Balancing Academic and Clinical Roles

It was anticipated that there would be a substantial degree of overlap between the research and clinical roles, with existing line management from the NHS side, and joint supervision of the research from the clinical and academic partners. It appears that the level of overlap between the roles was less than expected in a number of cases, in terms of the management of the role and the focus of the research being undertaken.

In terms of line management, one post-holder indicated that clinical line management through her clinical job was different to the clinical lead for the research side – the CARC role was seen as an add- on to her clinical role, rather than it being more integrated. The need for greater clarity of roles amongst the various people involved in managing either the scheme or the individual post-holders was also highlighted:

"So in my clinical role I’m managed within that, so that’s all taken care of. In the CARC role, the clinical nurse manager from [my clinical area], she’s like my line manager, so I go to her with any … HR things or bits and pieces like that, I’ve been using her for that support." “[in] our job descriptions … it clearly said that my line manager was the same line manager for my clinical post. But there was some confusion about the role of the clinical lead for the CARC scheme, because that person doesn’t have any supervisory or managerial role over me necessarily. … So that there is a role for them, but it’s not necessarily about managing or supporting me necessarily, more the scheme I would say."

Likewise, the idea behind the CARC scheme was to have a research programme that could be linked in to the clinical practice of the post-holder. Although there was overlap for some individuals, this was not always seen to be the case in practice.

“to me the whole notion of the CARC scheme is can you find a way to kind of marry the clinical and academic work, and actually for me that’s not really panned out. There could be a lot of reasons for that, which are a bit complicated, but at the moment my CARC work, my two and a half days CARC and my two and a half days [clinical work] are pretty much entirely separate.”

“And although [my academic supervisors] supposed to be heavily involved in the CARC Scheme from the university side, they’re very peripheral to our [clinical] activities. We’re very much in [one clinical area] and they seem to be very much in [another clinical area], so our paths don’t really cross to some extent. So there is that element of it.”

Different approaches had been adopted by post-holders towards integrating and balancing the time spent between the two halves of the CARC role, although time management remained an issue:

"I see it all as one job … I don’t try and balance my NHS time with my University time as far as I’m concerned it’s all one… I’ve had so much flexibility and freedom and autonomy, it’s been really lovely. I’ve really enjoyed that aspect of it."

"I have allocated days to do my research."

“I guess the NHS and the University both have half of you, but both want more than half of you.”

One of the post-holders had particular problems in getting back-fill for her clinical role, and had concerns about fulfilling her clinical role at the same time as trying to cope with the academic demands. This contributed to her decision to leave the scheme. She did stress the point that every effort was made to try and fill the clinical role:

“The biggest and the main reason I left was that I had to go back for my job, and so I was doing half my job and half uni, and I had to get somebody else to do the other half of my job, … so basically I was doing a whole time job and doing the PhD at the same time, and you just can’t really do that. … It wasn't the CARC scheme or the directorates fault as everything was done to fill the post. They advertised the post several times"

There were advantages to having an association with more than one organisation, such as having a choice of where to work, depending on what needed to be done. However, working between two different organisations was seen to hold a number of disadvantages too, mainly in having to negotiate different systems in different places:

“it’s a challenge negotiating two funding systems, so obviously coming from an NHS background and then having to work through the way the University does things it’s completely different. It’s a bit of a pain in the backside. And there’s two performance review systems they have. My whole NHS one here and then I’ve got the academic annual review and then I’ve got the CARC one as well.”

There is also a need to manage what is expected from each role (academic and clinical), in particular being clear about the responsibilities associated with the academic position:

“Well that’s been a little bit tricky, because I do feel that there are certain individuals at the University that think oh she’s our part time, you know, half of her belongs to us, what is she doing, we can get her to do some teaching. You know they’re so hard pressed I think it’s a case of grabbing a body, she’ll do.”

“But certainly with my post the focus is very much on the research training and doing this PhD"