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

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.

  1. Be clear about the roles and responsibilities support workers can – and cannot – undertake. This means listing clinical and other tasks.
  2. Establish the competencies (knowledge, skills and behaviours) support workers need in order to perform those roles and responsibilities.
  3. Agree the minimum entry-level qualification requirements needed at bands 2, 3 and 4 (or equivalent).
  4. Agree the minimum amount and type of experience required. For example, are new recruits expected to have some experience of working in a health or social care environment previously?
  5. Agree common job titles. The number of different titles for the same role continues to stagger me and must confuse the public.
  6. Map competences against apprenticeship standards but identify gaps in provision including steps into pre-registration degrees. Get these right and support workers will have access to a consistent national learning curriculum.
  7. Ensure best practice in respect of supervision and delegation.
  8. Create an expansive learning culture that is supportive of the whole workforce’s development.
  9. Leadership. Throughout the system leaders need to advocate clearly the contribution support workers make to care and that should start at the very top.
  10. Ensure consistent and sufficient funding for training and development (not just for apprenticeships).
  11. A feature of delivering these steps successfully is partnership working including with trade unions and professional bodies but also education providers, employers and the support workers themselves.

Are the above being delivered anywhere? Yes. Maternity, led by Health Education England, is leading the way nationally [1]. The approach taken to developing the Nursing Associate, albeit focused on a single role, is also encouraging [2]. There are signs other professions are beginning to systematically look at maximising the contribution of their support workers.

Richard Griffin MBE is Visiting Senior Research Fellow, King’s Business School.

Notes

  1. See: https://www.hee.nhs.uk/our-work/maternity/developing-role-maternity-support-worker/boosting-delivery-hee-national-maternity-support-worker which includes an economic evaluation undertaken by KCL of the return on investment on apprenticeships for Maternity Support Workers
  2. See: https://www.kcl.ac.uk/research/nursing-associates

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

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