One of my key priorities is advancing the pace of developing capacity and capability in nursing research. In November 2021 the Chief Nursing Officer (CNO) for England, Ruth May, launched a ‘strategic plan’ to support nurses to lead, participate in, and deliver research. In the foreword to the document (CNO for England, 2021) she highlighted the importance of research for ‘public benefit’—for example, improving public health and patient experience. The strategy sets out a vision for research to ‘reflect’ the priorities of patients, carers, service users, residents, the public and nurses.
‘Research led by nurses and contributions they make as members of multidisciplinary research teams can drive change. It is the cornerstone of high-quality, evidence-based nursing.’
The five themes underpinning the plan are:
- Aligning nurse-led research with public need
- Releasing nurses' research potential
- Building the best research system
- Developing future nurse leaders of research
- Creating a digitally enabled practice environment that supports nursing research.
The national plan is detailed to be delivered in three phases: discover, build, and sustain. A detailed implementation plan is expected in spring 2022 and will set out what will be delivered in 2022 and 2023.
This national strategy to anchor our local plans is extremely welcome but it also raises questions of local readiness. I have seen some great examples shared by colleagues of their local nursing research strategies, but ultimately success and delivery will only be truly enabled with investment into an infrastructure to deliver. As Chief Nurse in a university hospital, with a large biomedical research centre, you might consider my institution well-placed to deliver this exciting new strategy, however, in reality we have the same delivery constraints and workforce challenges as others across the NHS.
So, what are the options to put this into practice? Well, one thing that nurses are always good at is sharing ideas—joining together and increasing the opportunities for innovation, I see this time as a real opportunity for a toolkit to be put together for us to share good practice and incorporate nursing research into core business.
The national strategy refers to the development of ‘coherent systems underpinning transformation’. This includes developing a co-ordinated and consistent England-wide approach to building nurse-related research capacity and capability, from pre-registration to professorial level. This will help tackle variation and inequalities across the country and require working with partners to develop national and regional infrastructure. It will also involve fostering practices and processes that help accelerate change in nursing practice based on research findings.
So, what do we need to do to prepare? Many of us are already engaged in reviewing readiness locally, and I believe that with the right support and leadership much of our future infrastructure already exists. My local themes echo those I have heard from colleagues elsewhere; issues that need addressing include low levels of confidence in knowledge and skills to read, implement, apply, and undertake research. There is also a need to focus on advanced clinical practice and practitioners at consultant level who must show capability with the four pillars of practice, one of which is research. I have previously written about the systematic approach of the Health Education England ACP framework (Foster, 2022), and well documented variation of roles, bands, and qualifications including research knowledge and skills; many Trusts have no clear strategy for development of these roles and individuals in them, with the research pillar being seen as the one most lacking in levels of capability. In this context what is essential is the support for infrastructure to ensure the strategic aims of the Trust can be operationalised.
National standards set for Trusts include 1% of the non-medical allied health professional workforce in clinical academic roles by 2030. In my Trust this equates to approximately 65 staff, where we currently have 1 nurse. To support this level of development, the Trust needs to develop an infrastructure that can offer the appropriate mentorship and development. So far, from what I have observed locally and heard from board-level colleagues elsewhere, success has been achieved by joint working with local R&D teams, universities, charities and biomedical research centres, where these exist, to support posts to lead in this area. I do believe that we can work towards a future where research led by nurses is business as usual in health and care settings, but we really must do what we need to do locally and be supported nationally to increase the involvement of the nursing profession in decision-making about research-related developments. We need to be able to prove that high-quality research led by nurses is beneficial, and strive for an environment that encourages nurses to pursue a career that involves research.