Expansive approaches to supporting staff development? Opportunities and Barriers

1. Expansive approaches to supporting staff development? Opportunities and Barriers Supporting Employers in Developing Bands 1-4 Workforce: The education Agenda Newbury Manor Hotel, 17 November 2010 Alison Fuller

2. Overview • Setting the scene • Challenges for employers • Supporting employers: ideas and illustrations • Productive system, health visitors and innovation • hospital porters, expansive – restrictive learning environments • advanced apprenticeship (health) – pathways to jobs or careers • Conclusions

3. Setting the Scene • Growing demand for health and care workers • Growing expectations of support staff (bands 1-4) contribution; majority already working in healthcare • Growing awareness of ‘potential of education as a lever for service improvement’ (High quality care for all) • Growing emphasis on employers’ role in ensuring a ‘high quality workforce’ (commissioning and provision) • Growing investment in apprenticeships ‘in preparing staff for key support roles and for entry to professional training’ (High quality workforce)

4. Building capacity: challenges for employers • Understanding the context: workplace as a productive system • Understanding the workplace as a learning environment • Approaches to workforce development and their implications • Approaches to education and training for initial entrants (apprenticeship) and CPD

5. Supporting Employers: ideas and illustrations • Importance of the productive system: organisational context (health visitor illustration) • The workplace as a learning environment: the expansive – restrictive framework (hospital porter illustration) • Approaches to workforce development: expansive apprenticeship for nurse training

6. Productive Systems • Totality of social relationships entailed in process of producing goods and services • Multiple, interlinked social networks through which activity is organised, goods and services produced and consumed • Applying concept to both private and public sectors and beyond manufacturing • Two axes: vertical interconnections of scale (structures of production) and horizontal interconnections of transformation (stages of production)

7. Stages of Production Structures of Production Work organization & learning under the microscope

9. DH DCSF GPs Schools GPs PCT CCs Speech Therapists HV COP GPs Midwives Maternity Hospitals Social Services LA Housing Dept Public Health Authorities Police & Child Protection Etc, etc The Productive System ofHealth Visiting (2007)

10. Consequences of productive system • The horizontal axis of the productive system of the ‘community of practice’ generated opportunities for expansive learning; the vertical axis ultimately undermined the discretion, trust and morale necessary to sustain an expansive learning environment. • The productive system had paradoxical implications for the work organization and learning environments of ‘the community of practice’, generating uncertainty and distrust. • Ultimately, an opportunity for innovation through new ways of working and learning was lost

11. Hospital Porters Learning at Work • Context and rationale for the research links to focus on the development of support staff workforce • Interviews with porters, their managers and key informants (from theatre, radiology, emergency and operations centre), learning logs, task forms. • Expansive – Restrictive continuum (Fuller & Unwin 2003, 2004) used to analyse the character of the workplace learning environment

12. Expansive – Restrictive Continuum

13. Expansive – Restrictive Continuum cont.

14. Applying the Framework • Alignment of organisational and individual development • Post-induction training vision • Employees’ learning status • Pace and nature of transition to productive worker • Involvement in the occupational and workplace community

15. Applying the Framework cont. • Access to broader communities of practice • Qualifications, work and progression • Allocation of time for off-the-job learning • Value given to existing skills • Provision of support and feedback

16. Some conclusions from the porter study • Social relations (with each other, staff in other departments, patients and their families) is integral to portering – implications for porter training • Some experienced porters are regularly acting as teachers at work including to nurses and other porters – implications for developing an ‘advanced practitioner’ role and challenging inflexibility of banding system • Overlaps or ‘grey areas’ between the responsibilities and tasks of different staff groups - implications for shared training • Porters perceive their role to be poorly understood and under-valued –a more expansive vision of the role could make a more positive contribution to the achievement of organisational goals

17. Apprenticeship as a platform for progression to jobs (and beyond?) • 2 main types: health, and health and social care developed to support job pathways • The health framework includes 19 specialisms reflected in the components of a particular NVQ • Job roles are provided within the framework for each pathway (eg dietetic assistant, radiotherapy assistant, occupational therapy assistant) • AA Qualification requirements: CBE - NVQ 3 in Health (particular pathway); • KBE eg BTEC/EDI Cert in Working in the Health Sector – 110 GLH, 18 QCF credits, most not included in UCAS tariff (BTEC 20-60 pts)

18. From dietetic assistant to dietician • AA health pathway to dietetic assistant (NVQ3/ Band 3) • Dieticians need a degree (or post-grad Q) in dietetics (usually 4 yrs full-time) via a course approved by HPC • Newly qualified dietician start on Band 5 • How can the newly completed AA dietetic assistant progress to becoming a qualified dietician? Where and what are the ladders and bridges? • Where are the missing rungs? What about the FD? • Role of HEIs • Role of professional bodies

19. Employers’ competing priorities? • Competent and safe workforce • Career progression routes (skills escalator/CPD) • Widening participation • Commissioning and funding education and training • Others? • Resolving tensions through building in education to facilitate the development of career (not just job) pathways

20. Conclusions: supporting employers • Identifying the ‘pinch points’, remembering it’s a ‘productive system’ • Rethinking the workplace as a (more expansive) learning environment: improving working as learning • Mapping career pathways, qualification pathways and NHS pay bands and career grades: navigating through or clearing the undergrowth? • The challenge of aligning organisational and individual development goals • Increasing expectations of employers brings increasing need for capacity building: implications for management development

21. References • Felstead, A., Fuller, A., Jewson, N. and Unwin, L. (2009) Improving Working as Learning, London: Routledge • Fuller, A., Laurie, I. and Unwin, L. (2010) ‘Learning as Work in the Portering Department’, Research Report to Southampton University Hospitals Trust • Fuller, A., Turbin, J. and Wintrup, J. (2010) Finding their Way? Advanced Apprenticeship as a Route to HE, Research Report to the Hampshire and Isle of Wight Lifelong Learning Network • Department for Health (2008) High Quality Care for All • Department for Health (2008) A High Quality Workforce