Scottish Government

5 NUMBERS & PROGRESS OF HCSWS

Introduction

5.1 This chapter outlines the final numbers of healthcare support workers recruited and progressed through the learning and assessment process from the initial meeting with their workplace supervisor to being entered upon the occupational list. The following chapters present stakeholder and HCSW perceptions of the recruitment and learning and assessment processes.

5.2 The original bids from NHS Boards outlined their estimates of their potential sample to be included in the pilot. This figure was adjusted as criteria for eligibility were clarified and LPCs identified roles and job titles more closely. .

Number of healthcare support workers recruited and progress⁶¹

Table 5.1 Number recruited HCSWs by pilot site

Table 5.2 Volunteers by stages of the process

5.3 By the end of December 2008, a total of 2961 healthcare support workers had been identified as eligible for the pilot (Table 5.1). Sixteen percent ( 470) were recruited to the pilot and 71% ( 335) of these volunteers went on to have an initial meeting with their Workplace Supervisor to discuss arrangements for learning and assessment (Table 5.2). Of these volunteers, 61% had completed the observation assessment, 57% the oral assessment and 56% ( 263) had completed all assessment. Half the volunteers ( 233) had signed the Code of Conduct Declaration and 41% (193) had completed the whole process and their names had been formally entered on SWISS.

5.4 The proportion of recruits ( 470) across pilot sites was: Ayrshire and Arran 36%, Lothian 21%, Lanarkshire 43%. Both NHS Ayrshire & Arran and NHS Lanarkshire began with a smaller pool of eligible support workers but recruited a higher proportion (Ayrshire & Arran 33%; Lanarkshire 50% ⁶³) whereas NHS Lothian only recruited 5% (Table 5.1).

5.5 There was also variation in success in progressing HCSWs from recruitment through each stage of the process (Table 5.2). Ayrshire & Arran had run the longest and progressed the highest proportion through from the initial meeting with the WPS to being entered upon SWISS (43%, 73). Lanarkshire, having started much later, by the end of the pilot had more recruits and a similar percentage entered on SWISS (42%, 86). Lothian had 30% ( 34) entered on SWISS.

5.6 Almost one third of recruits did not even get to the first stage of having an initial meeting with their WPS and for the majority of these no reasons were available. 15% ( 20) formally opted out and some reasons given were: redeployment after ward closure, feeling too old for the course, feeling that the course was not relevant, being involved with other studies. Personal reasons were a factor for 19%: long term sick leave ( 12), maternity leave ( 2), relocation/left post/retired ( 11).

5.7 For 19% ( 26) organisational issues were given for delay: 22 domestic staff were to be assessed on a phased basis due to shortage of available supervisors, the WPS was on sick leave, unable to attend training sessions or had left the post, or it was not clear who would be the WPS. Five paediatric nursing assistants, who delivered packages of care in the community and worked entire shifts in clients' homes, signed up early in 2008 but were delayed from starting the pilot. The LPC subsequently met with the service manager to clarify that it would be the District Nursing Sister who would be their WPS.

5.8 Reasons given for lack of progress after the initial meeting were similar but there were more issues noted ( 14) to do with work pressures, 'Clinical demands, difficult arranging meetings', and conflicting WPS/ HCSW shift patterns. A further 6 staff formally opted out after the initial meeting and reasons included: 'aged 60+ only working 15 hours per week', 'lost interest' and concentrating on 'doing cleanliness champions'.

Table 5.3 HCSW recruits by pilot site and job grouping

Table 5.4 HCSW recruits by pilot site and job title

5.9 The Guidance ⁶⁴ sets out the staff groups to be included in the pilot. The pilot successfully recruited a good number of clinical staff. The majority (73%, 341) of recruits were nursing assistants (the post title is Clinical Support Worker in Lanarkshire) ⁶⁵. Fourteen percent ( 66) of recruits were unqualified allied health staff. The largest group was occupational therapy/speech and language therapy (8%, 36). Most of the groups listed by the Guidance were included but in small numbers (audiology= 1, music therapy= 1; podiatry= 8 radiography= 12, physiotherapy= 2). Others on the Guidance list (dietetic, orthotist and prosthetist assistants and play staff) appear not to have been recruited.

5.10 Very few non-clinical staff were attracted at the recruitment stage. These included a small group of laboratory assistants ( 9) in Ayrshire and Arran. Some 11% ( 54) of recruits were from support services, including 48 domestic assistants, 3 catering assistants and 3 portering staff.

Table 5.5 HCSW recruits by service group

5.11 Recruits came from all the target service area groups (Table 5.5). At least 27% came from mental health services for older people or adults and 8% came from children's services. A quarter were staff who might work across more than one service area (Bankaide staff - Lanarkshire, some allied health assistant staff, facilities staff).

5.12 Both hospital and community sites were represented (hospital 74%, 347; community/primary care hospital 19%, 88, community base 7%, 35).

Numbers completing the observation and oral assessment process

5.13 As noted above (Table 5.2) 71% of recruits had an initial meeting with their Workplace Supervisor to decide an action plan for assessment. At least 20% ( 67) of those having an initial meeting had already met some or all of the standards prior to the pilot, and most of these were nursing assistants/ CSW ( 55). We know from the LPCs and the HCSW volunteer survey that a good number already had an SVQ2 or above ( Chapter 7). The monitoring data confirms that at least 16% ( 53) of those having an initial meeting met six-to-ten standards or more and a further 4% ( 14) met up to five standards prior to commencing assessment.

Table 5.6 Assessment completed after initial meeting with WPS

5.14 By the end of the pilot, 79% ( 263) of recruits, who had an initial meeting with their Workplace Supervisor, had completed both the observation and oral elements of the assessment (Table 5.6). There was some variation in this pattern across the three sites. 70% had signed the Code of Conduct Declaration and 58% were entered upon the SWISS database.

Table 5.7 Assessment completed by job grouping

5.15 The majority 86% ( 206) of nursing assistants/ CSWs had completed some assessment after the initial meeting and 76% ( 181) had completed both elements. An even higher proportion of allied health assistants had completed all assessment 89% ( 54) (Table 5.7).

Table 5.8 Assessment completed by job title

5.16 Of those signing the Code of Conduct Declaration 67% ( 154) were Nursing assistants/ CSWs and 22% ( 52) allied health assistants, and just 9% ( 21) were facilities staff. Smaller numbers but similar proportions were entered on SWISS. The numbers within sub-groups of allied health assistants and non-clinical staff were small.

5.17 By the end of December 2008 193HCSWs had been entered upon the list, including 122 nursing assistants/ CSWs, 51 allied health support staff, 18 facilities staff and 2 laboratory assistants.

Summary

5.18 Of almost 3000 eligible HCSWs ( 2961), around one in six (16%, 470) were recruited, more than half completed assessment (54%, 263) and 41% ( 193) were entered upon the 'occupational list'. Recruits came from all target area service groups but the largest group was Clinical Support Workers working in Lanarkshire. The majority (73%, 341) of recruits were nursing assistants/Clinical Support Workers or allied health unqualified support assistants (14%, 66). The few non-clinical support staff recruited included laboratory assistants ( 9), domestic assistants ( 48) and catering assistants ( 3) and portering staff ( 3).

5.19 By the end of the pilot more than half (57%, 263) had completed both observation and oral assessment elements and 41% ( 193) were entered on SWISS as having achieved the HCSW standards.