VOL: 102, ISSUE: 33, PAGE NO: 23
Tania Morris, MSc, BSc, RMN, is a senior lecturer, mental health, University of Northampton
Today in the NHS new ways of working that aim to improve care for service users, address staff shortages and increase job satisfaction are continually being created, piloted and introduced in phases. One such role in the adult mental health arena is the support time recovery worker.
In 2003 the Department of Health laid down an ambitious workforce target when it declared that 3,000 support time recovery workers were to be in post across England by December 2006 (DH, 2003). The directive was the result of work carried out in 2001 by the national workforce team and their support time recovery steering group, which facilitated focus groups in consultation with service users, carers and frontline mental health staff.
This group was tasked with determining what the users of mental health services required from a non-professionally affiliated worker. Their research concluded that a worker was needed who could spend time with the service user, provide companionship, offer a caring, listening ear and work with the service user to help resolve any practical issues. The new worker would help in the recovery and independent living processes (DH, 2003), hence the job title ‘support time recovery worker’.
It was anticipated that those recruited to this new role would come from varying backgrounds. Also, it was foreseen that a good proportion of recruited support time recovery workers would be former service users, now recovered and back in the workforce. Emphasis was placed on the need to recruit the right people with the right interpersonal skills and characteristics such as empathy, a non-judgemental approach and the necessary sensitivity needed to carry out this role (DH, 2003).
Two general empirical themes underpin the role of the support time recovery worker.
Social inclusion requires that the support time recovery worker aims to help the individual they are working with to have a positive sense of belonging in their own community (DH, 2003). This involves helping them access appropriate resources, such as suitable employment, education, appropriate housing and community support, therefore challenging stigma and discrimination.
The support time recovery worker supports the service user in their restoration of a good quality of life, by helping to build a sense of:
- Meaning of life.
This can be achieved in many ways - for example by recommending a healthy lifestyle. The support time recovery worker can encourage an individual to take an active part in their own healthcare by working with the service user, and in some cases their families and carers, to take effective measures in identifying early signs of relapse. Support time recovery workers do not provide clinical or medical intervention, monitor or administer medication or provide therapeutic counselling.
The DH’s directive on support time recovery workers states that they should offer day-to-day support of people with mental health problems and work with communities to promote better understanding and acceptance of people with these problems. They should work as part of a multidisciplinary team and across traditional service boundaries of care and organisations (DH, 2003). For example, support time recovery workers could liaise across the primary, secondary, the social care and voluntary sector, in the acute ward setting, in assertive outreach, early intervention service, voluntary sector such as MIND or the social services sector.
In order to ensure that safe, competent, consistent practice is delivered, all those in the support time recovery worker role should have the necessary managerial supervision.
The importance of the education of those in the new roles is emphasised in several government directives (DH, 2004; 2003). It is recommended that support time recovery workers all receive a nationally agreed induction. Support time recovery workers should also have the opportunity to go on to train to NVQ Level 2 or 3 (DH, 2003) or have a level 2 or 3 certificate in mental health (DH, 2003).
Notably, many localities have also been proactive in involving service users in the training of support time recovery workers in recovery models such as the Wellness Recovery Action Planning training (WRAP). The Wanless (2002) review recommended the need for an enhanced educated support worker role and the support time recovery worker directive goes some way to achieve this in that it emphasises the enhancement of skills through education.
Support time recovery workers have been introduced in four stages. From stage one, the pilot project, in 2003, to stage two and three, which involved the phased introduction of the workers, right up to 2005-2006, the final year of implementation, which will see the accelerated delivery of the workforce initiative. This final stage will involve the recruitment of 1,425 support time recovery workers (DH, 2004).
An evaluation of the pilot project was undertaken in 2004 to determine if the new role is being successful in achieving its objectives and to ascertain the support time recovery workers’ true experience. It suggests that support time recovery workers are satisfied in their role inclusion (Huxley and Evans, 2004). The evaluation also found that service users employed in the role have also had positive inclusion experiences (Huxley and Evans, 2004).
Key mental health staff and support time recovery workers report that support time recovery workers are carrying out work that is fundamental to recovery and inclusion (Huxley and Evans, 2004).
As with every new initiative there are challenges. The target of recruiting 3,000 support time recovery workers is ambitious. Also posts are at risk of being created through conversion or the ‘rebadging’ of existing roles, a practice that runs the risk of not fulfilling the directive of this new workforce initiative.
However, if the transition is implemented professionally and sensitively, allowing for those already employed to have an opportunity to develop new skills, this can only be positive. Disparities in terms and conditions have also been highlighted as a problem because support time recovery workers are employed across health, social services and the voluntary sector and therefore pay and career support time can vary and inequalities emerge. In some areas in order to resolve these issues support time recovery worker deployment has been delayed (Huxley and Evans, 2004).
The creation of any new role will inevitably create challenges but a positive evaluation of the role suggests that if it is implemented and resourced appropriately support time recovery workers can be a very valuable resource. They can enhance the quality of care delivered to the service user in practical common-sense ways. The key issue now is whether support time recovery workers are a sustainable workforce for the future. As yet the role is not secure and therefore challenges are still to be faced.
This article has been double-blind peer-reviewed.
For related articles on this subject and links to relevant websites see www.nursingtimes.net