13 Dec 2018<
The UK-based founders of a workforce design framework, which has been steadily transforming the way health care is delivered across the South Island since 2015, recently visited Christchurch to share their expertise.
Jayne Duffy and Rachael Smith, of Effective Workforce Solutions UK, developed the Calderdale Framework as physiotherapists out of clinical need over 10 years ago. It is a seven-stage process to develop a competent and flexible health and social care workforce, by reviewing skill mix and roles within a service to ensure quality of care and safety for patients.
The Calderdale Framework has been used extensively across the UK and Queensland for many years. The South Island currently has 25 people trained in leading the use of the framework (Calderdale Framework facilitators) including two Calderdale Framework practitioners (‘train the trainers’). Jayne and Rachael visited Christchurch last month, where they held a seminar for health professionals wanting to learn about the potential of using the Calderdale Framework within their work areas, and also began the training of four new practitioners (two for the South Island and two for Central Region and a new cohort of facilitators.
There are currently 16 Calderdale Framework projects across the five South Island DHBs, with the majority focused on more effective use of the allied health assistant workforce in clinical care through skill delegation.
In Nelson Marlborough, one of the projects involves skill sharing between allied health professionals in ED. As part of the project, a multi-disciplinary team screening tool and a clear pathway for allied health referrals has been developed, which has helped to ease pressure on ED admission and bed occupancy rates. “Patients are spending less time waiting in ED thanks to a more streamlined admission process,” says physiotherapist Deirdre Crichton, MAPU (Medical Admissions and Planning Unit) team leader, Nelson.
In the West Coast DHB, utilising the Calderdale Framework has increased opportunities for allied health assistants to upskill and gain knowledge in order to safely and effectively work with patients in their communities. In August last year, qualified allied health assistants from Westport, Greymouth and Hokitika participated in training on specific clinical task instructions (CTIs): when to stop (a ‘first do no harm’ approach as a foundation to all training), mobility aides, mobility practice , and strength and balance exercises. An allied health assistant who went through the training says, “The training has clearly identified the expectations of me as an assistant and has extended my knowledge and skill base to inform better practice.”
Cantabrian patients are now receiving better care and rehabilitation in their own homes from 67 key support workers as part of a CREST (Community Rehabilitation Enablement and Support Team) project. Using Calderdale framework methodology, CREST physiotherapists identified a number of ‘high volume low risk’ tasks which could be safely and effectively delegated to the key support workers and provided the appropriate training for this using specific Clinical Task Instructions. A pre-and post-survey completed showed key support workers gained confidence and competence in completing therapy tasks with patients in their homes. To prevent falls in South Canterbury, the framework methodology is being used in a project aimed at increasing the number of people over the age of 65 years living in the community who are engaged in strength and balance exercises. Physiotherapist-led education is being provided to community key support workers and as with all training on Clinical Task Instructions involves teaching, modelling and checking for competence by observing key support workers ‘in action’ working with patients .
Not only is the Calderdale Framework helping to support our allied health workforce, it’s also improving safety and outcomes for our South Island communities. The word is spreading too – the South Island Workforce Development Hub have been supporting Central Region by helping them to train facilitators and set up implementation processes. The Hub has also confirmed an agreement for our South Island Calderdale Framework practitioners to provide training in Northland DHB early next year. This is to support a community-based project involving Māori health providers.