|Printable version||E-mail this to a friend|
Staff engagement and reshaping the health and social care workforce – Candace Imison
- Also published by:
The zone explored the progress made by the 50 vanguards developing and testing new models of care that can be replicated across different health economies. Candace Imison, Director of Policy at the Nuffield Trust, reflects on the discussion that came out of her ‘pop-up’ university session – staff engagement and reshaping the health and social care workforce: increasing staff satisfaction at a time of transformational change.
We prefaced our recent report Reshaping the workforce to deliver the care patients need with the statement from the NHS Five Year Forward View “We can design innovative new care models, but they simply won’t become a reality unless we have a workforce with the right numbers, skills, values and behaviours to deliver it”.
Our report focused primarily on the opportunities that new and extended roles give you to address our current deficits in workforce numbers and skills. Chairing a session at NHS England’s Health and Care Innovation Expo, where three vanguards described how they were supporting and enabling their workforce to deliver new models of care, brought home to me how important values and behaviours are to bringing about change. Having staff in the right numbers and with the right skills is not enough unless the right values and behaviours are embedded too.
A key driver of behaviour is trust. The evidence shows time and again how trust trumps structures when it comes to delivering integrated care. The team from My Life a Full Life (Isle of Wight) vanguardI (@MyLifeAFullLife) got us all thinking by asking us to give scores out of ten, on trust, to the people we most, and least, trust at work. If the difference between the two scores was more than five – our workplace might benefit from some trust building. The Isle of Wight has been building trust across their community with their training programme based on the ‘Speed of Trust’ methodology.
The training brings people from across roles and sectors together. It builds their people skills and trust in each other. The team feel the programme is not only enhancing the confidence of those that attend but changing the culture across their system – by giving them a common language. For example, one unforeseen consequence had been that district nurses and firemen undertaking fire safety visits have started referring vulnerable people to each other. It left me more than convinced that investment in building trust across the system is not a “nice to do” but an essential.
High performing teams have high trust. All three vanguards emphasised the importance of team working and “teams without walls”, particularly in caring for the top five per cent of patients that have multiple and complex needs. This facilitates holistic care and avoids unnecessary duplication. Both Dudley Multispecialty Community Provider (@atbdudley) and Northumberland Accountable Care Organisation (@N_LandNHS) described how the introduction of different and new roles to their teams had changed their culture and dynamics.
In Dudley they have introduced a link worker who visits patients at home and signposts them to services that address their social as well as care needs. One of the link workers told us that they saw themselves as “another eye in the room” able to spot and help remedy problems that would otherwise go unnoticed. The example they gave was of helping someone get a hearing aid – transforming their quality of life. Dudley said that the clinical commissioning group now sees itself as commissioning for a “life not a condition”.
In Northumberland they have developed multidisciplinary population-based teamsfocused on providing holistic care to patients in the community. Pharmacists have been introduced to these teams – offering additional skills and competences. They have driven a change in culture including better team working and the team operating with greater autonomy. As well as contributing to the multidisciplinary team, the pharmacists are providing input to residential and nursing homes; community visiting service and general practice. They have significantly reduced the GP workload. Northumberland estimate that up to 40 per cent of GP visits could be undertaken by other professionals.
One of the audience members at Expo posed the challenge to the vanguards – how did they know what skills were needed in their multidisciplinary teams? The response was that until you have teams working collaboratively, making the most of the existing team members, you may misjudge the gap.
If possible you need to make things simple for patients, not more complex. The type of person is just as important as their skills. Which takes us back to where we began. Numbers and skills without values and behaviours won’t work.
Candace Imison joined the Nuffield Trust in December 2014.
Candace was previously Deputy Director of Policy at The King’s Fund where she researched and published on a wide range of topics including future healthcare trends, service reconfiguration, workforce planning, polyclinics, community health services and referral management.
Candace has extensive senior management experience in the NHS, including at board level for providers and commissioners. She was director of strategy for a large acute trust and director of commissioning for large health authority.
Candace worked on strategy and policy at the Department of Health between 2000 and 2006, including work for the Modernisation Agency leading a workforce modernisation initiative. She is currently a non-executive director of a large NHS Foundation Trust.
Candace holds a master’s degree in health economics and health policy from Birmingham University and a degree in natural sciences from Cambridge University.
Latest News from
NHS and leading suppliers join forces to cut sugary drinks21/04/2017 14:15:00
The NHS is today (Friday) stepping up the battle against obesity, diabetes and tooth decay by announcing that sugary drinks will be banned in hospital shops beginning from next year unless suppliers voluntarily take decisive action to cut their sales over the next 12 months.
Report sets out progress on race equality standards for all NHS trusts in England20/04/2017 10:15:00
A second annual report into race equality across the NHS was been published yesterday (19 April).
Mental health patients set to benefit from pioneering new digital services13/04/2017 09:15:00
Seven areas across England are set to trail-blaze digital services for mental health patients, which will include innovative apps to improve care and online access to ‘real-time’ patient records.
Up to six million people set to benefit from more clinical pharmacists in GP surgeries12/04/2017 16:15:00
Patients across England are set to benefit from more convenient trips to the GP with the announcement by NHS England of new, surgery-based clinical pharmacists to help with routine medication and treatment.
Stroke patients in England set to receive revolutionary new treatment12/04/2017 11:15:00
An estimated 8,000 stroke patients a year are set to benefit from an advanced emergency treatment which can significantly decrease the risk of long-term disability and also save millions of pounds in long term health and social care costs.