Improved workforce utilisation and enhanced patient care by using competence-based roles to modernise services and develop staff skills

When Whittington Health NHS Trust was invited to test Skills for Health’s workforce tools and solutions, managers used the opportunity to modernise services, improve patient care and develop the skills of staff to meet this aim.

The Trust was looking at new roles as part of its requirement to address national initiatives and local financial pressures and already had considerable experience in role redesign and change management.

The Trust decided to develop a new role at the assistant practitioner level using Skills for Health competences for a new approach to role design. Managers and staff identified Therapies as an ideal service area for the new role.

With the new roles in place, patients were seen more quickly, and the quality of care was judged to have improved. Patients were more likely to see the same staff, leading to better continuity of care and a more personalised approach, and the length of stay on the wards reduced dramatically.

Benefits

• Reduced length of stay for patients over a two-year period, down from 17 to 12 days in the care of older people wards and 24 to 18 days for stroke patients
• New Therapy Assistant roles boost multi-disciplinary team working
• Enhanced workforce productivity and team efficiency
• Patients better able to manage at home after discharge
• Job profiles easier to produce
• Greater opportunity for career progression for those in new roles
• Post holders went on to complete the NVQ level 3 course in Occupational Therapy and Physiotherapy

“The Therapy Assistant roles, combined with other activities, have made a valuable contribution towards enabling the hospital to achieve bed saving days for neuro stroke patients and care of older people. We found the quality of care improved and in future there is potential for reduced re-admittance rates.”

Adrienne Simons, Service Manager for Physiotherapy, OT & Rehabilitation,
Whittington Health NHS Trust

Using Skills for Health competences for a new approach to role design, two clinical Therapy Assistant roles – one focused on the care of the older patient and the other working closely with stroke patients – were mapped out and recruited to.

The Therapy Assistant roles soon proved how they could support more flexibility within teams. Thanks to their competence-based training, the newly skilled Therapy Assistants were able to carry out interventions that qualified staff would have limited time to complete in the acute setting.

The post holders demonstrated they had developed and utilised transferable knowledge and skills. Patients were seen more quickly and frequently at the hospital’s Jeffrey Kelson unit and the quality of care was judged to have improved within the unit.

Work colleagues welcomed the positive impact of the new roles. As a result, staff can spend more time with patients who have been able to leave the hospital better prepared to manage at home.

“Taking a competency-based approach to role design has helped us to pinpoint exactly the right skills to meet the needs of patients, and this strategy has proven a real success.”

Adrienne Simons Service Manager for Physiotherapy, OT & Rehabilitation,
Whittington Health NHS Trust

Managers and colleagues from the allied health professions noted that the Therapy Assistants provided a vital link between Occupational Therapy and Physiotherapy teams. This underlined the importance of integrating working practices by breaking through working in silos – the new posts have offered a practical way of achieving this. In the future, the Therapy Assistant role will be developed into a generic post as it has demonstrated even more benefits for team working and seamless service provision.

Having seen that a competence-based approach really can deliver, the Trust is applying the lessons to a pilot in orthopaedics teams using an agreed process for developing new roles and a tool for role/service redesign.

As the Sector Skills Council for all health sector employers, we support NHS, independent, and third sector organisations. Since 2002 we’ve been working with employers to get the right people, with the right skills, in the right place at the right time. We are the authoritative voice on skills issues for the health sector and offer proven workforce solutions and tools – with the expertise and experience to use them effectively.