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.

Yes / Social care is vital to quality of life for people with young onset dementia and their families. Yet care is hugely variable, frequently lacking and poorly coordinated. We aim to establish current practice in English social care for people with young onset dementia and co-produce evidence-based recommendations and resources for improvement. In Work-Package 1, we will gather qualitative data from 25 people with young onset dementia and/or main supporters residing in England. We will ask them about their experiences of social care (broadly defined, including independent and voluntary sector provision) and suggestions for improvement. In Work-Package 2, we will conduct a short on-line survey with a wide range of staff with a role in adult social care in England. We will find out about current awareness, knowledge and practice and suggestions for improvements. Quantitative and qualitative analysis will provide a picture of current practice. In Work-Package 3, we will use convergence analysis to synthesise the findings from Work-Packages 1 and 2 and present the findings to a stakeholder workshop, to identify feasible priorities for improvement. We will establish what is already known about good practice relating to these key priorities using a scoping review and interviews with professionals. This knowledge will then feed into the co-production of resources and recommendations with key stakeholders to improve social care for people with young onset dementia and their families. This study seeks to address a gap in our understanding of social care provision for people with young onset dementia and develop recommendations and practical resources for improvements. The findings will help people with young onset dementia and supporters to receive higher quality social care. Study registration number: ISRCTN10653250. / This study is funded by the National Institute for Health and Care Research (NIHR) Research for Social Care (RfSC) Programme through grant NIHR204266. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

Darbo tikslas - išnagrinėti ir įvertinti senyvo amžiaus asmenų globos įstaigų veiklos organizavimo aspektus ir pateikti tobulinimo galimybes. Daugelyje socialinės globos įstaigų vykdoma veikla dar neatitinka šiuolaikinės socialinės globos sampratos. Socialinę globą teikiančio personalo sudėties, jo kvalifikacijos ir darbo organizavimo trūkumai, fizinė paslaugų teikimo aplinka, socialinės globos paslaugų reglamentavimo netobulumas daro įtaką senyvo amžiaus asmenų globos įstaigų veiklos organizavimui. Darbe analizuojama senyvo amžiaus asmenų globos įstaigų veiklos organizavimo specifika, kuri susijusi su šių įstaigų teikiamų paslaugų paskirtimi ir tikslais. Be to, aptariama socialinės globos vieta socialinių paslaugų sistemoje, apžvelgiama socialinės globos politika senyvo amžiaus asmenims, socialinės globos paslaugų plėtra, apibūdinta šių paslaugų valdymas, teisės aktai, reglamentuojantys globos paslaugų reglamentavimą. Siekiant įvykdyti iškeltus uždavinius atlikta mokslinės literatūros, statistinių duomenų analizė. Išnagrinėta socialinės globos samprata ir reikšmė, senyvo amžiaus asmenų socialinės globos įstaigų veiklos organizavimo aspektai. Apžvelgta Europos Sąjungos ir Lietuvos socialinė politika, nagrinėjanti socialinės globos klausimus, apibūdintas šių paslaugų valdymas. Atlikta socialinės globos įstaigų veiklą reglamentuojančių teisės aktų aprašomoji analizė. Socialinės globos įstaigų veiklos organizavimo vertinimas šiame darbe vykdomas atliekant tyrimą – interviu su... [toliau žr. visą tekstą] / The goal of the study is to analyse and evaluate the organization aspects of the actions of sheltered accommodation for advanced in age individuals and to propose the development possibilities. The actions performed in social sheltered accommodation mostly do not yet conform to the conception of contemporary social care. The make-up of social care providing staff, the shortcomings of its qualification and organization of actions, physical environment for providing of services, imperfection of regulation for social care services impact on the organization of actions of sheltered accommodation for advanced in years individuals. The study analyses the particularities of the organization of actions of sheltered accommodation for advanced in years individuals that are related to the purposes and goals of services provided by those sheltered accommodation. Moreover, the place of social care in the system of social services is discussed, the social care policy for advanced in years individuals and the expansion of social care services are reviewed, the management of those services and the acts of law for regulation of care services are defined. On purpose to accomplish the set tasks the analysis of scientific literature and statistical data is performed. The conception and importance of social care, the aspects of the organization of actions of sheltered accommodation for advanced in years individuals are examined. The social policy of European Union and Lithuania dealing with the... [to full text]

Managers in social care are being relied upon to lead and implement substantial change within the sector. Yet the prevailing view is that the pressure being put on managers by managerialism and the increase in the business aspects of their role is in conflict with social care managers’ values, causing concern and challenging managers’ identity. Additionally, managers in social care are presented as being part of the same homogenous group as social work managers, a potential misrepresentation, which again has consequences for how managers identify with their role. This study aimed to explore and explain how social care managers are experiencing their manager identity and how they categorise themselves from a group perspective. This research was undertaken using a critical realist philosophical approach. The key theoretical framework used is social identity theory. The study findings have achieved the overall aim of the research, establishing that social care managers appear not to be experiencing any conflict in their identities, that managerialism is accepted by managers and seen to be necessary, and that managers’ values, formed in childhood, are a key aspect of how they undertake their managerial role. In addition, social care managers are not the same as social work managers, their social identity is a synthesis of the multiple groups they are members of with the dominant group being social care, because of this they cannot be viewed as being within the same homogenous group. Neither is the social care manager role distinctive from manager roles in other sectors, however how they undertake the role is. The significance of the study is the contribution to both the existing social care literature and the literature on social identity theory.

The present doctoral thesis aimed to explore what it means to be a first-level manages in a Swedish municipal social care administration, seen from the managers’ perspective. The empirical data derives from a participative, constructivist project which intended to contribute to new practice-based knowledge and to the learning and development of the participating managers. The participating managers reflected over their work and their managerial role by the use of a combination of repertory grid interviews, personal diaries and group discussions. Qualitative descriptive phenomenological analyses of the extensive material painted a vivid and nuanced picture of their work situation and professional role. In Paper I the project and the used methods were described in detail. Short extracts of data illustrated the potential of the general approach of combining constructivist techniques in participative and action oriented projects. The first brief results illustrated by “A day in a team manager’s working life” and by three “leadership dilemmas”: The spider in the web; The border patrol; and The open door, presented a picture of the managers’ complex work situation and how they were stimulated to address the problems arising. Paper II showed the many facets of social care management, where six “faces” portrayed the complex managerial role. The results indicated that managers in this and other welfare organizations need to construe and re-construe their managerial role in order to balance the contrasting demands on their role, thereby ac-complishing a personal equilibrium. Paper III further explored the managers' leadership role ideal, grounded in the concept of care. Several aspects of the managers' work situation resulted, on their own or in conjunction, in difficul-ties fulfilling their caring leadership ideal. These difficulties of which the managers spoke were arranged into three distinct patterns: problems, dilemmas and paradoxes. The results gave insight of the nature of these difficulties, the implications which these might have on the managers, their staff and the delivery of service, and the discussed remedies. Taken together the results raises new questions about municipal managers’ abilities and possibilities to handle ideals and requirements which are difficult to consoli-date particularly in times or resource scarcity. Is it possible to be an at the same time caring and efficient manager? How can mangers’ options to handle the complexity of modern welfare organisations be strengthened?

This thesis concerns the role of the Social Care Worker in interventions into unacceptable sexual behaviour in people who have a learning disability. It takes as point of departure ways in which support organisations and individual members of staff become aware that a service user’s sexual behaviour needs to be addressed. This raises issues about the service user’s human rights, confidentiality, and the concept of what it is to be ‘professional’ which can affect information sharing between support organisations and also between fellow support workers. In the case of the latter this relates to the workers status within the organisation, relations of power/knowledge which also has implications for the status of these workers as ‘professionals’. The thesis goes on to determine the support workers’ perceptions of what Bourdieu has termed, their ‘field’. That is to say, those behaviours they feel they can address without consulting health professionals. In addition to this, criteria used to decide when it is appropriate to consult health professionals is also described which thus demarcates their ‘field’ as perceived by the social care workers. The subsequent roles of the SCW whether working with or without input of health professionals is then discussed in terms of the individual worker’s ‘proximity’ or working relationship with the service user in question, and also their status within the support organisation. Findings suggest that some front-line workers who can claim closer ‘proximity’ to the service user may not have the same level of information about the behaviour as their managers who work off-site and do not have their direct care. Consideration is then given to accounts of situations in which input from health professionals is sought but is not forthcoming leaving SCWs and their organisations to deal with the behaviour in-house. Some of these such as sexual assault and rape are thus being treated in the community when otherwise the individuals concerned would be treated in locked NHS wards. Thus a new ‘field’ emerges requiring of the SCW a level of responsibility and skill that goes unacknowledged. The thesis ends by considering the feelings of workers involved in interventions into unacceptable sexual behaviour and concludes with recommendations on the education and support these workers require. Acknowledgement of the work they do and re-assessment of their status as workers is also recommended.

Background: The Adult Social Care Outcomes Toolkit was developed to measure outcomes of social care in England. In this study, we translated the four level self-completion version (SCT-4) of the ASCOT for use in the Netherlands and performed a cross-cultural validation. Methods: The ASCOT SCT-4 was translated into Dutch following international guidelines, including two forward and back translations. The resulting version was pilot tested among frail older adults using think-aloud interviews. Furthermore, using a subsample of the Dutch ACT-study, we investigated test-retest reliability and construct validity and compared response distributions with data from a comparable English study. Results: The pilot tests showed that translated items were in general understood as intended, that most items were reliable, and that the response distributions of the Dutch translation and associations with other measures were comparable to the original English version. Based on the results of the pilot tests, some small modifications and a revision of the Dignity items were proposed for the final translation, which were approved by the ASCOT development team. The complete original English version and the final Dutch translation can be obtained after registration on the ASCOT website (http://www.pssru.ac.uk/ascot). Conclusions: This study provides preliminary evidence that the Dutch translation of the ASCOT is valid, reliable and comparable to the original English version. We recommend further research to confirm the validity of the modified Dutch ASCOT translation. (authors' abstract)

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.