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Bevan Exemplar Cohort 4 Projects

A role re-design model for co-producing health and social care roles

Tracy Walmsley

Hywel Dda University Health Board

This Bevan Exemplar project introduced a model to involve patients, carers and staff in role redesign.

Background

In healthcare, role re-design usually takes a top-down approach. Traditionally, the people who receive or give care and are therefore best placed to know what is needed, are not involved in designing work and addressing the challenges.

When working with the “Transforming Mental Health” Programme, an opportunity presented to work on an innovative model of role design.

This would enable a workforce model to draw in perspectives from carers and service users in health, social care and third sector agencies, building on the coproduced service model evolving through transformational pilot projects to support change and transformation.

The opportunity to engage in a dialogue on the “optimum care giver” with the identification of role, responsibility and competence requirements to generate positive experiences for carers, service users, health & social care professionals:

  • confidence to deliver appropriate care (or self-care).
  • confidence in those delivering care.
  • clarity on role in management of care and where skills best placed.
  • clarity on role in self-management and where skills best placed.
  • greater job satisfaction and from using expertise.

Aims

To create a model for redesigning roles in health and social care in coproduction with service users and carers.

To create an active and engaged process for role design to reshape the workforce to changing population needs, based on the principles of prudent healthcare.

The aim of the project was to create a simple framework in workforce design, to improve:

  • Healthcare outcomes.
  • Patient experience.
  • Staff experience.
  • Collaboration across health and care settings: professionals and carers.
  • Resource effectiveness and efficiency.

With the long-term intention that the methodology become a fluid and embedded practice to:

  • Enable advance assessment of efficiency and effectiveness of changing roles and align to health outcomes.
  • Enable approach to quantify and qualify impact of role design and enable consistent evaluation of role design outcomes.
  • Enable a framework for integration and possible cross organisational or sectoral accreditation of roles and learning provision.

Challenges

Challenges included:

  • Service change in an iterative framework
  • Coproduction as an operating model.
  • Internal project management landscapes shifting.
  • Engagement in a “dialogic” model of role design.
  • Underpinning contractual frameworks for employment.
  • Workforce challenges – capacity to engage; and impact upon.
  • A longer period of time to establish engagement would have been helpful, however, context as noted above had a significant This project may have been overambitious.

Outcomes

3 new role outlines were created; Navigator, Healthcare Assistant and Nurse in Community Mental Health Centre.

Outcomes to date include:

  • an outline model of new roles in a community mental health centres.
  • an outline model of a role design model based on coproduction, wellbeing and prudence.
  • knowledge on how to tackle the challenges of engagement.
  • knowledge on how to address the challenges of a contractual nature.

Next steps

  • Find a home within organisational structures or even wider regional spaces.
  • Utilise the core group and individuals who see value and build on this energy.
  • Encourage the mantra of do only what you can do and embed in practices that are small and practical.
  • Keep picking up on the signals and cues within groups and build on conversations
  • Track progress, however small and identify the shifts in engagement and practice.