Excellence in nursing and midwifery

Greenwich is a leading provider of education and training of nurses and midwives in the UK.

The university has been awarded the highest ranking by national regulator The Nursing & Midwifery Council, students have voted it No 1 in London, and the NHS, which commissions health education, has also consistently judged it the best in London.

In a period of unprecedented change, as the government restructures entry routes into the professions, Greenwich is working closely with health sector partners to find solutions and ensure the best experience for students.

It will be among the first four universities to offer new nursing degree apprenticeships next year. Health secretary Jeremy Hunt is introducing them as an alternative pathway into nursing to traditional pre-registration degrees. Registration, which enables nurses and midwives to practice in the UK, is given once a student gets their degree qualification.

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The apprenticeship will allow health care assistants and other unregistered staff to stay in work while studying, and will be paid for by employers through a levy into a central pot. It will be an important route to nursing for older students and those on low family incomes, as the government is also removing the bursary: all other students will have to rely on loans from September.

Dr Karen Cleaver, Head of Family Care and Mental Health at the university, says: "We are well known for our collaborative working with employers – from big NHS trusts to hospices and GPs. It is especially important for students because they spend half their time on placement in a clinical setting."

In an article this February, noting that placements are not always as good as they should be, Nursing Times reported that the University of Greenwich is in the top ten education providers nationally for student satisfaction with placements and puts high value on quality.

In the most recent National Student Satisfaction (NSS) survey, 96 per cent said they had been found a suitable placement and over 90 per cent felt they were sufficiently prepared, supervised and valued as part of the clinical team.

Dr Cleaver says: "Our students can choose where they are placed from a very wide range of settings including hospital wards, local surgeries and specialist services such as mental health."

Head of Adult Nursing & Paramedic Science, Morag Redfern, says: "Our priority is to ensure graduates are fit for practice as registrants, able to move seamlessly into the healthcare workforce and make a positive impact on patient outcomes. Patient and public safety is at the centre of all our programmes."

Challenging and rewarding careers

Greenwich offers all four undergraduate, pre-registration options in nursing: adult, mental health, children, and learning disabilities.

Morag Redfern says: "Nurses have to do a lot of thinking before they choose their course because they specialise in one of the four areas from the start. They need to clearly demonstrate that they are drawn to their field. The huge reward is that they will then be immersed in what they really want to do."

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Once registered, nurses can specialise further with post-graduate diplomas to become district nurses, health visitors, school nurses and practice nurses based in GPs' surgeries.

"Nursing and midwifery are among the most challenging and demanding careers but also the most rewarding," Morag says. "And unlike other degrees, students know they are highly likely to get a job. The number of our students in professional jobs six months after graduation consistently approaches 100 per cent."

Research: helping to shape the country's health services

As well as educating tomorrow's nurses and midwives, Greenwich is also helping to shape the country's health services to meet future needs. The Faculty of Education & Health has a large community of researchers who are continuously contributing to improvements for patients, professionals and services.

Professor Elizabeth West, Head of the Health & Society Research Group and the Centre for Positive Ageing, says: "One important research strand concerns the professions of nursing and midwifery themselves and their organisation, management and regulation. For example, why nurses leave the profession or choose to stay, or what factors affect their ability to provide patient care."

An example is recently published research led by Professor West into the progress and outcomes of black and minority ethnic (BME) nurses and midwives through the Nursing & Midwifery Council's Fitness to Practise process. The study found that BME nurses and midwives are disproportionately referred to the council for being potentially 'unfit to practice' by their employers. The council has adopted the report's recommendations including better data collection, and training in unconscious bias.

Professor West and senior lecturer Deborah Isaac both presented their work at the Royal College of Nurses' International Nursing Research Conference & Exhibition 2017 in April. Deborah was awarded funding under the Mary Seacole Leadership Award 2016/17 to research the career barriers facing BME mental health nurses, who are under-represented in the higher career grades where they can influence policy and approaches to service delivery.

Another project in this strand, 'Retention of nurses in their later careers – a pilot study', is being led by Dr Cleaver. The research, funded by the Burdett Trust for Nursing, seeks solutions to avoid the loss of expertise from this cadre of experienced nurses.

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The Avery Hill Campus has clinical skills laboratories, which replicate NHS wards

Understanding and improving patient outcomes is a second key research strand. The university is able to use its expertise in analysis of large data sets to detect trends which cannot always be observed from smaller studies. For instance, examination of the experience of 840,077 inpatients in England between 2002 and 2013 was able to show which services had improved and which deteriorated over time: the greatest improvements were for patients receiving copies of doctors' letters; single sex ward areas; clinicians' hand washing; ward cleanliness and planned admission waiting times.

The greatest decline was that fewer responders said their call bells were usually answered within two minutes. The research also showed which methods of change management were most effective.

Professor West's most recently published research, carried out with Dr David Barron from the University of Oxford, asked: "Do for-profit, not-for-profit or public sector residential care and nursing homes provide better quality care?"

Data on care quality for over 15,000 homes provided by the Care Quality Commission between 2011 and 2015 showed that for-profit facilities are likely to have lower CQC quality ratings than public and non-profit providers over a range of measures, including safety, effectiveness, respect, meeting residents' needs and leadership. The findings suggest greater investment in public and non-profit facilities is required if quality of care is to be maintained.

A third strand studies health inequalities and the experience of vulnerable groups, from young lesbian, gay, bisexual, trans and questioning (LGBTQ) people to children and adults with life-limiting illnesses. The work on Gypsies and Travellers by Dr David Smith, Principal lecturer in Sociology, is particularly well recognised in this area.

The university is also known for its expertise in a range of other areas including the health and wellbeing of older people, sexual and reproductive health, prisoner and offender health, and service user and public involvement and consultation.

Nursing and midwifery are among the most challenging and demanding careers but also the most rewarding

Leading the way on integrated care

With hospital beds overflowing and pressure on A&E departments rising, a key policy thrust for the health sector and government is how to better integrate services, especially within health services and between health and social care services, in order to help patients where they are in the community.

Policy documents talk about a 'seamless journey' for patients where their data is shared between providers, there is minimum waiting time, and different professionals, whether the practice nurse, care home supervisor, consultant or police officer, share the same perspective and compassion in dealing with the patient.

Dr Cleaver leads two key initiatives to integrate care in the region. She is Director of the Institute of Integrated Care, a partnership with Oxleas NHS Foundation Trust to promote multi-agency working and better patient outcomes through research, training and sharing good practice.

Multi-agency projects funded by the institute last year included 'MOVE', helping children and young people with disabilities and/or complex needs to achieve maximum physical movement wherever they are throughout the day, requiring coordination between families, schools, therapists and other agencies. Several projects focus on improving life for people with dementia living in care homes.

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The institute is also supporting an initiative to assess the value of music to help children and adults with Autism Spectrum Disorders (ASD). Therapists and parents will be able to assess a child's progress using a new evaluation tool and adapt the music therapy to meet their needs. The accumulated evidence will help NHS trusts develop cost-effective treatments.

Dr Cleaver is also lead academic in the ongoing development of three Community Education Provider Networks, in Greenwich, Bexley and Bromley. Each network brings primary and community care organisations together to collaborate on education and training. She says: "How do you bring all these different people together, from GP practices and pharmacists to NHS trusts and charities, and break down silos and boundaries? How do you get them to put themselves in each other's shoes so they can really help each other and work together? That's what we aim to achieve."

This integrated approach is also applied to teaching at the university: "We instil a professional identity in nurses and midwives, and crucial to that identity is the recognition that they are part of a bigger team, across professions and beyond the NHS to the social care, criminal justice, education and voluntary sectors."

Greenwich nursing and midwifery degrees get top ranking

Nursing and midwifery degrees at the University of Greenwich were awarded the highest ranking by the profession's national regulator earlier this year.

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The Nursing & Midwifery Council put Greenwich in the top 12 per cent of institutions providing the professional qualifications in the UK for performance and quality.

The council has a green/amber/red ranking for the nation's 77 'Approved Education Institutions' with most (58 per cent) ranked as green. Only nine institutions merit the outstanding 'blue' rank which sits above the other three.

Dr Linda Burke, Pro Vice-Chancellor Education & Health, and a qualified nurse herself says: "The NMC's blue ranking confirms the university as one of the country's leading providers of nursing and midwifery training. It is evidence of the excellent partnerships we have with healthcare providers and the outstanding commitment and talent of staff and students."

University climbs league tables

The Faculty of Education & Health has gone from strength to strength in recent league table rankings. Subjects including Nursing and Midwifery, Social Work, Psychology and Education have significantly improved their positions in the recently published Complete University Guide, and have achieved some of the best NSS results in London.

Greenwich undergraduates win Student Midwife of the Year – two years running

Greenwich midwifery undergraduate Claire Axcell was named Student Midwife of the Year 2017 by the British Journal of Midwifery. Fellow student Heidi Stone won the award in 2016.

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Claire Axcell

The prestigious national title was announced at the journal's annual Practice Awards which recognise outstanding commitment, efforts and achievements in the profession.

Claire, a former police officer and mother of two, says it was the outstanding care she received following the birth of her first child that rekindled her childhood dream of becoming a midwife: "I was impressed by the support I was shown and from day one I've tried to pass this on – to treat others as I would like to be treated myself."

Claire, currently completing her clinical practice at Lewisham & Greenwich NHS Trust, had warm praise for her tutors at Greenwich: "They've been amazingly helpful and always take the time to support and advise me. I've been able to go to them with any issues, and I could not have asked for better support."

Find out more

For more information about nursing, midwifery and paramedic degree programmes in the university's Faculty of Education & Health, go to: www.gre.ac.uk/eduhea/study/programmes

Institute of Integrated Care

The Burdett Trust for Nursing