HEAPHY 1 & 2 PLENARY Angela DUXBURY

1. ABSTRACT The need to keep practitioner skills evolving to meet changing context and agendas-name key workforce agendas / Francis report / Every contact Counts / Improvement Science, six C's and User carer initiatives etc. Changes in education commissioning and expectations-mandatory training requirements/service user involvements in admissions, curricular development, teaching etc...HCPC -regulatory body expectations now of service user involvement in training. Meeting service expectations-individual skills development to include management and leadership, strategic thinking, emotional resilience, entrepreneurial and interpreneurialskills (might use some of CoR research evidence on this) impovementscience etc. The continued importance of research and knowledge transfer skills, evidence based practice etc. This would then lead into going through how easy it is to submit a paper for publication by a demo of the Editorial manager for the JRP. What makes a good paper , a good reviewer. I thought I would conclude with as a profession we have come a long way over the last 20 years since becoming an all graduate profession and demonstrate this by presenting some outcomes of recent relevant research and its importance to practice-published HEAPHY 1 & 2 PLENARY Angela DUXBURY Sat 31stAug 2013 Session 1 / Talk 1 08:40 – 09:15

2. Radiation Technologists:What does it take to Practice? Professor Angela Duxbury Deputy Head of Department: Allied Health Professions

3. The Issues to be explored • How do we rise to the challenges, contribute to service improvement, and employ evidence based practice whilst working smarter, faster, safer, and with the right skills? • What are the important practitioner attributes? • What is the importance of innovation, ingenuity and entrepreneurialism? • Research skills are key to evidence based practice. How do we overcome the barriers to undertaking research in the clinical setting, and share these outcomes?

4. Some facts • In both the UK/NZ-massive increase in cancer, obesity and diabetes incidence and chronic disease • People living longer

5. UK-a rise in chronic disease

6. Changing world=we have some challenges!

7. New Zealand/ United Kingdom health care costs • Funding health systems: mainly from-Vote Health- $14,655 billion in 2013/14 cost per head of population $3,271(£~1807) • NHS mainly tax payers- £111,400 billion in 2013/14 cost per head of population £2,082 (~$3769)

8. In UK 10% of patients are harmed during their healthcare experience-900,000 people-impact on spending £1 billion per year (1) 1. Vincent C.Is health care getting safer? BMJ 2008;337;a2426

9. NZ: The Ministry of Health’s Statement of Intent 2013–2016 identifies three outcomes for the health system. • New Zealanders are healthier and more independent. • Health services are delivered better, sooner and more conveniently. • The future sustainability of the health system is assured

10. National Health Service (NHS) objectives:

11. New emphasis: Achieving outcomes depends on the performance of people • Telling and controlling the reality of the situation-through reports and policy agendas • Regulation and training of staff • Doing things differently-we cannot afford the growing demand for service or growing litigation costs-education and its people

12. It feels like....

13. NHS greater emphasis on patient voice and patient safety

14. Mid Staffordshire NHS Foundation Trust Public Enquiry:The Frances Report • A story of “appalling suffering of many patients.” • 400-1200 deaths attributed to poor care • First inquiry held in 2009 • First report in 2010 from Sir Robert Francis QC focused on Trust failings and patient / carer accounts of care – “patients not numbers” • Second report published 5 February 2013 focused on system failures and need for system and cultural change – no heads have rolled! • In total the report is 1776 pages long with 290 recommendations

15. Agendas • The NHS constitution: access to service- right place right time • Patient safety and patient voice • Values, ethics, compassion, adaptability of staff • Service improvement science agenda • Leadership-importance of taking responsibility • Reflective, resilient, innovative and entrepreneurial staff

16. Listening to what patient’s want

17. Regulation Health Practitioners Competence Assurance Act 2003 (NZ) The Health Professions Order 2001 Health and Care Professions Council (UK) Public Protection Registration Standards of Education Standards of Conduct, Performance and Ethics Standards of Proficiency Tribunals • health and safety of the public • high standard of treatment • requires update and improve their skills • properly trained and qualified before they can be registered • independent registering authorities to register and monitor health practitioners • independent Health Practitioners Disciplinary Tribunal

18. Frances report findings:

19. Spotlight on Educationand Training greater emphasis on: • Employability and Career Development • Graduate attributes • Resilience and Wistleblowing • Curricular design provides opportunity for Entrepreneurship and Social Enterprise • Personal and Professional Development Planning/Life Long Learning • Evidence based practice - Research

20. NHS Values and constitution-the brand

21. NHS Constitution Excellent Education: Treatment Simulation Competent & Capable Staff Adaptive & Flexible Workforce: Responsive to Innovation and knowledge dissemination of new technologies, Best Practice, and Research and Innovation in order to Reduce Variability and Poor Practice.

22. NHS Constitution • NHS Values & Behaviors: Compassion, values and behaviors to provide Person-Centered Care and improved patient experience by positive engagement with Continuing Professional Development. • Widening Participation: Talent and Leadership flourishes free from discrimination and individuals and groups are able to progress to fulfill their potential in best possible patient outcomes

23. Glossary of NHS Speak- Some of my favourites! (not serious!) • Patient-centred care-useful reminder of what we need to do for anyone prone to lapses of concentration • Joined-up thinking-something we aspire to when you’ve mastered joined –up writing and joined up shoelaces • Going forward-adds a sense of purpose to the idea of getting around to something at some point

24. Must do things differently..... • Emphasis on staff • Importance of people attributes

25. Skills and attributes

26. Importance of Culture? Personality, Attributes?

27. Different skills

28. Entreprenurial/ Intraprenurial Internal entrepreneurs are independent thinkers. They are willing to try new things. They don’t let past experience get in their way or cloud their judgement. They see possibilities where others don’t.

29. Entreprenurial/ Intraprenurial • They don’t sit back and wait for things to become clear. They control uncertainty by acting. • Internal entrepreneurs are totally engaged and energized by a challenge. They take on the toughest jobs.

30. Entreprenurial/ Intraprenurial Internal entrepreneurs are good at driving change. They are willing to take on risks to change their comfort zone. They make change happen. Internal entrepreneurs are highly effective leaders. They are able to break down barriers and create new systems to support them. They lead through complexity.

31. Internal entrepreneurs are good at execution. They have the discipline to stay focused and bring things to closure. They close the gap between strategy and execution. (2) (2) Amo B, Kolvereid L. Organisational strategy, individual personality and innovation behaviour, Journal of Enterprising Culture 2005;13(1): 7-19 Entreprenurial/ Intraprenurial

32. The skills and capabilities that were needed in the past are not the skills needed moving forward. The reality is that we all need to be entrepreneurs now and we need leaders who have the entrepreneurial talent to shake things up and get things moving.

33. Project: • 2 Inspire: Increasing intrapreneurial skills through pedagogy, increases innovation, retention and employability. Dr Heidi Probst. Sheffield Hallam University Reader and Principal Lecturer

34. Some quotes from the 2INSPIRE project • In response to a question about people starting out on the path to intrapreneurship: • “ this is not going to be an easy road. If your not prepared to take that level of challenge…then it’s get out of the kitchen now” • “to be an expert practitioner…in order to be confident in what you do you need to know that your underpinning theory is absolutely sound so that there is a commitment to learn about your subject…its about knowing you know”

35. Some quotes from the 2INSPIRE project • “ knowing your stuff is really important, expect to be challenged, and be prepared , but also it’s important to trust your institution and yourself….. and know that I am right”

36. Qu. What drives you to innovate, what are the motivators? “a real passion for wanting to do research, and also wanting to do research that I knew would change the patient experience” “when doors get slammed in your face...you just keep hammering away” “ we could be doing this so much better, this was the motivation to make change”

38. Motivation...synonyms for....

39. Innovation/ingenuity.....

41. Adopt a new approach... • Learning from your mistakes • Learning from your successes • And learning from the people around you ....to be the best you can

42. Innovation through ingenuity To be the best we can be.... We don’t have to be super human......

43. Personality or Psychometric Testing?Dr Hermann Rorschach-Ink blot tests

44. Research: evidence based practice • Importance of new practice and evidence based practice • There are well documented perceived barriers to research

45. Original Article:Promoting radiation therapy research: understanding perspectives transforming culture JRP 2013;12(2) 92-99 Authors: Turner, D’Alimore and Fitch • Identify challenges and opportunities that prevent RT led research in their clinic • Insite gained to lead to strategies that encourage and support RT research • Need to take a more active role and initiate own research

46. Promoting radiation therapy research: understanding perspectives transforming culture JRP 2013;12(2) 92-99 • Barriers to research identified: Culture: attitudes changing but Dept not being open to changes-de motivating • Time, support, education and training and individual motivation-some didn’t think they were capable of coming up with interesting unique questions-own barrier

47. Article: Promoting radiation therapy research: understanding perspectives transforming culture JRP 2013;12(2) 92-99 • Leadership dynamics-transformational leadership one that promotes an entrepreneurial spirit promotes power sharing • Creation of mentoring roles • Support must be a relationship between the institution and the RT’s-deliverables-reward

48. Article: Australian RT’s rank technology-related research as most important to radiation therapy.JRP 2011;10(4) 228-238 Authors: Cox ,Halkett, Anderson, Heard • Conclusions: • The strongest interest on research in technical research consistent with the rapid influx of new technology. • Authors identify over 30 research questions that RT’s view as being important

49. Article: Attitudes to and perception of research for health science lecturers. Radiography 2013;19 (1) 56-61 • Author- Catherine Williams • Findings • All groups found barriers to research, lack of time resources and skills. Perceived hierarchy of research. Those who were involved in research reported a feeling of isolation which reduced outputs. • Some didn't want to be involved in research and had difficulty identifying this with part of their role

50. What holds us back? • Importance of motivation or mission? • Importance of sharing the evidence base to improve practice and patient care-we can’t argue with this • Not difficult to publish! • You can do it.....here's how....