Developing effective health and social care workforces in the UK

An estimated one tenth of the UK’s working population are employed in the health and social care sectors. To meet growing health and social care needs, the health and social care workforce needs to be capable of adopting new models of person-centred, integrated care effectively and quickly. But knowledge about how to transform existing working practices on such a huge scale, and in a cost efficient and timely manner, is limited. New research at Northumbria, exploring how to achieve strategic workforce development, led to the development of a new approach, which has subsequently been implemented to upskill the North East and Cumbria’s care workforce in Positive Behavioural Support – a person-centred approach that is commonly used to support people with a learning disability and/or autism, in particular those who display behaviours that challenge. 

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 Anne McNall, a researcher at Northumbria at the time, developed a practical WFD approach, specific to sexual health services, that facilitates what could otherwise be a difficult and lengthy process of employee transformation.  

Since 2016, Dr McNall and her Northumbria-based colleagues, which included Clinical Psychologists Steve Noone and Professor Karen McKenzie, have applied this WFD approach to embed Positive Behavioural Support (PBS) into the health and social community care workforce in the north of England. PBS is a positive, person-centred, values-based approach that aims to improve the quality of life of people and encourage long-term positive changes in their behaviour. Key components of PBS include using assessment to understand the purpose of the person’s behaviour and to develop a function-based intervention, consistency, open communication and fostering respectful relationships with people and their families. With UK Government policy recommendations now encouraging community-based, rather than institutional, care for people with a learning disability and/or autism, it is essential that the community care workforce is equipped with PBS skills. 

To achieve this, the Northumbria team worked with a wide variety of ‘partners’ within the health and social care sector, including families and carers, practitioners, managers, and service commissioners, to understand sector-specific requirements; identify the skills or competencies that staff require to provide person-centred care; and determine how staff can develop knowledge, skills and values of PBS. 

The PBS WFD model is both practice- and systems-based. The practice-based learning element involved the implementation of mentorship, workplace coaching and leadership, and bespoke training programmes. A North East and Cumbria Community of Practice was also developed to help overcome time management issues related to releasing staff to learn. The systems-based aspect focused on developing the proficiency of individuals and addressing the wider organisational factors that put obstacles in the way of delivering new models of care. For example, organisations embraced new ways of recruiting, supporting, and managing staff, which included applying some of the values-based PBS principles to their own staff teams. 

The introduction of this PBS WFD programme to the North East and Cumbria has led to improved staff retention in the sector, improved practice, and ultimately better lives for individuals and their families. Following this success, this evidence-based WFD approach is also being applied to other areas and contexts, for example, to inform the care of older people with complex needs, care practices in prisons, community link working and primary care practice and general practice nursing.