Last year, the Leeds Health and Care Academy’s Collaborative Workforce Planning team undertook a major project to gain a better understanding of the Allied Health Professional (AHP) workforce in Leeds, and identify and explore common issues regarding supply and retention of staff within these roles.
What are Allied Health Professionals?
Allied Health Professionals (AHPs) are the third largest clinical workforce in the NHS. There are 14 different professions within the AHP category, who work across a variety of sectors, including health and care.
Allied Health Professional roles include:
Art therapists
Drama Therapists
Music Therapists
Chiropodists/
Podiatrists
Dietitians
Occupational Therapists
Operating Department
Practioners
Orthoptists
Osteopaths
Paramedics
Physiotherapists
Prosthetists and Orthotists
Radiographers
Speech and Language Therapists
The diverse range of AHP skills, and their reach across people’s lives and organisational boundaries make them ideally placed to lead and support changes that can transform the provision of health and care services across the city.
Project Background
AHPs have been recognised as increasingly important to the transformation of services across the entire health and care sector, although there was a lack of understanding about the citywide AHP workforce in Leeds.
When trying to understand a workforce, organisations tended to rely on professional judgement and local data. However, there wasn’t a citywide view of the AHP workforce, or an understanding of the common issues, risks and challenges affecting supply and demand of AHP staff.
The arrival of the Additional Roles Reimbursement Scheme (ARRS) in primary care was another main driver behind the project. The scheme meant that local GP practices working together in Primary Care Networks (there are 19 PCN’s in Leeds) across the city were given funding to recruit their own bespoke multidisciplinary teams. The ARRS includes five Allied Health Professions.
The introduction of these new roles highlighted the need to understand supply and demand for AHPs across multiple health and care partners, in order to ensure this new element of the AHP workforce was beneficial to the Leeds system. Without this insight, there was a risk that these new roles could destabilise the workforce by causing an unplanned large-scale movement of staff between partner organisations.
The following teams and partner organisations were involved in the project:
- Adult Social Care
- Leeds and York Partnership NHS Foundation Trust
- Leeds Teaching Hospitals NHS Trust
- Leeds Community Healthcare NHS Trust
- Primary Care
It marks the first time that we’ve attempted a collaborative approach to citywide workforce planning in Leeds.
Our Approach
Discovering the size and shape of both the registered AHP workforce, and the support workforce in Leeds was identified as the starting point of this project.
We initially developed a citywide AHP workforce overview, which included current staff, vacancy rates and turnover rates, alongside supply initiatives such as the number of trainees in the system, apprenticeships, returners to practice, and planned domestic and international recruitment.
This data was gathered across all participating partners, coordinated and collated by the Academy, in order to provide a full and comparable picture of the city’s AHP workforce. Work was also undertaken to understand the diversity of both the registered and support AHP workforce.
The quantitative data gathered was combined with qualitative research from Heads of Services and others, to gain insight into recruitment issues, reasons for staff leaving, retention initiatives and the flow of AHPs across the city’s health and care system.
Further research was then carried out to understand data quality, learner tariff, induction and preceptorships, placement capacity and opportunity, and how to ensure that there is a clear route from AHP support roles into professional registration.
Research Findings
It was found that the largest AHP professions in Leeds are:
- Diagnostic Radiographers
- Physiotherapists
- Occupational Therapists
The only AHP profession that is present across all participating partners is Occupational Therapy (OT). The project found that a successful citywide rotational OT programme already exists in Leeds, and Physiotherapists, Dieticians and Speech & Language Therapists are also present across the city’s NHS Trusts.
The findings showed that there are significant vacancies and difficulties in recruiting to AHP professions across the city, and that the diversity of the AHP workforce, particularly in senior roles (Band 7 and above), does not reflect the population it supports.
Potential for Collaborative Work
The discovery process identified five key areas where a collaborative approach could be implemented across the city to address AHP workforce needs:
Staff Portability
With current shortages of staff from different AHP professions and a shared understanding that a lack of bank arrangements across the city is problematic; the sharing of staff across partners was identified as a solution, and an existing method of doing this is the Staff Portability Framework. This Framework has been developed and implemented by the Academy and is designed to alleviate pressures in different parts of the system through the sharing of staff. The Framework addresses traditional barriers to the movement of staff between organisations, such as professional indemnity and data security, and allows AHPs to be located where they are needed most. Under this agreement, staff remain employed by their primary organisation, but can cover short term pieces of work for up to one year for other organisations. The project research found it was not well understood amongst the AHP workforce, but its potential for use could have a high impact.
Collaborative Apprenticeships
An identified solution to the shortage of AHP’s nationally is to grow the existing registered workforce. The project identified that organisations across Leeds could expand the offer of pre and post registration AHP apprenticeships, first offering a collaborative OT apprenticeship programme, before potentially expanding this into other AHP roles.
Rotational Training
The lack of opportunity to experience different specialisms was identified as leading to job dissatisfaction, and highlighted the difficulties partners were facing recruiting into specialist posts. It was also discovered that there were discrepancies surrounding the opportunity to progress to more senior clinical positions. A potential way identified to address these issues was to offer opportunities for staff to rotate into different roles, either within their own organisation, or across different organisations. By doing this, staff training can be shared, and evidence showed that levels of staff retention could be expected to increase by providing progression opportunities.
Additional Roles Reimbursement Scheme (ARRS) AHP roles
The project identified that organisations could work with Primary Care Networks to support AHPs in primary care through enhanced supervision and professional networks. It was found that this support could be most effectively provided through collaborative arrangements between partners.
Equality, Diversion and Inclusion
This project found that the diversity of the existing AHP workforce does not properly reflect the population it supports in Leeds. By engaging with underrepresented communities, it is possible to improve the supply of future AHPs to fill vacancies and create a more diverse workforce. The project identified the potential for collaborative recruitment for registered and non-registered AHP staff, and how to tackle the lack of diversity by sharing ideas, linking up projects and connecting with the West Yorkshire AHP Faculty workstreams already in existence.
The research also identified several areas that organisations could work independently on:
• Preceptorship/Induction
• Return to Practice
• ESR data cleanse
• AHP tariff governance
• Students in Primary Care
Programme Outcomes
This project significantly increased the profile of AHPs and escalated the issues facing this workforce group to a strategic level. Key qualitative and quantitative data was identified that is now being used in other projects within the Leeds Health and Care Academy portfolio of work.
The project facilitated collaboration across the system, bringing key decision makers for AHP roles together to explore collaboration around supply and retention. Achieving this level of understanding of the AHP workforce would not have been possible without the additional resource of AHP workforce development leads in each organisation.
Recommendations
This project was unique in the way that it provided a complete oversight of the workforce for an entire professional group, and the model and learnings can be taken forward to enable us to understand other workforce groups in the city.
It is important that, as a result of this work, measures are put in place at both a citywide and organisational level to support the AHP workforce, encouraging retention and development.
Future success requires strategic AHP leadership at an Integrated Care Board (ICB) level. There also needs to be continued work with AHPs around workforce planning before applying this model to another profession. Relationships should continue to be maintained between all partners post-project completion, to ensure this work continues to make an impact.
If you have any questions about the project, please contact chris.tissiman@nhs.net, Head of Collaborative Workforce Planning at the Leeds Health and Care Academy.
