Welcome to 'Meet the Expert', our new series bringing you informative interviews with Armed Forces researchers, policy makers and service providers. Read on to learn about current work, aspirations for progress and future work, and for insights into their perspective on key issues impacting ex-Service personnel and their families.
In this issue, we interviewed Professor Alan Finnegan, Professor of Nursing and Military Mental Health and Director of the Westminster Centre for Research in Veterans at the University of Chester. Alan chairs the Armed Forces Network (North West England), Contact Armed Forces Research Sub-Committee, and Cheshire Armed Forces Community Covenant Partnership. In 2022 Alan was inducted into the Sigma Theta Tau International Nurse Researcher Hall of Fame.
1. Professor Alan Finnegan, please tell us about your background and how you came to be involved in work relating to the Armed Forces Community?
As a dual qualified Registered Nurse Adult and Registered Nurse Mental Health, I worked in the NHS before my wife and I joined the British Army in 1987. During my military career, my primary clinical role was as a Community Psychiatric Nurse, and my appointments included being Manager of Military Departments of Community Mental Health, the Ministry of Defence (MOD) Nurse Consultant in Military Mental Health (MMH) and the MOD Nursing Advisor in MMH. I progressed to being the Senior Military Nurse and Commanding Officer at the Royal Centre for Defence Medicine during the peak of the Iraq and Afghanistan campaigns. My final appointment was as the first MOD Professor of Nursing. I completed tours in Iraq, Afghanistan, the Balkans, Northern Ireland and South Africa. During my military career, I lived away from home for 14 years, including several years on operational tours. My wife’s and children’s experiences are incredibly important to my work focus at the University of Chester.
2. What research projects are you currently working on and how do they fit into the bigger picture of understanding and supporting the Armed Forces Community?
I established the Westminster Centre for Research in Veterans at the University of Chester in 2016.[1] I have subsequently been nominated as the principal investigator/project lead for over 20 UK Armed Forces Community specific projects, including research awards from the NHS, the Armed Forces Covenant Fund Trust (AFCFT), the Forces in Mind Trust, as well as other charities and businesses. In addition, there have been grants from Health Education England and the AFCFT to develop Armed Forces community educational modules and materials. Current projects include studies on Primary Healthcare veteran registration and morbidity rates, minority ethnic populations, and NHS initiatives such as the Single Point of Contact and the Armed Forces Advocates in acute hospital settings. Also, we are currently conducting evaluations of suicide prevention projects, support to female veterans, and assessment of AFCFT projects. I have also worked with professional organisations including the Royal College of Nursing to establish an International Research Webinar Series[2] and the Royal College of General Practitioners to assess their Veteran Friendly GP Practice project. The aim of all of these projects is to have a positive impact that will inform policy development, clinical delivery, and educational knowledge through empirical evidence.
3. What other research or policy areas relating to the Armed Forces Community are you especially passionate about or feel need further attention? Please expand on this and tell us about them, as much as you can.
I am the Chair of the Contact Armed Forces Research Committee and included in our Terms of Reference is the requirement to identify areas that are either under-researched or emerging topics that warrant further attention.[3] The items which we have noted are minorities’ access to healthcare; ageing veterans (especially women) and dementia; and bereaved military communities, including the needs of Service widow(er)s (distinct from war widow(er)s). Other areas for development are the scope and nature of research on families, children and carers; complex grief, including that relating to instances of violent or traumatic death; and the impact of the August 2021 Afghanistan withdrawal on military (veterans’ and families’) mental health. Outside of the Contract identified areas, I feel that there is also a requirement for research regarding Traumatic Brain Injury and the widespread impact of vaccines and prophylactic medications on deploying troops. I am particularly passionate regarding the support and research (or lack of it) offered to Service partners and families. Without their contributions, the British Armed Forces would fail, and it is their sacrifices that require further attention.
4. What are your future aspirations for the impact and utilization of your work/research?
The aim is always to produce outcomes that make a positive difference, whether that be in policy development, clinical delivery, education modules, or to stimulate further research. Achieving impact requires widespread dissemination of the findings, which in turn requires the support of the grant holder and organisations such as FiMT to proactively engage and promote through the creative use of social media as well as traditional means of distribution. I’ve contributed to 45 publications since joining the University of Chester and provided multiple national and international papers at high profile conferences which stimulates the utilisation of our Centre research.
5. What do you think are the key challenges impacting current veterans and their families, and how do you think research and/or policy can be best used to address them?
The key challenges for veterans and their families are the same as for any other civilian: namely, being appropriately assisted in keeping a healthy mind and body. Veterans may face challenges around poor finance and lack of employment, and these situational stressors can easily lead to mental health problems. There is also definitely room for better research surrounding the ageing Armed Forces community population -his increasingly ageing population need support with all the challenges that getting older presents. When there is a physical or mental health need, the Armed Forces community require prompt access to a personalised health and social care programme. Any new initiatives to address any of these issues need evaluating, including a cost benefit analysis.
A key outstanding challenge is that there is currently no undergraduate clinical training to inform the future workforce of how to support the Armed Forces community. This lack of knowledge contributes to poor veteran registration levels in Primary Healthcare and poor referral rates to veteran specific services. With funding from NHSE, AFCFT and FiMT, our Centre is leading the way in trying to address these issues,[4], [5] including through the provision of free online resources.[6]
6. What do you think will be the leading challenges for the next generation of veterans and how do you think research and/or policy can be best used to address them?
Operationally-related challenges will be aligned to the physical health, mental health, and resilience of future recruits. The Armed Forces prepare their troops by training for the worst-case scenario, with these experiences intended to produce a healthy warrior for operational tours and to ensure that they remain strong until eventually departing the Armed Forces. Therefore, policy makers and researchers need to be attuned to the future battlefield and the challenges that will be presented to military personnel. The preparation of troops will be increasingly sophisticated and, with the further use of micro-simulation and macro-simulation, additional research will be required to detail the impact and effectiveness of these initiatives.
7. Can you tell us about the methods you tend to use in your research, and why you gravitate towards these kinds of approaches?
Clearly, the research question dictates the methods to be used.[7],[8] Whether it is qualitative, quantitative, or mixed methods, the choice of methodology should not be predetermined and should be the best means to address the research problem. A simple approach is to frame the potential topic as a research question, then articulate the problem to be addressed and specify the aim. The researcher can then determine what information is required to answer the question, designing a study that makes sensible, pragmatic choices between the method of data collection and how this will be analysed. But my preference is for a mixed methods approach, and I would class myself as a Grounded Theorist* which tends to underpin our Centre’s qualitative methodology. I am increasingly inclined to co-produce our studies to gain and learn from our participants’ lived experiences. Their narrative can both shape the study and help to validate the results. I have extended co-production** to partnering/employing peer researchers who are prepared for their role with training and supervision.[9] I am also eager to integrate members of the Armed Forces Community into the University Veterans Research Centre team.[10]
* Grounded theory is a qualitative research methodology involving determining new hypotheses and theories concerning a population or phenomenon through the process of data collection and analysis.
** Co-production is an approach to research wherein individuals with lived experience are partners in the production, development and undertaking of a project alongside researchers, providing knowledge and perspective from lived experience to benefit the quality and impact of research.
8. Given unlimited funding and time, what would be your dream piece of research to undertake involving the Armed Forces community?
I think that obtaining a much better understanding of the demands on Service spouses/partners and families is incredibly important, thereby identifying better ways of both improving their lifetime support and showing respect for their contribution to the British Armed Forces. In April 2023, our Centre received an AFCFT grant to explore the employment experiences of Service partners/spouses - this is an extremely important piece of work that our team is really excited about completing. Our Centre team includes 3 members of staff who are partners of serving personnel and they are leading this co-production study.
Many thanks to Professor Finnegan for sharing his insights.
Catch us next month for another interesting and informative interview with an expert from the Armed Forces research community.
[1] University of Chester (2023). Westminster Centre for Research in Veterans. Available at: https://www1.chester.ac.uk/westminster-centre-research-veterans
[2] Westminster Centre for Research in Veterans (2023). Armed Forces Community Research International Webinar Series. https://www1.chester.ac.uk/events/armed-forces-community-research-international-webinar-series
[3] Contact (2023). Research. Available at: https://www.contactarmedforces.co.uk/what-we-do/research
[4] Finnegan, AP, Jackson, R, Simpson, R (2018). Finding the Forgotten. Motivating Military Veterans’ to Register with a Primary Healthcare Practice. Military Medicine. 183 (11-12) 01 Nov: e509-e517. DOI: 10.1093/milmed/usy086 – Available at: https://www.fimt-rc.org/article/20180509-finding-the-forgotten-motivating-military-veterans-to-register-with-a-primary-healthcare-practice
[5] Westminster Centre for Research in Veterans (2022) Where Are All The Veterans? https://www1.chester.ac.uk/westminster-centre-research-veterans/research/where-are-all-veterans-finding-forgotten-phase-2
[6] University of Chester. Free Online Resource Launched Offers Training to Help Support Veterans: https://www1.chester.ac.uk/news/free-online-resource-launched-offers-training-help-support-veterans
[7] Finnegan, AP. (2014) Conducting Qualitative Research in the British Armed Forces. Theoretical, Analytical and Ethical Implications. British Medical Journal (Military Health), 160(2), pp 135-140. DOI: 10.1136/jramc-2013-000223 https://www.fimt-rc.org/article/20140124-conducting-qualitative-research-in-the-british-armed-forces-theoretical-analytical-and-ethical-implications
[8] Finnegan, AP. (2014) Fieldwork & Practical Implications for Conducting Qualitative Research in the Defence Medical Services. British Medical Journal (Military Health), 160(2) pp 141-145. doi.org/10.1016/j.jhepr.2020.100142 https://www.fimt-rc.org/article/20140109-fieldwork-and-the-practical-implications-for-completing-qualitative-research-in-the-british-armed-forces
[9] NHSE Veteran Aware (2023) Study into the Experiences of those from an Ethnic Minority who Served. Available at: https://veteranaware.nhs.uk/study-into-the-experiences-of-those-from-an-ethnic-background-who-served/
[10] Westminster Centre for Research in Veterans (2023) Who We Are? https://www1.chester.ac.uk/westminster-centre-research-veterans/who-we-are/centre-staff
