Author Archives: Stephen Martineau

In Pursuit of Ethically Sustainable Approaches to International Nurse Recruitment

Posted on by

Prof Ian Kessler of the NIHR Policy Research Unit in Health and Social Care Workforce is Professor of Public Policy and Management at King’s Business School. He introduces a new evaluation from the Unit: International Nurse Recruitment and the Use of Memoranda of Understanding: The Kenya and Nepal Pilots. (1,447 words)

With rising health and care needs as national care systems seek to cope with aging populations, the growing incidence of chronic conditions, and the shock of the Covid pandemic, there has been increasing pressure on the global supply of healthcare workers. Traditionally drawing upon overseas staff, this raises new and important questions for the NHS about how such employees are accessed and managed. The recent NHS England’s Long Term Workplace Plan, 2023, for example, cautions against an over reliance on any specific source of labour. More profoundly, the pressure on the supply of overseas healthcare workers prompts renewed concerns about the ethics of international recruitment as a practice.

Earth seen from space

There has been longstanding debate on the ethics of overseas recruitment by the NHS and other high income countries. This is reflected in international attempts to regulate the practice through, for example, the World Health Organisation Global Code, 2010, designed to ‘establish the ethical international recruitment of health personnel, accounting for the rights, obligations and expectations of source countries, destination countries and migrant health personnel.’ Debate on the ethics of the process has deepened with the new labour supply side pressures, and in response, government-to-government, or bilateral, agreements, whether in the form of Memorandum of Understanding (MoU) or tighter, more formal treaties, have emerged as a potential vehicle for addressing ethical concerns. Continue reading →

Occupational Health and Wellbeing (OHWB) and the Health and Social Care Workforce

Posted on by

Antonina SemkinaDr Antonina Semkina is Research Associate at the NIHR Policy Research Unit in Health and Social Care Workforce, King’s College London. (613 words)

Unit researchers Antonina Semkina and Caroline Norrie attended the annual Health and Wellbeing at Work Conference that took place in Birmingham National Exhibition Centre on 12-13 March, 2024. The conference featured 13 themes, including Future of Work; Equality, Diversity, and Inclusion; Health and Conditions; and Culture, Values and Engagement, among others. There were 100+ exhibitors representing Occupational Health providers, NHS and social care organisations, consultancies, training agencies, and charities.

Caroline and Antonina recently published the final report from their NIHR-funded study “Exploring the awareness and attractiveness of Occupational Health (OH) careers: perspectives of trainee doctors, nurses, OH trainees, OH career leavers” so they particularly enjoyed the opportunity to connect with and hear presentations from policy makers, researchers, practitioners, and providers in the field of OH. Continue reading →

The NIHR Policy Research Unit in Health and Social Care Workforce Programme of Work: The Next Five Years

Posted on by

Prof Ian Kessler of the NIHR Policy Research Unit in Health and Social Care Workforce introduces the Unit’s programme of work commencing this year under the 2024-28 award from the NIHR Policy Research Programme.

In the context of ongoing challenges to the recruitment, retention, and motivation of around three million staff employed in health and social care, the NIHR Policy Research Unit in Health and Social Care Workforce in the Policy Institute at King’s College London (KCL) has announced its programme of work as it sets out on its next five years (2024-28).

Developed in consultation with the Department of Health and Social Care, this programme is sensitive to the importance of workforce organisation and management to the delivery of high quality services as the health and care needs of the population change, and as technological and medical advances provide new opportunities to address such needs. The Programme has been framed by key policy initiatives, for example, the NHS England Long Term Workforce Plan (2023) and the DHSC White Paper People at the Heart of Care: Adult Social Care Reform (2021). It comprises the following seven related but discrete projects, with their Principal Investigators (PI):

Continue reading →

What are the experiences, motivations and plans of Health and Care Visa holders and their dependants?

Posted on by

Kalpa KharichaDr Kalpa Kharicha is Senior Research Fellow at the NIHR Policy Research Unit in Health and Social Care Workforce in the Policy Institute at King’s College London. She leads the Unit’s work on the Health and Care Visa, the report from Phase of 1 of which was published in October 2023. (679 words)

Internationally recruited care workers made the biggest contribution to reducing vacancies in frontline adult social care in England during 2022-3; 70,000 people came to the UK to work in a direct social care role. During this time the number of domestic recruits to care work fell. Vacancies in social care are currently at 152,000.

The increase in international care workers follows changes to government immigration policy in recent years. In particular, the addition of ‘Senior care workers’ and ‘Care workers’ to the shortage occupation list (on 27 January 2021 and 15 February 2022, respectively) allows people from other countries to apply for these jobs, with a licensed UK employer and if eligible for a Health and Care Visa.

Recent announcements on immigration policy mean that from early 2024 (exact date to be confirmed at time of writing), Health and Care Visa holders arriving in the UK after that time will no longer be able to bring their dependants with them Health and Care Visa holders who are already in the UK can bring dependants whilst on their current visa.

As part of our recent research to understand the impact of the Health and Care visa system on the adult social care workforce in England, we spoke to 29 internationally recruited care workers and dependants, as well as 22 social care providers, 8 brokerage agencies and 15 sector skills experts, who shared their views and experiences with us. Continue reading →

Something lost that’s worth revisiting

Posted on by

Brian Parrott reflects on the uncertain place of ‘community’ within the social work profession. (711 words)

In the 1968 Seebohm Report-influenced years for social work, the word ‘community’ was widely used, whether ‘community development’, ‘community work’, ‘patch working’, ‘community social work’ or other.

The common essence was something about the interrelationship of an individual or family’s circumstances with the place in which they live – its features, its wellbeing and the social forces and policies which impact on them.

During the first half of the 1980s, what came to be called ‘community social work’ in local authority social services departments or in projects supported by them, was described, promoted, supported and criticised. It has lived on ‘below the surface’ as other events in children’s services, adult social care, political favour, or public funding have dictated the nature and focus of social work.

For many of us, this has meant that something was ‘lost’ that might merit revisiting, particularly now in the contexts of greater focus on user-led services, collaborative working and ‘co-production’. Continue reading →

How can we scale-up innovations? Lessons from the development of four local Shared Lives schemes

Posted on by

Carl PurcellDr Carl Purcell is a Research Fellow based in the NIHR Policy Research Unit in Health and Social Care Workforce, part of the Policy Institute at King’s College London. He is also part of the team working on the SASCI project led by Dr Juliette Malley based at the Care Policy Evaluation Centre at the LSE. This is the second of two blogs on Shared Lives. (1,315 words)

In a previous blog we considered the successful spread of Shared Lives (SLs) schemes as an alternative model of care that seeks to replicate ‘ordinary’ family life for adults with care needs. This model has long enticed national and local policymakers’ attention and SLs schemes are now established in most English local authority (LA) areas. However, it remains a very small model accounting for just 1 per cent of those drawing on local authority funded adult social care and less than 0.5 per cent of the workforce. Furthermore, SLs continues to be used predominantly for the care and support of people with learning disabilities (LD) despite efforts to promote its wider use for a more diverse range of people. This prompted us to investigate the challenges faced by local schemes trying to ‘scale-up’. Continue reading →

How do innovations spread? What we can learn from Shared Lives schemes and the role of Shared Lives Plus?

Posted on by

Carl PurcellDr Carl Purcell is a Research Fellow based in the NIHR Policy Research Unit in Health and Social Care Workforce, part of the Policy Institute at King’s College London. He is also part of the team working on the SASCI project led by Dr Juliette Malley based at the Care Policy Evaluation Centre at the LSE. See also the second blog in this series by Dr Purcell. (1,129 words)

Innovation, or doing things differently, is commonly promoted by policymakers as a response to social challenges in the context of increased pressure on public services and stretched resources. Policy announcements on adult social care are testament to this, but we know surprisingly little about how innovations emerge and are developed, sustained, and spread. The Supporting Adult Social Care Innovation (SASCI) project – an ESRC funded study investigating innovation in adult social care in England – was set up to address this. The spread of Shared Lives (SLs) schemes across England has provided an intriguing case study. Continue reading →

Introducing a community approach to practice with homelessness and addiction

Posted on by
Ed Addison and Nathan Rosier

Ed Addison and Nathan Rosier

This blog is the third in a series of three by The People’s Recovery Project (TPRP), a charity building sustained recovery for people experiencing homelessness and addiction. As a follow up to their involvement in the HSCWRU Strengthening adult safeguarding responses to homelessness and self-neglect study, HSCWRU invited TPRP to facilitate an event at King’s.

This blog by TPRP co-founders Ed Addison and Nathan Rosier shares final messages from this event on re-thinking approaches to supporting people to move on from multiple exclusion homelessness (MEH), with a focus on building new communities.

Blog 3: A peer-led community – improving routes into residential treatment

As we continue to develop The People’s Recovery Project (TPRP) we emphasise the importance of a peer-led community in guiding and supporting our approach. In the previous blog in this series we heard from Danny, an active TPRP community member, about his experience of street homelessness, residential treatment and recovery from addiction. Danny’s story is an example of how getting the opportunity to access residential rehabilitation can contribute to individuals making huge and positive life changes. Despite the many obstacles faced by our community members experiencing MEH, Danny is not the only one who has managed to embark on a journey of recovery. Through building a peer-led community in recovery from homelessness and addiction, we are striving to create the conditions that will allow members to use their own experiences to demonstrate to those living on the streets that a permanent recovery from street homelessness is possible. Continue reading →

New study at the Unit on capacity assessment and homelessness

Posted on by

This month sees the start of a new study at the NIHR Health and Social Care Workforce Research Unit, King’s College London. Over the next two and a half years researchers will work with people with experience of homelessness and professionals who work with them to examine mental capacity assessments and multiple exclusion homelessness in England. Stephen Martineau, Research Fellow at the Unit, introduces the study, which is funded by the NIHR Health and Social Care Delivery Research (HSDR) Programme.

At the Unit this month we are starting a study, ‘Use of the Mental Capacity Act 2005 with people experiencing multiple exclusion homelessness in England’. The co-Principal Investigators are Kritika Samsi (KCL) and Michelle Cornes (Salford & KCL), with the main researchers being Jess Harris (KCL) and Stephen Martineau (KCL). The lived-experience Advisory Group (PPIE) is led by Stan Burridge, who, as a member of the research team, will also be carrying out interviews with people experiencing homelessness. The other research team members are: Alex Ruck Keene KC (Hon), KCL and 39 Essex Chambers; Nathan Davies, UCL; Alex Bax, Pathway; Sam Dorney-Smith, Pathway; Bruno Ornelas.

After an evidence review, interviews with national experts and a national practitioner survey, we will focus on three contrasting sites in England – interviewing people with experience of homelessness and a range of professionals engaged in their support and care. Finally, informed by our findings, we plan to bring together stakeholders and, in consensus, revise a pre-existing capacity assessment Tools and Guidance document for practitioners working with people experiencing homelessness.

Background

About a decade ago in the London Borough of Lambeth, a review into the death of a 63-year-old man who had been sleeping on the streets recommended work on ‘understanding how the Mental Capacity Act (2005) [MCA] can be used to safeguard people in this context.’* One consequence came in the form of a pioneering Tools and Guidance document – now in its third edition (2017) – that places the MCA in context with the Mental Health Act 1983 (MHA), risk assessment, adult safeguarding and hospital admission procedures, all calibrated for those working with people who are street sleeping. Continue reading →

Addressing homelessness in social work education

Posted on by

Carolin HessCarolin Hess is a PhD student in the NIHR Policy Research Unit in Health and Social Care Workforce who has been awarded Doctoral funding from the NIHR School for Social Care Research. She reports from a recent webinar, the latest in the Unit’s Homelessness series. (920 words)

The webinar, attended by over 200 people, presented emerging findings from an innovative study ‘Addressing Homelessness in Social Work Education’, conducted by Jess Harris and Karl Mason and funded by the National Institute for Health and Care Research (NIHR) School for Social Care Research (SSCR).

The study delved deeper into an aspect of a previous study on Safeguarding responses to homelessness and self-neglect, which examined why social workers, including those in safeguarding roles, may be inadequately prepared for working with people experiencing homelessness. The study is also connected to a previous webinar on a study on the ‘Homelessness Social Worker Role’ which explored the experiences and support needs of specialist homelessness social workers, as well as the systemic barriers they face. This earlier webinar revealed that many social workers reported limited exposure to homelessness-related topics during their qualifying courses and uncertainty about their role in this area. Continue reading →