The Allied Health Professional Workforce: Evidence and Impact

Health workforce issues have been on the top of the policy agenda across the globe in recent years. Any dialogue with health policy makers about the health workforce is likely to engender the following key questions: - How do we plan how many health workers to educate, and employ? - How can we improve recruitment, retention and return? - Which incentives are effective in motivating staff? - How can we determine and deploy the most effective skill mix of staff? - How do we improve productivity? These health workforce challenges were summarised by WHO in the 2006 World Health Report, which presented an estimate that there was a world-wide shortage of almost 4.3 million health care workers, and that 57 countries, mostly in sub-Saharan Africa, had critical shortages. Sub-Saharan Africa had only 4% of health workers but 25% of the global burden of disease (GBD); in contrast the Americas had 37% of health workers but only 10% of GBD (WHR 2006). One critical dimension of shortages- is that there is uneven distribution of health workers to meet demand, by country, by region, by sector and by occupational mix. Against this backdrop of global shortages, and in the context of cost containment measures in many countries, developed and developing, it is critical that the allied health professional (AHP) workforce receives sufficient policy attention to enable it to make an optimal contribution to meeting health needs. At the moment, this is not happening fully in many countries and contexts. In part this is because the AHP workforce is often a newer element in the health system, and may not have developed the policy influencing mechanisms that are used by more established- and larger in number professions such as medicine and nursing. In part it can also be because some policy makers do not understand fully just what a contribution is being made, and could be made, by the AHP workforce. This paper summarises the recent evidence base on the contribution of the AHP workforce to health service delivery, and highlights current AHP workforce priorities.sch_nurunpub4303unpu

Globalisation and healthcare labour markets: a case study from the United Kingdom

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International recruitment of physiotherapists: a report for the Chartered Society for Physiotherapy.

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Retirement patterns of doctors

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Exploring the impact of sport participation in the Homeless World Cup on individuals with substance abuse or mental health disorders

Objective To explore the role of the relationship between sport and social capital in negotiating improved social outcomes for homeless individuals with mental illness and/or substance abuse issues. Method A qualitative analysis of semi-structured interviews with 27 participants of the Melbourne 2008 Homeless World Cup (eight from Scotland and 19 from Australia). Interview questions focussed on the participants' interest of and participation in sport; factors influencing participation; any changes perceived by the individuals as a result of program participation; and in order to identify changes pre and post event, any current experiences of social exclusion. Results The role of social capital in mental health and substance abuse outcomes is addressed by the authors, in addition to the contribution of sport to the building of social capital. Conclusion Findings suggest that sport initially provided social bonding within a limited social network, yet over time other types of social capital (bridging and linking) were exhibited by participants, and enabled access to ancillary services provided by the program that led to reductions or cessation of both substance abuse and symptoms of mental illness. Implications Sport can provide an effective vehicle for the accrual of social capital, which may positively impact the mental health and substance abuse patterns of participants from marginalised and at-risk communities.sch_nur1.Dunn S. Creating accepting communities: report of the MIND inquiry into social exclusion and mental health problems. London: Mind1999. 2.Department of Health. Making it happen: a guide to delivering mental health promotion. London: Department of Health2001. 3.Mental Health Foundation. Strategies for living. London: MHF2000. 4.Hawkins R, Abrams C. Disappearing acts: the social networks of formerly homeless individuals with co-occurring disorders. Social Science & Medicine. 2007;65(10):2031-42. 5.Department of Health. Understanding Homelessness and Mental Health. Housing LIN Briefing No. 24. London: Department of Health2008. 6.Department of Health and Social Security. Inequalities in Health: Report of a Research Working Group chaired by Sir Douglas Black. London: DHSS1980. 7.Whitehead M. The Health Divide: Inequalities in Health in the 1980s. London: Health Education Council1987. 8.Department of Health. A First Class Service. London: Department of Health1998. 9.Scutella R, Wilkins R, Horn M. Measuring Poverty and Social Exclusion in Australia: A Proposed Multidimensional Framework for Identifying Socio-Economic Disadvantage. Melbourne: University of Melbourne; 2009. 10.Jarvie G. Communitarianism, sport and social capital. International Review for the Sociology of Sport. 2003;38(2):139-53. 11.Bailey R. Evaluating the relationship between physical education, sport, and social inclusion. Educational Review. 2005;57(1):71-90. 12.Bourdieu P. Cultural reproduction and social reproduction. In: Karabel J, Balsey AH, editors. Power and ideology in education. New York: Oxford University Press; 1977. p. 487-511. 13.Bourdieu P. The forms of capital. In: Richardson JG, editor. Handbook of theory and research for the sociology of education. New York: Greenwood; 1985. p. 241-58. 14.Coleman J. Foundations of social theory. Cambridge, M.A: Harvard University Press; 1990. 15.Putnam R. Bowling Alone: the collapse and revival of American community. New York: Simon & Schuster; 2000. 16.Szreter S, Woolcock M. Health by association? Social capital, social theory and the political economy of public health. International Journal of Epidemiology. 2004;33(4):650-67 17.Barry B. Social exclusion, social isolation and the distribution of income. In: Hills J, Le Grand J, Piachaud D, editors. Understanding Social Exclusion. Oxford: Oxford University Press; 2002. p. 13-29. 18.Stratton M, Conn L, Liaw C, Conolly L. Sport and Related Recreational Physical Activity - The Social correlates of Participation and Non-Participation by Adults. Sport Management Association of Australia and New Zealand (SMAANZ) Eleventh Annual Conference; 25-26 November 2005; Canberra, A.C.T.2005. 19.Irwin J, LaGory M, Ritchey F, Fitzpatrick K. Social assets and mental distress among the homeless: Exploring the roles of social support and other forms of social capital on depression. Social Science & Medicine. 2008;67(12):1935-43. 20.Kawachi I, Kennedy B, Glass R. Social capital and self-rated health: A contextual analysis. American Journal of Public Health. 1999;89(8):1187-93. 21.Poortinga W. Social relations or social capital? Individual and community health effects of bonding social capital. Social Science & Medicine. 2006;63(1):255-70. 22.Rowe N, Beasley N, Adams R. Sport, physical activity and health: Future prospects for improving the health of the nation. London: Sport England2004. 23.Veenstra G. Social Capital, SES and health: an individual-level analysis. Social Science & Medicine. 2000;50(5):619-29. 24.Skinner J, Zakus D, Cowell J. Development through sport: building social capital in disadvantaged communities. Sport Management Review. 2008;11(3):253-75. 25.Portes A. Social Capital: Its Origins and Applications in Modern Sociology. Annual Review of Sociology. 1998;24(1):1-24. 26.Australian Bureau of Statistics (ABS). Social Capital and Social Wellbeing. Discussion paper, August.: Australian Bureau of Statistics2002. 27.Coaffee J. Sport, Culture and the Modern State: Emerging Themes in Stimulating Urban Regeneration in the UK. International Journal of Cultural Policy. 2008;14(4):377-97. 28.Sherry E. (Re)engaging marginalized groups through sport: The Homeless World Cup. International Review for the Sociology of Sport. 2010;45(1):59-71. 29.Sherry E, Strybosch V. A kick in the right direction: longitudinal outcomes of the Australian Community Street Soccer Program. Soccer & Society. 2012;13(4):495-509. 30.Spaaij R. Sport as a Vehicle for Social Mobility and Regulation of Disadvantaged Urban Youth: Lessons from Rotterdam. International Review for the Sociology of Sport. 2009;44(2-3):247-64. 31.Crabbe T. Reaching the 'hard to reach': engagement, relationship building and social control in sport based social inclusion work. International Journal of Sport Management and Marketing. 2007;2(1-2):27-40. 32.Long J, Sanderson I. The social benefits of sport? Where's the proof? In: Gratton C, Henry I, editors. Sport in the city: the role of sport in economic and social regeneration. London: Routledge; 2001. p. 187-203. 33.Smart A. Gifts, Bribes and Guanxi: A Reconsideration of Bourdieu's Social Capital. In: Robbins D, editor. Pierre Bourdieu. London: Sage; 2000. p. 267-97. 34.Hartmann D. Theorizing sport as social intervention: a view from the grassroots. Quest. 2003;55(2):118-40. 35.Magee J, Jeanes R. Football's coming home: A critical evaluation of the Homeless World Cup as an intervention to combat social exclusion. International Review for the Sociology of Sport. 2014;48(1):3-19. 36.Collins M, Kay T. Sport and Social Inclusion. London: Routledge; 2003. 37.Homeless World Cup. Homeless World Cup. HWC; 2013 [cited 2013 29 January]; Available from: www.homelessworldcup.com. Reference Link 38.Sherry E, Karg A, O'May F. Social capital and sport events: spectator attitudinal change and the Homeless World Cup. Sport in Society. 2011;14(1):111-25. 39.Coalter F. A wider social role for sport. Who's keeping the score? London: Routledge; 2007. 40.Burnett C. Social Impact Assessment and Sport Development. International Review for the Sociology of Sport. 2001;35(1):41-57. 41.Jones M, O'Beney C. Promoting mental health through physical activity: examples from practice. Journal of Mental Health Promotion. 2004;3(1):39-47. 42.Penedo F, Dahn J. Exercise and Well-Being: A Review of Mental and Physical Health Benefits Associated With Physical Activity. Current Opinion in Psychiatry. 2005;18(2):189-93. 43.Donaghy M. Exercise can seriously improve your mental health: Fact or Fiction? Advances in Physiotherapy. 2007;9(2):76-89. 44.Oughton C, Tacon R. Sport's contribution to achieving wider social benefits. A Report for the Department of Culture, Media and Sport. London: University of London2007. 45.Halliwell E. Up and running? Exercise therapy and the treatment of mild or moderate depression in primary care. London: Mental Health Foundation2005. 46.Biddle S, Mutrie N. Psychology of physical activity: determinants, well-being, and interventions. 2nd ed. London: Routledge; 2008. 47.Schulenkorf N, Thomson A, Schlenker K. Intercommunity sport events: vehicles and catalysts for social capital in divided communities. Event Management. 2011;15(2):1105-19. 48.Sayd L. More than just football. An evaluation of the Salvation Army's street soccer. Oslo: Salvation Army2012. 49.Homeless World Cup. Impact Report. Edinburgh: HWC2007. 50.Homeless World Cup. Impact Report. Edinburgh: HWC2008. 51.Homeless World Cup. Impact Report. Edinburgh: HWC2009. 52.Homeless World Cup. Impact Report. Edinburgh: HWC20101pub3281pub

Determining skill mix in the health workforce: Guidelines for managers and health professionals

Discussion Paper 3. Department of Organization of Health Services DeliveryGenevaMost health systems are coming under increasing scrutiny with a view to cost containment, often as a direct or indirect result of health sector reform. Health care is labour intensive, and the level and mix of staff deployed is a central element in determining the cost of care and the quality of care. It is important that managers and health professionals in any health care organization strive to identify the most effective mix of staff achievable within available resources and organizational priorities. This report builds on the work already undertaken for WHO in this area, which developed a typology of approaches to skill mix (Buchan, Ball & O'May, 1996; see also Buchan, 1999). It examines the context in which decisions on skill mix are made,drawing from country case studies, and provides practical guidelines for health professionals and managers.sch_nurpub513pu

Safe staffing levels - a national imperative. The UK nursing Labour Market Review 2013

LondonThis report is the 2013 annual review of the UK nursing labour market commissioned by the Royal College of Nursing. Events over the last twelve months point to the urgent need to address both the national security of the supply of nurses, and the local ability to determine evidence-based nurse staffing levels.div_PaSThe Mid Staffordshire NHS Foundation Trust Public Inquiry (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry: executive summary. London: Stationery Office (Chair: R Francis). www.midstaffspublicinquiry.com/sites/default/files/report/Executive%20summary.pdf 2 Royal College of Nursing (2013) Mid Staffordshire NHS Foundation Trust Public Inquiry Report: Response of the Royal College of Nursing. RCN, London http://www.rcn.org.uk/__data/assets/pdf_file/0010/530956/004476.pdf 3 See e.g. Healthcare Improvement Scotland (2013) Announced Inspection Report - care for older people in acute hospitals, Aberdeen Royal Infirmary, NHS Grampian. Healthcare Improvement Scotland, Edinburgh www.healthcareimprovementscotland.org/our_work/inspecting_and_regulating_care/opah_grampian/aberde en_royal_infirmary_jun13.aspx 4 Scottish Government (2012) News Releases. Nurse staffing levels. 26th November. Scottish Government, Edinburgh. http://www.scotland.gov.uk/News/Releases/2012/11/staff261112 5 Buckland L (2013) 67 million boost to NHS staff to avert age crisis. Scotland on Sunday, August 11, p6. 6 Royal College of Nursing, Wales (2013) RCN in Wales responds to Health Minister's 10 million nurse recruitment announcement. www.rcn.org.uk/newsevents/news/article/wales/rcn_in_wales_responds_to_health_ministers_10_million_nu rse_recruitment_funding 7 DHSSPS (2013) Health Minister and RCN agree on nursing priorities for Workforce Plans. www.northernireland.gov.uk/news-dhssps-080713-health-minister-and 8 Department of Health (2013) The Cavendish Review. Review of healthcare assistants and support workers in NHS and social care. Department of Health, London. www.gov.uk/government/uploads/system/uploads/attachment_data/file/212732/Cavendish_Review_ACCESS IBLE_-_FINAL_VERSION_16-7-13.pdf 9 NHS England (2013) Review into the quality of care and treatment provided by 14 hospital trusts in England: overview report. NHS England, London. www.nhs.uk/NHSEngland/bruce-keogh-review/Documents/outcomes/keogh-review-final-report.pdf 10 National Advisory Group on the Safety of Patients in England (2013) A promise to learn- a commitment to act: Improving the Safety of Patients in England. NHS England, London www.gov.uk/government/uploads/system/uploads/attachment_data/file/226703/Berwick_Report.pdf 11 Imison C, Bohmer R (2013) NHS and social care workforce: Meeting our needs now and in the future? King's Fund, London www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/perspectives-nhs-social-care-workforcejul13. pdf 12 Centre for Workforce Intelligence (2013) Future nursing workforce projections - starting the discussion, London: CfWI. www.cfwi.org.uk/publications/future-nursing-workforce-projectionsstarting% 20the%20discussion 13 Buchan J Seccombe I (2011) A decisive decade. The 2011 UK nursing labour market review. Royal College of Nursing, London. www.rcn.org.uk/__data/assets/pdf_file/0006/405483/LMR2011_FINAL.pdf 14 RCN Scotland (2013) Student numbers maintained, but looming shortage of nurses, warns RCN. RCN Edinburgh, 25 February. www.rcn.org.uk/newsevents/news/article/scotland/student_numbers_maintained,_but_looming_shortage_of _nurses,_warns_rcn 15 Department of Health (2013) Delivering high quality, effective, compassionate care: Developing the right people with the right skills and the right values. A mandate from the Government to Health Education England: April 2013 to March 2015. Department of Health, London http://hee.nhs.uk/wp-content/blogs.dir/321/files/2013/05/29257_2900971_Delivering_Accessible.pdf 16 National Audit Office (2013). Managing the transition to the reformed health system. NAO, London. www.nao.org.uk/report/managing-the-transition-to-the-reformed-health-system/ 17 Timmins N (2013) The four UK health systems: Learning from each other. King's Fund, London www.kingsfund.org.uk/sites/files/kf/field/field_publication_summary/four-uk-health-systems-jun13.pdf 18 Audit Scotland (2012) NHS financial performance 2011/12. Audit Scotland, Edinburgh www.audit-scotland.gov.uk/docs/health/2012/nr_121025_nhs_finances.pdf 19 National Audit Office (2012) Progress in making NHS efficiency savings. NAO London. 34 www.nao.org.uk/report/progress-in-making-nhs-efficiency-savings/ 20 Jones N, Charlesworth A (2013) The anatomy of health spending 2011/12. Nuffield Trust, London. www.nuffieldtrust.org.uk/publications/anatomy-health-spending-201112-review-nhs-expenditure-and-labourproductivity 21 Roberts A, Marshall L, Charlesworth A (2012) A decade of austerity? Nuffield Trust, London www.nuffieldtrust.org.uk/sites/files/nuffield/121203_a_decade_of_austerity_full_report_1.pdf 22 Duffin C (2013) Stop start recruitment of nurses is damaging morale and patient care. Nursing Standard 27(48) p5 23 Department of Health (2013) National health visitor plan: progress and future implementation. DH London. www.gov.uk/government/publications/health-visitor-vision 24 NHS Employers (2013) NHS Staff Council. NHS Working Longer Review: Audit of existing research. NHS Staff Council/ University of Bath 25 Nursing Times News (2013) Retirement age health visitors offered sweeteners to stay in work. Nursing Times 27 (44), July 3 26 Sprinks J (2013) Minister tells trusts to cut spending on agency staff and equipment. Nursing Standard 27 (50), p10. 27 UCAS annual datasets (subject dataset v2.0, JACS3 subject line B7 Nursing) 28 NHS Education for Scotland, 2011, Untangling a complex issue: Nursing & Midwifery Student Recruitment and Retention Delivery Group Annual report 2010-11 www.nes.scot.nhs.uk/media/536359/delivery_group_-_annual_report_2010-11_final.pdf 29 Nursing Times, 27 September 2011, Huge fall in numbers dropping out of nursing courses 30 http://hee.nhs.uk/2013/05/09/top-nurses-to-oversee-pilots-on-pre-degree-care-experience/ 31 Centre for Workforce Intelligence (2013) Horizon scanning - A strategic review of the future healthcare workforce: Informing the nursing workforce www.cfwi.org.uk/publications/horizon-scanning-a-strategic-review-of-the-future-healthcare-workforceinforming- the-nursing-workforce 32 Queens Nursing Institute (2013) District Nurse Education 2012/13. QNI London www.qni.org.uk/campaigns/report_on_district_nurse_education 33 RCN Policy Unit (2012) The Community Nursing Workforce in England. RCN, London 34 Department of Health (2013) Care in local communities - district nurse vision and model. DH London. www.gov.uk/government/uploads/system/uploads/attachment_data/file/213363/vision-district-nursing- 04012013.pdf 35 Nursing Times (2013) Retirement age health visitors offered sweeteners to stay in work. Nursing Times, 27 (44) July 3rd. 36 http://frontlinefirst.rcn.org.uk/sites/frontlinefirst/index.php/blog/entry/scotlands-families-deserve-healthvisitors 37 Sprinks J (2013) Drafting in of Danish health visitors is just a short term fix, says Unison. Nursing Standard 27 (51), p9 38 House of Commons, Health Committee (2007) Workforce Planning: Fourth Report of Session 2006-07 Volume I Report, together with formal minutes. Health Committee, London: The Stationery Office Limited www.publications.parliament.uk/pa/cm200607/cmselect/cmhealth/171/171i.pdf R C N L A B O U R M A R K E T R E V I E W The RCN represents nurses and nursing, promotes excellence in practice and shapes health policies September 2013 RCN Online www.rcn.org.uk RCN Direct www.rcn.org.uk/direct 0345 772 6100 Published bypub3274pu

MY Voice: A participatory action research project with men, women and young people on female genital mutilation (FGM) in Scotland

MY Voice is an innovative participatory action research project with affected communities on Female Genital Mutilation (FGM) in Scotland. The project aims are to facilitate community engagement on FGM with women, men, young people and religious leaders, to enable their voices to be heard, and to contribute to the development of awareness-raising around FGM, as well as ensuring culturally appropriate services for Scotland. There have been multiple calls for greater community participation and leadership in the work on FGM in Scotland from those directly affected (see section 1.3). The findings from MY Voice can start to identify key issues and help determine ways in which community participation can be built in to the Scottish response to FGM more effectively.Funding was provided by the Scottish Government Violence Against Women Fund.https://www.waverleycare.orgpubpu

Physician Assistants in NHS Scotland: Reviewing the Issues. Report for the Scottish Executive Health Department.

EdinburghThis paper was commissioned by the Scottish Executive Health Department (SEHD). It provides background information on the role of physician assistants (PAs), and on their deployment in the United States and in England. The SEHD is planning to recruit and deploy a small number of US educated PAs in the NHS in Scotland in 2006. The primary focus of the paper is to identify lessons for consideration during planning and implementation of the planned pilot-. This paper highlights key lessons from the literature, and from key informants, on the employment of PAs. Readers who wish a comprehensive assessment and description of the development of the PA role in the USA, should consult the American Academy of Physician Assistants (AAPA) website (www.aapa.org) and also the core book by Hooker and Cawley (2003). Given constraints of time and resources the focus of the review was on identifying key messages for Scotland; it was not structured as a systematic review (no systematic review of physicians assistants was identified during the search). The review was supported by follow up contact with key individuals and representatives of organisations in the US and with UK organisations working with PAs. The purpose was to identify the issues that need be considered in the lead up to the recruitment and deployment of PAs in the NHS in Scotland. The remainder of the paper is in two sections: Section 2 reports key findings from the literature review; and Section 3 reports of follow up findings, and focuses on key messages for Scotland.sch_nurpub504pu

Report submitted to ScotMid Co-operative Society 'Recall, understanding and responses to the 'Sensible Drinking message' among supermarket shoppers in Scotland'.

EdinburghThis study was conducted with the following general aims; - To investigate the feasibility of carrying out a questionnaire-based study dealing with issues relating to alcohol drinking within the supermarket setting. - To document awareness and recall of the UK 'Sensible Drinking' message among shoppers. - To investigate the perceived usefulness of the message and the ability to apply knowledge to personal drinking. - To monitor awareness of, and response to, the initiative by the Co-operative Society to promote the 'Sensible Drinking' message on wine labels. - To distribute and monitor reaction to 'Sensible Drinking 'guidance literature.sch_diesubmitted506submitte