Tag Archives: Ian Kessler

In Search of Hidden Healthcare Workforces: NHS Therapists for Children and Young People with Special Educational Needs and Disabilities (Part 2)

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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 report from the Unit, scoping the demand and supply of NHS therapists for Children and Young People with Special Educational Needs and Disabilities.

This, the second of two blogs, focuses on the supply of, while the first addressed the demand for, therapists for children and young people with Special Educational Needs and Disabilities.

The Supply Side

Commissioning. While the capacity to address this increased demand rests in large part on the scale, structure, and capabilities of the therapy and, as already implied, the wider health and care workforce, the commissioning process for CPY with SEND, is pivotal. Commissioning determines the services available and at what level of resource, inevitably feeding through to determine the workforce required to provide them: to put it crudely, if a service is not commissioned, a workforce is not required. The close connection between service design and the workforce is apparent from various ‘good practice’ commissioning models [1]. These typically distinguish different levels of services linked to the nature of need and support, with implications for the requisite workforce: for example, accessible universal services delivered by a wider workforce; targeted services provided by registered therapists and their support co-workers; and specialist services the exclusive preserve of the registered therapist. Continue reading →

In Search of Hidden Healthcare Workforces: NHS Therapists for Children and Young People with Special Educational Needs and Disabilities (Part 1)

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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 report from the Unit, scoping the demand and supply of NHS therapists for Children and Young People with Special Educational Needs and Disabilities.

This, the first of two blogs, focuses on the demand for, while the second discusses the supply of, therapists for Children and Young People with Special Educational Needs and Disabilities.

Context

The workforce delivering care and support for children and young people (CYP) with special educational needs and disabilities (SEND) is an elusive one. In part this elusiveness stems from the diffuse and fragmented nature of the workforce as CYP with SEND typically engage with a variety of services- education, health, social care and sometimes housing. Even drilling down into these discrete service segments, tying the SEND workforce down in terms of its size, skill mix, and capacity remains challenging. Take health as an example. CYP with SEND will have a range of developmental, physical, and mental health care needs, addressed by a variety of staff groups to be found in different clinical settings including: nursing in both community, acute and mental health settings, clinical consultants in a similar range of settings, GPs in primary care, and healthcare visitors in the community. Adding to the challenges is the fact that those in any one of these staff groups will have clients which include but are rarely limited to CYP with SEND. With policies often framed by and centred on ‘children and young people with SEND’ as the named client group [1], the hidden nature of the workforce caring for and supporting them becomes a real challenge in meaningfully delivering on the policy initiative. Continue reading →

In Pursuit of Ethically Sustainable Approaches to International Nurse Recruitment

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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 →

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

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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):

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‘Opening the door’ to employment in healthcare: People with lived experience of homelessness

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Cover of a reportThe NIHR Policy Research Unit in Health and Social Care Workforce has published an evaluation of an access to employment programme in the NHS targeted at those with lived experience of homelessness. The pilot programme involved the homelessness charities Pathway and Groundswell and five NHS Trusts in England. Report author, Ian Kessler, here outlines the programme and the main findings of his evaluation.

Ian Kessler is Deputy Director of the NIHR Policy Research Unit in Health and Social Care Workforce. He is also Professor of Public Policy and Management at King’s Business School. (1,016 words)

Widening participation in the healthcare workforce has long been an important policy objective in the NHS. This has been reflected in an equalities, diversity, and inclusion agenda traditionally centring on gender and race, and more recently on young people with disabilities with the introduction of supported employment programmes by NHS Trusts, such as Project Search and Choice. However, the pursuit of widening participation is a rich policy space, connecting to an increasing range of workforce and broader service priorities.

Framed as ‘anchor institutions’, playing a key role as local employers, NHS Trusts have been encouraged to develop workforces which reflect, in socio-economic and demographic terms, the communities they serve. This role overlaps with moves to bring into the NHS workforce people with lived experience of various health conditions as a means of delivering patient-centred services and more effectively addressing health inequalities. Such moves have been especially evident in the introduction of the peer support worker role in mental health (which our Unit evaluated many years ago). More prosaically, but perhaps most pressing, the search for workforce diversity and inclusion addresses the recruitment and retention challenges faced by healthcare employers, with those at the margins of employment representing a new and reliable source of labour. 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 →

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 →