MEETING THE STAFFING CHALLENGE OF RAPIDLY GROWING LEARNING DISABILITY SERVICES

Brian O'Donnell, CEO of the National Federation of Voluntary Bodies Providing Services to People with Mental Handicap, gives an overview of the Federation's policies to meet increasing staffing requirements.

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Thankfully over the past two years, 2000–2001, there has been an unprecedented level of investment in new services development by government to deal in a meaningful way with the Waiting Lists for Services issue. The provision of £70m in Budgets 2000 and 2001 for new service developments, together with a three-year capital programme of some £85m, presents the largest single investment in intellectual disability services. After many years of lobbying for extra resources to deal with the waiting lists issue, the National Federation of Voluntary Bodies welcomes these budget announcements, and we will be redoubling our efforts during 2001 to ensure that this level of investment in new service developments continues until waiting lists for services are eliminated.

However, that said, it should be stated that the substantial increase in funding does present major challenges for National Federation members in terms of the recruitment of staff. Moreover, at a time of acute labour shortages in the market, many service providers are finding it increasingly difficult to retain good staff. There are also ongoing difficulties for many service providers in recruiting nurses and paramedical grades, such as speech and language therapists, physiotherapists, occupational therapists and psychologists, owing to problems on the supply side.

In view of the size of the challenge presented, the National Federation of Voluntary Bodies has formulated a comprehensive Human Resources Strategy to deal with the many issues arising. In this brief article it is impossible to outline all of the aspects of the strategy in detail, but the following is an outline of some of the important actions which we are implementing.

Manpower planning

It is our view that this is a logical and necessary starting-point if the waiting list issue is to be dealt with in an effective and meaningful way. The National Intellectual Disability Database gives a very good indication of the number of people on waiting lists for services, by level of disability. Using the available data it is possible to carry out a full assessment of the types of new service developments which will be required over the next few years and the numbers and types of staff needed in order to deliver those services. Therefore, we are currently cooperating with the Department of Health and Children in carrying out a comprehensive manpower planning analysis, having regard to those people who are currently on waiting lists for services and those who are likely to come onto waiting lists over the next few years. Regard will also be given to changing service requirements for those already in service.

Promotion of the intellectual disability sector as a career choice

In recent times school-leavers have had unlimited opportunities laid before them in terms of career choices. Individuals already in the labour market also have unprecedented opportunities for career change. It is vital that a career in intellectual disability services is promoted to the greatest possible extent, and the full range of opportunities and challenges highlighted.

The National Federation of Voluntary Bodies takes every opportunity to promote the intellectual disability sector as a career choice. Over recent months we have attended numerous recruitment fairs in Ireland and abroad. We are currently reviewing our website to ensure that careers in the sector are portrayed in the best possible light.

Many higher education institutions offer third-level courses in health/social care. The Faculty of Health Science at Trinity College provides degree-level courses for the clinical professions. Research recently completed by the National Federation indicates that eight different courses in Applied Studies in Social Care at certificate, diploma, primary degree and masters level are provided by six different Institutes of Technology around the country. However, in only one case was a module tailored specifically to intellectual disability issues included in the syllabus. This, in our view, has at least two serious consequences:

  1. the vast majority of social care students have no exposure to intellectual disability issues or to the possibilities which a career in the sector has to offer;
  2. the higher education institutions are not producing suitably qualified graduates in sufficient numbers to meet the needs of our sector.

Ongoing difficulties in the recruitment of certain paramedical staff, including speech and language therapists, physiotherapists and occupational therapists, has been a problem for many service providers over a number of years. Anecdotal evidence would suggest that in many cases these professions do not view a job in intellectual disability services as a rewarding career choice. In any event, these professionals are not being produced in sufficient numbers to meet service needs. The fact that very few third-level educational institutions are producing paramedical professionals, and that there is a high points requirement to gain entry, has been offered as a reason for the low availability. The relatively low salary scales applicable to these grades also mean that many are attracted to careers in the private sector after qualification.

As a National Federation it is our intention to use our influence to rectify this situation. At a meeting in June 2000 we brought these facts to the attention of the Minister for Education and Science, Mr Michael Woods TD. Some progress has been made, and a working group, under the auspices of the National Council for Educational Awards, has now been established to examine this matter. The National Federation has been invited to participate in this group and we will use this forum to ensure that our specific needs and requirements are met.

Recruitment

The issue of recruitment is obviously linked to the promotional activity proposed. However, it is conceded that the results of effective promotional campaigns will probably be seen more in the medium and longer terms. In the shorter term, National Federation recruitment campaigns will avail of the opportunity to promote the intellectual disability sector in an effective and meaningful way. In this regard, advertisements for all jobs by National Federation members is being coordinated centrally; all jobs are now advertised on a dedicated National Federation site within the national newspapers. This gives us an opportunity to be more cost-effective in terms of advertising, to free up financial resources for investment in services, and to convey a positive message regarding the range and scale of opportunities available in the sector.

As it becomes increasingly difficult to recruit certain categories of staff, such as nurses and paramedical grades, the skills mix within services will require thorough examination and analysis. It is our intention to discuss this issue with all the stakeholders to ensure that, where changes in skill mixes are required, there is no diminution in the quality of services provided. Presently there are 700 job vacancies, covering all grades of staff within the National Federation membership. Many of these vacancies will be filled locally through national and local recruitment campaigns. However, in the case of many nursing and paramedic grade vacancies it has become necessary to recruit internationally to ensure that much-needed services are developed and maintained. Many service providers have embarked on international recruitment campaigns and are expressing high levels of satisfaction with the people recruited.

Retention of existing personnel

As previously outlined, there are unprecedented opportunities for people already in employment to change careers. In this context, there are major challenges for many service providers to retain good staff. There is no easy fix to this problem, but it is vitally important that the people’s terms and conditions of employment are the best available within the set parameters. During this time the National Federation have been engaged with the Health Services Employers Agency to deal particularly with salary issues of care staff; happily, the matter was resolved satisfactorily during 2000- Additionally, people working at whatever level must be given the opportunity to further their careers within the sector, and in this regard National Federation members are taking the necessary measures which will facilitate personal development and career advancement.

The world of work is changing rapidly and radically. Employees are increasingly seeking to balance work with non-work activities and to have more choice in how and where they work. Intellectual disability services are, by their nature, limited in terms of the extent to which they can respond to these shifts. There is a need, nonetheless, to develop innovative responses to the issue of flexible working and other initiatives, such as the development of crèche facilities where possible and practical, which will help services to retain good staff.

An essential prerequisite to staff recruitment, staff retention and staff satisfaction is good people-management at all levels in the organisation. Well-focused training at all levels is critical for the achievement of this. The National Federation’s strategy for staff development is to adopt a comprehensive, coherent and systematic approach by:

  1. identifying the training and development needs of all staff
  2. establishing objectives/standards and developing a programme of training activities focused on identifying needs across the knowledge/skills spectrum
  3. supporting on the job development of staff
  4. encouraging individuals to take responsibility for their own development
  5. ensuring the commitment of Senior Managers to the process of staff training and development
  6. providing staff with accredited training and development programmes which offer a clear progression route to further education and career development.

Following an assessment of training needs carried out during 2000, the National Federation has put in place a programme of training events to meet the needs of all staff and we are currently exploring joint health board/National Federation initiatives to cover issues of mutual interest. We are also exploring the possibility of identifying and developing centres of excellence which will be equipped to provide high-quality training on specific issues. It is our intention that these training programmes will, where possible, be accredited and offer interested staff a clear progression route to further education and career development.

Conclusion

Clearly the level of investment in new service developments will present significant challenges to service providers over the next few years. The scale of the challenge demands a multifaceted response which will involve short-, medium- and longer-term actions. It will require strong cooperation between the National Federation of Voluntary Bodies, the health boards and the Eastern Regional Health Authority, various government departments and, not least, service user representative groups, such as the NAMHI and the National Parents and Siblings Alliance (NPSA).

The National Federation of Voluntary Bodies is committed to meeting these challenges head on. Over the next few years we will do everything in our power to develop the necessary services to ensure that the long-standing waiting lists problem will become a thing of the past.