Workforce integration: The rise of the everyday evaluators

From an excerpt of a recent working paper by Skills for Health, Jon Parry outlines the skills you need for successful workforce integration in healthcare.

The integration agenda exists to provide improvements to the quality of health and social care provision. With this ambition in mind, there is a need for local systems to be able to make ongoing sensible assessments of the impact that their initiatives may have.

Colleagues acknowledge that not enough evaluation is carried out. There is a great deal of mystique surrounding evaluation, and the associated jargon can be off-putting. Many may feel that these activities are out of their reach.

Therefore, there is a dearth of knowledge and understanding about how high-quality, proportionate evaluations might be developed to help assess the impact of the initiatives to integrate health and social care services. Our activities with local systems point towards the need for building confidence around evaluation, and how to undertake, purchase and deal with the findings.

To enable the rise of the everyday evaluators, guidance will need to be developed for each system. It is likely that some of this will be informed by the following principles:

Where possible, begin evaluation at the start of the programme of work.
Evaluation needs to be free (as far as possible) from jargon, using plain English to describe complex concepts.
Proportionality needs to be instilled; a rule of thumb, and indeed treasury guidance, indicates that evaluations should take up 2-5% of the resources for any one programme. The cloth will need to be cut accordingly, unless the project is of greater strategic significance.
Be practical and appreciate the use of data that is readily available; generating new data is usually costly.
Welcome negative findings from evaluation – these can be as valuable as those that demonstrate positive outcomes.
Where you see a potential improvement, make it.
Write it down and share it, be prepared to be challenged on it and take challenge well.

Critical skills and skillsets

Studies show that the world’s most successful healthcare systems make widespread and systematic use of improvement methods. These encourage learning by doing, using small tests of change to observe, reflect and explore what works best for a particular context.

The integration agenda presents an opportunity for colleagues in local systems to evaluate the service improvements that they have sought to undertake. This networking of knowledge could assist in the informing of any step change in the quality of service provision.

Other emerging skills and roles identified

The examples above have been highlighted as important insights into the range of possible future skills needs and role development priorities. The following are the skills and role developments identified as important by colleagues in the context of delivering the integration agenda.

Coaching skills: Focusing on staff development, people within the health and social care sector would need to be able to support one another to develop the services quickly. The ability to support and develop colleagues through coaching is likely to continue to be of use, and indeed grow.
Information technology skills: Information technology will continue to grow in its influence for those providing health and social care, as well as those who are using the service.
Compassionate care: Being able to show compassion for those receiving care; such skills are likely to encompass such attitudes as empathy.
Social interaction skills: Those offering health and social care need to become highly skilled in a wide range of communication-related skills. These include ‘recognising signals’ and ‘understanding body language’, as well as verbal skills.
Communication skills: These were also cited – being able to truly listen and think about what the patient or service user might need.
Motivational interviewing skills: These are a very specific set of skills to enable a healthcare provider to work with those seeking to use the services to take action themselves. Skills to enable the patient to pursue ‘self-care’: This set of skills looks at how the care professional can help the patient undertake a range of tasks for themselves.
Making every contact count: Skills will be needed across many roles in the health and social care sector to provide prompts, advice and guidance to patients on a range of mainly wellbeing subjects.
Knowledge management: The services in health and social care will continue to grow in complexity. There is a wealth of information andintelligence about the services being offered, as well as information about how the services are being used and valued by patients and the population.
Personal assistants: This is emerging as a role in the health and social care sector, enabling people to make use of personal care budgets and employ others to undertake personal assistant activities.
Coaching skills: This skill focuses on coaching patients to make choices, take decisions, improve their own health and become empowered. Advice and guidance: These skills were focused on advice and guidance on encouraging people to join the sector to undertake work in health and social care.
Role modelling and professionalism: Helping people to ‘learn how to learn’ in health and social care; this skill was highlighted as modern careers demand that people learn new skills as they develop, therefore skills, knowledge and understanding would need to be developed on an ongoing basis.
Person-centred advice and guidance: Providing such support will rely on those working with patients to listen to their needs, and provide tailored advice and guidance.
Marketing skills: For example, developing a directory of services to focus on the compilation of intelligence about services that are available. Care as a profession: This is about careers advice and promoting the care sector as somewhere for rewarding jobs, and where roles might be developed.
Key workers: These act as a central point of contact for the family and can help co-ordinate the work of other agencies. The key worker role would be to carry out an assessment with the family so that, together, they can identify the family’s needs and the objectives they want to achieve. Both parties can then develop a Family Action Plan to help achieve the goals.