Rural Generic (Health and Social Care) Support Worker: The Journey so far........ Fiona Fraser – Project lead RRHEAL Mary Richardson – MER Consulting www.rrheal.scot.nhs.uk

Rural Generic Support Worker (RGSW) Background Drivers (policy/ service/ employment) National progress Board/ partnership developments Programme for the event journey through planned delivery of content Specialist speakers contributing Sharing the evidence base and the contributions developing employers guidance/ an employers pack

RGSW: background D4RRH RRIG RRHEAL “To pursue generic support worker roles and supporting educational frameworks” Lengthy engagement to date Changing climate Programmes of enquiry “coming of age” Significant interest policy directives around 20:20 vision re sustainable workforce ,doing things differently ,innovation, improving service 

Need more, but not more of same! Quantity Quality Relevance ISBN 978 92 4 156401 4 (NLM classification: WA 390) © World Health Organization 2010Educational

National Progress

2013 in Orkney competency mapping educational mapping workshop – supporting service improvement

Competency 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

Stakeholder 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)

Capability 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)

The 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)

Using 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

Educational 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 and other NES resources

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 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

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

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

Intended Outcomes By the end of the workshop participants will have: 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. have made some suggestions about what can be done to improve the service, focusing on the role of the RGSW have made suggestions for the way forward

Summary of Outcomes Great deal of support for development of the RGSW role RHSW 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

RGSW 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

Summary of Challenges Challenges related to RGSW training supervision mentorship 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

Moving forward Findings of both the mapping and the workshop used by Orkney Health and Care and to inform the final job description and development of the RGSW role Current National Occupational Standards (NOS) and SVQ Units have been mapped to the job description and framework. Funding for pilot being sought

NHS Highland Approaching the development of RGSW roles from a slightly different angle Aim to develop flexible roles which can operate in different settings (“less remote and rural but more generic.”) Centred around the multiple care workers involved in ‘care at home’ - can one person perhaps do all these things? Test site for a Health and Social Care Co-ordinator role (band 4) (modelled on a similar post in Torbay) Next step - ongoing development of competencies and consideration of educational requirements for these roles Working group has recently been established

Argyll & 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?

Shetland 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

Western 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

I www.rrheal.scot.nhs.uk