Applying a health psychology approach to workforce redesign
The NHS People Plan sets out the need to design integrated service and workforce models that reflect the current and future needs of local populations with a stronger focus on the broader social determinants of health, such as education and employment, working across local health systems to:
- identify how best to develop and adapt roles to match people’s skills to changing population needs
- design multidisciplinary teams that provide more person-centred care
- redesign workforce models to reflect digital and technological innovation
- consider the contribution and support needs of volunteers, carers and those working in the third sector
Workforce redesign is key to this; the NHS People Plan commits to helping stimulate workforce redesign by providing organisational development support to help integrated care systems (ICSs) build flexible and agile teams that work across multiple organisations to provide seamless, patient-centred care.
Applying a health psychology approach to workforce redesign will help colleagues to understand and embrace organisation/system change.
This will support the development of new models of care to not only recover services following the pandemic, but also optimise the potential in primary, secondary and community care settings, facilitating enhanced and accelerated multi-disciplinary team (MDT) working.
Health Education England (HEE) is undertaking this pilot programme to build capacity and capability for workforce redesign across whole system pathways. By applying the psychology of system and health behaviour change, we can enable/facilitate change for the benefit of staff, patients, and health and social care organisations.
The capability, opportunity, motivation, and behaviour framework (COM-B) will be used to do this, with seven experts in the psychology of system and health behaviour change delivering this over a two-year period.
The psychology experts will be trainee health psychologists, who have already completed an MSc in health psychology, accredited by the British Psychological Society.
The trainees will build capability within organisations and systems to apply the framework through direct application to workforce projects and will also train others within the health and care system.
This ensures systems are equipped and able to respond in an agile way to the new and revised models of care required in the recovery, restoration, and improvement of services.
The trainees will be supervised by senior practitioner health psychologists with expertise in the psychology of behaviour change adding an additional knowledge transfer through the trainees to the host systems.
Additionally, as part of their training, the health psychologists will develop and conduct research projects and feed findings directly back into the systems, increasing the evidence base regarding successful and sustainable workforce redesign.
As part of this programme of work a new role of National Training Director for Health Psychology in Workforce Redesign has also been established and is an important development in the application of health psychology within the NHS. The role, and involvement of the wider programme steering group, is trailblazing the integration of experts in both health psychology and workforce redesign, with staff and patients set to benefit because of this innovative approach.
This work is linked to wider programmes to expand the psychological professions across NHS service pathways, set out in the Psychological Professions Workforce Plan for England.
Why has the programme been developed?
Trainee health psychologists have had considerable impact on health and care transformation in Scotland, where they have operated a similar framework for over 10 years. Projects have included, establishing a liaison service, treatment of long-term conditions, and integrated teams within primary care.
A pilot study in the north-west of England also found this approach welcome and feasible.
In this pilot programme, the trainee health psychologists will be applying theories, evidence and methods from health psychology and behavioural science, engaging organisations in the development of new ways of working across the seven HEE regions in England.
The importance of psychology of behaviour change is well recognised and the COM-B framework presents an opportunity to build capacity within organisations, systems, and regions for positive and enduring culture change.
Health psychologists are Health and Care Professions Council (HCPC) regulated health professionals with extensive training in behavioural science in health and healthcare. Having them embedded in local systems means that they can be responsive to the needs of the region in workforce redesign.
This two-year funded project will be evaluated with a view to developing a sustainable national implementation plan to:
- use the skills of health psychologists (both the trainees and their supervisors) to support organisations to embed new ways of working that improve health and care
- use evidence-based tools to understand behaviour change requirements and develop sustainable interventions
- build capacity in regions in behavioural science methods and practice (in line with Public Health England’s behavioural and social science strategy)
- provide national coverage, with a consistent offer across the seven regions of England
How will the programme work?
The seven trainee health psychologists will each work within one of the seven regions across the NHS in England, delivering projects and learning within that region and the host organisation they will primarily work in for the two-year period.
The projects delivered will be pertinent to regional and system priorities and will be identified by the region and host organisation they are working within.
Each trainee will have a workplace supervisor, who will agree their job plan and be their day-to-day contact, advising on system priorities, help them to engage with appropriate networks, and supporting the trainees to deliver the agreed work.
The workplace supervisor should work within the same organisation to ensure they can provide this level of support.
Trainees will also be provided with a coordinating educational supervisor, who will be a qualified health psychologist from within or outside of the system.
During the two years, the trainees will complete a portfolio demonstrating their competencies in psychological intervention and behaviour change, training, research and consultancy, the completion of which will be discussed by the system and both workplace and educational supervisors.
All these competencies will be developed during the delivery of the workforce projects.
The teaching and training competency will be fulfilled by building capacity across the system for others to use the COM-B framework.
Completed portfolios will be submitted by trainees to the British Psychological Society for assessment, and once they have successfully completed this stage the trainees will have completed the Qualification in Health Psychology (Stage 2) and will be eligible to register with the HCPC. Completion will also signify that the individuals are now further qualified and experienced in both health psychology and in working in the health and care sector, supporting future recruitment and integration into our workforce.
The project is currently being managed by a steering group, with representatives from Health Education England, NHS England via the National Psychological Professions leadership team, and the British Psychological Society Division of Health Psychology.
Additionally, there is a part time training director working half a day per week to support regions, systems, and trainees to get the most out of the programme.
Following the appointment of the trainee health psychologists and host organisations, membership of the steering group will be extended as appropriate.