Nancarrow Susan A, Shuttleworth Penny, Tongue Alison, Brown Lucy
University of Sheffield, Institute of General Practice and Primary Care, Community Sciences Center, Northern General Hospital, Sheffield, UK.
Health Soc Care Community. 2005 Jul;13(4):338-44. doi: 10.1111/j.1365-2524.2005.00563.x.
Despite the proliferation of support worker roles in the UK, little is known about their actual numbers, employment conditions or levels of training. Intermediate care services appear to be an important employer of support workers, but the diversity of intermediate care services makes the task of understanding support worker roles even more complex. This paper presents data from 33 services which were involved in an NHS Modernisation Agency's Changing Workforce Programme project, the Accelerated Development Programme for Support Workers in Intermediate Care in England. Within this project, the main employers of support workers were primary care trusts and/or social services. Participating intermediate care teams were involved in admission avoidance, assisted discharge and reablement, or combinations of these services, and the majority of care was provided in the patient's own home. The 33 services employed 794 support workers and 368 professionally qualified staff. The mean ratio of professionally qualified staff to support workers was 0.95 (range = 0-4.9, SD = 1.05). Support worker roles included multidisciplinary working, meeting rehabilitation needs, providing personal care and enablement. Team leaders included nurses, social workers, physiotherapists, professional managers, home carers and support workers. The most commonly reported sources of support worker training were National Vocational Qualifications and in-house training. In 80% of the services, at least half of the support workers had a qualification. Three models of supervision emerged across the services: the allocation of a mentor; team supervision; and formal and informal line management. These findings illustrate the diversity of employment of support workers in intermediate care. The variations in training, supervision and skill mix have implications for clinical governance and support worker regulation. The employment of support worker staff jointly across health and social care raises cross-boundary issues around employment contracts and pay.
尽管英国辅助人员的角色不断增加，但对于他们的实际数量、就业条件或培训水平却知之甚少。中级护理服务似乎是辅助人员的重要雇主，但中级护理服务的多样性使得理解辅助人员角色的任务更加复杂。本文展示了来自33项服务的数据，这些服务参与了国民保健服务体系现代化机构的“劳动力变革计划”项目，即英格兰中级护理辅助人员加速发展计划。在该项目中，辅助人员的主要雇主是初级保健信托基金和/或社会服务机构。参与项目的中级护理团队涉及避免住院、协助出院和恢复能力，或这些服务的组合，并且大部分护理是在患者自己家中提供的。这33项服务雇佣了794名辅助人员和368名专业合格人员。专业合格人员与辅助人员的平均比例为0.95（范围 = 0 - 4.9，标准差 = 1.05）。辅助人员的角色包括多学科协作、满足康复需求、提供个人护理和提供便利。团队领导包括护士、社会工作者、物理治疗师、专业经理、家庭护理员和辅助人员。最常被报告的辅助人员培训来源是国家职业资格证书和内部培训。在80%的服务中，至少一半的辅助人员拥有一项资格证书。在所有服务中出现了三种监督模式：分配一名导师；团队监督；以及正式和非正式的直线管理。这些发现说明了中级护理中辅助人员就业的多样性。培训、监督和技能组合的差异对临床治理和辅助人员监管有影响。卫生和社会护理部门联合雇佣辅助人员引发了围绕雇佣合同和薪酬的跨界问题。
