Integrating health and care in the 21st century workforce

2019 ◽  
Vol 27 (2) ◽  
pp. 100-110 ◽  
Author(s):  
Matt Aiello ◽  
Julian D. Mellor

Purpose The NHS needs to adapt as never before to maintain and plan for an integrated and sustainable multi-professional workforce, spanning all health and care sectors. This cannot happen without system leaders embracing workforce transformation at scale and enabling system-wide collaboration and support for multi-professional learning and role development. “By learning together, we learn how to work together”. The paper aims to discuss these issues. Design/methodology/approach The case studies included in this paper provide evidence of the ability of NHS systems to adopt integrated workforce models at scale. The case studies were chosen to demonstrate how system-wide change is possible, but still requires a partnership approach to innovation, strategic workforce planning and commissioner support for new models of care. Findings With partnership working between arm’s length bodies, commissioners, educators and workforce planners, the NHS is more than capable of generating a transformed workforce; a workforce able to continue providing safe, effective and joined-up person-centred care. Research limitations/implications The focus of this paper is integrated workforce development undertaken by Health Education England from 2017 to the date of drafting. The case studies within this paper relate to England only and are a cross-section chosen by the authors as a representative of Health Education England activity. Practical implications The NHS needs to find ways to use the wider health and care workforce to manage an ever-increasing and diverse patient population. Silo working, traditional models of workforce planning and commissioning no longer provide an appropriate response to increasing patient need and complexity. Social implications The evolution of the NHS into a joined-up, integrated health and social care workforce is essential to meet the aspirations of national policy and local workforce need – to centre care holistically on the needs of patients and populations and blur the boundaries between primary and secondary care; health and social care; physical and mental health. Originality/value This paper contains Health Education England project work and outcomes which are original and as yet unpublished.

2018 ◽  
Vol 21 (3/4) ◽  
pp. 108-122
Author(s):  
Patricia Dearnaley ◽  
Joanne E. Smith

Purpose The purpose of this paper is to stimulate a wider debate around the coordination of workforce planning in non-statutory services (in this case, specialist housing for older people or those with long-term health and social care needs, such as learning disabilities). The authors argue that current NHS reforms do not go far enough in that they fail to include specialist housing and its workforce in integration, and by doing so, will be unable to optimise the potential efficiencies and streamlining of service delivery to this group. Design/methodology/approach The paper used exploratory study using existing research and data, enhanced by documentary analysis from industry bodies, regulators and policy think tanks. Findings That to achieve the greatest operational and fiscal impact upon the health care services, priority must be given to improving the efficiency and coordination of services to older people and those requiring nursing homes or registered care across the public and third sectors through the integration of service delivery and workforce planning. Research limitations/implications Whilst generalisable and achievable, the model proposed within the paper cannot be fully tested theoretically and requires further testing the in real health and social care market to evidence its practicality, improved quality of care and financial benefits. Originality/value The paper highlights some potential limitations to the current NHS reforms: by integrating non-statutory services, planned efficiency savings may be optimised and service delivery improved.


2019 ◽  
Vol 27 (4) ◽  
pp. 328-345 ◽  
Author(s):  
Nancy El-Farargy

Purpose The Public Bodies (Joint Working) (Scotland) Act 2014 set the framework for the integration of adult health and social care services. Teams, organisations and sectors are now required to work in partnership and interdependently to deliver shared outcomes for the people they serve. The purpose of this paper is to explore any features, practices and behaviours that could influence effective partnership working across sectors. Design/methodology/approach A questionnaire was designed and distributed to a range of stakeholders working in health, social care and the third sector. With reference to the changing health and social care reform agenda, the aims of the survey were to gather views, experiences and perceptions of working across sectors, and any workforce development needs. Findings The majority of respondents were from the NHS (80.3 per cent, 118/147), and experiences were largely drawn from those working with the third sector. The utility of working with the third sector was positively highlighted; however, there were limited opportunities to fully engage. Whilst formal education and training was welcomed, workforce development needs were mostly related to fostering relationships and building mutual trust. Originality/value This paper highlights views, perceptions, enablers and barriers to integrated care in Scotland. Whilst the Scottish integration landscape is currently not fully fledged, insights into prevailing attitudes towards integrated care, by a cohort of the Scottish health and care workforce, are offered. In particular, reflections by the NHS workforce to working with third sector services are discussed.


2014 ◽  
Vol 27 (7) ◽  
pp. 562-572 ◽  
Author(s):  
Keith Hurst ◽  
Deirdre Kelley Patterson

Purpose – The purpose of this paper is to discuss the issues relating to getting the right health and social care staff with the right skills in the right place at the right time and at the right price. Design/methodology/approach – Key points arising from several master-classes with health and social care managers, supported by a literature review, generated remarkable insights into health and social care workforce planning and development (WP&D). Findings – Flawed methods and overwhelming data are major barriers to health and social care WP&D. Inefficient and ineffective WP&D policy and practice, therefore, may lead to inappropriate care teams, which in turn lead to sub-optimal and costly health and social care. Increasing health and social care demand and service re-design, as the population grows and ages, and services move from hospital to community, means that workforce planners face several challenges. Issues that drive and restrain their health and social care WP&D efforts are lucid and compelling, which leave planners in no doubt what is expected if they are to succeed and health and social care is to develop. One main barrier they face is that although WP&D definitions and models in the literature are logical, clear and effective, they are imperfect, so planners do not always have comprehensive tools or data to help them determine the ideal workforce. They face other barriers. First, WP&D can be fragmented and uni-disciplinary when modern health and social care is integrating. Second, recruitment and retention problems can easily stymie planners’ best endeavours because the people that services need (i.e. staff with the right skills), even if they exist, are not evenly distributed throughout the country. Practical implications – This paper underlines triangulated workforce demand and supply methods (described in the paper), which help planners to equalise workloads among disparate groups and isolated practitioners – an important job satisfaction and staff retention issue. Regular and systematic workforce reviews help planners to justify their staffing establishments; it seems vital, therefore, that they have robust methods and supporting data at their fingertips. Originality/value – This paper stock-takes the latest health and social care workforce planning and development issues.


2016 ◽  
Vol 11 (2) ◽  
pp. 112-121 ◽  
Author(s):  
Andrea Mayrhofer ◽  
Claire Goodman

Purpose – People with dementia require care at home, in care homes and in hospitals, which has implications for the current and future workforce in health and social care. To inform regional workforce development planning in dementia care, Health Education East of England commissioned an organisational audit of current dementia training at NHS Trusts and in social care across Hertfordshire and Bedfordshire. The paper aims to discuss this issue. Design/methodology/approach – Qualitative methods and non-probability purposive sampling were used for recruitment and data collection. The audit included NHS Trusts, local authorities, clinical commissioning groups, and health and social care organisations involved in commissioning and providing dementia education and training in the two counties. Findings – Whilst there was considerable investment in dementia awareness training, learning was not targeted, assessed or structured to ensure on-going professional development. Practical implications – This has implications for workforce development and career-progression for staff responsible for the care of older people with dementia. Conclusion: if a future workforce is expected to lead, coordinate, support and provide dementia care across health and social care, a qualifying curriculum could play a critical part in ensuring quality and consistency of approach and provision. Originality/value – This paper makes a timely contribution to discussions on the skills and competencies needed to equip the future workforce for dementia care across health and social care.


2015 ◽  
Vol 10 (3) ◽  
pp. 170-179 ◽  
Author(s):  
Kirsteen Beart ◽  
Adam Barnard ◽  
Hannah Skelhorn

Purpose – This lack of knowledge and experience meant that students often found it difficult to engage with this very complex, conceptual and controversial area of health and social care. The use of visual methodologies in learning mental health and illness was being examined here with a view to its potential for overcoming this obstacle in the students’ learning and further assisting students in their conceptual understanding of the subject. The paper aims to discuss these issues. Design/methodology/approach – In total, 30 participants were recruited from a student population of 44 undergraduates studying a module at level three on mental health. Ethics and consent were secured by giving students full information to decide whether to be part of the study group. The methodology of interpretative phenomenological analysis was the philosophical framework used for the study and this was directed using a five-staged process. Data were collected through group discussions and collation of the students analysis of their visualisations. Findings – Students in the study were encouraged to think about mental health and illness in a non-traditional way of learning. Visualisation of their own perceptions or pre-conceived ideas of MH were explored. This led to some very insightful learning which included not only learning about the subject from a holistic perspective but also a continual reframing of students’ conception of mental health and an enhancement of their understanding. They demonstrated this by developing skills in “self-reflection and professional values development” which are key skills of a mental health practitioner. Research limitations/implications – The findings have implications for further research into how this type of learning can actually influence practitioners when they do work with people with mental health challenges and illness. This study was limited to a fundamentally theoretical plan for how the learning contributes to professional practice. It is also important to note that the students were also benefitting from the evidence, experience and value of the teaching and learning in a traditional sense so it is not completely clear of that influence of the innovative methodology. Therefore another aspect of study which could enhance the understanding of the influence of visualisation in mental health is to compare practitioners practice who use this technique to learn and develop and those who use a more traditional educational approach. Practical implications – This research will inform the use of a pedagogy approach in education, learning and teaching about concepts of mental health and illness and contribute to professional practice in health and social care education. Social implications – This paper makes contributions to mental health practice, visualisation, mental health education. Originality/value – Overall, the study offers an opening into the value of visual methodology in mental health awareness, education and practice and a contribution to professional practice in mental health education.


2016 ◽  
Vol 45 (6) ◽  
pp. 1132-1155 ◽  
Author(s):  
Janet McCray ◽  
Adam Palmer ◽  
Nik Chmiel

Purpose Maintaining user-focused integrated team working in complex care is one of the demands made of UK health and social care (H&SC) organisations who need employees that are resilient, resilience being the ability to persevere and thrive in the face of exposure to adverse situations (Rogerson and Ermes, 2008, p. 1). Grant and Kinman (2012) write that resilience is a complex and multi-dimensional construct that is underexplored in social care team work. The purpose of this paper is to capture the views of managers in H&SC to explore the making of resilient teams, identify factors that influence team performance and inform organisational workforce development strategy. Design/methodology/approach A general inductive approach (Silverman, 2011) was applied. Five focus groups were facilitated (n=40) each with eight participants all of whom were leaders and managers of teams in H&SC, working in the integrated care context in the UK. Findings Findings indicate that further investment in strategies and resources to sustain and educate employees who work in teams and further research into how organisational systems can facilitate this learning positively may contribute to resilient teams and performance improvement. The authors note specifically that H&SC organisations make a distinction between the two most prevalent team types and structures of multi-disciplinary and inter-professional and plan more targeted workforce development for individual and team learning for resiliency within these team structures. In doing so organisations may gain further advantages such as improved team performance in problematic care situations. Research limitations/implications Data captured are self-reported perceptions of H&SC managers. Participant responses in the focus group situation may have been those expected rather than those actually modelled in the realities of team work practice (Tanggaard, 2008). Further, in the sample all participants were engaged in a higher education programme and it is possible participants may have been more engaged with their practice and thinking more critically about the research questions than those not currently undertaking postgraduate study (Ng et al., 2014). Nor were the researchers able to observe the participants in team work practice over time or during critical care delivery incidents. Practical implications The preliminary link made here between multi-disciplinary and inter-professional team type, and their different stress points and subsequent workforce intervention, contributes to the theory of resilient teams. This provides organisations with a foundation for the focus of workplace learning and training around resilience. H&SC practitioner views presented offer a greater understanding of team work processes, together with a target for planning workforce development strategy to sustain resilience in team working. Originality/value This preliminary research found that participants in H&SC valued the team as a very important vehicle for building and sustaining resilience when dealing with complex H&SC situations. The capitalisation on the distinction in team type and individual working practices between those of interprofessional and multidisciplinary teams and the model of team learning, may have important consequences for building resilience in H&SC teams. These findings may be significant for workforce educators seeking to develop and build effective practice tools to sustain team working.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Louise Kermode

PurposePerson-centred care is a fundamental component of any service. This case study aims to explore the delivery of person-centred care in the voluntary sector, discussing how integrating support can be achieved to benefit individuals. It identifies challenges, best practice and learning that can be applied across sectors and promotes further enquiry.Design/methodology/approachThis case study is the result of a service audit at a mental health charity. The findings are a blend of reflections, observations and examples from service delivery, synthesised with national policy to provide evidence of best practice and processes that enable person-centred care.FindingsA focus on need not diagnosis, creating accessible and inclusive services, employing dual trained practitioners, having a varied skill mix along with holistic self-assessment tools are all enablers for integrated person-centred support. Multi-agency assessment frameworks, collaboration across services, cross-agency supervision and a shared vision for integration and person-centred care support services to coordinate more effectively. Barriers to integrated person-centred support include complex physical and mental health needs and harmful risk and safeguarding. The diversity of the voluntary sector, a lack of resources along with complex and competitive funding also hinder integration.Originality/valueThis case study provides a valuable insight into the voluntary sector and shares its findings to enhance best practice. It aims to promote interest and invites further research into health and social care delivery by the voluntary sector. As this delivery continues to increase, it is vital to examine the interface between the voluntary and statutory sector. Through better understanding and further research across all sectors, the author can identify how they can achieve person-centred outcomes and deliver the national policies.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Karen Louise Bester ◽  
Anne McGlade ◽  
Eithne Darragh

Purpose “Co-production” is a process in health and social care wherein service users and practitioners work in partnership. Recovery colleges (RCs) are educational establishments offering mental health education; a cornerstone feature is that courses are designed and delivered in parity by both mental health practitioners and “peers” – people with lived experience of mental illness. This paper aims to consider, through the identification of key themes, whether co-production within RCs is operating successfully. Design/methodology/approach The paper is a systematic review of qualitative literature. Relevant concept groups were systematically searched using three bibliographic databases: Medline, Social Care Online and Scopus. Articles were quality appraised and then synthesised through inductive thematic analysis and emergent trends identified. Findings Synthesis identified three key themes relating to the impact of co-production in RCs: practitioner attitudes, power dynamics between practitioners and service users, and RCs’ relationships with their host organisations. As a result of RC engagement, traditional practitioner/patient hierarchies were found to be eroding. Practitioners felt they were more person-centred. RCs can model good co-productive practices to their host organisations. The review concluded, with some caveats, that RC co-production was of high fidelity. Originality/value RC research is growing, but the body of evidence remains relatively small. Most of what exists examine the impact of RCs on individuals’ overall recovery and mental health; there is a limited empirical investigation into whether their flagship feature of parity between peers and practitioners is genuine.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Daryl Mahon

Purpose Practitioners, organisations and policy makers in health and social care settings are increasingly recognising the need for trauma-informed approaches in organisational settings, with morbidity and financial burdens a growing concern over the past few years. Servant leadership has a unique focus on emotional healing, service to others as the first priority, in addition to the growth, well-being and personal and professional development of key stakeholders. This paper aims to discuss Trauma Informed Servant Leadership (TISL). Design/methodology/approach A targeted review of the servant leadership and trauma-informed care literature was conducted. Relevant studies, including systematic review and meta-analysis, were sourced, with the resulting interpretation informing the conceptual model. Findings Although there are general guidelines regarding how to go about instituting trauma-informed approaches, with calls for organisational leadership to adapt the often cited six trauma-informed principles, to date there has not been a leadership approach elucidated which takes as its starting point and core feature to be trauma informed. At the same time, there is a paucity of research elucidating trauma outcomes for service users or employees in the literature when a trauma-informed approach is used. However, there is a large body of evidence indicating that servant leadership has many of the outcomes at the employee level that trauma-informed approaches are attempting to attain. Thus, the author builds on a previous conceptual paper in which a model of servant leadership and servant leadership supervision are proposed to mitigate against compassion fatigue and secondary trauma in the health and social care sector. The author extends that research to this paper by recasting servant leadership as a trauma-informed model of leadership that naturally operationalises trauma-informed principles. Research limitations/implications A lack of primary data limits the extent to which conclusions can be drawn on the effectiveness of this conceptual model. However, the model is based on robust research across the differential components used; therefore, it can act as a framework for future empirical research designs to be studies at the organisational level. Both the servant leadership and trauma-informed literatures have been extended with the addition of this model. Practical implications TISL can complement the trauma-informed approach and may also be viable as an alternative to trauma-informed approaches. This paper offers guidelines to practitioners and organisations in health and social care on how to operationalise important trauma-informed principles through leadership. Social implications This conceptual model may help reduce the burden of trauma and re-traumatisation encountered by practitioners and service users in health and social care settings, impacting on morbidity. Originality/value To the best of the author’s knowledge, this is a novel approach, the first of its kind.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Steve Noone ◽  
Alison Branch ◽  
Melissa Sherring

Purpose Positive behavioural support (PBS) as a framework for delivering quality services is recognised in important policy documents (CQC, 2020; NICE, 2018), yet there is an absence in the literature on how this could be implemented on a large scale. The purpose of this paper is to describe a recent implementation of a workforce strategy to develop PBS across social care and health staff and family carers, within the footprint of a large integrated care system. Design/methodology/approach A logic model describes how an initial scoping exercise led to the production of a regional workforce strategy based on the PBS Competence Framework (2015). It shows how the creation of a regional steering group was able to coordinate important developmental stages and integrate multiple agencies into a single strategy to implement teaching and education in PBS. It describes the number of people who received teaching and education in PBS and the regional impact of the project in promoting cultural change within services. Findings This paper demonstrates a proof of concept that it is possible to translate the PBS Competency Framework (2015) into accredited courses. Initial scoping work highlighted the ineffectiveness of traditional training in PBS. Using blended learning and competency-based supervision and assessment, it was possible to create a new way to promote large-scale service developments in PBS supported by the governance of a new organisational structure. This also included family training delivered by family trainers. This builds on the ideas by Denne et al. (2020) that many of the necessary building blocks of implementation already exist within a system. Social implications A co-ordinated teaching and education strategy in PBS may help a wide range of carers to become more effective in supporting the people they care for. Originality/value This is the first attempt to describe the implementation of a framework for PBS within a defined geographical location. It describes the collaboration of health and social care planners and a local university to create a suite of courses built around the PBS coalition competency framework.


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