The non‐professionally affiliated (NPA) worker as co‐producer of public services: how is the role experienced in UK mental health services?

Abstract

Recent workforce reforms have led to the widespread expansion of non‐professionally affiliated (NPA) support and assistant roles within UK public services. Research into these roles has been confined to a limited range of settings, with a focus on the consequence of change for professional workers. This article explores the emergence of ‘co‐production’, whereby NPA workers contribute alongside the professional in a distinct, complementary way. Findings are drawn from semi‐structured interviews with frontline workers and managers within the context of mental health workforce reform. The results build a picture of NPA working life characterised in part by autonomy and responsibility. At the same time, NPA workers rely on colleagues for support and are subject to being used indirectly by professionals. Contextual influences are considered. The conceptual implications of the analysis are brought out, both for the NPA role itself and for the broader issues involved in front line service work.

Getting to what works: How frontline HRM relationality facilitates high‐performance work practice implementation

“…The article's framework also resonates with the workforce innovation literature's emphasis on complementarity, and indeed advances this field by putting a stronger emphasis on managerial facilitation. Workforce innovation studies often examine managerial interventions that allocate some of an established profession's tasks to a lower‐skilled role such as, for example, healthcare assistants (Chen et al., 2022; Kessler et al., 2015; Krachler & Kessler, 2022; Procter et al., 2018). While these studies acknowledge the role of managerial facilitation, they emphasize the autonomous regulation of occupational relations over time.…”

“…As opposed to 'substitution', where the new role performs tasks that are traditionally in the established professionals' domain for a lower cost, 'complementarity' develops when new roles assume tasks that were not previously performed or are considered 'lower-status', thus 'freeing up' professionals to perform higher-status tasks (Bach et al, 2008;Kessler et al, 2015Kessler et al, , 2017. While these processes could occur without managerial intervention, these studies found that HR practices such as training, mentorship, autonomy (Chen et al, 2022), multi-disciplinary teamworking, and assigning manageable workloads (Procter et al, 2018) could facilitate cross-occupational working.…”

Institutional support for new work roles: The case of care coordinators in the United States and England

“…Other studies have highlighted the increasingly active role of managerial supports like career structures (Bach et al., 2008). For example, Procter and colleagues (2018) argued that managers’ use of team structures and workload assignment facilitated joint working between professional mental health staff and lower‐skilled, mental health assistants. Similarly, Krachler and Kessler (2023) documented how primary care physicians in England used managerial control practices (e.g.…”

“…This article opens up two areas for further research. First, while this novel study examined a process of new task creation through a new role, most research in this area concerns the reallocation of existing tasks from an established occupation to a new role (Kessler et al., 2013; Procter et al., 2018). Therefore, further research could study the applicability of institutional supports to such cases of task reallocation as well.…”