Evaluating the Nursing Associate Role: Initial Findings

Interim Report

Ian Kessler is  Professor of International HRM at King’s Business School and Deputy Director of the Policy Research Unit in Health and Social Care Workforce (HSCWRU). Prof Kessler is lead author of the Interim Report and two case studies from the HSCWRU Nursing Associates study, published today. (1,624 words)

Take part in a free webinar where we discuss these findings on 23 November 2020, 10-12.

The introduction of the Nursing Associate (NA) role in England represents a decisive step towards changing the structure of the nursing workforce, with a view to improving the quality of health and social care. Originally proposed by the 2015 Willis report on nurse and care assistant education[1], as ‘a bridging role’ between the care assistant and the registered nurse, the NA has emerged in NHS England as a pay band 4 role, requiring a two-year level 5 qualification, registered with and regulated by the Nursing and Midwifery Council (NMC). The NA programme was launched in early 2017 in two waves 11 pilot and 14 ‘fast follower’ sites, respectively taking-on 1,000 Trainee Nursing Associates (TNA). There were subsequent waves, with 5,000 TNAs recruited in 2018 and 7,500 in 2019. It is a role which attracts interest given its capacity to address a variety of workforce and care management goals. However, as with the introduction of any new role, there are organisational challenges to be faced in ensuring that it becomes established at the workplace level and accepted by the various actors with a stake in it, including nurses, managers, healthcare assistants and service users. Continue reading

Grow your own – an idea whose time has come (again)

Richard Griffin MBE is Visiting Senior Research Fellow, King’s Business School. (869 words)

Back in 2010 I produced a paper for the Department of Health with the snappy title of Widening Participation Into Pre-registration Nursing Degree Programmes. Nursing was becoming an all degree profession and there was a concern at the time that this might narrow the pool of future recruits as vocational routes were closed. The document mapped pathways up to and into pre-registration degrees for existing support staff, including via the then current version of apprenticeships. It also set out the wider benefits of a “Grow Your Own” (GYO) approach to workforce development and recruitment. These included, not only securing future labour supply, but also helping ensure that the NHS workforce better reflected its local population, supporting diversity and reducing turnover.

Fast forward a decade and I’m having a conversation with an NHS Trust who had hoped to recruit from their existing support staff on to a degree apprenticeship. There is no shortage of candidates, but it appears the step up from support role to a pre-registration degree is too large for staff and the Trust is unable to recruit. The 2010 paper, which I repeated for Camilla Cavendish’s review three years later, made the point that GYO needs to be “end-to-end”, starting even before employment begins and delivering investment in the formal education of support staff at every level, creating clear pathways to mobilise what we called back then, the NHS “skills escalator”. GYO seeks to create progression steps creating horizontal and verticals career routes, avoiding the “gap” problem experienced by the Trust I was talking to. Continue reading

Health inequalities among older BAME groups in later life

Dr Nayyara TabassumDr Nayyara Tabassum is Evidence Officer in the Centre for Ageing Better. (917 words)

In March of this year when we were still learning about COVID-19 in the UK, I remember listening to a journalist on the telly saying the coronavirus does not discriminate – it infects and kills everyone, rich or poor, young or old. But as more news started filtering in, a pattern of who the virus infected the most began emerging. Even while scientists and public health personnel were grappling with this new virus and how it spreads, one of the earliest news trends of the pandemic is that the virus seemed to affect particular groups, such as older people, those with underlying health conditions, those living in deprived areas, lower-skilled workers, those working in social care, those living in care homes and BAME (Black, Asian and Minority Ethnic) groups more than any other group.

The COVID-19 pandemic has shone a light on health inequalities that disproportionately affect older people and BAME people, something also confirmed by the recent PHE report published in June 2020.

This blog looks at what we know about health inequalities of older BAME groups, what we need to know more about and what are some key recommendations to promote healthy ageing that is inclusive for all. Continue reading

Fair Care Work: A Post COVID-19 Agenda for Employment Relations in Health and Social Care

Ian Kessler, Stephen Bach, Richard Griffin and Damian Grimshaw introduce their new paper, Fair care work. A post Covid-19 agenda for integrated employment relations in health and social care, published yesterday by King’s Business School. Lead author, Professor Kessler, is Deputy Director of the NIHR Policy Research Unit in Health and Social Care Workforce. (908 words)

The courage and sacrifice of the health and social care workforce have emblazoned themselves on the national consciousness as the challenge of COVID-19 continues. While classified as ‘key workers’, along with other occupations essential to the community in times of crisis, the distinctive contribution of frontline care workers, reflected in their direct and relentless engagement with the virus, has until recently been reflected in the Thursday night applause reserved for them. This public applause sits uneasily, however, with the treatment of over two million health and social care employees, mostly women, often from black and minority ethnic backgrounds, typically in undervalued, relatively low paid and insecure employment. In a new paper, we seek to kick start a policy debate on the development of fair care work, to stimulate discussion on a refreshed employment relations (ER) agenda which acknowledges and reflects the worth of care workers to our individual and communal well-being. Continue reading

Is the answer to the NHS workforce crisis right in front of its eyes?

Richard Griffin MBE,Visiting Senior Research Fellow, King’s Business School, today begins a series of guest posts on the healthcare workforce. He argues that, in the face of the widely acknowledged problem of shortages in this workforce, we should turn to current NHS support staff for part of the solution. (477 words)

Workforce is the biggest challenge facing the NHS. Not only is it short of 50,000 nurses, it also needs more podiatrists, midwives, radiographers and a host of other occupations. Total vacancies are approaching 110,000.

Whilst the government is committed to addressing this shortfall, a key question is – where will all those extra nurses, podiatrists, midwives and radiographers come from? Continue reading

Promoting the importance of human relationships: hospital social work

Jo Moriarty, Senior Research Fellow at the NIHR Health & Social Care Workforce Research Unit, King’s College London introduces the new hospital social work report, which she wrote with Dr Nicole Steils and Prof Jill Manthorpe. World Social Work Day is on 19 March 2019 #WSWD2019 is the official hashtag. (602 words)

Mapping Hospital Social WorkThe theme for next week’s World Social Work Day is ‘promoting the importance of human relationships.’  In preparation for this we are launching our report into hospital social work, which was funded by the National Institute for Health Research Policy Research Programme at the request of the Chief Social Worker for Adults, Lyn Romeo.  Lyn has also kindly written the report’s foreword.

The origins of hospital social work lie in the decision made by the Royal Free Hospital in 1895 to appoint Mary Stewart as the first ‘lady almoner’. Her role was to interview people to decide who would be eligible for the free medical treatment that the hospital provided.  Other hospitals soon followed this example and by 1948, the Institute of Almoners had over 1000 active members.[1]  Written in the style of the time, Flora Beck’s textbook for almoners noted that their two key tasks were:

… to determine whether social problems are likely to have a bearing on the patient’s illness. The second is to make the patient feel that here is a person with whom he could, if necessary, discuss his personal difficulties; someone to whom he need not mind admitting any trivial misunderstanding which had been bothering him, and to whom he could reveal serious and confidential problems without embarrassment.[2, cited in 3] Continue reading

At the 7th International Health Humanities Network Conference

Dr Martin StevensMartin Stevens is Senior Research Fellow at the Social Care Workforce Research Unit at King’s. (1,276 words)

I was pleased to be asked to chair a few sessions of this conference, on 2nd-4th August 2018, at St Mary’s Stadium, the home of Southampton Football Club. Overcoming the prejudice about all things Southampton inevitable in a Portsmouth resident, I have to admit it was a great venue.

This was the 7th International Health Humanities Network (IHHN) conference. The venue has alternated between the USA and Europe; this year the conference was run in collaboration with the Good Mental Health Cooperative and speakers and delegates came from the USA, Australia, Europe and Nigeria. The IHHN:

…provides a global platform for innovative humanities scholars, medical, health and social care professionals, voluntary sector workers and creative practitioners to join forces with informal and family carers, service-users and the wider self-caring public to explore, celebrate and develop new approaches in advancing health and wellbeing through the arts and humanities in hospitals, residential and community settings. (from the IHHN website)

St Mary's Stadium, Southampton

St Mary’s Stadium, Southampton

Continue reading

Gambling: legitimate leisure or escalating public health issue?

Caroline NorrieSCWRU Researcher, Caroline Norrie, reports on a NatCen-hosted debate about whether gambling should be treated as a public health issue. (1,335 words)

Researchers, industry and government representatives, LA staff and gambling-support organisation workers gathered to debate whether gambling is a legitimate entertainment activity or an escalating public health danger on 7 March 2018 at the NatCen (National Centre for Social Research) offices in London.

Opportunities to gamble have burgeoned in England since the introduction of the Gambling Act 2005 (implemented in 2007). Industry de-regulation combined with technological advances have triggered an explosion of new online and offline gambling products which has been accompanied by widespread cross-media advertising. Continue reading

Being a Member of Healthwatch ‘Enter and View’ team – a positive learning and volunteering experience

Caroline NorrieCaroline Norrie is a Research Fellow at Social Care Workforce Research Unit, King’s College London. She writes about her experiences of volunteering for Wandsworth Healthwatch. (908 words)

I first heard about Wandsworth Healthwatch when I randomly attended a meeting about changes in my local hospital. It was a heated meeting where the hospital CEO was grilled by attendees of all ages and backgrounds about controversial issues such as privatising certain areas of service provision, the cost of auditors and care quality on specific wards. I’ve been regularly involved with Wandsworth Healthwatch since then and have found it a rewarding and interesting experience. Continue reading

Is Donald useful?

NigelCharlesOct17Nigel Charles is a health services researcher at the University of Exeter Medical School. He also has Non-Hodgkin Lymphoma and draws on his experience of this to suggest a patient informed research study about using statistics to help patients deal with the emotional impact of cancer. (1,418 words)

I’m in a club no one wants to be in. The Cancer Club. This post is about a hunch I have about how to handle being a member of this club and the need for this to be researched. I’m also waving the flag for patients shaping the research agenda.

I was diagnosed with an aggressive variety of Non-Hodgkin Lymphoma—a type of blood cancer—in October 2016. (Indeed, I write this on the day of the anniversary of my first hospital admission which led to the diagnosis. Happy Birthday.) The haematologists who specialise in the treatment of NHL found a cricket ball sized tumour buried deep inside my abdomen. Surgery was needed to stop it blocking my bowel but subsequent chemotherapy hasn’t worked. We have yet to see if the next and last available option—radiotherapy—will. Continue reading