Category Archives: Workforce

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 →

A National Workforce Plan for Approved Mental Health Professionals

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Stephen Martineau was at a day conference last week focusing on a new national workforce plan and proposals to introduce AMHP service standards as well as changes to the AMHP competencies. (1,030 words)

Recent empirical research at this Unit on the Approved Mental Health Professional (AMHP) workforce has focused on why so few in the eligible health professions are taking up the role. AMHPs are responsible for organising and undertaking assessments under the Mental Health Act 1983 (MHA) and, where statutory criteria are met, authorising detention under the Act. Traditionally a social worker role (they were formerly known as Approved Social Workers), it has been open to occupational therapists, learning disability and mental health nurses, and psychologists since November 2008. But about a decade since these professionals were enabled to become AMHPs, they still only make up around 5% of the AMHP workforce. Continue reading →

National study starts of new nursing role

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How can the new Nursing Associates help resolve some of the workforce recruitment and retention problems in health and social care? A new King’s College London-led study is finding out the answers to this question and it will also be seeking the views and experiences of patients and people using care services of these new staff. The study, funded by the National Institute for Health Research (NIHR) at the NIHR Policy Research Unit in Health and Social Care Workforce, will be the first to gather information, statistics and experiences of the new Nursing Associates in practice and from people supporting them. Continue reading →

Promoting the importance of human relationships: hospital social work

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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 →

Cameos of Care Homes: stories from social care Vanguards

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Jess Harris is Research Fellow at the Social Care Workforce Research Unit, King’s College London. She led the Cameos of Care Homes project. (616 words)

Six ‘Vanguard’ areas across England have been developing approaches to enable care homes to better support the increasingly complex health needs of their residents. These six, focusing on ‘Enhanced Health in Care Homes’, were among 50 Vanguard pilot areas (2015 to 2018) tasked with developing models of care that can be sustained and replicated across England, helping the health and social care system tackle financial pressures and rising demands.

A recent National Audit Office (NAO) report has examined the Vanguards’ impact so far, in terms of value for money, and concluded: ‘there are early signs of a positive impact on emergency admissions’. However, at this early stage it cautions that ‘the longterm impact and sustainability of Vanguards is still not proven’. (page 47)

Staff members taking part in ‘Cameos of Care Homes’

Continue reading →

The Role of the AMHP: A Fool’s Errand?

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Caroline Norrie and Nicole Steils are researchers at the Social Care Workforce Research Unit (SCWRU), King’s College London. (618 words)

The identity of Approved Mental Health Professionals (AMHPs) was the subject of a joint SCWRU and Making Research Count seminar held on Thursday, 23 August 2018, at King’s College London (KCL) as part of the Contemporary Issues in Mental Health series.

Dr Caroline Leah

Dr Caroline Leah

The presenter, Dr Caroline Leah, Senior Lecturer at the Faculty of Health, Psychology and Social Care at Manchester Metropolitan University, discussed findings from her recently completed PhD about the role and identity of AMHPs, as well as enabling the audience, many being practising AMHPs, the chance to participate in lively discussions throughout the seminar.

An AMHP is a professional who is authorised to make certain legal decisions and applications under the Mental Health Act 1983; their powers include sectioning service users. This professional will usually be a social worker, who has undertaken additional training. In 2007, however, the law was amended to allow other mental health professionals to train for and to undertake this role. It is therefore now possible for psychiatric nurses, occupational therapists or psychologists to qualify as AMHPs, although this is still unusual. Continue reading →

Research reveals reasons for low take-up of Approved Mental Health Professional role

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Pay levels, poor awareness of the role, and a lack of associated career benefits all discourage health professionals from training and working as Approved Mental Health Professionals (AMHPs), according to new research by the NIHR Social Care Workforce Research Unit at King’s College London.

AMHP Final Report 2018Published today, Who wants to be an Approved Mental Health Professional?, finds that closer working between Mental Health Trusts and local authorities, higher remuneration and enhancing the reputation and profile of AMHP work would encourage more health professionals to take up such positions.

Greater engagement from the Royal Colleges of Nursing and Occupational Therapists, and the Nursing and Midwifery Council, may also make the AMHP role more attractive by helping to embed it in these health professionals’ career plans.

The research highlights how organisational barriers – such as difficulties in managing AMHPs across separate local authority and mental health trust teams – deter many health professionals from taking up the role.

The study consists of more than 50 interviews with individuals involved in AMHP services, as well as a survey of Local Authority AMHP Leads.

Unsurprisingly, health professionals interviewed for the research reported needing a high degree of motivation to become AMHPs, often having to overcome opposition from their managers. Some also feared being responsible for decisions to detain patients, which they thought would make it more difficult for them to establish and maintain therapeutic relationships. Continue reading →

Social care recruitment and retention – the sector speaks

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Facing the facts, shaping the future, the Department of Health & Social Care and Skills for Care adult social care workforce consultation, focuses on a number of workforce challenges specific to the adult social care sector: attracting and recruiting into the workforce; improving retention; how to improve professional development; the role of regulation, and ensuring effective workforce planning. The consultation runs from 20 February to 9 April 2018. 

In light of the launch of this consultation we are re-posting this recent piece by Jo Moriarty, Jill Manthorpe and Jess Harris in which the authors introduce their report on the topic (first published 1 February 2018). (663 words)

Recruitment and retention reportHigh turnover rates among people working in social care are troubling. Both getting and keeping staff are difficult. Experts often talk about what needs to be done to make sure that the right people with the right values are there to support people needing care. New insights into possible solutions to care recruitment and retention problems are reported today in a report from King’s College London. The researchers turned to the workforce themselves to ask what needs to be done. One hundred and forty people working in different jobs or with different experiences of social care discussed what needs to change in areas such as pay, competition between employers, and work pressures. Subjects covered included better organisation of locum working, ensuring zero hours contracts are fair, and that people who are part of the ‘gig economy’, where people are called on to work only when necessary, enjoy this flexibility rather than find it anxiety-making. Continue reading →

Campaigning for more Dementia Care at Home – a carer’s call

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U Hla Htay is a former carer of his wife with dementia. Email: uhlahtay9@gmail.com (964 words)

I am involved in many research studies as someone with experience as a family carer. In this role I have come to understand that practitioners in health and social care can limit some of the negative effects of family caregiving on carers’ health. Some of them can use interventions such as therapy to increase family carers’ physical health and spiritual well-being. Improving carer well-being and increasing our ability to care for our family members is likely to increase quality of life for both carers and our family member (World Health Organization, 2012).

Mittelman and colleagues (2007) found managing the care of a relative with dementia is very lonely, time consuming and difficult, nevertheless, most of the family members they interviewed said they would prefer to keep their spouses at home with them for as long as possible. In my view the quality of life of both someone with dementia and family carers is generally better at home. These aspirations are achievable but come with a cost in human terms and financial terms. Most people with dementia want to remain living independently in their own homes as long as possible and to have a good quality of life and end of life. I am pleased to be supporting the new NIDUS (New Intervention for independence in Dementia) Study (being conducted by Claudia Cooper and colleagues) which is being funded by the Alzheimer’s Society.¹ The Social Care Workforce Research Unit is a partner in this study with other universities. Continue reading →

Who wants to be an Approved Mental Health Professional?

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Stephen MartineauAs the Unit embarks on a new piece of Department of Health commissioned research examining the role of the Approved Mental Health Professional (AMHP), Stephen Martineau and colleagues report from the AMHP Leads Network conference, held in London last week (10 July), and map out some of the background to the study. (977 words)

AMHPs carry out a variety of tasks when it comes to the use of compulsion under the Mental Health Act 1983 (MHA). Chief among these is coordinating the assessment under the MHA of individuals whose mental disorder is such that it fulfils the statutory criteria; the application for a formal admission to a hospital must be ‘founded’ on medical recommendation, as the pink form for a detention under the MHA has it, but the AMHP takes the decision.[1]

Form A2 Section 2 appl by AMHP for admiss for assess-page-001

Form A2. Section 2 MHA: application by an approved mental health professional for admission for assessment (photo links to pdf)

Of course, this is only the very barest description of what is involved in the job: last week, someone who had been the subject of a MHA assessment by an AMHP wrote vividly of the experience in Community Care. Elsewhere, the Masked AMHP has asked, and answered, the question: What is an AMHP?

In making a MHA assessment of a person, AMHPs bring to bear a ‘social perspective’. And it is social workers—initially under the MHA, Approved Social Workers (ASWs)—who have been historically associated with the role. But in 2008 ASWs became AMHPs, and with the change in designation came a loosening of the ties to the social work profession: it was now also possible for certain kinds of nurses, occupational therapists and psychologists to take up the role. Continue reading →