Sophie Sarre1, Jill Maben2, Clare Aldus3, Justine Schneider4, Heather Wharrad5, Caroline Nicholson6, Antony Arthur7. 1. Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK. Electronic address: Sophie.Sarre@kcl.ac.uk. 2. School of Health Sciences, University of Surrey, Faculty of Health and Medical Sciences, Rm 22, DK04, Duke of Kent Building, Guildford, Surrey GU2 7XH, UK(1). Electronic address: j.maben@surrey.ac.uk. 3. School of Health Sciences, University of East Anglia, University of East Anglia,1.27 Norwich Research Park, Norfolk, NR4 7TJ, UK. Electronic address: c.aldus@uea.ac.uk. 4. Institute of Mental Health, School of Sociology & Social Policy, University of Nottingham, Law & Social Sciences Building, University Park, NG7 2RD, UK. Electronic address: Justine.schneider@nottingham.ac.uk. 5. Faculty of Medicine & Health Sciences, University of Nottingham, School of health sciences, Room B53, Queen's Medical Centre, Nottingham, NG7 2UH, UK. Electronic address: heather.wharrad@nottingham.ac.uk. 6. Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK. Electronic address: caroline.nicholson@kcl.ac.uk. 7. School of Health Sciences, University of East Anglia, University of East Anglia,1.27 Norwich Research Park, Norfolk, NR4 7TJ, UK. Electronic address: Antony.Arthur@uea.ac.uk.
Abstract
BACKGROUND: Ever-growing demands on care systems have increased reliance on healthcare support workers. In the UK, their training has been variable, but organisation-wide failures in care have prompted questions about how this crucial section of the workforce should be developed. Their training, support and assessment has become a policy priority. OBJECTIVES: This paper examines: healthcare support workers' access to training, support and assessment; perceived gaps in training provision; and barriers and facilitators to implementation of relevant policies in acute care. DESIGN AND SETTINGS: We undertook a qualitative study of staff caring for older inpatients at ward, divisional or organisational-level in three acute National Health Service hospitals in England in 2014. PARTICIPANTS: 58 staff working with older people (30 healthcare support workers and 24 staff managing or working alongside them) and 4 healthcare support worker training leads. METHODS: One-to-one semi-structured interviews included: views and experiences of training and support; translation of training into practice; training, support and assessment policies and difficulties of implementing them. Transcripts were analysed to identify themes. RESULTS: Induction training was valued, but did not fully prepare healthcare support workers for the realities of the ward. Implementation of hospital policies concerning supervision and formal assessment of competencies varied between and within hospitals, and was subject to availability of appropriate staff and competing demands on staff time. Gaps identified in training provision included: caring for people with cognitive impairment; managing the emotions of patients, families and themselves; and having difficult conversations. Access to ongoing training was affected by: lack of time; infrequent provision; attitudes of ward managers to additional support workforce training, and their need to balance this against patients' and other staff members' needs; and the use of e-learning as a default mode of training delivery. CONCLUSIONS: With the current and unprecedented policy focus on training, support and assessment of healthcare support workers, our study suggests improved training would be welcomed by them and their managers. Provision of training, support and assessment could be improved by organisational policy that promotes and protects healthcare support worker training; formalising the provision and availability of on-ward support; and training and IT support provided on a drop-in basis. Challenges in implementation are likely to be faced in all international settings where there is increased reliance on a support workforce. While recent policies in the UK offers scope to overcome some of these challenges there is a risk that some will be exacerbated.
BACKGROUND: Ever-growing demands on care systems have increased reliance on healthcare support workers. In the UK, their training has been variable, but organisation-wide failures in care have prompted questions about how this crucial section of the workforce should be developed. Their training, support and assessment has become a policy priority. OBJECTIVES: This paper examines: healthcare support workers' access to training, support and assessment; perceived gaps in training provision; and barriers and facilitators to implementation of relevant policies in acute care. DESIGN AND SETTINGS: We undertook a qualitative study of staff caring for older inpatients at ward, divisional or organisational-level in three acute National Health Service hospitals in England in 2014. PARTICIPANTS: 58 staff working with older people (30 healthcare support workers and 24 staff managing or working alongside them) and 4 healthcare support worker training leads. METHODS: One-to-one semi-structured interviews included: views and experiences of training and support; translation of training into practice; training, support and assessment policies and difficulties of implementing them. Transcripts were analysed to identify themes. RESULTS: Induction training was valued, but did not fully prepare healthcare support workers for the realities of the ward. Implementation of hospital policies concerning supervision and formal assessment of competencies varied between and within hospitals, and was subject to availability of appropriate staff and competing demands on staff time. Gaps identified in training provision included: caring for people with cognitive impairment; managing the emotions of patients, families and themselves; and having difficult conversations. Access to ongoing training was affected by: lack of time; infrequent provision; attitudes of ward managers to additional support workforce training, and their need to balance this against patients' and other staff members' needs; and the use of e-learning as a default mode of training delivery. CONCLUSIONS: With the current and unprecedented policy focus on training, support and assessment of healthcare support workers, our study suggests improved training would be welcomed by them and their managers. Provision of training, support and assessment could be improved by organisational policy that promotes and protects healthcare support worker training; formalising the provision and availability of on-ward support; and training and IT support provided on a drop-in basis. Challenges in implementation are likely to be faced in all international settings where there is increased reliance on a support workforce. While recent policies in the UK offers scope to overcome some of these challenges there is a risk that some will be exacerbated.
Authors: Carolina Pinazo-Clapés; Sacramento Pinazo-Hernandis; Alicia Sales Journal: Int J Environ Res Public Health Date: 2020-11-28 Impact factor: 3.390
Authors: Heather Wharrad; Sophie Sarre; Justine Schneider; Jill Maben; Clare Aldus; Elaine Argyle; Anthony Arthur Journal: BMC Health Serv Res Date: 2020-11-04 Impact factor: 2.655