In the previous sections we have identified the best practice pathways, outcome measures and enablers required to deliver effective integrated service delivery and monitoring. Whilst these are all essential elements the overall quality and effectiveness of services to children and families will depend heavily on the knowledge and skills of the workforce that deliver them.
Historically workforce development, like other areas of service delivery and commissioning, has been approached from a uni-professional/organisational perspective despite the fact that the core skills and knowledge required by anyone who works with children and young people is the same.
The complex nature of services for children and families requires a clear focus on the need for both integrated delivery and commissioning if the ambitions of the HCP are to be achieved. The same principles should also be applied to the development of the workforce responsible for delivering the services.
The following section describes a system wide model for the integrated development of the children and families workforce.
The needs of children and families receiving services delivered through the HCP will be diverse, and the knowledge and skills required in the workplace need to reflect this diversity. In addition any model needs to take into account the individual roles and responsibilities of staff and the knowledge and skills required to support effective delivery. It is therefore essential that any educational model reflects the various levels of learning interventions required to enable the safe and effective provision of care from the core skills through to the complex and specialist skill.
The model described below (figure 8) proposes three levels of education and training provision to reflect the differing levels of knowledge and skills required to ensure appropriate, safe delivery of the HCP programme.
It should be noted that in developing this model a number of key assumptions have been made, these are: • Supervision and mentorship is available for all staff
At the first level is the provision of core knowledge which all staff that come into contact with children and families should poses in order to deliver the HCP 0-5 years. This can be delivered through e-learning, workshops or resource packs and should be widely available across the system. The focus of this training is to ensure that all staff that are delivering services to children and families are equipped with the necessary skills and knowledge to ensure provision of relevant, up to date and consistent advice.
At the second level, the educational input required to develop the necessary knowledge and skills will be tailored to the specific needs of staff depending on their role, and may include decision making, assessment skills and planning as examples. This may take a combined approach of face to face and e learning, depending upon the local system. This will still be based on a generic skill set, necessary to support integrated working, but will be underpinned with a need to provide increased knowledge and skills in specific areas of care for children and their families.
The third level of educational input focuses on those staff that, by virtue of their role, are responsible for the delivery of care to children and families who are more vulnerable or have highly complex or specialist needs. As a result this group of staff are likely to be smaller in number but will require more complex or specialist knowledge and skills. In addition to providing the necessary level of learning, this level should provide an increased focus on an integrated approach to educational delivery that ensures multi-professional cohorts are learning together to aid understanding and support the delivery of integrated care pathways.
Whilst it is acknowledged that the training needs of staff working within individual health & social care systems may vary according to the needs of their local population, the following tables identify the range and nature of training likely to be required at the three levels identified within the proposed model.
It is recommended that all new staff should undertake the following training within the first year of employment or when identified separately within the table.
Method of delivery | Suggested length of delivery | Interagency | Single Agency | Examples of Roles / Comments | |
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Communication Skills |
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Face to Face | 2 days | Yes | Will Require | Programme Development |
Record Keeping inc IT |
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Face to Face | Variable according to organisation | Yes | |||
Safe Working |
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Scope of practice Lone working Basic risk assessment Domestic violence | Face to Face | 1 day | Yes | ||
Child Development |
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Basic milestones Physical, emotional, speech and language, behaviour. | e-learning + experience in workplace | Completed within first 6 months in post | E-learning only currently available for NHS | ||
Parenting |
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Basic parenting skills looking at physical and emotional needs, attachment Maternal mental health | e-learning + experience in workplace | Completed within first 6 months in post | E-learning only currently available for NHS | ||
Health Promotion |
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Breastfeeding Awareness | e-learning + experience in workplace | 2 hours | Yes | ||
Smoking cessation - level 1 | e-learning + experience in workplace | 2 hours | Yes | ||
Nutrition and Healthy Lifestyles | e-learning | Completed within first 6 months in post | E-learning only currently available for NHS | ||
Sexual health/drugs/alcohol | Face to face | Half day – 3 hours | Yes | ||
Immunisations/screening | e-learning | Completed within first 6 months in post | Yes | ||
Safeguarding – level 1 | Face to face | 2 hours | Yes |
It is recommended that, where appropriate to their role, staff should undertake the following training over a two year period.
Method of delivery | Suggested length of delivery | Interagency | Single Agency | Comments | |
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Communication Skills |
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Group work Skills | Face to face | 1⁄2 day – 3 hours | Yes | HV’s, midwives, nursery nurses, children’s centre staff | |
Working with families with additional risk factors |
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Domestic violence | Face to face | 1 day | Yes | ||
Adult mental health | Face to face | 1 day | Yes | ||
Perinatal mental health | Face to face | 1 day | Yes | ||
Infant mental health – specialist support e.g. mellow parenting | Face to face | 1 day | Yes | ||
Drugs and alcohol | Face to face | 1 day | Yes | ||
Child Development |
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Speech and language disorders | Face to face | Half day | Yes | This may exist in some organisations or may need development | |
Assessing development
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Face to face | 2 hours | Yes | This may exist in some organisations or may need development | |
Knowledge of developmental disorders e.g. autism | Face to face | Half day | Yes | This may exist in some organisations or may need development | |
Parenting |
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Triple P – to support delivery of Triple P | Face to face | To be identified | Awareness session may need development | ||
Solihull | Face to face | 3 days | |||
Preparation for Birth and Beyond | Face to face | 2 days | Yes | ||
Promotional Guides – use of guides | Face to face | 2 days | Health | ||
Promotional Guides – train the trainer | Face to face | 1 day | Health | ||
Sleep management programmes e.g. Millpond | Face to face | To be identified | Yes | May need development | |
Family Partnership Model | E – learning + face to Face | To be identified | Yes | Essex only | |
Health Promotion |
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Prevention and management of obesity e.g Henry | Face to face | 2 days | Yes | ||
Unicef Baby Friendly – breastfeeding management | Face to face | 2 days | Yes | ||
Train the trainer | Face to face | 3 days | Yes | ||
Smoking Cessation level 2 | Face to face | To be identified | Yes | ||
Infant massage | Face to face | 3 days | Yes | ||
Leadership |
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Skills and approaches Self-awareness Influence and managing change |
Face to face | 3 days | Yes | This may exist in some organisations or may need development | |
Community Development |
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BCC | E learning + practical delivery | Yes | |||
Workplace Advisor Training | Face to face | 1 day | Yes |
As indicated above level 3 training will be targeted at a relatively small number of staff, who by virtue of their role will require more complex or specialist knowledge and skills. Given the differing needs of local populations the nature and level of training required will vary between different health & social care systems. For this reason it is difficult to identify the full range of training likely to be needed at this level; however examples of the type of training that may be included in this level are:
The importance of integrated commissioning and delivery of services is well understood and acknowledge by those actively involved in the delivery of the health child programme and has provided a clear focus over recent years. However, the importance and benefits of providing an integrated approach to the delivery of training and education specific to the health child programme appears to date to have lacked the same focus.
The ability to provide relevant, purposeful and role appropriate integrated training will assist local systems to provide a skilled, consistent and stable workforce capable of delivering high quality services to children and families. Whilst there is a need to acknowledge the differences in professional roles, responsibilities and accountability, specialist skills should where possible be nurtured, shared and celebrated.
In order to maximise both the service and cost benefits of delivering a local integrated workforce development plan, individual areas will need to ensure the appropriate systems and processes are in place to co-ordinate, manage and commission the necessary training.
To achieve this local health & social care systems should, under the leadership of the Health & Wellbeing board or through local workforce partnership groups, consider the establishment of a ‘Health & Social Care - HCP Partnership plus Workforce Development Team’. Whilst the membership of this team would need to be agreed at a local level it should include a range of stakeholders such as:
The core responsibilities of this group would include: