Yes / The recruitment and retention of a digital health and social care workforce in the United Kingdom (UK) is challenging for several reasons that include the shortages of these employees in the National Health Service (NHS) and social care and the high demand for digital skills from other sectors (HEE, 2021a; NHS Providers, 2017). Brown (2022:7) notes that ‘high staff turnover rates, chronic recruitment and retention issues, and low morale are increasingly identified as major challenges for those working in social care’. Liu et al., (2019:5) in their report ‘NHS Informatics workforce in England: Phase 1 Project Report’ estimated that the size of the NHS informatics workforce in 2019 was between 40,640 Full Time Equivalents (FTEs) to 53,936 FTEs based on electronic staff records. However, significant shortages in digital and information technology staff in health and social care were identified that pose a challenge. This rapid review examines the strategies used to recruit and retain the health and social care digital workforce and potential solutions to issues raised.

Yes / Effective strategic workforce planning for integrated and co-ordinated health and social care is essential if future services are to be resourced such that skill mix, clinical practice and productivity meet population health and social care needs in timely, safe and accessible ways globally. This review presents international literature to illustrate how strategic workforce planning in health and social care has been undertaken around the world with examples of planning frameworks, models and modelling approaches. The databases Business Source Premier, CINAHL, Embase, Health Management Information Consortium, Medline and Scopus were searched for full texts, from 2005 to 2022, detailing empirical research, models or methodologies to explain how strategic workforce planning (with at least one-year horizon) in health and/or social care has been undertaken, yielding ultimately 101 included references. The supply/demand of differentiated medical workforce was discussed in 25 references. Nursing and midwifery were characterised as undifferentiated labour, requiring urgent growth to meet demand. Unregistered workers were poorly represented as was the social care workforce. One reference considered planning for heath and social care workers. Workforce modelling was illustrated in 66 references with predilection for quantifiable projections. Increasingly needs-based approaches were called for to better consider demography and epidemiological impacts. This review’s findings advocate for whole-system needs-based approaches that consider the ecology of co-produced health and social care workforce. / Claire Sutton and Julie Prowse are seconded (from February 2022 to March 2023) to the Workforce Observatory, the University of Bradford, West Yorkshire. Their research posts at the Workforce Observatory are funded by Health Education England.

Government policies have emphasised the importance of patient and client involvement in all aspects of health and social care delivery, with a corresponding impetus for their involvement in the education of practitioners. Professional education programmes adopt andragogical, student-centred approaches and incorporate both academic and practice based learning and assessments. Practice experience is recognised as a crucial aspect of student learning and has become a major focus of quality reviews in health and social care education. Whilst it might seem self-evident that students on practice placements will learn from their interactions with patients and clients, this is a relatively neglected area for formal modeling, evaluation and research. This study, therefore, explores pre-qualifying nursing, midwifery and social work students’ experiences of learning from patients and clients during practice placements. The research project is underpinned by a descriptive phenomenological approach and the extensive data are analysed using phenomenological reduction (Giorgi, 1989a; 1989b). Two key themes and six categories emerged from the data. The first theme is presented as the ‘Ways of Learning’ and this comprises the categories of: facilitation of learning; critical incidents/patient stories; and role modeling. The second theme is presented as the ‘Nature of Learning’ and comprises three categories: professional ideals; professional relationships; and understanding patients’ and clients’ perspectives. It is evident that contemporary theories, including andragogy, social learning, experiential, reflective and transformative learning theories, remain relevant to professional education. The new knowledge obtained in this research is that the most powerful learning opportunities result from unplanned, informal learning opportunities involving interactions with patients and clients. However, this is not fully explained by these contemporary learning theories. This thesis will, therefore, argue that complexity theory is relevant to the requirements of professional education programmes. It will present an overarching framework to explain the data from this study and will propose strategies to harness the complexity inherent in this important aspect of student learning.

This thesis develops our understanding of the roles and processes underlying the co-production of public services. The co-production concept encapsulates the joint contribution made by service users and service providers to the delivery of services, acknowledging the expertise, inputs and role of service users. There has been an expanding stream of literature within the public management field focusing on co-production, recently enhanced through combinatory insights drawn from the service management literature. The thesis builds on this perspective, and addresses a current gap in understanding regarding the processes and roles that underpin the concept of co-production. In particular the research questions consider: the factors that facilitate co-production; the features of co-production that are evident within everyday service interactions; how service users and employees interact within the processes of co-production; and how these impact upon the delivery of public services at an individual level. The research for the thesis is undertaken within the context of community health and social care services for older people, at two locations in Scotland. An interpretivist, constructionist approach is taken to the inductive study which adopts a qualitative case study methodology. The research findings are drawn from semi-structured interviews with managers, older people and employees delivering services, together with observations of meetings and service interactions. Extant research has often conflated the roles of employees and public service organisations, and equal attention is rarely paid to the co-productive roles of service users and employees. The study makes a theoretical contribution by: developing the concept of active co-production; highlighting the complexities of the roles and processes underpinning co-production; revealing the different types of learning occurring within co-production; and developing a model to explicate the processes that combine the expertise of older people and employees, during the delivery of public services. On a practical level the study also highlights how more advanced and ‘active’ forms of co-production have developed, and the impact this has on the delivery of health and social care services for older people in Scotland.

The demands upon the social care workforce in the UK are only likely to increase over the next decades. The social care sector is heavily reliant on NVQs and this is regulated through the Care Standards Act (2000). It is thus important that these qualifications appropriately support staff development. The purpose of the research was to explore this in one social care organisation (Homecare) through researching staff perspectives on factors that inhibited or supported learning through NVQs and to examine the Homecare/Centre delivery of NVQs and workplace learning with this in mind. The research is broadly qualitative in design and draws on the principles of narrative research combined with analysis focused on key themes (interpersonal, personal and organisational factors). The research found that an understanding of the key concepts of workplace learning is relevant to the delivery of NVQs and can help these qualifications be implemented successfully as a part of a more holistic approach to teaching, learning and the assessment of competence in the workplace. The research identified that the organisation had a particular approach that strategically integrated assessment both at organisational and practice level. Additionally the research identified areas within the NVQ process, where integrated assessment proved of benefit to practice through professional level development of skills and knowledge, values and reflective learning and confidence. From this eight key elements of an enhanced model of NVQ delivery were identified that constitute the contribution to practice. The contribution to theory lies in linking the literatures of NVQs, competence and workplace learning and the suggestion that previous understanding of NVQs as behaviourist and atomistic is not as important as the approach to assessment adopted by organisations. The research has relevance to any social care organisation but also to wider audiences where NVQs are used as it adds to understanding of workplace learning through a depth of practitioner-researcher understanding of specific qualifications in a specific context.

Yes / Ex Memoria is a short film - just 15 minutes long - which focuses on the experience of Eva, a woman with dementia living in a nursing home. The film - which is the result of a collaboration between Bradford Dementia Group (BDG), writer/director Josh Appignanesi, and producer Mia Bays - attempts to show how life might be experienced from Eva's point of view, in her 'version of reality'. In this article I will outline the to the making of Ex Memoria, explain how the film is being used on the Dementia Studies courses provided by BDG, and - without giving away too much of the story for people who haven't yet seen the film - summarise some of the responses to it.

No

Yes / The aim of this study was to establish the impact of dementia education and training on the knowledge, attitudes and confidence of health and social care staff. The study also aimed to identify the most effective features (content and pedagogical) of dementia education and training. Cross-sectional survey study. Data collection occurred in 2017. Health and social care staff in the UK including acute care, mental health community care trusts, primary care and care homes. All health and social care staff who had completed dementia education and training meeting the minimal standards as set by Health Education England, within the past 5 years were invited to participate in an online survey. A total of 668 health and social care staff provided informed consent and completed an online survey, and responses from 553 participants were included in this study. The majority of the respondents were of white British ethnicity (94.4%) and identified as women (88.4%). Knowledge, attitude and confidence of health and social care staff. Hierarchical multiple regression analysis was conducted. Staff characteristics, education and training content variables and pedagogical factors were found to account for 29% of variance in staff confidence (F=4.13, p<0.001), 22% of variance in attitude (knowledge) (F=3.80, p<001), 18% of the variance in staff knowledge (F=2.77, p<0.01) and 14% of variance in staff comfort (attitude) (F=2.11, p<0.01). The results suggest that dementia education and training has limited impact on health and social care staff learning outcomes. While training content variables were important when attempting to improve staff knowledge, more consideration should be given to pedagogical factors when training is aiming to improve staff attitude and confidence. / NIHR Policy Research Programme (Understanding Effective Dementia Workforce Education and Training: A Formative Evaluation (DeWET Evaluation), PR-R10–0514-12006).

Frailty poses a complex challenge for some people through their experience of ageing. In Wales, devolution requires organisations to use a whole systems approach with a model of partnership to deliver public services. An integrated care approach is offered to meet the service user focus or ‗value demand‘ which impacts on clinical, professional, organisational and policy levels within the system. Therefore, the aim of this study was to explore whether there was a difference between integrated health and social care day services and non- integrated health and social care day services. In doing so, answering the questions, how were these services different, what were the differences as perceived by the participants, why were they different, what could be learned from this study and how could health and social care services integrate in practice? The study utilized Gadamer‘s interpretative hermeneutics with a single intrinsic case study design. Using this approach ensured that the unique voice of the individual lived experience was heard and interpreted within the whole system of the study. The participants were service users, carers and staff in a day hospital, an outpatient clinic, day centre, reablement team and a joint day care facility. The methods included a survey questionnaire (SF12v2 and London Handicap Scale), in-depth interviews, observations; and historical and service documents; and reflective diary. Data collection occurred January 2005 to December 2006. Quantitative and qualitative data were analysed separately. The qualitative data was analysed using Gadamer‘s five stage approach developed by Fleming et al (2003) and Nvivo 7.0. The embedded quantitative data was analysed using SPSS version 13.0. Triangulation was achieved through the use of a meta matrix which merged the qualitative and quantitative data. The difference between integrated and non integrated services is expressed through the four themes, ‗the study participants‘, ‗commissioning and decommissioning integrated services‘, ‗the journey within day services‘, ‗navigating services and orchestrating care‘. The four themes were developed through a strategy used for interpreting the findings, which was to follow the study questions, propositions and ‗emic‘ questions. The differences between the integrated and non integrated services were in the meaning of their purpose, culture, level of integration, team orientation of practice and the model of service user/carer relationship observed within the services. The thesis identified challenges in respect of integrated working such as concept confusion, negative experiences of care for frail or older people, a vertical gap in knowledge transfer between strategic organisation, the operational services and service users. Mapping each service level of integration and team orientation to the model of service user and carer relationship, found that the level of team orientation and integration does not appear to be proportionate to the service user and carer relationship. The thesis concludes that in order to attempt to answer the question as to whether these day services can integrate in the practice, all levels of the system should focus on the service user/carer relationship. We need to understand service user diagnosis, how its characteristics and effect are interpreted by the service user, carer, professional and wider society in relation to independence and autonomy. It argues that knowledge emerges at this micro level (service user and carer relationship) and how we engage with this relationship and manage the knowledge we gain from it (both vertically and horizontally), will lead us to understand how we can ensure that integration occurs and that services in the future are person focussed.

Thesis in Healt Care Administration, C-level. Author: Madelaine Kjellström. Supervisor: Alf Sundin. Autumn semester 2017. Title: Management system as a Planning Instrument in Health Care Services -        A Study of Management System for Systematic Quality Work in three swedish municipalities in Värmland; Karlstad, Sunne and Storfors – In the year 2011 the Swedish authority Socialstyrelsen published a prescription (SOSFS 2011:9) and also a recommendation who where adressed to the municipalities, who are responsible for  the public servises in Sweden, to implement a Management System for Quality Work within Health and Social Care Services. The aim of this study is to examine how municiapilities in Sweden is planning for implementation and evaluation of the Management system for Quality Work within Health and Social Care Services. The question for approaching the thesis choice of subject are: Is the Management System for Quality Work Work within Health and Social Care Services more likely to succed in the municipality of Karlstad which is a bigger municipality comparing to Sunne and Storfors municipalities, which is smaller municipalities comparing to the size of budget and population? Is there any similarities and/or differences between the different municipalities capacity to planning for implementation and evaluation of the Management System for Quality Work within Health ans Social Care Services? As mentioned above there are three municipalities that has been selected as cases in this comparative case-study. All three municipalities is located in the region of Värmland, Sweden. The main findings and the result of this comparative case-study is that; all of the three municipalities independent of their respective sixe have capacities to fullfill the prescription and recommendation according to the authority Socialstyrelsen intentions concerning the planning of implementation and evaluation of the Management System.                                            Keywords: Planning, implementation, evaluation, Mangagement system, quality work, health and social care service.