Quality Education for a Healthier Scotland Multidisciplinary Rural Generic (Health and Social Care)...

Quality Education for a Healthier Scotland

Multidisciplinary

Rural Generic (Health and Social Care) Support Worker:

Supporting Person Centred Care

Fiona Fraser – Project lead RRHEALwww.rrheal.scot.nhs.uk

http://www.rrheal.scot.nhs.uk/


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Remote and Rural Healthcare Educational Alliance/RRHEAL

NHS Education for Scotland/NES

• Access, Rural specific content & support for Remote and Island learners the key issues to be addressed by RRHEAL.

• RRHEAL provides assistance to remote and island NHS Boards and Partnerships, being a linking force between healthcare services, partnerships and education providers.


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Delivering for Remote and Rural Health+Remote and Rural Implementation Group RRHEAL to

“To pursue generic support worker roles and supporting educational frameworks”

Scoping study with SSSC outlined potential for Generic Support Worker http://

www.scotland.gov.uk/Resource/Doc/222087/0059735.pdf


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Significant international evidence base supporting change –

• Need more, but not more of same!

• Quantity • Quality • Relevance

• ISBN 978 92 4 156401 4 (NLM classification: WA 390)

• © World Health Organization 2010Educational


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Significant international evidence base supporting change –

• Need more, but not more of same!

• Quantity • Quality • Relevance

• ISBN 978 92 4 156401 4 (NLM classification: WA 390)

• © World Health Organization 2010Educational


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NES & SSSC outlined potential for Generic Support Worker

“Clear and increasing” demand in both health and social care services for range of support workers who provide direct care, with indication of benefits to health and social care workers at a local level.

RRIG action plan 2008 described developing a

Generic (Health and Social Care) Support Worker

an essential component for required stratified workforce.

- RRHEAL to develop an appropriate education programme to support development of this role.


MultidisciplinaryGeneric Support Worker (GSW)“Why”

• Changing population needs

• Recruiting a sustainable workforce

• Creating career opportunities


MultidisciplinaryGeneric Support Worker – Why...

• Future models of health and social care delivery based on integrated teams demonstrating a range of competencies, defined by client need

• Person centeredness

• Remote and Island staff teams/different skill sets required



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Our Orkney Our Health – transforming clinical services;

• Generalist skill set• Multi- skilling and multi -

tasking – a breadth of knowledge and

experience required of post holders

• Lone working and associated challenges with supervision

• Time spent on travel (e.g. single visit to Isles can take a full day)

Recognition • Health and social care staff require Core Skills

and Competencies• Reduce multiple visits from different disciplines• Care individualised and delivered appropriate to

individual needs

Focus on-o Fostering enablement and building self careo Multi- professional assessment of needso Supporting independence and ensuring a

rehabilitative approacho Ability to support identification of complex

needso Using telehealth and telecare o Case management approach


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How....

• Developing a responsive and sustainable workforce (desirable employment)

• Creative team working and Integration• Shared competencies • Solutions ... Developing sustainable and affordable services

Generic (health and social care) Support Worker

- To support delivery of core outcomes - Supporting lead health and social care professionals- Increasing efficiency with improved service and responsiveness to

clients


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The Partnership that is Orkney Health and Care

• Competency mapping• Educational mapping• Workshop – supporting service

improvement


MultidisciplinaryCompetency Mapping

• Compare and contrast the competency statements for existing health and care workers with draft job description for the RGSW

• Map with existing competencies • Identify existing service gaps and opportunities for

service improvement that the RGSW may provide in large and small island settings

• Capability framework• Mapping of core competencies


MultidisciplinaryCapability Framework

• A capability framework is a broad outline of what practitioners should be able to do in practice

• Capability frameworks usually supported by discipline-specific competency frameworks detailing the level of expertise required

• Framework incorporates practice learning outcomes:– details what practitioners should be able to achieve – captures the notion of capability as current competence combined

with the development of future potential competence (Price, 2004)



MultidisciplinaryThe RGSW Framework

• Broad areas of capability under five headings:– Knowledge for Practice– The Multi-professional Approach– Practising Ethically– Care and Intervention – Personal, Professional and Service Development

• Practice learning outcomes • Indicative key content that would be required in education and

work-based learning programmes for the RGSW• Links to the NHS Knowledge and Skills Framework (KSF)• Links to relevant National Occupational Standards (NOS)


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MultidisciplinaryUsing the Framework

The Framework can be used to:• Support the development of the RGSW role• Guide the development of education and training (including

work-based learning, short courses, study days, online learning or accredited programmes of study)

• Support, guide and facilitate staff development through PDP• Support self assessment and planning personal development


MultidisciplinaryEducational Mapping

• The content section of the capability framework mapped against training currently delivered by Orkney College UHI as an SVQ Award, using the identified NOS as a guide.

• Candidates would be required to complete (or have completed) four mandatory Units, two ‘fixed’ optional units covering the largest variety of outcomes, and two optional modules

• Other learning and development options were also identified including those available through induction in both health and social care settings, NHS LearnPro modules, other NES & SSSC resources


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The Workshop

To explore how the RGSW role may support service improvement within the context and challenges of integrated care delivery in Orkney using the NES Skills Maximisation Toolkit (SMT) process

• provides a step-by-step process to support service re-design and allows those involved to be clear about the skills and skill mix needed to provide good quality services

• workbook focuses on the client journey and looks at three stages:– clarifying the client journey – what’s

happening now?– capturing uniqueness – what’s the

best contribution?– creating improvement – making it

happen, capturing impact



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Process adapted

Stage 1: Clarifying the client journey • Prior to the workshop:

– project team identify and map typical client journeys– steps and activities that are involved when a user begins

their journey– how do patients/clients and their families access the

service?

Stage 2: Capturing uniqueness• consider who is currently undertaking each of the tasks and

activities• discuss and agreed which of these demand the unique

contribution from the qualified practitioner, and what could be done by the RGSW

• identify other issues that need to be taken into account


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Stage 3: Creating improvement• focused on the work that can be undertaken by the RGSW,

suggesting changes that can be made to result in a positive impact on the patient journey, on the team and on team-working.

• making suggestions about what can be done to improve the service, focusing on the role of the RGSW

• making suggestions for the way forward


MultidisciplinaryIntended OutcomesBy the end of the workshop participants had;

• considered who is currently undertaking each of the tasks and activities• discussed and agreed which of these demand the unique contribution

from the qualified practitioner, and what could be done by the RGSW• identified other issues that need to be taken into account• focused on the work that can be undertaken by the RGSW, have

suggested changes that can be made to result in a positive impact on the patient journey, on the team and on team-working.

• made some suggestions about what can be done to improve the service, focusing on the role of the RGSW

• made suggestions for the way forward



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Summary of OutcomesGreat deal of support for development of the GSW role

• GSW role could contribute to :– a smoother client journey– a more person-centred approach to care– better outcomes for the service user and their family

• Reduce the need for hospital admissions• Facilitate earlier discharge• Reduce re-admissions• Allow people to return to their own homes rather than a care

home

www.rrheal.scot.nhs.uk



MultidisciplinaryGSW Requires ....

• Wide range of knowledge and skills including:– diplomacy– communication– assertiveness– organisational skills– nursing skills– home care skills– AHP related skills

• Aware of the limit of their knowledge, skills and professional boundaries


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Summary of Challenges• Challenges related to

– GSW training– Support & supervision– Funding – Clinical governance

• Education programmes would need to be:– available locally– flexible– use a blended approach

• Access to continuing professional development and the application and engagement of new technology key


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Moving forward

• Competency and educational mapping informed final revision of Orkney job description and development of the GSW role

• Current National Occupational Standards (NOS) and SVQ Units have been mapped to the job description and framework

• **Educational Case Studies** present options for GSW dev’t

• Informing development of Generic Support Worker roles in a number of Boards and Partnerships


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Progress.........

RRHEAL Reporting Development of Rural Generic (Health and Social

Care) Support Worker Roles: Summary of National Policy, Reporting and Progress April 2014

Options for educational development of new and existing Rural Generic (health ad Social Care) Support Worker Roles April 2014

SG Short Life Working Group for the health and Social Care Support Worker now currently guiding next stage developments.




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I




MultidisciplinaryArgyll & Bute CHP

• Pragmatic approach to setting up the health and social care team

• Rehabilitation support workers currently employed within the OT service and provide assistance to physiotherapists

• Training provided for home care teams and the independent sector

• These support workers are delivering generic care and receive training dependant on what is required by the individual service user

• Review of what nursing staff are doing and why they are providing multiple assessments with multiple people going in to one home is being carried out; can someone do it all?


MultidisciplinaryWestern Isles

• Recruitment and retention is an ongoing challenge • Developing career pathways for health and social care roles

and mapping support worker roles to skills, competencies and qualifications

• Pre-employment scholarship for support workers • RGSW role being explored• Rehabilitation support worker in post working closely with

physiotherapists• Pilot underway of ‘Hospital at Home’• Some support workers are employed by both organisations and

some mandatory induction


MultidisciplinaryShetland

• Currently no plans to develop a RGSW role• Consideration being given to joint learning and

development• Recently appointed a Director of Health and Social

Care to lead the integration agenda


MultidisciplinaryStakeholder Agreement

• Mapping of existing job descriptions• Identify gaps in RGSW job description

THEN AGREED: • RGSW role should be at level 3 on the NHS Career

Framework (Senior Healthcare Support Worker). This equates to SCQF level 7 (SVQ3/ HNC)

• Develop a framework which outlines the RGSW capabilities and areas of responsibility, and map these to NHS KSF and existing National Occupational standards (NOS)


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