Image: Humber NHS Foundation Trust.Mental Health Case-study Series
Bands 1-4

Humber NHS Foundation Trust

Humber NHS Foundation Trust delivers a broad range of mental health, community services (including therapies), children’s and learning disability services to people living in Hull and the East Riding of Yorkshire, a population of approximately 600,000, spread over 1000 square miles.  The Trust also provides forensic services to patients from the wider Yorkshire and Humber area.

The Challenge

With services and a workforce spread across a large region, understandably this has led to variations in job titles, roles and responsibilities across the organisation’s clinical support workforce.  In addition managers and staff often found it difficult to differentiate between the level of work and responsibilities of clinical support staff working, for example, in Agenda for Change Bands 2-3 or Bands 3-4 roles.  Also, due to low educational attainment levels achieved in Hull and parts of the East Riding there is a shortage of key skills, including literacy, numeracy and IT skills when looking to recruit support staff from within the local labour market. With Skills for Health’s support the Trust set out to address these issues for Bands 1-4 through vigorous role redesign for support worker roles and a new, non-traditional apprenticeship programme.

How they did it

A Bands 1-4 Steering Group was established to oversee the delivery of a project plan and engage with the organisation on a wider level to ensure broader goals were also being met. Two key areas were identified to focus on.  These were:

  • Redesigning support staff roles; and
  • Developing and implementing an Apprenticeship Scheme.

Redesigning Support Staff Roles

To support the Trust’s change and transformation programmes the organisation began to focus on redesigning of roles for clinical support staff, primarily with staff working in Community & Older People’s Mental Health Services, including Community Hospitals and the Stroke Service in the East Riding.

About 40 members of staff took part in two Skills for Health’s role redesign workshops.

“Through the workshops we wanted to identify the potential for new clinical support staff roles, together with gaining clarity on the level of knowledge and skill and type of work staff would be expected to undertake in the different Bands.  Another key aim was to achieve clear outlines of the learning and development for the different roles so we could offer a defined framework to clinical or admin support workers if they wanted to progress their career.”

Julie Jones
Senior Training and Organisational Development Manager, Humber NHS Foundation Trust

The outcomes

  • Role redesign is supporting a recent transformation programme in the East Riding to integrate community nursing services with older people’s mental health nurses, physiotherapists and occupational therapists into 7 new Neighbourhood Care Services (NCS) Teams.
  • Skills for Health’s role redesign workshops have now enabled them to identify roles for clinical support workers in the integrated NCS Teams at Bands 2, 3 & 4 (seven different roles identified initially across the Bands).
  • Neighbourhood Care Services Teams worked with Skills for Health to develop one new, standardised role for each Band 2, 3 & 4; rather than the previously identified seven different roles.
  • New roles were also identified at Bands 1, 2, 3 & 4 for the Community Hospitals, Bands 3 & 4 for the Stroke Service and Bands 3 & 4 for Dietetics.
  • The team have a clear picture of the learning and development required for each role and service.

“Skills for Health have been invaluable throughout this work and facilitated the role redesign across a range of services.  From the roles that came out of their workshops they were then able to identify the elements common to all and provide a clear view of core competences."

“As more people have learnt about the project the more they’ve wanted to be engaged. So we’re really pleased with the way things have gone.”

Julie Jones

Image: Humber NHS Foundation Trust.

Apprenticeship Scheme

The apprenticeship scheme they decided to put in place was not the traditional approach to employing apprentices.  The Humber scheme is specifically geared towards vacancies for permanent positions.  As these permanent positions are recruited to, part of the requirement for each Band 1-4 role is the satisfactory completion of a Structured Development Programme, which includes the completion of the relevant national apprenticeship qualifications.  Individuals appointed to these Structured Development Posts are assessed on being recruited; the outcome of the assessment determines the appropriate level of qualification and learning and development to be undertaken.  The Trust is also working with their training provider to ensure the requirements of the new Care Certificate are embedded within the training programmes.

Although there was some resistance from managers at first, once the Apprenticeship Co-ordinator was in place and able to explain the benefits for the service and the staff, there was a groundswell of support for the new approach. 

“A key lesson is to be very clear at the outset and invest time in allaying fears and concerns on what you are aiming to do through using the apprenticeship qualifications frameworks.”

Julie Jones

Gill Lowe, Unit Manager, Hawthorne Court, a rehabilitation unit for people with mental health problems, was one of the first managers to implement the new scheme and believes this is beneficial to both patients and staff.  Gill said “After looking at various qualifications and through discussion with HR, I decided to put all unregistered staff through an Apprenticeship to gain the Level 3 qualification in Health and Social Care.  At the time we had a few staff close to retirement, so I wanted to make sure all future Health Care Assistants coming into our service went through the same training process.  Overall, it looked the best option to give them the right skills to ensure the service we deliver is consistent throughout.” 

The outcomes

  • 39 staff in, or about to start in, Structured Development Posts and undertaking the relevant level apprenticeship qualification, most at level two or three.
  • 21 of the 39 are clinical support worker roles.
  • The HR team is now talking with managers who have expressed an interest in introducing the more traditional apprenticeships alongside their current approach.
  • Nathan Fleming, one of the first staff to be appointed via the Apprenticeship Scheme said “The post required that I did an NVQ qualification in Health and Social Care which suited me because the thought of doing an exam based qualification scared me a little.  I started the NVQ in March 2014 and I feel this has given me the skills to progress in my role as HCA and my confidence has grown”.

The project is ongoing but has been recognised as a success. Jacqui Bilton, a Mental Health Support Worker at the Trust’s Psychiatric Intensive Care Unit, was nominated, and subsequently awarded Highly Commended, in the Advanced/Higher Clinical Apprentice of the Year.  Their Apprenticeship Co-ordinator, Rachel Sunderland, was also awarded Ambassador of Year for her work in launching the project at the Talent for Care Awards held by Health Education Yorkshire and Humber to celebrate National Apprenticeship Week.

On winning their awards Jacqui said “I feel very privileged to have been involved in the process. My employer has been supportive throughout and I would encourage anyone thinking of joining the Apprenticeship Scheme.”  Rachel said “I was absolutely delighted and honoured to receive this award.  Having started off my career as an apprentice myself, my current role is one that I am particularly passionate about, so receiving recognition for the work I have done to implement this scheme was extremely rewarding.  I hope to inspire others in the future to do well through the Apprenticeship Scheme.” 

David Hill, Chief Executive at Humber congratulated Jacqui and Rachel saying “We all know that the Trust is fortunate to have many dedicated and compassionate staff but it’s great news when other organisations recognise this as well and help to celebrate the success of individual colleagues.  It’s really important to us that we continue to develop great people in the Trust and I hope you are both proud of your achievements.”