Scope
The HSDR Programme would like to fund high-quality research to generate new evidence on skills, training and development for staff to deliver health and care in an ever-changing context, from ageing populations with complex needs to increased digitisation and integration of services. This research call has been framed to include some of the priority areas identified at a recent workshop, convened by the NIHR incubator for clinical education research, and encompasses the full breadth of the health and social care workforce. Research applications are welcome from all relevant disciplines and professions, including those less represented in education research to date. We welcome studies focused on the skills, training and development of non-clinical or unregistered staff, from support to management roles, in health and social care.
All research should generate national learning and include a robust evaluation, rather than small-scale descriptive studies. Research applications may take a range of approaches, including mixed-methods, observational and other research designs. Use of routine data is encouraged, from electronic staff records to national clinical audit and other databases as well as registry data from national regulators. Appropriate theoretical framing, for instance, drawing on relevant evidence on workplace learning and career path development, will help to increase generalisability of findings and advance knowledge on education and skills.
Research to support changes in the national pre-registration or purely undergraduate curricula would not be within remit for the HSDR Programme.
Studies are welcome from researchers working in all parts of the UK.
Background
The UK faces a staffing crisis in health and social care services, with reported shortages of more than 200,000 staff across these sectors in England alone. Retaining experienced staff is difficult and equipping the workforce to meet rising demands for care – and new challenges such as digitisation, personalised medicine and service integration – remains the most pressing task for national and local services and their leaders.
Workforce is 1 of the 3 top areas of research interest identified by the Department of Health and Social Care. This includes evidence which would help to target the right training, development and support for staff to deliver new and more efficient models of care with a focus on prevention (including shifts to public health and wellbeing activities). In addition, the NHS Longterm Workforce Plan in England, and the National Workforce implementation plan in Wales, has highlighted important changes in the way healthcare staff are trained, developed and supported. Some of these changes include expanding numbers of new staff, shifts towards a greater focus on generalist skills, and designing broader clinical and other placements in recognition of the growing population that lives with multiple and complex care needs. Plans to expand the workforce have been welcomed, while recognising challenges, for instance, in embedding new roles, the time taken to develop capacity, and finding and keeping experienced staff to supervise staff in training.
There are also extreme pressures on the adult social care workforce, with vacancy rates at a record high and levels of turnover rising to over 50% for younger staff (according to The State of the adult social care sector and workforce in England, 2022). Knowing how best to support, train and retain staff with flexible skills for rising demands is an urgent ask. There has been reasonable engagement with the Care Certificate, but registered managers are older than other sectors of the workforce and there are gaps in training and leadership needs – and in evaluation of existing development initiatives for social care staff.
Identified research need
Research investment and activity on skills, training, development and support of the health and social care workforce has been limited to date. Most investment and work to date has been in the field of medical education, but the area has not always been recognised as an important academic field in its own right. Less research attention has been paid to addressing important uncertainties and evidence gaps in skills, training, development and support for nursing, midwifery, dentistry, therapy, social care and support staff. In order to build research capacity, the NIHR launched a national incubator for clinical education research in 2020.
In February 2023, the incubator convened a workshop with stakeholders across different professions and areas of practice to discuss emerging gaps and priorities in clinical education research. Some of these are reflected in the areas of interest below. In this call, we are extending the brief of the incubator to include non-clinical health service roles and professions, and the full range of social care staff.
Researchers should exploit sufficiently accurate routine databases, where available. This includes UK-wide assets, like electronic staff records, as well as other valuable databases from the NHS Staff Survey and the Adult Social Care Workforce Dataset to registrant data held by professional regulators. UKMED, for example, provide a rich platform for longitudinal research, combining undergraduate and postgraduate data to enable researchers to track medical practitioners from application through foundation training and beyond.
Collaborative and mixed-methods research studies that include generation of empirical data and/or synthesis of high-quality qualitative data are encouraged.
Relevant studies in the HSDR portfolio, with rigorous study design and theoretical framing, include and range from evaluation of communication skills for nurses caring for inpatients with dementia to enhancing compassion in ward staff to examining doctor remediation programmes to evaluation of foundation doctor training programmes or clinical leadership of allied health professionals.
Areas of interest
Applicants should make the case for research which can generate national learning, and may be relevant to other service areas or staff groups from those studied. Research is likely to be mixed-method and should be ambitious in scale to generate national learning. Theoretically informed studies are welcome which may draw on conceptual and empirical understanding from broader fields of education research and adult learning. Adaptations of approaches or innovations from other countries or systems may also be worth exploring.
The following areas are of particular interest to the HSDR Programme, but other applications are welcome along with justification for the value of the proposed research:
Equity in the workforce.
Research to assess the impact of initiatives to broaden access, uptake and advancement of staff at all stages of career and all entry routes (from apprentice to university). In addition, development and assessment of interventions to enhance staff awareness and skills in caring for diverse populations are welcome.
Models of workplace learning.
Research into new approaches to workplace learning and supervision, including new placement structures and broader understanding of how workplaces and teams can provide good learning environments across the full life course of a career.
Generalist knowledge and skills.
Research to understand best ways of supporting staff throughout careers to develop generalist – alongside necessary specialist – skills and treat the whole person, recognising increasing numbers of people with complex and multiple needs.
Technology.
Research into use and effectiveness of technologies such as simulation and virtual reality for continued workplace learning.
Apprenticeships.
Experience of learners and organisations in implementing apprenticeships (at all levels) and supporting new staff as they build careers in NHS and social care.
Communication skills.
Research into new approaches to developing and maintaining communication skills for staff in patient or public facing roles and in teams and inter-agency work.
Working in teams.
Research into the best ways of preparing, training and supporting staff to work effectively in multidisciplinary teams and negotiate changes in scope of practice or task shifting with new roles. This would include assessment of joint training programmes for health and social care staff in integrated services. Studies may draw on existing bodies of knowledge on interprofessional learning outside health and care.
Assessing skills.
Research into most appropriate ways of maintaining and assessing skills throughout careers, including workplace assessments and e-portfolio approaches.
Addressing poor performance.
Evaluation and development of remediation programmes and different approaches in addressing poor performance for range of staff in health and social care.
Social care skills and training.
Particular attention is needed to the most effective forms of training and learning for social care staff, including priority areas such as leadership skills, literacy and numeracy support and training needs for internationally recruited staff.
Career progression and workforce sustainability.
Mapping career journeys and pathways, transitions and impact of training, and skills development to support transitions, recruitment and retention at different stages of career on staff (including international recruits and those returning to work after breaks or leave). This incorporates impact of training at different life stages on retention and career advancement.