Category Archives: Workforce

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

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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. Continue reading →

Understanding the impact of COVID-19 on ethnic inequalities in health and social care – Have your say!

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Introducing a King’s College London study examining inequalities experienced by people from racial and ethnic minority groups working in health and social care during COVID-19. (570 words)

Prof Stephani Hatch

Leading the study: Stephani Hatch, Professor of Sociology and Epidemiology in the Department of Psychological Medicine, King’s College London

We have launched a study to help improve working conditions and to tackle the inequalities experienced by people from racial and ethnic minority groups working in health and social care during the COVID-19 pandemic. Based at King’s College London, we are working in partnership with NHS England Workforce Race Equality Standard, NHS Confederation and the Royal College of Nursing. The study findings will be used to develop education and training materials (e.g. Virtual Reality training) available nationally to all staff, specifically to better support and improve the workplace experiences of NHS and social care staff from Black, Asian and minority ethnic groups.

COVID-19 pandemic

The pandemic has shone a light on existing inequalities that have a great impact on Black, Asian and minority ethnic communities. These communities are approximately 14% of the population in England and Wales, yet they have had greater exposure to the virus and are more likely to have poorer outcomes, including severe health complications and death. We have also seen that higher numbers of racial and ethnic minority health and social care workers have died from COVID-19. Despite making up 21% of the NHS workforce, 63% of those who died from COVID-19 were from racial and ethnic minority groups. What is less often known and discussed is that health and social care staff from racial and ethnic minority groups experience greater levels of workplace harassment and discrimination compared to other staff and these experiences have been compounded by the pandemic. This can have long-lasting effects on their health, wellbeing, and their ability to do their job. Continue reading →

Evaluating the Nursing Associate Role: Initial Findings

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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)

Film of webinar (23/11/20) where Prof Kessler discussed these findings.

We are conducting a survey of senior health and social managers on the use and management of the nursing associate role. The survey is open until 18 December 2020.

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)

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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 →

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

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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 →

The COVID-19 Effect On Flexible Working: The Good, The Bad, The Ugly

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Dr Nayyara TabassumDr. Nayyara Tabassum is Evidence Officer in the Centre for Ageing Better. (828 words)

In the UK, as soon as the lockdown was announced by Boris Johnson in his televised address on 23 March 2020, one of the first things a lot of employers did was to announce that all staff would need to start working flexibly, with immediate effect. Overnight, companies that did not even have a flexible working policy, reviewed their policies and allowed employees to start working from home.

Research vs Pre-COVID Reality

While research has always shown the business benefits of flexible working on employee productivity and wellbeing, there was not enough buy-in from employers and there were lots of misconceptions and stigma attached to flexible working.

Now with the COVID-19 outbreak, employers have wholeheartedly adopted technology for staff to continue working remotely during lockdown. Job sectors, such as the insurance and banking sectors, which were previously quite averse to flexible working, also allowed staff to work flexibly during the lockdown. The results of this flexible working experiment thanks to the pandemic was that a lot of job sectors are now acknowledging that businesses can continue as usual even when staff work flexibly from home. Continue reading →

From desk to doorstep

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Living well with dementia is important, though there may come a time when initiating social contact becomes a challenge. For some people living with dementia there may be increased isolation. For those living with a partner or family and friends, as dementia progresses their daily care needs may be hard to manage or support.

Attending a day service which offers stimulating activities, whilst at the same time providing respite for family carers, benefits not only the person with dementia, but also helps families continue their support.

The COVID-19 lockdown brought an end to this overnight.

Foreseeing the psychological or emotional consequences of the loss of day centre support, one day centre has switched to offering daily support via phone calls to its former attenders and their carers. Additionally, as day centre staff have great experience in providing ‘customer care’ to relatives, they quickly became part of the COVID-19 Emergency Shielding Residents Response. Continue reading →

International Women’s Day, 8th March 2020: Remembering the achievements for health and social care of some great women in South London

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Caroline Green, who is NIHR ARC South London Post-Doctoral Fellow, reflects on the lives of prominent women figures in the health and social care context in South London. (838 words)

International Women’s Day is an annual celebration of the achievements of women and a day to put special emphasis on raising awareness of gender bias and taking action for gender equality. Women contribute significantly to England’s health and adult social care. The adult social care workforce is dominated by women, with 83% of the workforce being female. In 2017, 77% of NHS health workers were women. However, beyond “holding up” England’s health and social care system, women have revolutionized it at many points in time. This blog post looks back at some significant female figures in South London, who have shaped health and social care either directly or indirectly. This list is of course not exhaustive. Countless women with a diversity of backgrounds are driving today’s health and social care provision in South London and have done so for many years. Yet, the stories of the women below offer an indication of the rich female history of health and social care in this part of London:

Florence Nightingale (1820-1910)

Florence Nightingale is widely considered the founder of modern nursing and a social reformer of health and social care. She first gained prominence as a manager and trainer of nurses during the Crimean War, looking after wounded soldiers. In 1860, she established the nursing school at St Thomas’ Hospital in London, the first secular nursing school in the world, and now part of King’s College London. Many say that Nightingale here laid the foundation of professional nursing, with the International Nurses Day celebrated annually on her birthday. Nightingale’s social justice work extended to the abolition of prostitution laws, advocating for hunger relief in India and expanding acceptable forms of female participation in the workforce. Continue reading →

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

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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 →

Hourly ward rounds may not be the best way for nurses to deliver care: findings from a new nursing study

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Professor Ruth Harris works in the Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care at King’s College London. (458 words)

The widespread practice of intentional rounding (IR) in England may not the best way for nurses to deliver care and IR makes a minor contribution, if at all, to the way nursing staff engage with patients. This is the main finding of our study that was commissioned and funded by the National Institute for Health Research (NIHR).

Intentional rounding is a protocol of standard regular checks with individual patients at set intervals and was introduced in hospitals in England in 2013 as part of the government’s response to care failures in the NHS, most notably at Mid-Staffordshire NHS Trust. Continue reading →