PHT and UoS

● National working group for Workforce Strategy and Clin Ac Careers

● Contributed to development of toolkit

● Steering gp – University and HEE Wessex

● HSJ Special Issue– Nov 2015

What are we looking for?

● Better patient care/ improved outcomes

● Acceptance of research on the front line

● Improved patient experience

● Fresh eyes

What are we investing in?

Demonstrate improvement/

outcomes

Drive research, generate evidence

Build partnerships

Inspire others

Support use of best

evidence:

Engage and

involve pts

Engage and involve staff

Innovate, publish,

advocate

A skilled

clinician who

can support a

service to:

The model

Clinical

Academic

Interface

NHS Trust employer perspective

● Culture of research as core business, embedded in front

line care

● Driving research from within clinical services and HEI

● Understanding of community and mental health services

● Network of support – internal and external; critical mass

● Demonstrable added value – visibility

● Has to be done in partnership – make friends

“Having Carolina in the team has had lots of

benefits for us. She is positive and energetic and

has really helped us become motivated about

measuring outcomes and looking into research.

She has helped us to demonstrate good practice

in our area. She brings knowledge and

enthusiasm and has guided us in an area that

often feels outside of our experience. We are

looking forward to the results of some of the

service evaluations and the raising of the profile

of OPMH therapies”

The pathway

Clinical Academic Roles in Solent

Example of success: podiatry

● In 3 years…(started Jan 2013)

● NIHR Clinical Lecturer

● 2 Clinical Doctorate (1 out to advert)

● 4 MRES

● 3 internships

Audit

Service Evaluation

Research

Pt. satisfaction: Pod – TD, EW, GB

NICE compliance: VTE – NT, SM

Pod Sx outcomes – SM

Pt. education: DM – SP

NICE compliance: DM– SS, LF, MY

Charcot pathway – EW, KF

Referral review – HR, GB

Referral review: forefoot – CD

Referral review: PR – RM, LC

Referral review: Pod Sx – SM

Drawtex dressing – MY

Eykona camera – MY

Juvenile foot posture – RD

Pt. education: PF – CJ, NT, GK

NICE compliance: PR – RM, JB, LC

Pt. assessment: PR – BB, DM, LCNICE compliance: OA – SG, LC

RA wounds – RM, CB, SS, LC

RA NSx outcomes – NM, LC

REFORM – NT, LC

RAW foot – MDH, CE, LC

FeeTURA4 – LC

Rheumafoot – LC

BHPR calculator - LCNeuromata – CJ & SM

Themes:

Organisation & delivery of care

Demonstrating service efficacy & quality

Development of outcome measures

Pt. satisfaction: Pod Sx – SM

PREACHER – ??

Neuromata – CD

Neuropathy – KS

● Research income/ activity increasing exponentially (shortlist for £3m grant,

& Industry trials)

● Centre of excellence - National awards and recognition

● Move towards outcome/ QI based commissioning

● Ongoing service investment

● Education - Inform curriculum for trainee podiatrists, clinical educators,

student placement (income generation)

● Seen as a model for clinical academic success

● All staff culture, not a few individuals

The clinical academic post has resulted in a

significant impact on direct clinical care and service

development. This has been underpinned with a wide

range of Podiatry staff engaged within service

evaluation, clinical audit and research. As Head of

Podiatry, I am seeing this translating in to improved

patient care in areas such as Rheumatology and

Diabetes. The ability for the clinical academics to

drive and produce a series of comprehensive and

robust service evaluation, audit and research reports

is fantastic and one that gives me great confidence

and I have shared this with the organisation, local

commissioner and used as evidence for our

regulators.” Head of Service

● “

“It has led to us challenging the level of care

we provide, raising standards and putting

measures in place to help protect the service

as much as possible. Working within a

multidisciplinary team, we have been able to

challenge other MDT professional’s

perceptions of our role and extended our

scope of practice. For this to happen we have

had to demonstrate improved patient care

throughout” Clinical Colleague

What has worked …

● Flexibility – no one model

● Relationships

● Tenacity and Patience

● Talented clinicians with enthusiasm for clinical and academic

practice

● Commitment of key senior managers and execs

● Support of Health Education Wessex & University of Soton

● Infrastructure to support collaboration e.g. strategic Steering Group,

Operational Group, CA facilitator role

● Focus on the ‘so what?’ – it isn’t just about research

● It isn’t just about formal clinical academic posts (research active

workforce)

Challenges…

● Finance

● Shifting landscape – particularly in community

● Meeting needs of University and Trust

● Sustainability and future proofing (need a career

pathway)

● AfC ‘roles’/ banding

● Critical mass… can be isolating for individuals

● Practicalities – rosters, contracts, expenses, ‘milestones’

etc

● Communication

The money

● Internships – research budget

● MRES – studentship (full backfill)

● Doctorate – Trust funded – service/ research (occasional studentships plus

some funding from University)

● Post doc - Shared funding – service and university/ research (or grant)

● Often use part of vacant post or secondment (existing posts)

Our top tips

● Be flexible, ‘make it fit’

● Top level support and strategic direction

● Visibility and demonstrable outcomes/ value

● Ongoing open and honest communication between Trust

and HEI - partnership

● Relationship/ communication between manager,

clinician-academic and academic supervisors

● Local context needs to be ready and supportive

● Long game.. Look forwards.

● There is still a lot to learn….