Brilliant clinicians need a brilliant support workforce

In healthcare, the focus is often on brilliant surgeons, nurses or doctors (who, of course, we applaud). However, nurses and other medical professionals in the UK would not be able to do their job without the dedicated assistance of the support workforce.

The level of responsibility these health and care support workers have is increasing as the financial strain on the NHS makes the case for transferring more activities away from clinical staff. Skills for Health recently concluded that for every 1% of activities shifted from band five to band four (i.e. from clinical staff to support staff), a total of £100m might be saved across the health sector. This is based on a model whereby numbers of nurses remain static, while the proportion of support workers increases. The development of the support worker roles in the sector could therefore provide considerable savings and quality improvements.

Support workers therefore have a vital role to play in the future of the NHS and it’s no exaggeration to say that brilliant clinicians require a brilliant support workforce. To make this happen, managers and employers need to ensure that support workers across the board are given the support and time to develop their craft.

This hasn’t always been the case and the 2013 Cavendish review of healthcare assistants and support workers in NHS and social care identified inconsistencies in support worker development as well as lapses in oversight that saw support workers taking on clinical responsibilities without

supervision or training

Launched in April 2015, the care certificate has been a big step towards improving patient care by helping to standardise the initial training given to new entrants to the sector. The certificate has been designed to improve care across the board, especially in the development of so called soft skills such as teamwork and communication.

The support worker ecosystem

Sadly, some areas of support work, such as administration, are thought of as “back office” and unrelated to patient care. This is a narrow view, however, as one of the main complaints about the health service is the lack of information given to patients and customer service. While the 15 care certificate standards are primarily aimed at patient facing staff, there are certain aspects that could be applied to all support workers. Clerical staff may not be on the front line, but they can enhance the patient experience though a strong understanding of standards such as information governance and communication.

Beyond the care certificate

A 2014 ONS labour force survey found that just 35% of support workers received some form of training in the previous 13 weeks compared to 55% in the non-support workforce. Customer service and administrative staff fared even worse, with just 26% and 34% reporting job related training over the same period. The introduction of the care certificate will address some of this disparity, but this only covers the induction period for new staff and does not apply to so-called “back office staff”.

In any job, self-motivation will be a key factor in success and the same will be true for support workers. Believing that they are worthy of and fighting for training investment may be an important step for support worker development, especially if employers are not forthcoming in allowing time or budget.

Psychologist Carol Dweck has led research into self-belief and the difference between a fixed and growth mindset. Essentially she has found that people who believe they can progress through hard work (a growth mindset) rather than through innate talent (a fixed mindset), are more likely to persist and gain expertise.

Literacy and numeracy skills may be an area of development for some support workers, but this could remain unaddressed if they believe that they “don’t have a brain for figures”. They may be less likely to push for training from their managers or take up more advanced courses to further their learning.

By contrast, if the supporter worker or their manger believes in the power of hard work, support workers may be more motivated to improve their ability to handle information and take on further training. As Matthew Syed put it in his book Bounce: The Myth of Talent and the Power of Practice, they might begin to think, “I may not be good at maths now, but if I work hard, I will be really good in the future”.

Support workers can find ideas for training at the Skills Platform’s dedicated learning page.

Managers and management

A truly brilliant porter, radiographer or health care assistant won’t be developed overnight. Only through years of experience will they develop the necessary technical and interpersonal skills. Managers need to ensure that support workers gain the right experience through training and daily work place interventions.

Managers and leaders can help in many ways, not least by providing clarity to support workers on their roles and responsibilities. Change management skills are also vital as the NHS experiences regular upheavals from the top down.

However, the biggest role that managers can play in the development of a brilliant support workforce is by acting as a coach and mentor.

In another experiment involving 400 students, Dweck found that praise that emphasised effort over intelligence (such as “wow you must have worked very hard”) resulted in more students choosing a tougher task over an easier option. The students praised for effort then improved their performance on a subsequent task by 30%.

Managers therefore play a crucial role in fostering the development of support workers. If a young support worker believes that they can be brilliant through the force of their efforts, it could have a profound impact on their career and the entire health sector. Support workers and their managers can find management, leadership and coaching courses on the Skills Platform’s dedicated leadership section.

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