Background Previous embedded researcher models have focused predominantly on an individual being a temporary team member and embedded for a project-limited short-term placement. Aim To develop an innovative research capacity building model to address the challenges of developing, embedding and sustaining, research led by Nurses, Midwives, and Allied Health Professionals (NMAHPs) in complex clinical environments. This healthcare and academic research partnership model offers an opportunity to support the ‘how’ of enabling NMAHP research capacity building from within the researchers’ clinical area of expertise. Method Collaboration between three healthcare and academic organisations and the iterative process of cocreation, development and refinement took place over 6 months during 2021. The collaboration relied on virtual meetings, emails, telephone calls and document review. Results A codesigned NMAHP embedded research (ER) model is ready for trialling with the individual being an existing clinician working collaboratively within the healthcare setting and with academia to develop the skills to become the ER. Conclusion This model supports NMAHP-led research activity in clinical organisations in a visible and manageable way. As a shared, long-term vision, the model will contribute to research capacity and capability of the wider healthcare workforce. It will lead, facilitate and support research in and across clinical organisations in collaboration with higher education institutions.

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Embedding research (ER) led by nurses, midwives and allied health professionals (NMAHPs): the NMAHP-ER model

: Care homes are central to the provision of care for older people and it is essential the leaders in this sector are supported to enhance the equality of care provided to these residents, often with multiple and complex needs and co-existing health conditions. The My Home Life Leadership Support program (MHLLS) is an innovative approach that enhances the culture of care in these settings. This study explored the findings of 298 participants who completed the program in England, Scotland, and Northern Ireland. Data were analyzed from two questionnaires which are routinely completed, by participants on the MHL LSP, the Assessment of Workplace Schedule (AWES) and the Perceptions of Workplace Change Schedule (PoWCS). The results were categorized by factors identified by the exploratory factor analysis. This study focuses only on the quantitative findings from pre-and post-questionnaires. The study also provides an updated factor analysis of the AWES and POWCS. The results provide robust evidence of the overall positive impact of the MHLLS program across the three participating countries. The key areas in which MHL participants report significant change within their care homes are recognition and regard for them and their staff, workload, quality of care, and working relationships. Overall, this study has demonstrated a significant positive change in managers' leadership skills and their perceptions of the impact of this on staff, relatives, and residents.

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An Evaluation of the ‘My Home Life’ Leadership Support Programme for Care Home Managers

Abstract • Background: Care homes are central to the provision of care for older people it is essential the leaders in this sector are supported to enhance the equality of care provided to these residents, often with multiple and complex needs and co-existing health conditions. The My Home life leadership support programme (MHL LS) is an innovative approach which enhances the culture of care in these settings. This study explored the findings of 298 participants who completed the programme in England, Scotland and Northern Ireland. • Methods: Data were analysed from two questionnaires which are routinely completed, by participants on the MHL LSP, the Assessment of Workplace Schedule (AWES) and the Perceptions of Workplace Change Schedule (POWCS). The results were categorised by factors identified by the exploratory factor analysis. This paper focuses only on the quantitative findings from pre- and post-questionnaires. The study also provides an updated factor analysis of the AWES and POWCS • Results: The results provide robust evidence of the overall positive impact of the MHL LS programme across the three participating countries. The key areas which MHL participants report significant change within their care homes are, recognition and regard of them and their staff, workload, quality of care and working relationships • Conclusions: Overall, this study has demonstrated a significant positive change in managers’ leadership skills and their perceptions on the impact of this for staff, relatives and residents. 

An evaluation of the ‘My Home Life’ Leadership Support programme for care home managers 

This paper aims to share the findings of a realist evaluation study that set out to identify how to strengthen nursing, midwifery and allied health professions (NMAHP) leadership across all health-care contexts in the UK conducted between 2018 and 2019. The collaborative research team were from the Universities of Bangor, Ulster, the University of the West of Scotland and Canterbury Christ Church University.,Realist evaluation and appreciative inquiry were used across three phases of the study. Phase 1 analysed the literature to generate tentative programme theories about what works, tested out in Phase 2 through a national social media Twitter chat and sense-making workshops to help refine the theories in Phase 3. Cross-cutting themes were synthesised into a leadership framework identifying the strategies that work for practitioners in a range of settings and professions based on the context, mechanism and output configuration of realist evaluation. Stakeholders contributed to the ongoing interrogation, analysis and synthesis of project outcomes.,Five guiding lights of leadership, a metaphor for principles, were generated that enable and strengthen leadership across a range of contexts. – “The Light Between Us as interactions in our relationships”, “Seeing People’s Inner Light”, “Kindling the Spark of light and keeping it glowing”, “Lighting up the known and the yet to be known” and “Constellations of connected stars”.,This study has illuminated the a-theoretical nature of the relationships between contexts, mechanisms and outcomes in the existing leadership literature. There is more scope to develop the tentative programme theories developed in this study with NMAHP leaders in a variety of different contexts. The outcomes of leadership research mostly focussed on staff outcomes and intermediate outcomes that are then linked to ultimate outcomes in both staff and patients (supplemental). More consideration needs to be given to the impact of leadership on patients, carers and their families.,The study has developed additional important resources to enable NMAHP leaders to demonstrate their leadership impact in a range of contexts through the leadership impact self-assessment framework which can be used for 360 feedback in the workplace using the appreciative assessment and reflection tool.,Whilst policymakers note the increasing importance of leadership in facilitating the culture change needed to support health and care systems to adopt sustainable change at pace, there is still a prevailing focus on traditional approaches to individual leadership development as opposed to collective leadership across teams, services and systems. If this paper fails to understand how to transform leadership policy and education, then it will be impossible to support the workforce to adapt and flex to the increasingly complex contexts they are working in. This will serve to undermine system integration for health and social care if the capacity and capability for transformation are not attended to. Whilst there are ambitious global plans (WHO, 2015) to enable integrated services to be driven by citizen needs, there is still a considerable void in understanding how to authentically engage with people to ensure the transformation is driven by their needs as opposed to what the authors think they need. There is, therefore, a need for systems leaders with the full skillset required to enable integrated services across place-based systems, particularly clinicians who are able to break down barriers and silo working across boundaries through the credibility, leadership and facilitation expertise they provide.,The realist evaluation with additional synthesis from key stakeholders has provided new knowledge about the principles of effective NMAHP leadership in health and social care, presented in such a way that facilitates the use of the five guiding lights to inform further practice, education, research and policy development.

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Strengthening nursing, midwifery and allied health professional leadership in the UK – a realist evaluation

Purpose: This paper aims to present the impact evaluation findings from a multiprofessional leadership programme commissioned in the South East of England to support primary care networks (PCNs) to lead system improvement together. It identifies programme impact at micro and meso system levels; a leadership impact continuum that can be used by individuals and teams to evidence impact of improvements in PCN practices; the learning and development strategies that were effective and proposes implications for other networks. Design/methodology/approach: Mixed methods underpinned by practice development methodology were used to explore the impact of the programme on two practitioner cohorts across 16 PCNs. Data were collected at the start, mid-point and end of the eight-month programme. Findings: Results illustrate an innovative approach to collective leadership development. A continuum of impact created with participants offers insight into the journey of transformation, recognising that “change starts with me”. The impact framework identifies enablers, attributes and consequences for measuring and leading change at micro, meso and macro levels of the health-care system. Participants learned how to facilitate change and collaboratively solve problems through peer consulting which created a safe space for individuals to discuss workplace issues and receive multiprofessional views through action learning. These activities enabled teams to present innovative projects to commissioners for service redesign, enabling their PCN to be more effective in meeting population health needs. The authors believe that this programme may provide a model for other PCNs England and other place-based care systems internationally. Originality/value: This study offers insight into how to enable a journey of transformation for individuals and PCN teams to enhance team effectiveness and collective leadership for system-wide transformation required by the National Health Service Long Term Plan (2019). Contribution to Impact:

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Kim Manley

Papers

Strengthening nursing, midwifery and allied health professional leadership in the UK – a realist evaluation

Change starts with me: An impact evaluation of a multiprofessional leadership programme to support primary care networks in the South East of England