Healthcare Support Staff: A Strategy For Recruiting, Retaining . - UHS

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Healthcare Support Staff: a strategyfor recruiting, retaining anddeveloping the talentJuly 2015

Healthcare Support Staff: a strategy for recruiting, retaining anddeveloping the talent“Train people well enough so they can leave, treat them well enough so they don’twant to” Richard Branson (March 2014)1. IntroductionThis aim of this strategy is to set out a framework for recruiting, retaining and developinghealthcare support staff who work either directly delivering care for our patients or indirectlysupporting those who do. It will identify the requirements needed for the Trust to meet thenational priorities from Health Education England (HEE) Mandate 2014 – 20151 that are setout in the Talent for Care strategy (HEE November 2014)2. There will be animplementation plan to achieve this strategy (appendix 1).2. Background and national NHS prioritiesThe majority of healthcare support staff work in NHS Agenda for Change Band 1-4workforce and makes up approximately 40% of the 1.3 million workforce and deliver around60% of the direct care to patients. However, only 5% of the national training budget for theNHS is allocated to this staff group. In UHS there are 3372WTE staff in Bands 1-43 which is32% of the total workforce (38% of total non medical staff).The Francis Report4 highlighted the issue of poor care and the adverse effect of inadequatetraining and development of all staff, registered and non-registered, who are involved indelivery of high quality care that all our patients expect and deserve. One outcome of thisreport was the commissioning of a review of support worker training and development inhealth and social care by Camilla Cavendish. The Cavendish Review5 outlined a numberof recommendations, including the development of minimum training requirements and theintroduction of a certificate of fundamental care; now referred to as the Care Certificate.1Delivering high quality, effective, compassionate care: Developing the right people with the rightskills and the right values. A mandate from the Government to Health Education England: April 2014to March 2015 www.gov.uk/dh2The Talent for Care: a national strategic framework to develop the healthcare support workforce.part of Framework 15, the Health Education England guide to action: October 2014http://eoe.hee.nhs.uk/our-work/1to4/ accessed November 20143Agenda for Change Bands 1-4 workforce ffigures taken from UHSFT Electronic Staff Record(ESR), January 20154Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry: February fault/files/report/Executive%20summary.pdf accessedJuly 20145Cavendish Review: An independent Review into Healthcare Assistants an Support Workers in NHSand Social Care Setting: DH July ploads/attachment data/file/236212/Cavendish Review.pdf accessed July 20141

The Care Certificate is currently being piloted across the country and progressionopportunities have now been included in the HEE mandate.The HEE mandate identifies the development priorities for healthcare support staff:Robust career developmentMeeting Cavendish Review recommendationsDoubling the number of apprenticeships in healthcareSupporting the progression of support workers and healthcare assistants who wantto progress into nursing and midwifery careersDevelopment of a national bridging programme to help career progression intoprofessional training in health and social careSupporting flexible methods for entering employment and trainingDuring 2014 Lord Willis undertook a review on behalf of HEE of the future educationrequirements of nurses and clinical support staff working in health and social care. InMarch 2015 the final report ‘Raising the Bar, Shape of Caring: A review of the FutureEducation and Training of Registered Nurses and Care Assistants’6 was published. Thisreport refers to Talent for Care and includes the same principles for the development ofsupport workers.3. Not only clinical support staffWhen using a ‘catch-all’ such as Bands 1-4 it is easy to forget that staff who work in theseroles are not all in the same occupations. In fact there are 28 different Band 1-4 job rolesacross UHS.This is why we have chosen to use the term ‘Healthcare Support Staff’ within this strategy.As part of the culture change that is needed to make this strategy a success we need tomove away from using the terminology Bands 1-4 and start using healthcare support staff.However, there are further differences. There are those who provide direct healthcaresupport, for example, healthcare assistants, assistant/associate practitioners, rehabilitationassistants and maternity care assistants, radiology assistants and porters. There are alsoindirect healthcare support staff which include, for example, ward clerks, administrativestaff, finance support staff, materials management and pathology staff.The training and development needs for all of these staff are equally diverse and equallyimportant. This strategy will seek to support these differences, whilst also enabling stafffrom different occupations to learn together where this brings added benefits of improvedunderstanding of their diverse job roles, communication and team working.Although the biggest improvements in development opportunities in the last 10 years havebeen for the direct healthcare support staff, in particular nursing healthcare assistants,ongoing work has also improved career opportunities for other staff groups such asadministrative staff. With this strategy we will continue with department leads and externalpartners to create equally robust career pathways for all our healthcare support staff.This strategy as part of other UHS strategiesThis strategy should not be seen in isolation to other service and workforce strategies.Representing one third of the total workforce, identifying and developing the talent of over3000 people is going to be essential to help UHSFT become the world class organisation itaspires to be. Because of the traditional hierarchy of the NHS, support workers often feel6Raising the Bar, Shape of Caring: A review of the Future Education and Training of RegisteredNurses and Care Assistant: March 2015 review/2

their knowledge and experience is undervalued and under-utilised. This was borne out inthe feedback that was received from the Talent for Care national consultation (August2014)7.Staff in support roles may lead complex personal lives outside work and to do this they mayhave developed personal organisational skills for themselves and in order to support theirfamilies, for example time and budget management etc. We need to maximise thesecapabilities, and capture and further develop this talent. Where they are given the supportto develop and contribute fully as part of the team the benefits fed back into the service canbe enormous.Widening Participation and other UHS strategiesThe role these staff groups play in delivering direct care or support behind the scenes must bereflected in other UHS strategies:Education and Training Strategy – this strategy for Healthcare Support Staff will be acomponent part of the education and training strategy and the same aspirations to createand support excellent development opportunities provided in our high quality learningenvironments, both on the job and off the job will be offered to healthcare support staff inthe same ways as our registered staff and those in leadership roles. This will includeappropriate mentoring and supervision to enable them to fully maximise any developmentthey undertake in their day-to-day practice.Workforce planning – when reviewing skill mix changes or developing new roles, theopportunity to maximise the skills and aspirations of the support workforce are a readyresource that should be considered.Recruitment and retention – the opportunity to recruit from entry level onwards, creating apipeline of well trained staff will support longer term workforce planning. Utilisingapprenticeships across a number of careers will allow us to maximise external funding fortraining and encourage staff retention.Equality and diversity strategy – providing access to careers from entry level to fullyqualified roles will also allows us to develop local & social policies creating a home grownworkforce .Service improvement – we often do not make the most of the experience andorganisational knowledge these staff often possess. Many have been here for asignificant amount of time and often have very sensible practical ideas and informationbut may be ignored or not encouraged to voice their opinion. We need to ensure that webroker the skills and confidence in these staff to make suggestions about ways we canimprove services and patient care. Leaders need to ensure they fully include support staffin these changes.Leadership and management – leaders need to recognise the valuable asset they have inthe support staff in UHS and create an inclusive environment which enables them toparticipate fully in the team including giving them responsibilities for appropriate parts ofthe service. Leaders should also play a part active role in encouraging and planning thedevelopment of the talent of support workers in their teams.7The Talent for Care; Here’s what you said Feedback on consultation for development of thehealthcare support workforce, August 2014. 2014/08/HEE-The-Talent-for-Care-Response.pdf3

4. Developing Healthcare Support Staff talent at UHS – thesuccess so farUHS has been a leader in enabling support workers to undertake training and creatingcareer pathways. As an approved City and Guilds NVQ and now Apprenticeship Centre weconsistently receive excellent reports. In addition we have been inspected by Ofsted andhave also received positive comments and outcomes. Some of the good practice UHS hasled or been involved in includes:commissioned research with University of Southampton into learning environmentsfor porters8leading a project to increase young apprenticeships across the City of Southampton9helping design and develop new support rolesrecognition for best practice in adult and vocational education by Ofsted10participating in national groups helping to set the agenda for support worker trainingand developmentshort listed as finalists for HSJ workforce awards (2012) and as a regional finalist forthe National Apprenticeship Service awards (2012)in conjunction with Southampton Solent University developed Foundation Degree inHealth and Social CareWe want UHS to continue to be leaders in best practice for the education and developmentof support staff and this strategy and the implementation plan sets out aspirations that, withthe help of Trust managers, staff and our partners, we will ensure that we do this.5. Talent for CareThe first national strategy for healthcare support staff, ‘Talent for Care’ has been developedthrough England wide consultation to implement the HEE Mandate deliverables describedabove. The Talent for Care strategy is set out under the following headings:Get in – widening participation into employment and education in the health sectorGet on – information, advice and guidance and CPD of support workers in theirrolesGo further – career opportunities and pathways for support workers wanting toprogress6. Get in widening participation into employment and education inthe health sectorWhy is Widening Participation in employment and learning important to health?The National Institute of Adult Continuing Education (NIACE) contribution to theGovernment’s 2013 Spending Review, ‘The Case for Investment in Learning for Adults’118‘Learning at work’ in the Portering Department Fuller, Alison, Laurie, Ian and Unwin,Lorna (2010) ISBN 9780854329144 University of rning at Work in the Portering Department .pdf9‘The Southampton Skills Development Zone Apprenticeship: Research Report’ Alison Fuller andSadaf Rizvi, (July 2012) ISBN 9780854329557 LLAKES ESRC Research 3/01/SSDZ-Research-Report.pdf10‘Carefully designed vocational programme: University Hospital Southampton NHS FoundationTrust’ Ofsted Good Practice Resource, 28 January -university-hospital-southampton-nhs-f4

looked at many different research studies and identified the following benefits of publicinvestment in adult education:Health and wellbeing benefitsResearch has shown millions could be saved from health budgets if adults undertakeaccredited courses. It increases the chances for smoking cessation by age 42 years by14% and for women that achieve Level 2 qualifications the chances of developingdepression by age 42 years decrease by 15%. In addition the sense of wellbeing of havingsustainable work and earnings (to which the achievement of qualifications contribute) leadsto a more active lifestyle with significant savings on health, social care, pensions and otherbenefits by upto 14%.Employment and Social mobilityThere is recognition that education can support social mobility. Young people who areNEETs (not in employment, education or training) are likely to have reduced lifetimeearnings and up to 36% of adults have not participated in learning since they left school.This can mean that they are more likely to continue to need state benefits to support them.Community cohesionThere is evidence that adults who undertake learning are more effective at supporting theirchildren through school life and reduce the chances of those children ending up in poverty.In addition it been shown that even informal learning raises racial tolerance within acommunity.Information advice and guidance (IAG)Wider communityIn recent years the IAG provided in schools has changed and to a large extent reduced andtherefore the giving of helpful career advice has diminished.UHS has a good reputation around Southampton and the wider Hampshire area ofsupporting schools and colleges to deliver excellent career advice to students. We do thisthrough visits to schools and hosting on-site visits in the hospital. An excellent example ofthis includes the Health Science career fair that is held at SGH and introduces students tothe wide range of potential health science careers the NHS has to offer.In addition ‘teacher tours’ are offered throughout the year to enable teachers to have abetter understanding of the roles and careers available in health to help them to give betterIAG to their own students.The UHS Volunteer Services manages a large number of requests for work experiencefrom both schools wanting work experience for students and from local charities supportingunemployed people into work who need this invaluable time to help with their CV and oftentheir self-esteem. In addition UHS staff have been supporting the NHS on-line mentoringscheme12 for young people (16-18 year olds) and NEETs. This is a 13 week programme tosupport young people to research and find information about possible healthcare careeroptions.IAG for Trust staffUHS has a career support co-ordinator who provides personal IAG to any staff, regardlessof role, who are looking for advice regarding the next steps in their career. Career advice is11‘The case for investment in learning for adults’: A contribution to the 2013 Spending Review by theNational Institute of Adult Continuing Education (NIACE: March 2013) www.niace.org.uk12The NHS on-line mentoring scheme (2014) http://www.thebrightsidetrust.org/5

also provided to those who are at risk during organisational change or where individualsmay no longer be able to remain in their current role due to ill health. This enables theTrust to retain talent.The Trust had IAG Matrix accreditation and is applying for re-accreditation. This nationalquality standard is often a requirement for national funding arrangements, particularly toaccess Skills funding Agency funds for apprenticeships.Values based recruitment (VBR) and recruitment talent streamWe will work with the local community to developnew ways to advertise support role vacancies andMaryam Hayat,create a talent stream that will help us to recruit inadministration assistanta more structured way and enable us to fillwho was a volunteer atvacancies quickly. UHS is moving to a VBRUHS .approach when recruiting staff and this will also“I started volunteering so itinclude support staff in the future, starting withcould help me to decidehealthcare assistant roles.whether I wanted to go toAge diversityAccording to the Trust’s Equality and DiversityStrategy (2014)13 the 2011 census shows thatabout 13.09% of the Southampton population isaged between 20 and 24, (this includes the studentpopulation at the city’s two universities). Childrenand young people under 20 years of age living inthe city make up 24.11% of the population.Comparing these figures against the Trust’shealthcare support workforce, approximately 3% ismade up of young people aged 16-20 years andapproximately 13% of those aged 21-25 years. Inaddition we have an ageing healthcare supportworkforce with those aged 51-60 years in theseroles making up approximately 27% of the totalworkforce. We are currently not recruiting enoughyoung people to replace the number of staff whoare likely to retire in the next 5 to 10 years.The majority of our healthcare support staff livelocally and we are unlikely to attract individualsfrom other parts of the country (or internationally)to relocate to Southampton to work in these roles.At the present rate of underemployment of youngpeople in the Trust we will struggle to recruitenough of them locally to replace even those staffwho will be retiring.university or to get a job.Training was given to be avolunteer. I used to askpatients if they wanted tocomplete a survey. After this, Istarted doing administrationand clerical tasks in variousdepartments.I enrolled into an interpreter’scourse as I like to try newthings. The part which Ienjoyed the most was workingin the volunteers’ office. Allmembers of staff andvolunteers were warm andwelcoming. I enjoyed this,and this swayed me to find ajob.I was offered anadministration job in apsychiatric hospital. I enjoyedmy time there and thisequipped me on how tounderstand individualssituations, how to deal withdifficult situations. Now I havean administrator job working inthe volunteer’s office at UHS”Pre-employment opportunities for young people and traineeshipsThe employment or work experience for young people has often been difficult to achievewithin the NHS overall. This has been largely a cultural issue because of the belief thatrecruitment of young people is not allowed. There has never been any directive over the13‘Equality and Diversity Strategy; 2014 – 2017’; November 2014, University Hospital SouthamptonNHS Foundation Trust,6

lifetime of the NHS that specifically barred this age group from being employed and thisbelief has grown out of ‘custom and practice’. UHS can no longer afford to restrict youngpeople working in the NHS. However, we must properly support them and the staff who willbe training them in the workplace to ensure a good experience. The result should be staffwelcoming this age group into the workplace and giving young people a positive trainingand employment experience encouraging them to follow health careers.The Traineeship is an initiative by the National Apprenticeship Service (NAS) to enableyoung people who are not in employment, education or training (NEETs) an opportunity toundertaken pre-employment training and gain real work experience (up to a maximum of 6months) as a precursor to applying for work or apprenticeships. These individuals oftenneed greater support as they may have left school with few GCSEs and had littleemployment experience which means they are not ready to move straight into anapprenticeship.As one of the largest employers in Southampton it is essential that UHS meets its socialresponsibilities through enabling young people who are not in employment, education ortraining (NEETS) and other long-term unemployed people to access work and training. Asoutlined at the beginning of this strategy this has social, health and economic benefits to usand the wider community. We will continue to work with local partners to ensure the Trust isactively working with all sections of the diverse local community to attract and retain localtalent into health careers. This supports UHSFT’s social responsibility to the localcommunity by helping to reduce the City’s unemployed youth and longer term unemployedadults into work.UHSFT and the local communityUHS has a good track record of working with local community partners and we will continueto build on this. We led and are involved in projects in the City. We have worked withpartners such as Job Centre Plus to support unemployed local people of all ages to get intowork or training. We have done this by offering structured work experience, preemployment training (PET) and apprenticeships enabling them to be better placed to findwork either with us or within the local economy.Private employers are also increasingly looking to develop their business and attract thebest local talent as can be seen in the Solent Local Enterprise Partnership (Solent LEP)‘’Skills for Growth Plan (2013)14. We will therefore need to work hard to compete with otherlocal employers to recruit talent from our local area, particularly to fill support roles. As it isunlikely we will be able to compete through pay incentives alone we need to be able to offera career pathway so that individuals (and young people in particular) can see how they canpotentially increase their income through career progressionLinks to local colleges and schools to embed structured learning placementsUHS has had exploratory discussions with a local college to work more closely with them toenable students undertaking health and social care courses to undertake structuredlearning placements (instead of work experience) at UHS. This would entail them spendingtime in a variety of settings over a period of several weeks during their course. The aim ofthis would be to give them an insight into the different occupations and professions thatexist to help them make an informed choice about their future careers. This could includeprogression to pre-registration professional programmes or apprenticeships.14‘Skills for Growth Plan’; Executive Summary, Solent Enterprise Skills Zone, Solent LocalEnterprise Partnership May nt Enterprise Zone Skills Plan Executive Summary - May 2013.pdf7

Initial assessment of numeracy, literacy and the use of technologyThe confident use of numbers and the ability to use the English language clearly, bothwritten and verbally, are essential skills for all staff who work anywhere in UHS. Literacyand numeracy skills underpin effective communication between staff and with patients andrelatives and ensure safe patient care and other workplace activities.Being confident to use technology (not just IT keyboard and software skills) on-linesystems, send email, browse the internet or data entry are essential skills not only in ourwork life but also our personal life. In fact these skills are necessary to check rotas, bookannual leave, book onto a course, undertaken statutory and mandatory learning online or toclaim overtime as many of our employment systems are becoming automated and moreand more equipment becomes more technology based.These skills are also essential for staff who wish to progress in their career as manycourse, including apprenticeships and undergraduate programmes, increasingly use on-linelearning environments and e-portfolios. Improving and developing these underpinningpersonal skills will enable staff to study more effectively and with increasing confidence.It is therefore essential that we ensure our support staff have the skills and confidence touse technology and have numeracy and literacy skills at a level that is appropriate for theirrole. As part of the recruitment and induction process we will check the skills our recruitsalready have in these areas and help them plan to improve these either as stand-alonedevelopment or combined with other study such as apprenticeships.(Cavendish) Care Certificate15One of the outcomes of the Cavendish Review is the development of the new CareCertificate. This certificate is recommended as initial training for any support staff withdirect patient contact. It forms part of the induction requirements for new healthcareassistants and we will have to provide assurance that our newly recruited healthcaresupport staff have met this. The Care Certificate was piloted during 2014 and formallylaunched nationally in March 2015. We will ensure that training programmes delivered inUHS for healthcare assistants are reviewed to support the implementation of the certificate.A review of the workplace support required to mentor staff as they complete the practicalassessment of the certificate has been undertaken, and there will be ongoing publicity toensure managers and staff are aware of what is required.7. Get on. information, advice & guidance and CPD of support staff intheir rolesApprenticeships and QCF awardsIn recent years there has been encouragement from Government for more employers,including the NHS, to increase the number of apprenticeships.At UHS we have a City and Guilds Centre developing and delivering clinical apprenticeshipprogrammes including health, pharmacy and peri-operative care. Clinical managers cancontact the Centre to find out more. We also deliver apprenticeship programmes forhousekeepers and porters.15Information and resources for the Care ards/item/216-the-care-certificate (accessed April 2015)8

Managers in non-clinical areas areencouraged to support apprenticeshiptraining in their work area and UHS worksin partnership with external trainingproviders to ensure this training can bedelivered flexibly in a cost effective wayand is of high quality. Non-clinicalapprenticeships and QCF awards that arecurrently offered include engineering,administration, finance and call centres.Kasia Juzwiak is a healthcareassistant working in intensivecare and has completed herapprenticeship, “I haveworked in the hospital for morethan 4 years now. First I startedworking as a ward hostess forCompass Group. After a year Ileft catering job and startedworking as a Healthcare SupportWorker in General IntensiveCare Unit.To help UHS offer as manyapprenticeships as possible we work inpartnership as a sub-contractor with theNational Skills Academy in Health toenable us to access Skills Funding Agencyapprenticeship funding for some of ourcourses.Shortly after I started in IntensiveCare my manager mentionedthat it would be good opportunityfor me to complete an advancedapprenticeship in clinicalhealthcare support.Apprenticeship Training Agency (ATA)An ATA is an organisation that recruits andmanages apprentices on behalf ofemployers. The apprentices are then‘placed’ with an employer for the durationof their apprenticeship. The ATA takescare of all of the recruitment andemployment processes and pays theapprentices a salary (reclaimed from theemployer) and will help employers sourcea suitable apprenticeship training provider.An example of this is the National SkillsAcademy for Health which runs an ATA.The advanced apprenticeshipincluded a lot of work andknowledge but with that I got atremendous amount of supportfrom my manager, my mentor, aswell as, from my assessor invocational skills centre. I found itchallenging at times but it wasworth all the hard work.Completing the apprenticeshiphas enabled me to develop myknowledge and my clinical skillsa lot more than I could haveimagined. This has helped medeliver more patient centredcare.Although apprentices trained using thisroute have no guarantee of a post at theend it does open up the opportunities foryoung people to gain valuable skills, workexperience and a nationally recognisedqualification. This puts them in a strongerposition to apply for future jobs.At UHS we will continue to investigateways to use the ATA model to increaseopportunities for young people to make astart in their careers in healthcare.Continuing Personal Development(CPD)Although many healthcare support staffwant to progress onto higher qualificationsand roles we know many decide forvarious reasons to remain in their currentposition or move within the Trust into otherjob opportunities at the same pay band.My manager was then happy tosupport me in applying for aFoundation Degree the sameyear and I applied for and got aplace to further my career on theFoundation Degree in Health andSocial Care at SouthamptonSolent University.Completing any work-basedcourse is a very good opportunityto develop your knowledge, skillsand become more experiencedin your work place.”“All of this would not bepossible without my hard workand people believing in me”9

We also know that many staff still wish to remain up-to-date or develop more in depthunderstanding of their role through continuous personal development. As a Trust it is in ourbest interest to support this. Some staff can use also use CPD to provide enoughadditional knowledge and skills to enable them to progress in their career. Staff at any levelwho have access to ongoing development are more motivated and able to fully engage withservice delivery changes and offer new and innovative ideas on ways of working.360 degree feedbackThe Trust has, for a number of years, recognised the importance of 360 feedback for staffdevelopment, but to date this has not been offered to staff in healthcare support staff,though a pilot has been undertaken. There are plans to review this pilot and revisit with thenext FD in

staff, finance support staff, materials management and pathology staff. The training and development needs for all of these staff are equally diverse and equally important. This strategy will seek to support these differences, whilst also enabling staff from different occupations to learn together where this brings added benefits of improved

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