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Developing effective health and social care workforces in the UK

The King’s Fund estimates that one in ten of the UK’s working population are employed in the health and social care sectors. Employing over 1 million people, the National Health Service is said to be the fifth largest employer in the world, with the social care workforce far larger. To meet growing health and social care needs, current policy requires a health and social care workforce capable of adopting new models of patient-centred, integrated care – and doing so effectively and relatively quickly. But knowledge on how to transform existing working practices on such a huge scale, and in a cost efficient and timely manner, is limited. New research is gathering much-needed evidence on the how to achieve strategic workforce development – improving employees’ capability to work innovatively, and effectively provide vital services to the public.

Dr Anne McNall, an associate professor working with a range of academic staff, collaborates with key stakeholders in businesses, services or industry to understand and meet their workforce development needs. 

Workforce development (WFD) is a relatively recent concept. The aim is to recruit, retain and transform existing workforces, and, ultimately, improve their ability to work innovatively and effectively. In 2012, Dr McNall developed a practical WFD approach, specific to sexual health services, that facilitates what could otherwise be a difficult and lengthy process of employee transformation. The approach has now extended its reach into other health and social care contexts – including learning disability and autism, elderly care and health in prisons – and a key factor in the WFD model is collaboration. 

Dr McNall and her colleagues work with a wide variety of ‘partners’ within the health and social care sectors. These partners might include patients, their families or carers, practitioners, managers, and commissioners of services or education, and the aim of the research is to understand, from each perspective, the sector’s specific requirements; identify the competencies required of various staff to provide person-centred care; and determine how staff might develop relevant knowledge, skills and values, and maintain proficiency in their role. The team also analyse key policy drivers as well as the latest evidence of what constitutes effective WFD in a particular health or social care sector. 

The WFD model is both practice and systems-based. A practice-based learning and assessment approach – which involves mentorship, workplace coaching and the development of communities of practice – helps overcome time management issues related to releasing staff to learn, a major barrier for effective WFD.

Similarly, through a systems-based approach, the focus is not only on developing the proficiency of individuals, but also on examining factors impacting the ability of the workforce to deliver new models of care; for example, accepted practices influenced by dominant discourses, existing culture or ways of working, or lack of governance to enable practitioners to practice effectively. The result is a WFD model that brings all stakeholders together into communities of practice to collaboratively identify solutions, test them out in the real world environment and evaluate outcomes. 

An innovative and efficient workforce is an organisation’s greatest asset. By better understanding WFD needs, and co-producing solutions with relevant stakeholders, employers can improve existing working practices in the health and social care sectors to provide integrated, patient-centred care. These evidence-based solutions can also be applied to other areas or contexts. Indeed, Dr McNall’s research was originally conducted in the context of providing integrated sexual health services. Today, the WFD approach is helping to inform the care of individuals with challenging behaviours associated with learning disabilities or autism, older people with complex needs, care practices in prisons, community link working and primary care practice. 



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