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

2. 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

3. 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 

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

6. National Progress

7. 2013 in Orkney
competency mapping
educational mapping
workshop – supporting service improvement

8. 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

9. 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)

10. 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)

11. 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)

13. 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

14. 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

16. 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

17. 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

18. 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

19. 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

21. 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

22. 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

23. 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

24. 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

25. 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

26. 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?

27. 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

28. 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

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