We all know that the NHS is under enormous pressure and so we need to start being more innovative about ways in which we can resource the NHS. Support workers, of course, play an enormously important role, both within the NHS and further afield.
The RCSLT has developed a framework which is specific to speech and language therapist support workers, which defines the competencies and skills required in the role, how are these recognised and how should supervision take place, as well as providing a structure for the career progression of support workers.
In this podcast, we are joined by some of the people who were involved in the development of that framework. And they’re here to talk to us about what it is and why it matters. Whether you’re a support worker, an speech and language therapist, or a manager.
Interviewees:
Resources:
The interview was produced by Jacques Strauss, freelance digital producer.
We all know that the NHS is under enormous pressure and so we need to start being more innovative about ways in which we can resource the NHS. Support workers, of course, play an enormously important role, both within the NHS and further afield.
The RCSLT has developed a framework which is specific to speech and language therapist support workers, which defines the competencies and skills required in the role, how are these recognised and how should supervision take place, as well as providing a structure for the career progression of support workers.
In this podcast, we are joined by some of the people who were involved in the development of that framework. And they’re here to talk to us about what it is and why it matters. Whether you’re a support worker, an speech and language therapist, or a manager.
Interviewees:
Resources:
The interview was produced by Jacques Strauss, freelance digital producer.
Transcript Name:
Support-workers-framework (1)
Transcript Date:
3 May 2023
Speaker Key (delete/anonymise if not required):
HOST: JACQUES STRAUSS
SAM: SAM THINNESEN
CHARLOTTE: CHARLOTTE MCCOLLUM
ALICE: ALICE HOWELLS
RUTH: RUTH HOWES
MUSIC PLAYS: 0:00:00-0:00:06
HOST: 0:00:06 Welcome to another RCSLT podcast. My name is Jacques Strauss. We all know that the NHS is under enormous pressure and so we need to start being more innovative about ways in which we can resource the NHS. Support workers, of course, play an enormously important role, both within the NHS and further afield, and that’s one reason why Health Education England has developed a support workers framework, which defines the competencies and skills required in the role, how are these recognised and how should supervision take place, as well as providing a structure for the career progression of support workers.
Now RCSLT have developed the framework which is specific to speech and language therapist support workers and, in this podcast, we are joined by some of the people who are involved in the development of that framework. And they’re here to talk to us about what it is and why it matters. Whether you’re a support worker, and SLT or a manager.
I started by asking the panel to introduce themselves.
SAM: 0:01:12 Hi, my name’s Sam Tennyson, I currently work as a speech and language therapy assistant at North Manchester General Hospital and I specifically work with head, neck and voice but do do general acute and community work as well.
CHARLOTTE: 0:01:24 Hi everyone, I’m Charlotte McCollum, I’m a speech and language therapist and I work for a social enterprise called ChatterBug. I am a paediatric speech and language therapist and I specialise working with young people with social and emotional mental health difficulties. I’m also a manager within the service and I support a lot of our speech and language therapists and our support workers.
ALICE: 0:01:45 Hello, I’m Alice Howells, I was previously a speech and language therapy assistant working in the community with adults with learning disability. I’m currently studying my speech and language therapy master’s at City in London.
RUTH: 0:01:58 I’m Ruth, Ruth Howes, and I left my NHS post in Lancashire and I now work independently at Communicology SLT Consultancy and ARC Supervision and CPD. Today, though, I’m here as the lead author for the RCSLT project developing the framework for support workforce, support workers.
HOST: 0:02:20 Thank you so much, guys, we really do appreciate you all making time to come and talk to us today. Bearing in mind that we have quite a wide audience, I wonder if I could start by asking a really simple question, and I’ll address it to you, Ruth, is what does a support practitioner do?
RUTH: 0:02:38 Within speech and language therapy and for the support workers who work across multidisciplinary teams, the role is wide and varied. Within our project, we have struggled to actually find terminology which encompasses the very broad nature of the role.
You can find support workers who are working in very specialist roles within hospital settings. Indeed, we have Sam here today, who was in that role. We have support workers who work with families developing early language and literacy skills on a very much more universal, preventative way. So every role is different.
And we have found, right across the UK, that the titles of support workers are very different as well. Although every single support worker is supporting the work which speech and language therapy undertakes with people who have communication and swallowing difficulties, it’s each person’s role within that is to some extent a little unique.
HOST: 0:03:42 Do all of them attach to specific specialities or is it possible to be a support worker across specialities? How exactly does it work?
RUTH: 0:03:51 There are the two. It’s possible to be either. You can be, and most are, a support worker supporting a speech and language therapy service, and that could be in the NHS or independently or in an educational setting. However, perhaps for [inaudible 0:04:12] we have a stroke team, there can be support workers who support speech and language therapy, physiotherapy, occupational therapy and have a role across all services. So both are possible.
HOST: 0:04:28 I wonder if you could just, before we move on, explain to us how integral the role of the support worker is within the NHS and, of course, in other areas as well.
RUTH: 0:04:40 It’s absolutely essential, particularly in the times when we have incredible pressure on services. I met my first colleague, speech and language therapy assistant, when I was a student. So this role has been around for a long time, because I’ve actually been working quite a long time now.
However, over time, it’s changed and, in my role, I’ve worked with teachers who’ve decided to leave the teaching profession and become a speech and language therapy assistant and colleagues who often have a degree in a related area, perhaps in special needs. And, within my teams, I’ve had two assistants who transitioned to become speech and language therapy assistants. As Health Education in England are hoping in the future, it’s actually possible to have that passport of skills and work across different AHP professions.
HOST: 0:05:34 Sam, you’re currently working as a support worker, I wonder if you could just tell the listeners a little bit about how you got into the role and a little bit more about what you do now?
SAM: 0:05:45 Initially, I actually started working for the NHS as a healthcare professional support worker, which I did ward-based work for about 15 years. And from that, working a lot with dementia, stroke patients, people who had swallowing difficulties, communication difficulties, learning disabilities. That, for me, spiked a bit of an interest with the whole speech therapy umbrella. From that then I worked as a stroke speech and language therapy assistant or a support worker. And then, from that, I used to help facilitate and support with a laryngectomy valve changing service. As part of the trust that I worked for, the assistants there did a rota-based support with that clinic. And then, from that, I then moved and specialised into head and neck and voice.
HOST: 0:06:40 Alice, you used to be a support worker and now you are busy completing your MA in SLT. Can you tell the listeners a little bit more about how you became a support worker and then what motivated you to say that now you wanted to go and do your degree in SLT.
ALICE: 0:06:58 I first learned about SLT working in SEN college. I started there as a learning support assistant and, when I was there, I just saw how the SLTs, what their role was around the college and how they interacted with learners and I just really liked what they were doing and was really interested in it. I was then lucky enough to get a SLT support worker role in Nottinghamshire, where I lived, working in the community with adults with LD. There, I supported the SLTs in that MDT. And, again, really enjoyed it, liked all the different aspects of my role. But, just for myself, I really enjoyed my assistant role but felt I really enjoyed the profession and the field and wanted to become qualified myself. Yeah, after a few years in that role, I have returned to uni to do the MSc at City University to be qualified, hopefully, soon as a speech and language therapist myself.
HOST: 0:07:46 Charlotte, I’ll come to you. You work as an SLT and work with a number of support workers. I wonder if you could just talk to me a little bit about your experience of working with support workers and how they support the SLT work that you do.
CHARLOTTE: 0:08:00 Absolutely. I think, for me, it’s really important to acknowledge the fact that a support worker is very much a career and very much a job in its own right and support workers and speech and language therapy assistants complement each other so, so well. And particularly in settings and services where there might be lower funding levels or we are strapped for staff as it is, I think it’s really, really important that different members of the team and different people can bring so many different things to the care of the young person or care of the family. And that doesn’t necessarily mean that it all comes from a speech and language therapist down to a support worker, which I think has possibly been the service structure in a few services in the past. I think it’s really, really important that that information flows both ways and that it’s really understood that everybody has their unique role within that young person’s care. So we can support each other to support that family and that young person in the best way possible.
HOST: 0:09:05 Next we started talking about the framework itself and how it was created.
RUTH: 0:09:14 Yes, there’s two strands of work started, one with RCSLT and one with HEE, Health Education England, around looking at how there could be more structure in support and supervision of the support workforce and, within that, risk assessment of potentially practitioners and support workers who perhaps didn’t have as much support, training, supervision, our recording of competencies as would be preferred.
Health Education England developed their AHP support worker competency education and career development framework, which is on the RCSLT website. And it looked at a structure for employers to put together much more of a structure to plan and develop and deploy the support workforce. That’s a bit of management speak there. But it also, more practically, gives a guidance for training, education and competencies for support workers. And the aspiration behind it is that it demonstrates a very clear pathway for recruitment and progression, with transferable skills identified across key domains in a job role. For example, supporting patients and service users, being an effective communicator; there are eight domains, which are very relevant to a job role.
RCSLT, alongside, have adapted things, so they’ve very much dovetailed with Health Education England, has put together a framework. With 19 speech therapists and speech and language therapy assistants and support from officers at Royal College, have built a learning model, which is the basis of the framework for speech and language therapy. And the learning model is very much based around work-based learning, recognising the competencies which people have in their job role and also a structure for identifying where we go next in a job role. I think that’s where we are at the moment.
HOST: 0:11:52 Next I wanted to know, for anyone who was interested, whether any formal qualifications are needed to start work as a support worker?
RUTH: 0:12:03 In speech and language therapy, no, it’s open access. And that’s incredibly important, because the diversity of the workforce is something which is its strength. Within the role, you would then develop within a structured framework. But you might find that there’s somebody who’s worked as, I’m trying to think… done a degree in drama, for example, who has that ability to connect with people, who’s looking for a career choice and has no experience at all within healthcare but very many relevant skills to the role. Or another pen picture I could give you might be an experienced occupational therapy assistant who is looking to extend their skills, might see a role in speech therapy.
My background, paediatric complex needs specialist. Many support workers who I have worked with have come from educational settings, where they’ve supported children in classroom, during daily life, at mealtimes and during daily life skills, and they’ve chosen to go into that as a different career, as a support worker for speech and language therapy.
CHARLOTTE: 0:13:24 A lot of our support worker colleagues are from education backgrounds themselves and it’s interesting to hear some of the things they say and the moment they found speech and language therapy. And it’s almost the, so I was quite happily doing my job and I was quite happily being a teaching assistant or a nursery nurse, whatever their previous role was, and then it’s almost like they find speech and language therapy because they’re like, we had a speech and language therapist come in, or I did a speech and language therapy programme, or I worked with this one specific child. And it’s almost that eye-opening moment. And I love hearing those conversations, that’s when I found speech and language therapy. And you often hear people talking about that’s where… I always knew I wanted to work with children but then this is where I found my calling, this is where I found the exact thing that I wanted to do. And I think that can be really special.
SAM: 00:14:12 That’s one of the ways… the avenues that I found speech therapy, was working within the hospital. In all honesty, didn’t even know that speech therapy role existed within… people automatically assume that speech therapy is to do with your speech only. But working within the hospital, especially with a lot of the dementia patients that I used to care for, the speech and language therapist’s role there was quite vital really in helping people understand the progression of dementia, which I had a big interest in. And how eating and drinking, it changes for them as the condition progresses, the same with strokes, learning disabilities. But actually being on the ward, if I hadn’t have done that support worker role to start with as a healthcare assistant, I wouldn’t have really known the extent of speech therapy. It’s interesting that people can come from different backgrounds and find the niche that they love and enjoy.
HOST: 0:15:06 What I’m hearing is, and I’m sort of throwing this question open to the floor is, we’re developing a framework to help formalise the position in some way, so that we’re not in the situation, Ruth, that you were talking about earlier, where it’s… it can mean lots of different things and lots of different places, so there’s some structure. Which also includes what are your core competencies in various areas and then also so that there is a progression pathway for the role. Is that what the framework’s about and is that what you guys, who’ve all worked on this project, hope it’s going to do?
RUTH: 0:15:45 Yes, that’s absolutely right. I think the important thing is that the individuality of each role will remain the same. But, within that, there’s the permission to have a structured plan for development, which is based around competencies which are… the working phrase in our project group was about what makes the role of a support worker successful? What is needed, what is the professional knowhow for a successful support worker in role? And what Charlotte said earlier about how this is a complementary role to speech and language therapy, in my opinion, developing as a professional role in its own right and it’s very much as a structure.
SAM: 0:16:43 I would just like to add on in respect to the structured pathway of the framework, it’s about providing again, as I said before, with the supervisor support and guidance and help to support and guide support workers through the career and have that understanding, really, around that.
RUTH: 0:17:05 RCSLT did a survey, towards the end of 2019, but it still feels very relevant, and that’s absolutely what came out of the survey. That many speech and language therapists didn’t feel that they were confident in their competencies in supporting their support workforce and as supervisors and in supporting development. And also there is a lack of very formal training. It’s starting to improve a little, in that Health Education England are bringing in, over the next few months, apprenticeships which are for support workers and assistant practitioners who are perhaps employed at Band 4. So there is a change but, at this point in time, there are courses but you have to search hard for them. It’s very much about learning on the job, work-based learning and being a reflective practitioner.
CHARLOTTE: 0:18:04 It think it’s really important to think about this framework as quite a set structure but also bringing people’s individual skillsets within that. Because everyone’s got different backgrounds and everybody’s got different skillsets and, equally, some people are already working as support workers. We can use the framework quite flexibly and they can have a discussion, and it’s a team discussion, with their managers to work out at what level they sit and how much support they need for the different competencies. While it is a one-size framework, it can be very much tailored to the individual, so we’re hoping that this really opens up those discussions between managers and the support worker workforce.
RUTH: 0:18:47 There is a toolkit which includes job tools, one of which is for signing off existing competencies. We didn’t want, as a project group, any assistants who were very experienced and competent in their role looking at this framework and thinking, oh my goodness do I really have to start from the beginning of this. What Charlotte said about conversation is the starting point, there absolutely has to be a conversation about the job role and the competencies and where any gaps are. And that’s the starting point.
HOST: 0:19:34 What do we hope, in a few years from now I guess I could say to you, what does success look like? What do we really hope this framework is going to achieve for, largely the NHS but obviously other areas too, what’s it going to do?
CHARLOTTE: I think, as a general… light at the end of the tunnel, for me, would definitely be a sense of value, job satisfaction and also the understanding that support workers can do a really, really great job with as much or as little guidance as they need that reflects the competencies and also the support supervision ladder that’s part of the framework. I just think it’s just nice to have that. And also, if you do need the support and guidance, that you can have that from a really good supervisor and then have them transferrable skills nationally. So if you did want to do a career progression or get a new role, you’ve got evidence there that you can actually show that you’ve got skillsets already in place and that you understand certain aspects of the role already.
ALICE: 0:20:48 When I was reflecting about the framework and the toolkit and how it would have been useful for myself when I was in the role. I was new to SLT as a profession, so when I started I just wanted to learn everything about everything, all at once, and I think the framework would have really helped me to identify which areas of both personal skills and specific knowledge I wanted to focus my goals on and my development on. I think another really important aspect is it helps to show that SLT and the wider MDT what your role is exactly and how you can be used. There wasn’t anyone in my role for a long time before me, so I think when I first came into the SLT’s working week they weren’t sure how best to place me in to make the best use of all our time, just because it was quite new. I think the framework can really help with that.
And, as I mentioned, I had a time when I was thinking of moving onto the next step and having something like a framework would have helped me to look at the skills I’ve got and the knowledge that I’ve worked on and what goals I’ve achieved, to put on my application. It would have also really helped to think what else I could develop more on before I applied and things. I think it can be used so well to value yourself and your own development, as well as help the MDT know how best you can be utilised to support individuals and the team as a wider team too.
HOST: 0:22:01 Thank you so much. Charlotte, that’s a really interesting point, that the framework is not just for the support practitioners, the support workers, presumably it’s of use to SLTs and the MDT. Is there a difficulty you find generally with understanding how to use the support workers in roles and is that something that people need to learn more about?
CHARLOTTE: 0:22:25 Absolutely. I think sometimes, as with a lot of things, it comes down to confidence. And I think, like Alice was saying, if you’ve never worked with a support worker of any kind in any service before, then it can be really, really daunting as well for the speech and language therapist. Because they think, actually, I’ve not only got to organise my time, I’ve got to organise what somebody else might be doing with this child, and sometimes it can be daunting as well.
So, I definitely think the toolkit is going to be really, really useful to support speech and language therapists and managers and service overheads to really think about this. And I know the staff within ChatterBug, our support worker service, are really, really excited to get started doing this and they keep pestering me, asking me when they’re coming out and when they can get going. I think it’s been really, really useful for me to have a really open conversation with them as well about what they want within these competencies and what want within this. And I’ve actually fed that back into the project, so they feel really invested as well, which is lovely.
They’re really excited to be able to think of their development opportunities and feed that back to us as the management team within ChatterBug. And then we can really work with them on their individual development plans and really think about where they want to go, as well as what we need as a service. And balance that between us.
HOST: 0:23:49 Ruth, could you just give us an overview of that it actually consists of? I know we’ve touched on it, but could you just give us an outline.
RUTH: 0:23:57 Yeah, it’s probably easier if I describe the overall project. The outcome of the project is a special section of the RCSLT website, which is the support workers hub. And, on the support workers hub, you find all sorts of very valuable information, such as cameos written by various members of our author group, our project group, about their role and their experiences. And some information for those who might be looking into this as a career. We have the framework and the toolkit but we also have the RCSLT support workers hub on the website, which houses and pulls together all aspects of the project.
There is a forum, with the aspiration that support workers could put forward a question and have communication with another support worker in role. We’ve looked actually, as a project group, at all different levels of how we could improve things and move things forward for those who are looking at this a career or those who have lots of experience.
But, within that, is this very much more serious learning and development framework, which you can find on the RCSLT website with a visual representation, and we have that. And we have the basis of the core competencies coming into the role, which are actually designed by Health Education England and common across all AHP professions, so that’s the starting point. And then we move up to much more specialist, speech therapy specific clinical competencies, and that’s probably where most people will be focused and spending time. Devising their competencies, deciding which are relevant to their job role.
You asked us what success looked like. I think it’s that. It’s knowing that that development in role and work-based learning within a role be actually taken seriously and valued. We looked to the formal courses but we’ve also got the work-based learning as something which is… research and evidence tells us is a strong way of learning for our professional lives and that recognition of a very complementary role within the profession.
HOST: 0:26:39 Right. And I’m guessing then that, hopefully, one of the outcomes will also be retention and recruitment, both of support workers but also presumably of SLTs and, if we’re looking at this project very broadly, other AHPs?
RUTH: 0:26:57 Yeah. I’m working in the independent sector at the moment as a practitioner and recruitment is a huge issue. And the practices which are thriving and surviving are looking at, very carefully, at the role of the support workforce for their future survival and development.
As an ex-NHS manager, I know that recruitment and retention changes over time but, at this point in time, it’s a difficult time. But we’ve actually got an evolving professional role here and I would say to the assistant practitioners, the support workers that I’ve worked with, that there are certain things which they do within their job where they are far more competent in their skillset than I would be. And it really has to be looked at as a developing, evolving professional role, which could therefore be the answer to many of the strain on service recruitment and retention issues.
Within that though, you’ve got to have some sort of career progression. And that’s in very, very early stages, because, although this is… Health Education England is very aspirational about career development, we know the reality about funding for services and for development and it’s difficult. But there should be… for the future, the improvement would be a career development framework with the opportunity to actually move and progress within role.
SAM: 0:28:39 I just think it’s about working more efficiently as well. That could possibly be related to the cost implications of… the NHS is struggling, if we have these kind of frameworks developed for career development, etc., your staff can be more confident, competent and efficient in their working. And safe, as well.
CHARLOTTE: 0:29:01 I think that’s a really big one as well, for me, Sam, is confidence. For everybody involved, I think this will just give people a little bit of structure, because that’s what a lot of us like and a lot of us need, a little bit of structure and a little bit of support to have those conversations and to feel confident in all of the different types of roles that we’ve discussed today.
RUTH: 0:29:21 And it’s part of the learning model we’ve devised and developed, a ladder of support and supervision. Which is a very important idea, concept here. Because it’s about, if you are competent in aspects of your job role, then you will be negotiating your level of support and supervision. And some of that supervision might be arms-length, it might be a telephone call away and you might be responsible for working autonomously in an aspect of work. It’s that. This new idea of the ladder of support and supervision, which is integral to the framework we’ve developed as a project group.
HOST: 0:30:02 How do you anticipate using the framework and all the associated materials in the future? How do you see yourselves using it?
SAM: 0:30:11 My intention is going to be to get involved more with the reflective side. And I know the toolkit, we’ve not really discussed in as much detail, but for me the toolkit, I’m going to definitely utilise that a lot more. In sense of I’m really poor at reflective practice. And I think, if you can’t reflect on your practice, you can’t really develop and understand the gaps and where you can get better support. For me, definitely, I’m going to be using that toolkit a lot more and using the framework alongside my current competencies that I have to see if we can chip in and progress any further with other things.
ALICE: 0:30:54 I was thinking about how the framework could have been used… or how I’m planning to use it but how also I could have used it at each stage of my career. When I was an SLT support worker, it would have been really helpful as a new role and new field for myself to be able to help structure my supervisions and develop goals for my own learning. And then, I think I mentioned this earlier, but moving onto the next step of going to university, it would have been really helpful to reflect on the areas that I feel I had a lot of skills in or knowledge that I gained and the areas I wanted to get more in to add to my application.
And then looking towards how I’m going to use it in the future, as a newly qualified SLT. If I’m there to support support workers and have supervision with them, I can use the framework as an SLT to make sure the support workers are all aware of it and for them to help see where they want their development to come from. And I think, as an SLT, I can help them to have personalised goals. On the flipside, obviously it’s really useful for support workers but for myself, hopefully in the future, and SLT, it would be useful for me to make sure that the support workers I work with feel really valued and I’m making sure I can do as much as I can to support them.
CHARLOTTE: 0:32:05 Our first steps, from a management point of view, were to actually upskill the entire workforce in this plan and this plan going forward and what the ideas are going to be. Set up those meetings with line managers and the support workers. But then, more importantly, keep this conversation go, so bookings or meetings or drop-ins or conversations going forward of how it’s working, how can we change it, how can we make sure it’s even better and how can we keep the motion, the forward trajectory of this going to support the entire team? I think those open conversations are really important.
HOST: 0:32:43 A lot of this type of work is ongoing and RCSLT, in conjunction with universities, like the University of Essex, are piloting apprenticeship schemes in speech and language therapy, which is a fantastic way of combining the theoretical work of the university with on-the-job training in hospitals or schools or other settings. There are no silver bullets in getting our health and educational outcomes to where we want them to be, rather it’s going to depend on a series of incremental changes and improvements, trials and pilots, which can be replicated and expanded if they show promise. A very big thank you to all the panellists, not only for making the time to talk to us but also the hard work they’ve put into the creation of the framework. Please see the show notes for links to the framework and other materials.
Finally, we do ask that you share this podcast with colleagues and, if you could take a moment to rate and review us, we’d be very grateful, as it helps support research and advocacy in speech and language therapy.
Until next time, keep well.
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