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The Delivering the Future (DtF) leadership programme was established in 2005 to strengthen senior clinical leadership capacity and capability across NHS Scotland. This paper reports on an evaluation of the programme to determine the extent to which the programme outcomes had been achieved. Sixty-seven (57%) programme participants responded to a questionnaire survey about their experience, and semi-structured interviews were conducted with participants (n=8) and senior leaders (n=7) at NHS Board level. \ud The programme was highly regarded by participants and strategic level leads. The majority of DtF participants had been promoted or taken on expanded roles since completing the programme, taking on greater leadership responsibility. The programme was seen to be a significant influence on accelerating the progression of individuals to these roles, and in developing skills to perform at a senior leadership level. The significant investment in the programme was thought to be worthwhile in terms of wider benefits, albeit with a need to make better collective use of the alumni at a national level.

Background: A substantial amount of work has been ongoing in NHS Scotland to develop and strengthen advanced nursing practice. In postgraduate education for neonatal and children’s services, this has been underpinned by funding from NHS Education for Scotland of the post graduate certificate Qualified in Specialty (QIS) and MSC in Neonatal and Paediatric Advanced Practice. Two Scottish Universities have been delivering both qualifications in collaboration since 2013. A collaborative approach was expected to provide greater consistency in quality and content of the programme, and overcome the challenges associated with running courses with small student numbers, whilst ensuring service needs and expectations were met (Morgan et al., 2012; Pinfield et al, 2011). \ud Aim: To evaluate the effectiveness of the collaborative approach to teaching postgraduate education programmes from the perceptions of the students, the University staff and of paediatric and neonatal unit managers in practice.\ud Method: A mixed method approach was used to gather the views of the participant groups over two years. A survey of students in year 1 was followed up in year 2 with six focus groups with n=30 students. Semi-structured interviews with HEI staff (n=6) were conducted at two points in time. The views of neonatal and paediatric unit managers were gathered at the end of year 2, using both surveys and semi-structured interviews. Quantitative data was analysed using descriptive statistics; qualitative data was transcribed and analysed thematically. \ud Findings: The courses have evolved over time, and students appear to be satisfied with their experience of being on the programme. The programmes largely met the needs of unit managers, who reported increased confidence and competence amongst students. The collaborative approach worked successfully in areas such as student recruitment and skills based work, although presented a number of challenges including working around university regulations and aligning methods of assessment. \ud Conclusion: Whilst working in collaboration can undoubtedly be challenging, the evaluation has highlighted a number of areas where a collaborative approach to teaching in higher education can work successfully and could be used for other specialist teaching programmes with small numbers of students.

A key part of policing is recognising vulnerability, and providing an appropriate response; however there are variations in defining vulnerability and applying this in practice. To enhance the vision of a UK police force alliance to protect vulnerable people from harm, a change programme was implemented which included two one-day workshops which were delivered to officers, staff, and their supervisors, across the organisation. These were intended to promote a change in attitudes and behaviours, and increase participants’ confidence in recognising and responding to vulnerability. \ud The programme evaluation aimed to identify the perceived impact of the workshops in raising awareness and influencing confidence and behaviours of officers and staff, in relation to vulnerability and professional curiosity. A mixed methods approach was used, with a pre- and post-intervention questionnaire (n=97), followed up with semi-structured interviews with stakeholders (n=16).\ud The findings of the evaluation focus on changes in the participants’ understanding of vulnerability and professional curiosity as applied to their roles, and their levels of confidence in responding to different and complex vulnerabilities. Participants identified situations where they felt less confident about providing an appropriate response. Small changes in practice following the workshops were identified, along with potential organisational barriers to change.

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.\ud Aim: To assess the processes involved in setting up and managing the scheme and progress and achievements to date.\ud 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.\ud Results: Outcome measures\ud 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.\ud Post holder views\ud 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.\ud Stakeholder views\ud 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.\ud 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:\ud • Agreeing a plan of sustainability including identification of potential new CARC sites;\ud • Wider publicity, and dissemination of achievements and lessons learnt;\ud • More flexibility in recruitment, including wider advertisement of CARC posts within NHS Lothian, and elsewhere;\ud • Greater alignment with other elements of the clinical academic career pathway and integrating with other degree options;\ud • Simplifying administrative processes, for example by facilitating the adoption of the CARC model in other clinical areas.\ud Further evaluation, at the end of the current funding period will be useful to assess achievements against outcome measures.

Service user involvement has become an essential element for many organisations looking to meet\ud the needs of their clients through including them as active participants in making decisions about\ud aspects of the organisation that affect their life. Service user involvement involves partnership\ud between the organisation and the service users to influence policy and improve service delivery.\ud Developing this collaborative approach between service providers and service users in the development of service delivery, is crucial for any organisation which is looking to empower women.\ud Successfully engaging service users in these processes needs effective planning, management and review. One approach is to employ a Service User involvement Worker. This toolkit has been prepared to help organisations looking to support their clients through establishing a Service User Involvement Worker role, based on the experience of Anawim, a registered charity based in Birmingham that provides a variety of support services to a client group of women who have a range of complex and often overlapping needs.\ud The toolkit aims to:\ud - Support organisations wanting to establish a Women’s Involvement Worker role.\ud - Share the experience of how a Women’s Involvement Worker can engage with the women and support them to have a voice and actively contribute to life within the organisation and beyond.\ud - Provide guidance and ideas about how to do service user involvement well.

The Patients First practice development programme supports nurse-led projects focused on implementing and evaluating patient-centred improvements in healthcare settings across the UK. The programme is managed by the Foundation of Nursing Studies (FoNS), with funding from the Burdett Trust for Nursing. This evaluation aimed to assess the extent to which the aims of the programme had been achieved; the added value of participation for individuals, their practice and patient care; and the longer term benefits of the programme.\ud A mixed method approach was used, including: a review of project reports; online questionnaire for project leads (n=23, response rate =50%); semi-structured interviews with key stakeholders (n=15) and case studies.\ud The programme has largely achieved its aims, albeit with variable outcomes at project level. The main outcomes have involved increasing the skills and confidence of nursing staff, and enhancing their ability to influence change within their working environment, thereby having a positive impact on patient care and clinical practice. The questionnaire and interviews responses indicated that the programme is worthwhile. Funding was used to facilitate staff engagement and to backfill staff time.\ud Benefits identified by project leads included assistance with reflective practice; feeling more engaged in talking and listening to patients; enhanced skills in practice development techniques; and greater confidence implementing these skills effectively in different settings. \ud Added value at an organisational level was seen through better engagement between team members, improved collaboration and communication between nursing and medical teams, and empowerment of nursing staff to influence change within their workplace. Patient benefits included patients feeling that service provision better met their needs, with an increased awareness amongst staff of issues around user involvement in care planning.\ud Three-quarters of individual projects resulting in changes in care had, at least in part, been continued or mainstreamed. Capacity and capability in implementing practice development approaches appear to have increased in a small number of areas, with several former project leads coaching their colleagues in practice development skills.