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Two months ago I wrote about the need for NHS and adult social care staff to help save more lives by getting their flu vaccine ahead of this winter.

This crucial vaccine helps protect staff and those they care for from catching what can be a serious and sometimes life-threatening virus.

As we head towards winter, I’m taking a moment to reflect and review on how engaged staff already are with this scheme and how, together, we can increase vaccine uptake even further. 

The latest figures show that during September and October 46.3% of NHS healthcare workers took up the flu vaccine offer – that’s roughly 6,700 more staff than in the same period last year.

It’s positive to see that more NHS staff are getting their flu jab earlier; and I hope this puts us on a good course towards achieving our vision for 100% of frontline health and care workers vaccinated.

Although there isn’t much flu about yet, we can’t be complacent. We need to encourage the 1.47 million social care workers in England, who can access the flu vaccine from their GP or pharmacy for the second year running this winter, to get theirs too.

We know that people aged 65 and over are more vulnerable to the complications associated with flu. That’s why social care workers taking up their free vaccine is vital and can help to protect this vulnerable group. Up to 50% of flu infections are asymptomatic, which means that the infection is easily spread without realising.

I want to ask you – our hardworking health and social care workers – to continue to promote this vaccine to your colleagues and to let me know in the comments section below what you think we could be doing differently to help inspire people to get vaccinated.

Are there barriers to you getting the vaccine in time that we need to know about? Or perhaps your care home is very good at helping staff get vaccinated and you’d like to advise us and the NHS workforce on the practical steps you have taken.

By staff taking up their flu vaccine they can help save lives, so we need your help!

To find out more about the flu vaccine visit the NHS Employers website, where you can also download digital resources such as: campaign planning guidesevaluation guides and a communication toolkit

Matt Hancock meets with frontline NHS staff

As soon as we come into contact with the NHS, most of us can be confident that we will get compassionate, high-quality care from hardworking staff who have trained for years to be some of the best in the country at what they do.

They know how it works and they know what patients want and need. But too often, their many years of vital experience doesn’t inform the way the NHS is run, with too few clinicians making the move into NHS leadership roles.

Some have done it with great success - Professor Jane Cummings at NHS England;Dr Nick Broughton at Southern Health; Professor Marcel Levi at UCLH.

Another is Dr Sonia Swart, Chief Executive of Northampton General, who firmly believes clinicians have a key role to play in always being aware of the need to improve the systems of care in which they work.

But there must be something stopping talented people, who possess the qualities great leaders need, from rising to the top.

A review by the Faculty of Medical Leadership and Management has identified a number of barriers for clinicians considering senior leadership roles in the NHS – a lack of a clear career path into leadership roles; a lack of exposure to management and leadership responsibilities; and the perception that being a leader and being a clinician are “incompatible”.

This has to change.

We want clinical staff to use the invaluable experience they’ve gained on the frontline to drive forward progress at departmental, trust and national levels. To instigate this new approach, we will be identifying the best ways to support staff who want to be on a pathway to senior leadership, as well as providing guidance for easy ways for all staff to engage in leadership activities.

We want this mindset to permeate throughout every level of the NHS. From day one of a junior doctors’ career to the retirement of the most senior nurse, they should be encouraged to think about leading from the front, driving a culture of innovation and striving for better processes at every turn.

As a result, undergraduate and postgraduate education will have a new focus on leadership qualities, enabling clinicians of tomorrow to embrace this new mindset today.

This isn’t about creating more management roles – it’s about making sure those on the frontline know decisions from the top are thought-through, well-intentioned and informed by years of practical, front-line experience.

We need the right mix across the NHS leadership community, combining frontline clinical knowledge and experience with leadership skills and vision to benefit the whole team, benefit the NHS, and benefit the nation.



Roger Kline
is Research Fellow at Middlesex University Business School

Duncan Lewis is Professor of Management at Plymouth University Business School

24% of NHS staff in England report that in the last 12 months they have been bullied, harassed or abused by their managers or colleagues. This does not include the full impact of incivility or of witnessing bullying.

Such behaviours adversely impact staff wellbeing and ultimately the quality and safety of care. Bullying has been a factor in many scandals affecting the quality of NHS care. Bullied staff are less likely to admit mistakes, raise concerns or work in affected teams.

We have made a comprehensive estimate of the financial costs of bullying.  It is at least £2.2 billion annually. We drew on available research and data sources to calculate the impact of bullying on resultant sickness absence costs to the employer, employee turnover, diminished productivity, sickness presenteeism, compensation, litigation and employment relations costs. 

This is likely to be a considerable under-estimate because it excludes primary care, national NHS bodies, legal costs, the financial impact of rudeness, and the impact on those who witness bullying.

Research makes clear that the traditional reliance on policies, procedures and training must change since evidence suggests that in isolation they will not change toxic cultures. Employers must be proactive, not waiting for individuals to raise grievances, exit or go sick. It is organisational climate/culture that allows bullying to be so common so there must be honest reflection on leadership behaviours that permit, encourage or collude in bullying.  Holding managers and staff at every level to account for their standards of behaviour can radically reduce bullying. However, this requires independent voice mechanisms that NHS staff trust and believe will work for them.

It is possible to reduce bullying even amidst funding and workforce pressures. Our work provides compelling reasons why the NHS (and Ministers) cannot afford to look the other way.

The price of fear: estimating the financial cost of bullying and harassment to the NHS in England: https://bit.ly/2qATIuu

 

 



Kim Sunley is National Officer at the Royal College of Nursing

Last month the Royal College of Nursing ran a summit on tackling workplace violence in the NHS. The summit focussed on the new Assaults on Emergency Workers (Offences) Act 2018 and along with hearing examples of good practice on supporting staff following assaults, the RCN shared data on the extent of workplace violence in the NHS. 

The report made interesting reading, but to paraphrase the epidemiologist Sir Austin Bradford Hill “statistics are people with the tears wiped away” and perhaps the most sobering part of the event was hearing from nurses and other emergency workers who had been assaulted.

Whilst physical scars and injuries heal over time, the emotional scars can take much longer to heal and affect both work and life outside. 

We were delighted that Matt Hancock, Secretary of State, joined us at the summit and welcomed his announcement on addressing violence against staff as a step in the right direction. 

We have always been clear that the Act is just one measure and that there needs to be more focus on prevention, be that through safe and effective staffing, design of environments and appropriate training for staff.  We must also be aware of all the environments healthcare staff work in, including the community. 

 The causes of violence in healthcare can be complex so data collection is key, not just the number of assaults, but what type of environments they are happening in, what time of day and information on the perpetrator, so we can target interventions.  

One issue that can be addressed quickly and without the need for major investment is the level of support that is given to nursing staff who are assaulted. Sadly this can all too often be found wanting. The culture of accepting it as ‘part of the job’ needs to change.  

At the summit we heard from organisations who had tackled this head on with a case management system and the Police Federation’s seven-point plan, which calls for police officers who are attacked to be treated like any other victim of assault.  

We look forward to working with the respective system leads and key stakeholders on this issue and making a difference to the working lives of nursing staff.

 

It was the threat of divorce which galvanised me to push for a different style of working. I’d had years of unfriendly registrar rotas, long commutes and difficult exams in order to get to the golden prize of being a consultant.  And now I’d arrived, I was somewhat disappointed.

It felt more like a bronze medal. Other doctors still talked to me as if I were a junior, patients were still waiting too long for beds but worse than that, the rota was still affecting my home life. I had made promises to my wife that all her issues with my working life would be resolved by my new consultant job, but I was still doing shifts that didn’t often coincide with nappy duty and I missed my eldest kid’s first nativity play.

The rota was hard; we were down on consultant numbers and often lacked middle grades. I also felt somewhat aggrieved about the fairness of it all, when I covered for sickness or stayed late it was often done at my own expense.

After 6 months in post, I wanted to decrease my clinical work to do more at the medical school. But the medical school commitments were never fixed and it was hard, within the existing system, to make the job plan I needed work for me, the department and the medical school.

As time moved on, I started resenting what I genuinely love doing: being on the shop floor treating the variety of patients we see, with their multitude of problems and pharmacologically enhanced personalities.

The consultant rota needed to be adapted to take account of increasing out of hours requirements, and to suit the staff better. In addition, the Trust had asked the consultant body (with our agreement) to start doing shop floor nights.

So, a few of us pondered how we could introduce a different way of rostering – annualised self-rostering.  This had to meet the Trust’s requirements, ensure that we got remunerated for what we did and paid us for when we stayed late. We put the idea to colleagues and got the green light of our clinical lead. So, with a crash course in Microsoft Excel and the support of our management team, I went to work.

I’m now proud to say that we now have an annualised rota system, with self-rostering and a whole lot more flexibility for the trust and for staff than we used to have. In simple terms, the way we do it is to:

  1. Calculate for each consultant what they could offer the department. First people decided how many clinical sessions they could work on their contract.
  2. Then we take that and work out how many sessions each person will therefore do annually.
  3. Then take account of other demands on time that will reduce available clinical sessions (everything from CPD time to bank holidays).
  4. We then work out how best to use those sessions for the departmental needs – essentially designing a roster.
  5. Staff then self-roster onto the template according to their preferences.

We pre-allocated weekends and certain shifts to ensure fairness, but otherwise everything was self-rostered. I did lots of evening/night work as it fitted in with childcare. Others did day shifts if it suited them better. People did what suited them and as long as all the shifts were covered safely, then everyone was happy. If you wanted leave, you just didn’t self-roster. 

It has helped us move towards 24/7 working, allowed consultants to go on secondment. We have also used the template to roster for our junior doctors (including middle grades) – and it helps with their sustainability too.

Our experience hasn’t been perfect. The rota doesn’t fix the intensity of the work during the shift, flow problems or difficult speciality doctors, but it makes it easier to deal with.

I think annualisation and self-rostering can help people be persuaded to go into emergency medicine as a career. It increases the attractiveness of the speciality, especially for less than full time staff, and helps with sustainability.

At the college, I have been involved in working with a team developing resources for use by others. We are developing a guide to self-rostering which will be published later this year.

For me personally, I have noticed a difference to my wellbeing. I have cut the number of my clinical sessions, and work those sessions at the medical school instead. I have also had the time to pursue other interests such as writing, being a crowd doctor, running critical appraisal courses and being involved with the Brighton Marathon.

But most importantly, because of the new roster and ability to self-roster, this year I did attend my kids’ nativity plays. It may not have been the traditional nativity story (there was a penguin present at the birth of Jesus) but at least I was there – something my fellow school gate dads, doing traditional 9 to 5 jobs, were unable to do. It was also the first time that I remember other people being  jealous of my rota and my work-life balance.

I am happy to answer questions and how it could be implemented at your work, (or give more info if you want to work in a nice place by the sea with this style of working!). I can also provide more information on the rota software we helped develop and now use. For any questions, please email drrobgalloway@gmail.com

A career in adult social care is incredibly rewarding and care work is a hugely worthwhile vocation with more than 100 different roles on offer. With a growing need for more care workers we want to support providers to recruit the best possible talent.

That’s why last week, following feedback from the sector – including on Talk Health and Care – we announced the launch of two month-long pilot recruitment campaigns to promote jobs in adult social care in Gloucestershire and Tyne and Wear.

There are an estimated 110,000 vacancies nationally, and the pilots will look to test which channels, messages and tactics are most successful in highlighting the variety of rewarding roles which can make a difference every day.

This will help inform the national roll out in the new year, to ensure we have a workforce fit for the future and able to meet the needs of some of society’s most vulnerable.

Find out more information at www.everydayisdifferent.com, visit the Facebook page and share your ideas in the comments section below on how we can encourage more people with the right values to work in adult social care.

 



You may have spotted a red briefcase being waved around on the news last week, and that can only mean one thing. The Budget.

So I’d like to take this opportunity to reflect on what the contents of that briefcase will mean for health and care staff.

Firstly, I’m immensely proud that the NHS was marked out as the number one priority for government spending over the next year, and beyond.

Why? Because this historic £20.5 billion funding increase is vital to the government’s long-term plan to guarantee the future of the health service.

The Budget explained how some of that £20.5billion will be spent – confirming that at least £2billion of the funding with be spent solely on mental health services. This includes setting up new mental health crisis services, including specialist crisis teams for children and young people across the country, along with mental health support teams in schools. It will give staff the resources to continue to deliver life-changing support to patients, and spot the signs of mental illness early for children and young people.

Not only is it welcome news to those of us who have relatives, friends and colleagues who have experienced mental illness – as many of you have raised on this platform – it also shows how important it is to ensure staff and our healthcare systems are equipped to provide the help people need as part of the long-term plan.

Social care funding also got more support with local councils to be given £650 million. Of this, £240 million is for adult social care to make sure more people can leave hospital when they are ready, into a care setting that best meets their needs. The remaining £410 million will enable local areas to improve their social care offer for older people, people with disabilities and children. While there is still more to do on social care, this is a positive first step, coming ahead of the green paper later this year.

There was also funding for specific parts of the health sector.

A Defence and National Rehabilitation Centre in Nottingham will receive £70 million to fund services for non-military patients. This will mean that the public will benefit from the resources of an internationally recognised medical rehabilitation and research facility.

£10 million will also be donated to air ambulance trusts in England. This is excellent news for those of you working as volunteers, or alongside air paramedics, as you know just how essential they are – especially in rural areas.

There’s a lot to digest in this budget. But if you take away one thing away let it be this – through the government’s long-term plan for the NHS, the health and care sector was given more funding than any other public service.

This is all thanks to the tireless work of each and every member of staff. We know how important it is that you have the resources and support you need to do your job, and care for patients day in day out. And I am committed to keeping it that way and guaranteeing the sector’s future.

If you want to know more about the budget check out this helpful summary, and I would like to hear how this new funding might affect your area of work.

 

NEWS UPDATE ON VIOLENCE REDUCTION AGAINST THE NHS WORKFORCE 

Around one in seven NHS employees have experienced violence in the last year. That is why today, Health Secretary Matt Hancock announced a series of measures to clamp down on violence against NHS staff as part of a zero-tolerance approach.

During a speech to the Royal College of Nursing, the Secretary of State for Health and Social Care announced the first ever NHS Violence Reduction Strategy to protect the NHS workforce against deliberate violence and aggression from patients, their families and the public, and ensure offenders are punished quickly and effectively.

Shocking statistics from the most recent NHS staff survey show over 15% of employees have experienced violence from patients, their relatives or the public in the last 12 months – the highest figure for five years.

The new strategy to be announced today will set out how:

  • The NHS will work with the Police and Crown Prosecution Service to make sure victims are supported to give evidence and achieve prosecutions in the quickest and most seamless way possible
  • The CQC will scrutinise violence as part of their inspection regime - and identify trusts who need further support to reduce violence against their employees
  • Staff will be provided with better training to deal with a violent situation, including challenging circumstances involving patients with dementia or mental health issues
  • Staff who have been victims of violence will be able to access prompt mental health support

Secretary of State for Health and Social Care, Matt Hancock said: “NHS staff dedicate their lives to protecting and caring for us in our times of greatest need and for any one of them to be subject to aggression or violence is completely unacceptable.

“I have made it my personal mission to ensure NHS staff feel safe and secure at work and the new violence reduction strategy will be a key strand of that.”

“We will not shy away from the issue – we want to empower staff and give them greater confidence to report violence, knowing that they will see meaningful action from trusts and a consistent prosecution approach from the judicial system.”

The strategy takes into account a number of sensitive and challenging circumstances staff may be faced with when working with some of the most vulnerable patients.

Where prosecution is not the most appropriate result, for example when assaults are carried out by patients with dementia, brain injuries or other mental health conditions, trusts will be supported to improve staff training and access to support. The current training in de-escalation and conflict resolution will be assessed to ensure it it up to date and effective, with improvements made where necessary.

To understand the reasons behind the rise in reported violence, the strategy will include a new system so staff can more easily record assaults and other incidents of abuse or harassment. Trusts will also be expected to ensure every incident is investigated in full and lessons used to protect staff from future incidents.

Plans are being drawn up for violence and abuse data from across the NHS to be reported nationally and analysed so the government and NHS England can determine which staff are most vulnerable to violence and allow for appropriate action to be taken.

The new plans follow the Assaults on Emergency Workers (Offences) Bill, which was recently brought into law by the government and will see the maximum prison sentence for assaulting an emergency worker double from six months to a year.

The new measures demonstrate government delivering on its manifesto commitment to implement robust action against those who target the men and women who work tirelessly to deliver the best care for their patients, at every level of the health service, in every town and city in the country.

UNISON Head of Health and Social Partnership Forum Staff Side Chair, Sara Gorton said: “NHS staff spend their working days caring and saving lives, and their safety should be paramount.

“No-one should be abused, threatened or attacked at work - especially when all they’re trying to do is help people.

“It is encouraging that the government has listened to unions and agreed to review measures in place to ensure staff safety. This includes a more joined up approach between the NHS, police and CPS. Anyone who threatens or abuses NHS staff should be prosecuted under to the new law protecting health care workers.”

All health and care staff are encouraged to continue sharing their experiences and ideas on the Talk Health and Care engagement portal, to improve the health and social care sectors and their own working environments. The portal was launched in the summer by the Secretary of State and currently seeks views on six key challenges, including ‘working without fear of bullying, discrimination and violence’.

Royal College of Nursing National Officer, Kim Sunley said: “Nurses and health care workers understand their roles aren’t risk-free but, to many, it still seems as if the threat of physical violence is a daily reality.  

“These measures are another way to change this for good by increasing the accountability of employers for the safety of their staff and ensuring those who wilfully assault healthcare workers feel the full force of the law. Victims of assault at work have their lives turned upside down and it affects their wellbeing, their families and their livelihood and there’s always more we can do to support them.”

Find out more about the Health Secretary’s announcement here: www.thetimes.co.uk/article/an-assault-on-nhs-staff-is-an-assault-on-us-all-52f2hwp6d

As a consultant anaesthetist with 30 years’ experience in the NHS, providing care and support for patients in Nottingham, I live the daily experiences of any other doctor. The ceaseless resolve of colleagues, the crossed fingers of family members, the sincerity of a patient’s “thank you”.

However, I also have the privilege of being President of the Royal College of Anaesthetists (RCoA) a position that gives me the benefit of feedback from a membership of nearly 22,500 working across the NHS (and indeed in 75 other countries) and a picture of the common issues that emerge.

While I may wear two hats, I have a single view that, in all things, the best work is delivered by teams with a range of expertise and experience. Ensuring that the NHS has the workforce to enable this is a huge challenge.

To overcome this we need to recruit, train and retain a sustainable supply of anaesthetic doctors – but we also need to ensure that these doctors have the other team members that make it all work.

In my specialty, the newest team members are Physicians’ Assistants (Anaesthesia) (PA(A)s).

PA(A)s are highly trained and skilled practitioners who work within an anaesthetic team under the direction and supervision of a consultant anaesthetist. Since their introduction into the NHS workforce in 2003, approximately 180 PA(A)s are already working in the UK, having trained via the PA(A) postgraduate diploma programme.

They can assist in a variety of ways and many anaesthetic departments have already realised the benefits the PA(A) role can bring to their workforce, ensuring high quality, safe care for their patients, as part of the anaesthetic team.

Many anaesthetic departments have already included the PA(A) role within their workforce, but the potential contribution has been limited by a lack of regulation.

But this is set to change following the welcome announcement from the Secretary of State that the Department of Health and Social Care with proceed with the regulation of PA(A)s. 

Statutory regulation of PA(A)s – something the RCoA has long been advocating for – will provide the standardised framework of governance and assurance for the clinical practice and professional conduct that will enable these healthcare professionals to make a greater contribution to patient care.

So, back to my two hats. As President of the Royal College of Anaesthetist I look forward to working with partners at the Association of Physicians’ Assistants (Anaesthesia) in developing the PA(A) workforce and I look forward to the possibility of working with new, regulated, PA(A) colleagues

Matt Hancock speaking at the Global Ministerial Mental Health Summit 2018

This month, not only did we mark World Mental Health Day on October 10th, but we welcomed delegates from across the globe to the first ever Global Mental Health Summit.

This was a landmark moment to help change the way mental illness is perceived worldwide. More than 40 countries sent representatives to the Summit, and we made a global declaration that mental and physical health should be treated in the same way.

During the Summit I announced an extra £30m of funding for global mental health research. And we announced the creation of the world’s first ever Minister for Suicide Prevention, a role being taken up by the excellent Mental Health Minister Jackie Doyle-Price. She will lead a new national effort on suicide prevention to overcome the issues that prevent people from seeking help.

I’m aware that promoting healthy mental wellbeing starts in the workplace. For example, we know many GPs have experienced mental health conditions such as depression, anxiety, bipolar disorder and post-traumatic stress disorder. So we’re doing something about it. Simon Stevens, Chief Executive of NHS England, recently announced funding for a new mental health support scheme to prioritise doctors’ mental health. The confidential NHS GP Health Service provides support to GPs with issues relating to a mental health concern, including stress, depression or addiction – you can find out more details at www.gphealth.nhs.uk.

There’s plenty of advice available on this subject, but if you and your team are facing any issues, mental health charity Mind recently shared some helpful tips on our #TalkHealthandCare blog on how staff can look after their wellbeing.

We’re committed to turning the tide and changing the way mental health is perceived and treated. I’d love to hear your views on what more we can do to support you where you work.              

I'm Beverley Latania - Principal Social Worker at London Borough of Newham and co-chair of national PSW network.

Local authority offices are busy, hectic places where many people are thrown together. Not everyone will get on with each other – that’s ok, that’s normal.

What’s not normal is to turn that dislike into something bigger, where staff start to gossip, impersonate others or isolate a single member of staff. This is bullying.

Bullying and discrimination in the workplace can take place in many shapes and forms. It can come from colleagues or managers, groups or individuals, and it can be subtle or in your face – either way, it is not acceptable.

As a manager, I remember a situation where a fellow manager would constantly go back to an individual worker about their work, stating it was not good enough, telling the staff member to rip it up and start again. At first, I thought that this was harsh but maybe it was how the manager led his team to make sure work was produced to a high standard. I tried to normalise it. However, after a couple of months I started to recognise this was not the case and he was singling out this member of staff. 

Eventually the situation was resolved with help from a supportive supervisor who was able to mediate between the worker and the manager so a beneficial working relationship could be established. Not everyone may be that lucky, but there’s normally one person within a team or organisation who you can approach, share how you’re feeling and who will be able to offer some advice. It’s important to share as the first step in getting some help and support. 

If I were to be faced with the same situation again, I would step in and approach the staff member one to one to offer support and ascertain what was going on, with a view of discussing it further with the manager. Sometimes it takes someone on the outside to raise the concern so it can then be addressed in a suitable manner or to be formally investigated.

There are many stories online about cases where staff have had to put up with the bullying, where they were shut up or pushed out if they spoke up.

It is vital that we do all we can to prevent this from happening, not only because we care about our staff and their wellbeing, but also because of the overall effect this has on how an organisation functions – 11 million days at work are lost every year due to stress at work.

Keeping staff safe and supporting one another

Most local authorities will now have a whistleblowing policy in place. These policies are designed to enable staff to speak up in confidence and report issues that can help to alert HR to poor practice.

Camden Council’s Raising Concerns at Work sets out clear guidance on the expectations from staff, managers and the organisation. More importantly, it offers top tips for staff and managers on how to report a concern. Newham Council’s employee code of conduct outlines that every staff member must be accountable for their behaviour and how it could be perceived by others. As part of supervision, reflective spaces are offered to staff to look at their knowledge, skills and developmental needs. These are just 2 local authorities which have placed an importance on tackling this area, I know there are many more.

However, good policies alone are not enough. We, as social care staff need to support each other, take cases of bullying seriously, question and challenge it when seen and, most importantly, report it.

My name is Emily. I’m a trainee nursing associate and have been working in care at a nursing home run by Amber Care for 8 years. I really enjoy it. Prior to becoming a trainee nursing associate, I was a healthcare support worker and having worked with my manager for six years she encouraged me to apply.

I’m now coming towards the end of 2 years of training. This involved one day a week learning with other trainee nursing associates in a variety of health and care settings. I really enjoyed learning new knowledge and skills while getting to know others with the same motivation as me.

My role supports the nursing team and means that I can provide hands-on care to service users at a higher level than I was previously able to do. It enables me to share my knowledge and skills within the care team. My role as a nursing associate helps me to support the team to provide more hands-on care. It also helps my colleagues feel better supported with increased confidence to develop their skills and knowledge.

I’ve been trained through one of the test site partnerships, as part of the national pilot for trainee nursing associates. It has identified that there is a gap between nurses and seniors where people like me can develop upon skills we already have and learn new ones.

The nursing associate role also makes me feel that our work is recognised as part of the wider nursing and social care professional. I feel proud to be part of innovative and new ways of working to improve the personal care we can deliver in health and social care.

The nursing associate role is a new one which will be registered by the National Medical Council (NMC) who will set standards for nursing associates. 

The nursing associate role will enable many existing staff in care roles to progress their careers through further training, and for those who want it, it will enable further progression on to registered nurse training.

Starting out on my journey to become a mental health social worker last year was really daunting, but I’ve loved it.  

I am doing my training through the Think Ahead programme, a 2-year graduate programme for mental health social workers. I spent my first year working in community mental health services with Tees, Esk and Wear Valley NHS Foundation Trust (TEWV). In my second year I’ll work as a newly qualified social worker in an Early Intervention in Psychosis team. I’m looking forward to continuing learning in the second year, and I’ll be carrying out original research as I work towards my master’s degree. 

I’ve already gained so much training, development and support. These are some of the things which have been vital to my experience.

Access to high quality, varied training  

Think Ahead introduced me to the knowledge and underpinnings of being a mental health social worker, including learning social interventions at 3 levels: individual, family and community. These interventions have become really familiar to me, and are now embedded in my day-to-day practice.

I’ve also had access to a huge range of training through TEWV. I’ve completed training in many areas, including the Mental Capacity Act, trauma and managing emotions, all of which I have been able to put into practice. This focus on training has made me feel really valued as a member of the organisation.

Understanding different teams

Being able to work in and shadow several different teams has also been really valuable. I have mostly split my time between a crisis team and a community mental health team, but I’ve also spent short periods of time working in an older people’s team, children and adolescent mental health services and a hospice.

I also had loads of shadowing opportunities – including Deprivation of Liberty assessments and Mental Health Act assessments. This has helped me understand processes and the nature of teams in different areas.

Support from other staff

I’ve been really supported by my manager and by other staff. Informal support from my fellow trainees on Think Ahead has also been invaluable – they understand best what I’m going through! The social work network within TEWV has also been a great opportunity to get to know other social workers in the organisation.

Weekly meetings

Weekly case consultation meetings were a requirement from Think Ahead, following a format developed by the University of York, who are the academic partner for the programme.

I came to really rely on them for helping me face challenging situations. The meeting format allows application of theory and research to a situation, and enables you to draw on other people’s experiences and perspectives. I’ve been able to develop really robust care plans from those meetings, and will keep having them in the future.

Overall, I’ve really enjoyed my learning experience and although it has been challenging, the training and development opportunities have made that challenge easier. I now feel confident and competent in many areas of my work but I will continue to learn through these opportunities. Investing in and supporting staff is vital for them to feel valued and ensure they enjoy their role.

It is well documented that people with severe mental health illness have a significantly lower life expectancy than the UK adult population. Sadly, the majority of this disparity is due to factors such as smoking. Smoking rates are estimated to be 40% among people with severe mental health illnesses.

At Tees, Esk and Wear Valleys NHS Foundation Trust, where I work as the smokefree lead, we provide mental health services to people in County Durham, Teesside and most of North Yorkshire. My role is to implement a smokefree policy across the trust for service users, staff and visitors.

While the health of our service users is a huge focus, the health of our staff is also important and we need to make sure that our colleagues understand the importance of what we are trying to achieve. It’s not helpful if staff take breaks and come back smelling of smoke when we are implementing a smokefree policy. We encourage staff to lead by example, by not smoking during working hours, and have put measures in place to support this.

There was a lot of initial work behind the scenes. We have an internal smoking cessation and harm reduction leadership group involving staff from a wide range of disciplines along with service users and carers, as well as sub-groups looking at various elements, from information and training to policy and communication.

The trust covers a large area, with a lot of staff and service users to communicate with. We work closely with the communications team to make sure information is cascaded through relevant channels.

The success of the project largely centres on the buy-in of staff and service users. However, it’s our staff that are central to our overall success – it’s so important that they are on board and support our ambitions.

Staff can purchase nicotine replacement therapies from Lloyds Pharmacies on 3 of our main hospital sites. We also promote stop-smoking services and confidential stop-smoking drop-in clinics too.

Myself and smoking cessation trainer and support Lynda Tench communicate with staff directly, through training sessions, as well as supporting corporate staff inductions to make sure that new staff understand the smokefree policy.

We’ve also recruited smokefree champions across the trust, who work with us to promote the smokefree agenda to staff. They help keep up the momentum of the project and are involved in a variety of activities from general awareness sessions to supporting cessation clinics in the community.

We are currently running 2 promotions across the trust in the run-up to and during Stoptober. The first is a campaign to encourage staff to pledge to go smokefree using the British Heart Foundation’s ‘I/we quit at work’ pledge. Secondly, we are also setting a challenge to our smokefree champions for them to come up with innovative ways to deliver our smokefree messages during Stoptober. Both campaigns involve a prize draw for staff and it is hoped that it will give a fresh boost to our smokefree campaign.

Follow @TEWV on twitter

A man at a desk with head in hands looking at a document

I'm Head of Workplace Wellbeing at Mind, where we're helping employers recognise the importance of mental health.

Working within the health and social care sector doesn’t make you immune to developing mental health problems. If anything, the unique pressures can mean it’s more important than ever to look after your wellbeing.

The causes and symptoms vary from person to person, so it’s important to identify your own triggers and the best coping strategies for you. Lots of people find it helpful to make sure they take breaks when they can, ideally outside, don’t routinely work over their contracted hours and get as much physical exercise as much as possible (more information at mind.org.uk/stress).

Workplaces are now recognising it’s time to take mental health seriously, but we have a long way to go. Too many employees still don’t feel able to talk about it or seek support in the way they would for their physical health. According to a Mind survey of nearly 45,000 employees across 74 diverse organisations, nearly half (48 per cent) have experienced mental health problems at their current place of work, and only half of those have talked to their employers about it.

In October 2017 the independent government-commissioned employment review ‘Thriving at Work’ was published. This review highlighted some startling statistics, including that every year, around 300,000 people with a long-term mental health problem lose their job in the UK. The scale of the problem is so great that it costs the economy between £74 billion and £99 billion a year.

The government accepted all the recommendations made, committing to take steps as employers to promote mental wellbeing at work, with positive implications for those that work within NHS and social care, among others.

Mind works with employers to help them tackle the causes of work-related stress and poor mental health and promoting wellbeing. We urge all employers to create mentally healthy workplaces and implement workplace wellbeing initiatives, such as flexible working hours, employee assistance programmes (confidential, 24-hour support line), subsidised exercise classes and buddy systems.

Above all, we want all staff to work within an environment where they feel able to talk openly if they’re struggling with their mental health and know that if they do, they’ll be met with support and understanding, rather than facing stigma and discrimination.

If you do not get the support you need, or feel discriminated against, seek advice from Acas or Mind’s legal line (email legal@mind.org.uk).

Under the Equality Act 2010, employers have a legal duty to provide reasonable adjustments for an employee who has a disability, which can include a mental health problem if it has a substantial, adverse, and long-term effect on normal day-to-day activities.

If you have a mental health problem and you want the protection of the act, you have to tell your employer about it. Adjustments will need to be discussed but might include things like changes to working hours, work space or roles and responsibilities.

Lots of employers and employees don’t know where to start when it comes to workplace wellbeing. With funding from the Royal Foundation, and support from 11 partners including the Work and Health unit, Mind has launched the Mental Health at Work gateway, which has plenty of information from a range of trusted sources.

People working or volunteering within police, fire, ambulance and search and rescue services in England and Wales can also benefit from our Blue Light Programme, tailored to the more specific pressures of 999 workers.

I’ve had a very busy few days in Birmingham, but I’ve still been reading your ideas – we’ve had another great crop this week.

Laura raised a really important issue on recognising the skill and professionalism of care workers on the front line. She is right that it is a job many of us would struggle to do. I know that my colleague, Care Minister Caroline Dinenage, is working hard to make sure that the social care workforce feel valued and have the resources and recognition they need.

I really do want to hear more from the social care sector, so if you agree with Laura, or have ideas as to how we can do better as a government to recognise the essential role they play, then please let me know here.

The issue of rostering has come up again this week – this time the administrative burden is highlighted by PDuncan. He makes an interesting suggestion that skilled admin staff could complete a lot of the heavy lifting of rostering more efficiently. I’m sure wards across the country approach this in different ways: if you’ve experienced alternative approaches then do post in the comments.

Efficiency was a common theme this week. Sarah spoke about the need for a probation period in some NHS jobs, and where perhaps the health and social care system could benefit from a more business-savvy approach. This is the case in Joanne’s comments about use of the internet in the workplace.

Sometimes what makes the NHS and care sector great places to work is that they aren’t like any other workplaces. But I think both of these points reflect that sometimes there needs to be clear professional expectations and behaviours.

All of these ideas reflect the importance of culture and attitudes at the very top. I’ll be sure to reflect this when I meet chief execs in the coming weeks.

Finally, you may have seen that this week I spoke publicly about my dyslexia for the first time. This was a difficult subject for me to tackle, but I am not shy about speaking up where I think it might bring positive change. I hope you won’t be shy about your ideas here either.

Every client is an individual; working in care is about human beings, discussions, empowerment and confidence. As a service we blend these values with an ambition to keep our clients safe and at home, with an emphasis on mobility.

I learnt early on that communication is key to safe moving and handling. Mobility is so important to independence, but there’s more to it than just knowing the right exercises to take someone through or how to use a hoist.

Gentle guidance, patience and discussion ensure that the people we support feel secure and have confidence in us. Talking to people means they are involved in their care, they know what to do and we know what they want. This on-going discussion gives carers confidence and empowers them, as they are part of a person’s decisions.

Imagine returning home from hospital, a very secure place, and arriving home to a carer saying, “come on, up you get”. They’ve already decided what you can do and need to do, and they expect you to be able to do it. That is not how it should be. So much of our work is about trust, so our approach is to ask people what they want to do and what they can do. We listen to them and work as a team.

Primarily this means our clients get to set their own pace. For people who have lost mobility and independence it can be an uphill struggle, so we may have to start with small steps. Similarly, we know that people have good days and bad days, so what someone wants to do and can do each day is an on-going conversation.

This strong person-centred culture is part of how I train and support staff. I’ve been training moving and handling for 9 years and I tell my team that if they are assisting a client to mobilise then the first step is communication.

Training gives people the practical and theoretical knowledge to support someone, but you cannot teach everything in a classroom. So, I visit each carer and their client at the client’s home to make sure that we are all happy with how things are being done and how equipment is being used. It means we can offer support that is tailored to the individual’s abilities and needs.

My approach to communication extends to how I lead my team. As a service we thrive on feedback. We listen to our staff, our clients and their families and have a digital care management system that means we can keep very individualised care plans up-to-date instantly. This includes individualised hoisting and moving and handling plans which are kept in each client’s home for the carer to refer to when they are working on their own with their client. If a carer is having an issue, they are always able to contact either me or another member of the management team for guidance 24 hours a day. 

The feedback we receive from clients and their family members means we know we aren’t just doing a job, we’re making a difference to people and that makes you think, “Yes! We’ve accomplished something!” 

 Care Concern Home Care have been rated as Outstanding by the CQC who praised their “strong, visible person-centred culture” and who noted that staff were “exceptional at helping people to express their views”. You can read the full report here

It’s the time of the year when health and care services take a collective deep breath – flu season is approaching. We can never predict in advance what’s ahead of us.

We’re all aware of the risk to patients and the pressures that flu and wintertime together place on the NHS and social care services. Before flu activity begins to increase, it’s incredibly important that all NHS and social care staff get prepared to play their part, and a big part of that is staying well themselves.

That’s why we want as many staff as possible to sign up for their flu vaccine – which is again being offered to social care staff and this year is also being offered to hospice workers for the first time.  

Fortunately, the vaccine uptake in healthcare workers increased last year from 63.8% to 68.7%, so we’re moving in the right direction – but we cannot be complacent. The sad fact is flu kills an average of 8,000 people every year and places huge pressures on health and social care services.

Flu is unpredictable and contagious and up to 50% of people with flu show no symptoms but may still be able to spread the illness. The vaccine is the most effective way to protect yourself and your patients from this potentially fatal illness.  Last year around 80% of flu outbreaks in closed settings took place in care homes – so social care staff have an important part to play in this.

The way the vaccine is administered is led by individual Trusts, but I urge you to read the why it matters page. There are a range of resources that employees in the social care sector can use.

The Department of Health and Social Care has committed an extra £145 million to NHS trusts ahead of winter to improve emergency care. But the vaccine is still our best defence for ourselves and our patients – so we need all staff to do their bit and take their jab.

Last year there were pockets of excellence across the country, but also some areas where staff uptake was very low. If your Trust is doing well or facing any barriers, please let me know in the comments.

Find out more from the NHS Employers website, which includes digital resources that can be downloaded, including: campaign planning guides, evaluation guides and a communication toolkit

Over 100 ideas

Posted by Matt Hancock 2 months ago

We’ve now had over 100 ideas on the #TalkHealthandCare platform and I’ve been reading them with interest.

Many have focused on culture within health and care organisations.

Rosemary wrote about the importance of shared values that have been developed by staff at all levels within an organisation. I completely agree with this and believe that strong leadership is crucial to developing a strong set of core values within an organisation.

Another issue, raised by Jamie, is the regulation of physician associates. Jamie suggests that statutory regulation of physician associates would mean more rigorous testing and would be better able to support doctors in future.

I know this view is shared by many, which is why the Government went out to public consultation in October 2017 to seek views on the possible statutory regulation of physician associates. We’ll be publishing our response to the consultation soon.

Richard’s comments about the need for social care employers to provide better support and development opportunities for staff knowledge and skills in providing high quality care, and making them feel valued and engaged really resonated with me.

That’s why we want more views on challenge three: having access to training, development and support.

My department is considering ideas for improving training for care workers, registered managers and other staff working across the adult social care sector. If you feel similarly to Richard, or have ideas about how social care employers can provide better support then tell us here.

Last Tuesday I did the overnight shift in Plymouth Hospital A&E where I saw first-hand some of the challenges that many of you face every day.

The compassionate and good-humoured nurses, doctors and paramedics I met all told me the same thing: they focus relentlessly on patient safety.

They said they need safe systems around them. Opportunities to learn from mistakes are crucial, as is a culture where staff are empowered to speak out when things go wrong. I am committed to making sure staff can do this.

Thanks so much for contributing all your ideas and comments. Let’s aim for another 100! 

There have been multiple major reports recently recognising that doctors want the way they work to be different. The foundation programme career destination report 2017 showed that only 42.6% of F2s progressed directly to specialty training. The latest GMC report on training pathways reveals that the 3 most common reasons for not entering training are:

  1. dissatisfaction with the training environment
  2. health and wellbeing
  3. uncertainty about specialty choice or career direction

Feeling some of the above, I thought about Australia, I thought about a masters, I thought about travelling, and I briefly considered training. But really, I wanted to dedicate time developing clinically in a trust I already enjoyed working in, while also having the opportunity to have paid time working on quality improvement, research and teaching – and to continue to live in a city and flat I love, to boot.

Fortunately, such a job exists… Reflecting on my short- and long-term personal and career aims I applied for one of the 12-month clinical fellow posts at Brighton and Sussex University Hospital Trust (BSUH) established by emergency department consultant Dr Rob Galloway (@DrRobGalloway) and the team.

14 months and a further reapplication later, I feel I couldn’t have made a better choice. I chose working for an organisation and department that values me and treats my work and life with equal high importance. I chose fully integrating within a team, making friends, and work colleagues who enrich my life personally and professionally.

I also chose being part of an engaged group of doctors full of quality improvement ideas who, with our split clinical and non-clinical posts, have the time and resource to effectively implement them. Through this post I have been able to support significant and lasting changes within the trust and region, be involved in award-winning improvements having national recognition, such as our single clerking and acute floor model, and learned skills that have opened doors to opportunities I didn’t know existed.

Rotas don’t have to stay the same as they have always been. Our shifts are designed ergonomically, gradually adjusting your body clock – from early, to late, to night. Your annual and study leave is guaranteed. If you want to get married in June next year and have 2 weeks off after, you can. Flexibility and cover is built into the rota, so sickness and absence has less of an impact. A large pool of doctors as fellows makes swaps for study and annual leave much easier and just a simple Whatsapp away. Moreover, we have no locum spend and no rota gaps. For the registrars and consultants, we use innovative software called Health Rota, which makes self-rostering and preserving work–life balance much easier.

Valuing doctors with jobs and rotas that respect and cultivate their personal and professional needs keeps us refreshed and motivated to keep working long term for the NHS, not only benefitting the staff but also the patients within it.

We have just been featured by the British Medical Association as an example of best practice as part of their medical rota gaps campaign and feature. Our video lets you hear more about our experience, and more detailed information is on NHS Improvement.

We need a change in culture and how our employers, regulators and educational bodies design how doctors work. Our fellow-posts and rotas at BSUH are an example of a growing resource of how we can do things differently and for the better for all doctors. We hope this is just the beginning of good things to come. Fourteen months ago I might have left the NHS, but now – provided practice like this is spread more widely – I am looking forward to the future.

@PhilipRankin

 

I'm Programme Head of Workforce Innovation at Skills for Care, a 6-foot plus, white middle-aged bloke and I have been bullied and witnessed discrimination and violence at work at different times in my career.

In each instance I talked to my manager about what had happened to me or what I had witnessed, I followed organisation policy and procedure, and I was never completely sure that the outcome was what I had hoped for.

Each time it was my fear ‒ of those I worked with, of my manager and my senior managers ‒ that had the biggest impact on what happened next.

Fear is not an emotion that many of us like to confront and it takes many forms in the workplace. If I report the person bullying me, I fear they will bully me more. I fear that others look at me sadly, thinking to themselves: “how brave, to stand up to the bully,” “how stupid,” or “it won’t end well for him”. I fear that if I tell others that what they are doing is discriminatory, I won’t be taken seriously.

When raising concerns about violence at work, there can be fear about what people will say. “Well, as long as no one gets really hurt, let’s not say any more about it.” “We are being inspected soon and if they hear about this it might affect our rating.”

Is fear about the consequences of standing up to bullying, confronting discrimination and protecting people from violence in the workplace a reason not to act? The answer is: we must act. However, the reality is that many of us will find reasons not to.

We might do this by pretending the bullying doesn’t really hurt. Being relieved when the bully moves on to someone else. Convincing ourselves that the person being discriminated against is just being over-sensitive. Unconsciously deciding that a certain level of violence at work is to be expected. Eventually, that might mean going and finding another job, leaving the bullying, discrimination and violence for others to cope with.

If I think more widely about bullying, discrimination and violence at work, I also see a direct link to the productiveness (or lack of it) of the workforce. Bullying, discrimination and violence damage the quality of people’s care and support, and ability of workers to do a good job.

Bullying can make people frightened of challenging poor practice. Discrimination can create a narrow workplace culture where anyone that doesn't conform is marginalised and the knowledge they bring is not taken seriously. Violence can increase absenteeism, burn-out and turnover. 

Standing up to bullies, challenging discrimination, not tolerating violence at work is hard. But, in my experience of each of those things, the key to success is to not face any of this alone. A bully will usually be bullying more than one person. Discrimination will impact on everyone in different ways. Violence at work will lead to people getting badly hurt.

Open and transparent conversations with your colleagues and managers is key. Everyone will be frightened about changing things, but fear can be lessened if you act together. You are never on your own.

Like any other sector, bullying can be an issue for people who work in adult social care. In this blog, I reflect on my own experiences and what can be done to tackle the problem.

I think the subject of bullying in the workplace is complicated. I have worked in social care for many years and the truth of it is, over this time I was once accused of bullying and have also felt bullied myself.

When accused of bullying by a colleague I had a responsibility to line-manage, I felt quite desperate that this word was used to describe how I made someone feel. I read the Acas definition over and over: “bullying may be characterised as offensive, malicious or insulting behaviour, an abuse or misuse of power through means intended to undermine, humiliate, or denigrate or injure the recipient.”

I didn’t recognise these words as a description of anything I intended to be when managing my colleague’s performance issues at work. The matter was resolved following an investigation, yet the feelings I was left with felt unresolved for some time afterwards. I imagine the feelings my colleague felt were unresolved for some time too. I watched her distress in investigatory meetings and I’m sure she observed mine.

When I felt bullied I felt distressed too, out of control and a great sense of injustice about the way I felt treated by a colleague. 

Looking back and looking forward, the lasting thoughts for me are about how we make people feel working with them when we go about doing our job, and also the feelings of people with care and support needs we work with in our social care job roles. I always conclude that how we make people feel can be more important and more lasting than what we actually do, with the memories of how we felt about something being more lasting than our actual experiences. 

As a social care practitioner, I believe the best protection we can adopt to look after people – whether our colleagues or people we provide care and support to – as we go about meeting our job responsibilities, is to be continually reflective on the values that inform how we think and behave.

Checking out with ourselves: are we doing what we need to do in a caring way, giving due consideration to how we might make someone else feel and are we doing it in a way that treats people fairly and with respect? Sounds simple – just always think about the impact of how we behave on others and ourselves – like I said, it’s complicated.

Assaults on emergency workers bill

Posted by Amy J France (Admin) 2 months ago

This blog is an update on the "Assault on emergency workers bill"

Matt Hancock on emergency workers

Last week the Ministry of Justice announced it will be doubling the maximum jail term for anyone convicted of assaulting an emergency worker

The move was welcomed by Health and Social Care Secretary Matt Hancock, who recognised emergency workers have some of the most important and challenging jobs in our society.

More than 17,000 NHS staff were deliberately assaulted in 2015 to 2016. Since then, the annual NHS staff survey reported that 15.2% of the staff who responded say they have been physically assaulted or abused – this is a 5-year high. 

The Royal Assent Bill is a big step towards reducing violence against staff, and helping people feel safe to go to work.   

The Department of Health and Social Care’s Simon Goodwin has first-hand experience of the hostility staff can face on the frontline, through his role as an Emergency Responder for the London Ambulance Service.

Simon Goodwin

“Sadly, assaults on emergency staff will never be completely eradicated, and spending so much time interacting with patients and families puts those in the 999 family at far greater risk than most jobs,” said Simon.

“Having experienced violent and threatening behaviour first-hand, I believe those who make a reasoned decision to attack staff deserve to have the book thrown at them.

“It’s good to know myself and my blue light colleagues have a more protected status when it comes to the sentencing of assaults. I hope the publicity around this new Bill will make potential attackers think twice.”

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Keep your ideas coming

Posted by Matt Hancock 2 months ago

 

Last week we launched #TalkHealthAndCare in Bristol and one week in, I’m so pleased that thousands of you have already visited the site and given specific ideas about how we can support you at work.

I’m really grateful to all of you who have taken the time to tell us what you think, and I have already read with interest many of your suggestions, including how we better learn from serious incidents, to ideas about empowering staff to bring their compassion to the fore when dealing with patients.

Kieran’s post, ONE healthcare record system to rule them all…, was the first idea I commented on and there are many more that I have read and hope to respond to soon. I completely agree that IT systems need to talk to each other and in the future we will publish robust standards that IT systems must meet if they’re going to be bought by the NHS.

We’ve also been asked, when we have a gap in a rota, why not offer more money to NHS staff instead of relying on external agency staff? And I completely agree – we’re encouraging trusts in the NHS to move more and more work over to staff banks instead. This is the in-house solution to temporary staffing, where NHS staff are paid to fill gaps in rotas, saving money on agencies, and ensuring better continuity of care. For the staff members, working through a bank can provide much needed flexibility and we’re working with several trusts to pilot new ways to make these banks work even better for you, and for patients.

Another area that has come up is working without fear of bullying, discrimination or violence. It’s one of the toughest areas to talk about but I have been impressed with those who have shared their experiences of how it has been handled in the workplace. We have a lot to do but are already making progress, with the introduction last week of new laws to better protect NHS staff by increasing maximum prison sentences for those who assault our hardworking emergency services colleagues.

There is so much to do, please keep contributing.

 

NHS doctors gathered around in hospital

I registered as a pharmacist and started on the NHS Graduate Management Training Scheme (GMTS) in September 2017. I joined the policy & strategy stream in London and have worked in different areas within the NHS before and during the scheme.

Throughout my time in the NHS, I have experienced many teams and seen different levels of empowerment. To me, empowerment is about supporting people to do their best. While on the scheme as a graduate trainee, it can be very difficult to make an impact within the NHS as you are seen as a junior member of the team.

During most of my time in the NHS, I felt empowered by my colleagues and senior management to make an impact. For example, when working on a project alongside senior clinicians to improve patient safety on the wards, I noticed a gap in a different policy area which could also result in a compromise for patient safety, but was not part of the scope of the project.

I raised this with the management team and my team, who expressed much interest as no one had brought it to their attention before. The management team said they were happy if I were to run with this idea to see how it worked out and report my findings back to them. I enjoyed this, as I felt trusted and valued by my colleagues. I was the only person going to be working on this, but I didn’t feel isolated as I knew I could knock on a colleague’s door for help due to their open door policy.

In turn I have been able to bond with and develop meaningful respect for them, and feel comfortable discussing problems with them, knowing they will listen. My findings have shown that since I introduced my idea there’s been a change in the way the service works that has had a positive impact on patient safety.

As part of the GMTS, I have developed personal mental techniques to empower myself, which I developed during the study days. Led by a facilitator, we confidentially discussed real-life problems and used a structured approach to help each another solve them. The technique has enabled me to enhance my leadership skills and become more strategic in the way I work, which makes me feel more confident about the decisions I am making.

To empower a team, the key is leadership, which through living the values, creates the culture. In my experience, there was a clear drive to be supportive of staff and help them do the best they can, allowing leaders to deal with barriers to delivering good patient care. The training from the GMTS provides the groundwork for good leadership that empowers all staff to move towards a vision and provide high quality care.

Staff at Middleton Hall

People often tell me how impressed they are by our facilities at Middleton Hall Retirement Village. 

I frequently point out that it does not matter how much we spend on facilities, it would be wasted if we did not have the best people working in those facilities. We’re fortunate to have a great team working here, but it may not be a total coincidence.

For me, there are 8 key areas that have contributed to our success in social care.

1. Visible leadership

It starts at the top. Our directors all work in the business and are highly visible and accessible to staff and residents. This includes a weekly drop-in with me, when any employee can come and ask questions or talk about their concerns.

2. Vision and values

Middleton Hall is driven by a clear vision and strong values that are consistently demonstrated by its leaders. Our senior managers and directors can be found eating with residents, attending resident and staff meetings and taking part in events.

3. Making sure staff are supported and enjoying their job

We understand that there’s a clear link between customer satisfaction and employee satisfaction. Our leaders cannot deliver care and support personally to all our residents.  However, we can ensure that our employees have the right support and training and, most critically, enjoy their jobs – I’ve been known to loiter at the staff entrance asking people finishing work how their day has been!

4.Recruiting on values

We recruit on values and attitude rather than experience. When we opened our newest care facility last year, over half the new recruits had not worked in a care home before.

5.Enjoyable, educational training

We have our own training manager but also use external trainers. Our training is both technical and values-based, and is designed to be enjoyable as well as educational – past sessions have featured the New Zealand All Blacks and the Haka!

6.Values-based management

A key part of our management process is Middleton Hall’s ‘values commitment’.  This looks at how our people go about their jobs rather than what they do.  All employees are measured against our values commitment at least once a year. 

7.Planning to improve services

Each manager writes a service improvement plan for their service each year. These plans are based on our company objectives and key performance indicators. The plans are then shared with their teams, linked to individual objectives and employees are asked to contribute ideas.

8.The 3Cs: challenge, change and communicate

The ‘3Cs’ encourage everyone to take responsibility. We all have a part to play in challenging managers or colleagues, being open to change and communicating.  Our monthly employee newsletter highlights achievements, outlines what’s on and shares best practice. Meetings are timed to communicate up and down the organisation. 

Does our approach work? Well, 96% of employees say they would recommend Middleton Hall as a great place to work, residents and families have rated the service as ‘excellent’ (60%) or ‘good’ (40%) in last year’s customer satisfaction survey, and the Care Quality Commission has given Middleton Hall an Outstanding in every area – but we can always do better!

Young woman and her carer

Frustrating, hard work, under resourced, viewed as low status and often under recognised – I wouldn’t swap my career in social care for the world!

I began my career in social care as a care assistant in 1979. Since then I’ve moved across social care jobs, into the NHS, lecturing, and learning and development, but never far away from the beating heart of social care. What always strikes me is that I, along with many of the 1.47 million social care workers, love my work despite the many challenges the sector faces.

Skills for Care’s report Recruitment and retention in adult social care: secrets of success gives us an insight into what makes the people at the heart of social care love the work they do, and shares best practice so that we can learn from each other’s achievements.

There are around 21,200 separate organisations working in social care. Unlike many sectors, you don’t need to have a statutory qualification to become a care worker, and job descriptions vary greatly from organisation to organisation. The absence of these factors means that a coherent, meaningful career pathway isn’t always obvious. However, this does not mean the sector is low skilled.

During my time in learning disability services I worked with a fantastic support worker who, once a month, supported a young man to watch live wrestling (think WWE). He loved to sit in the front row, shout and get fully involved. She hated wrestling with a passion. As she sat with him and joined in, you would have never known. No qualification was needed, but what was needed was a values-driven approach to support that young man and enable him to live the life he wanted.     

We cannot underestimate the skill and knowledge needed to deliver personalised care and support in a pressurised work setting, and we must not underestimate the personal challenge that parts of the work can bring.

While for some people social care is simply a job that may be convenient or may be the only job available, for many others, social care in all its forms is a passion and a vocation for people who want to make a difference, add value to people’s lives and enable people to live the best lives possible. Many in the social care workforce turn up each day and night 24/7 and give their all despite what can be thrown at them.

Recruiting and keeping staff

In the Secrets of Success report, Skills for Care sets out some tips from employers who recognise the current issues and are doing something about it.

We’ve learned that many of the sector’s challenges can be addressed if employers:

  • advertise in the right places and in the right way
  • adopt a values-based recruitment approach and tell it like it is
  • offer taster days or shifts
  • invest in a good induction and offer meaningful ongoing learning and development opportunities
  • involve the people who receive care and support, their families and advocates in the selection process where appropriate
  • develop a positive culture that recognises workers as the most valuable resource   
  • deliver compassionate leadership

The full report is available for the sector to read, discuss, embrace and build upon.

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