The development of the allied health support workforce.

Snell, Laura and Grimwood, Tom (2020) The development of the allied health support workforce. Health and Society Knowledge Exchange (HASKE). (Unpublished)

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Abstract

Context:
Health and Society Knowledge Exchange (HASKE) was commissioned by Health Education England (HEE) to evaluate the development of the support workforce across the fourteen allied health professions. This project aimed to map the existing allied health support workforce and bring together current knowledge and examples of workforce development. It was therefore delivered in close dialogue with the related project developing the enabling Education and Career Framework. The analysis and conclusions of the evaluation were used to produce a toolkit to enable departmental managers to successfully prepare for and implement the framework.

Methodology:
The data collection involved three stages: scoping the current support landscape through conducting a review of existing literature, contacting allied health professional bodies, and interviewing AHP regional leads; the collation of quantitative data to map the current support workforce; and deep dive interviews to explore the development of the allied health support workforce.

Findings:
- The study shows that the allied health support workforce landscape is varied and complex. Support workers have an integral role in supporting AHPs and enhancing patient care, but this is achieved in multifarious ways within and across the different allied health professions.
- The research findings indicate there are approximately 35,064 FTE support workers in the allied health professions across England: 34,358 FTE are employed in the NHS and 706 FTE are employed by independent healthcare providers. In February 2020, the 34,358 FTE support staff employed in NHS settings across England included: 17,773 FTE ambulance support staff, along with 16,585 FTE support workers in chiropody/podiatry, dietetics, occupational therapy, orthoptics, physiotherapy, radiography (diagnostic and therapeutic), art/music/drama therapy, prosthetics and orthotics, speech and language therapy, and operating departments.
- It is currently difficult to accurately map the size and scope of the support workforce due to the limited data available at both national and regional levels.
- The findings highlight significant variation in the job titles of the allied health support workers, which can be attributed to the distinct development of each profession and organisational factors. The support workers have a diverse scope of practice that is very much determined by the allied health service in which they are based and the specific needs of the patients in their care.
- The process of developing the support workforce can be hindered by a dearth of training aimed specifically at support roles, financial issues, time constraints and a lack of organisational support. In addition, the unregistered status of the assistant practitioner role can result in a lack of awareness about the scope of this role and the potential benefits for the whole allied health team.
- However, upskilling has been successfully implemented in a number of different Trusts, through formal learning (e.g. the Care Certificate, level 2 and 3 NVQs, the level 5 assistant practitioner qualification, degree apprenticeships) and informal learning opportunities within the workplace. There was a particular emphasis on the development of niche skills to create sustainable learning for the support workers which enables role development and fulfils the specific needs of their service. The apprenticeship levy and band 4 assistant practitioner role particularly significant for some services.
- A theory of change was constructed based on the findings to capture the inputs, outputs and longer term outcomes of support workforce implementation.
- Overall, the findings show that developing the support workforce can be beneficial for the individual, the allied health service and the patients: the support workers develop personally and professionally, expand their scope of practice and feel valued as members of the team; the allied health service can improve staff retention, enhance the skill mix within the team, develop the scope of their service and experience a positive culture shift; patients can benefit from shorter waiting lists due to an increased capacity for appointments, along with a consistent and enhanced level of care.
- In this respect, the findings can be represented in terms of two cycles of practise: on the one hand, the current state of the workforce exists in what we might term a vicious cycle, where the localised significance of support roles do not translate into wider development opportunities to address population health needs. The challenge for the future is to turn this vicious cycle into a virtuous one, improving the representation of support workers and their activities and establishing them more effectively within wider organisational strategies, without losing their responsiveness to local need.

Conclusions and Recommendations:
- In order to successfully implement change, it is important to undertake detailed workforce planning, engage relevant stakeholders and articulate a clear vision to their allied health team.
- This can only be done with a more consistent approach to data collection and reporting measures. Guidance for this is included in the Implementation Toolkit. Adopting a standardised approach to documenting the support workforce will enable the data to be easily reviewed and provide an accurate picture of the workforce. A template for this document is provided in the accompanying Implementation Toolkit.
- It is recommended that mechanisms for standardising the various job titles across the allied health support workforce are explored. This is likely to require consultation across professional bodies.
- The assistant practitioner role has been around for several years, but remains a less visible path into allied health professions. It would be beneficial to promote the role in specifically in terms of its ability to enhance the scope of practice for the whole allied health team, and to clarify any misperceptions that still exist about this unregistered workforce.
- Although some of the allied health professional bodies are actively involved with their support workforce, this is not the case across all 14 professions. Therefore, it is recommended that the professional bodies should review their approach to engaging support workers and consider strategies for raising the profile of their support workforce, including professional development opportunities.

Item Type: Report
Publisher: Health and Society Knowledge Exchange (HASKE)
Departments: Research Centres > Health and Society Knowledge Exchange (HASKE)
Additional Information: This project was commissioned by Health Education England (HEE). The report was authored by Dr Laura Snell and Dr Tom Grimwood at Health and Society Knowledge Exchange (HASKE), University of Cumbria.
Depositing User: Laura Snell
Date Deposited: 12 Feb 2021 10:52
Last Modified: 26 Feb 2021 09:58
URI: https://insight.cumbria.ac.uk/id/eprint/5934

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