Defining and identifying common elements of and contextual influences on the roles of support workers in health and social care: a thematic analysis of the literature

Moran, Anna; Enderby, Pam; Nancarrow, Susan

doi:10.1111/j.1365-2753.2010.01505.x

Cited by 28 publications

(39 citation statements)

References 67 publications

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“…This aligns with previous research, in which staff expressed similar concerns regarding collaborative working with support workers (Hussain & Marshall, 2011;Moran, Enderby & Nancarrow, 2011). The…”

Section: Main Findingssupporting

confidence: 90%

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Task shifting Midwifery Support Workers as the second health worker at a home birth in the UK: A qualitative study

et al. 2018

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TITLETask shifting Midwifery Support Workers as the second health worker at a home birth in the UK: a qualitative study ABSTRACT -318 words ObjectiveTraditionally two midwives attend home births in the UK. This paper explores the implementation of a new home birth care model where births to low risk women are attended by one midwife and one midwifery support worker (MSW). Design and settingThe study setting was a dedicated home birth service provided by a large UK urban hospital. Participants73 individuals over three years: 13 home birth midwives, 7 MSWs, 7 commissioners (plan and purchase healthcare), 9 managers, 23 community midwives, 14 hospital midwives. MethodQualitative data was gathered from 56 semi-structured interviews (36 participants), 5 semistructured focus groups (37 participants) and 38 service documents over a three year study period. A Rapid Analysis approach was taken: data were reduced using structured summary templates, which were entered into a matrix, allowing comparison between participants.Findings were written up directly from the matrix (Hamilton, 2013). FindingsThe midwife-MSW model for home births was reported to have been implemented successfully in practice, with MSWs working well, and emergencies well-managed. There were challenges in implementation, including: defining the role of MSWs; content and timing of training; providing MSWs with pre-deployment exposure to home birth; sustainability (recruiting and retaining MSWs, and a continuing need to provide two midwife cover for high risk births). The Service had responded to challenges and modified the approach to recruitment, training and deployment. ConclusionsThe midwife-MSW model for home birth shows potential for task shifting to release midwife capacity and provide reliable home birth care to low risk women. Some of the challenges tally with observations made in the literature regarding role redesign. Others wishing to introduce a similar model would be advised to explicitly define and communicate the role of MSWs, and to ensure staff and women support it, consider carefully recruitment, content and delivery of training and retention of MSWs and confirm the model is cost-effective .They would also need to continue to provide care by two midwives at high risk births.

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Section: Main Findingssupporting

confidence: 90%

“…between professionals and support workers have been found to be important in effective working (Moran et al, 2011).…”

Section: Main Findingsmentioning

confidence: 99%

Task shifting Midwifery Support Workers as the second health worker at a home birth in the UK: A qualitative study

et al. 2018

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“…Based on audit interviews, this relative underutilisation of advanced level assistants may be attributed to a number of factors including ambiguity in duty statements or the unwillingness of professionals to delegate more complex tasks (despite those tasks being recorded on the task list). Interestingly while recent studies have noted numerous concerns with greater use of assistants [30,31], they do not appear to have recognised underutilisation and the practical implications of underutilisation in these positions.…”

Section: Resultsmentioning

confidence: 99%

Pilot implementation of allied health assistant roles within publicly funded health services in Queensland, Australia: results of a workplace audit

Stute¹,

Hurwood²,

Hulcombe³

et al. 2014

BMC Health Serv Res

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BackgroundAllied health assistants provide delegated support for physical therapists, occupational therapists and other allied health professionals. Unfortunately the role statements, scope of practice and career pathways of these assistant positions are often unclear. To inform the future development of the allied health assistant workforce, a state-wide pilot project was implemented and audited.MethodsNew allied health assistant positions were implemented in numerous settings at three levels (trainee level, full (standard) scope and advanced scope level). Six months after implementation, 41 positions were audited, using a detailed on-site audit process, conducted by multiple audit teams.ResultsThematically analysed audit findings indicated that both the full (standard) scope and the advanced scope positions were warranted, however the skills of the allied health assistants were not optimally utilised. Contributing factors to this underutilization included the reluctance of professionals to delegate clinical tasks, inconsistencies in role descriptions, limitations in training, and the time frame taken to reach an effective skill level.ConclusionsOptimal utilisation of assistants is unlikely to occur while professionals withhold delegation of tasks related to direct patient care. Formal clinical supervision arrangements and training plans should be established in order to address the concerns of professionals and accelerate full utilisation of assistants. Further work is necessary to identify the key components and distinguish key features of an advanced allied health assistant role.

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“…Within health and social care, the support workforce is large; an estimated 1.3 million working on the frontline of care19 and can be categorised under the different types of role they perform, including direct care, indirect care, administration and facilitation 20 21. While growth in the support workforce has sometimes been driven by initiatives to reduce costs, which has involved role substitution for regulated staff, there is evidence to show that support workers can act as an additional resource to enhance older people's experiences by improving the contact with care practitioners 22 23.…”

Section: Introductionmentioning

confidence: 99%

Improving skills and care standards in the support workforce for older people: a realist review

et al. 2014

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IntroductionIn the context of a population that is growing older, and a number of high-profile scandals about care standards in hospital and community settings, having a skilled and knowledgeable workforce caring for older people is an ethical and policy imperative. Support workers make up the majority of the workforce in health and social care services for older people (aged 65 years and over), and yet little is known about the best way to facilitate their development. Given this gap, this review will draw on evidence to address the question: how can workforce development interventions improve the skills and the care standards of support workers within older people's health and social care services?Methods and analysisAs we are interested in how and why workforce development interventions might work, in what circumstances and with whom, we will conduct a realist review, sourcing evidence from health, social care, policing and education. The review will be conducted in four steps over 18 months to (1) construct a theoretical framework, that is, the review’s programme theories; (2) retrieve, review and synthesise evidence relating to interventions designed to develop the support workforce guided by the programme theories; (3) ‘test out’ our synthesis findings and refine the programme theories, establish their practical relevance/potential for implementation and (4) formulate recommendations about improvements to current workforce development interventions to contribute to the improvement of care standards in older people's health and social care services, potentially transferrable to other services.Ethics and disseminationEthical approval is not required to undertake this review. Knowledge exchange activities through stakeholder engagement and online postings are embedded throughout the lifetime of the project. The main output from this review will be a new theory driven framework for skill development for the support workforce in health and social care for older people.Trial registration numberCRD42013006283.

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Defining and identifying common elements of and contextual influences on the roles of support workers in health and social care: a thematic analysis of the literature

Abstract: Despite the heterogeneity of support worker roles, there are some uniting 'generic' features, which may form some or all of the role of these practitioners. Contextual factors influence the specific technical aspects of the support role, accounting in part for their heterogeneous role.

Cited by 28 publications

References 67 publications

Task shifting Midwifery Support Workers as the second health worker at a home birth in the UK: A qualitative study

Task shifting Midwifery Support Workers as the second health worker at a home birth in the UK: A qualitative study

Pilot implementation of allied health assistant roles within publicly funded health services in Queensland, Australia: results of a workplace audit

Improving skills and care standards in the support workforce for older people: a realist review

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