How to improve health and social care unregistered staff’s education and development

Richard Griffin MBE is Visiting Senior Research Fellow, King’s Business School. (434 words)

I write a fair bit about the challenges and barriers support workers can face. Research by King’s College London and others has identified persistent issues such as poor job design, lack of funding for training, pay levels that too often do not reflect the extended nature of the roles and poor progression pathways. I thought though, particularly in the run up to the Royal College of Midwives’ annual Maternity Support Worker Week (23-27 November) and the Royal College of Nursing’s first Nursing Support Worker Day (23 November), I would set out my views of some of the ways these problems can be addressed in the NHS.

  1. Be clear about the roles and responsibilities support workers can – and cannot – undertake. This means listing clinical and other tasks.
  2. Establish the competencies (knowledge, skills and behaviours) support workers need in order to perform those roles and responsibilities.
  3. Agree the minimum entry-level qualification requirements needed at bands 2, 3 and 4 (or equivalent).
  4. Agree the minimum amount and type of experience required. For example, are new recruits expected to have some experience of working in a health or social care environment previously?
  5. Agree common job titles. The number of different titles for the same role continues to stagger me and must confuse the public.
  6. Map competences against apprenticeship standards but identify gaps in provision including steps into pre-registration degrees. Get these right and support workers will have access to a consistent national learning curriculum.
  7. Ensure best practice in respect of supervision and delegation.
  8. Create an expansive learning culture that is supportive of the whole workforce’s development.
  9. Leadership. Throughout the system leaders need to advocate clearly the contribution support workers make to care and that should start at the very top.
  10. Ensure consistent and sufficient funding for training and development (not just for apprenticeships).
  11. A feature of delivering these steps successfully is partnership working including with trade unions and professional bodies but also education providers, employers and the support workers themselves.

Are the above being delivered anywhere? Yes. Maternity, led by Health Education England, is leading the way nationally [1]. The approach taken to developing the Nursing Associate, albeit focused on a single role, is also encouraging [2]. There are signs other professions are beginning to systematically look at maximising the contribution of their support workers.

Richard Griffin MBE is Visiting Senior Research Fellow, King’s Business School.


  1. See: which includes an economic evaluation undertaken by KCL of the return on investment on apprenticeships for Maternity Support Workers
  2. See: