New ways of working for adult social care workers

Research aim This research aims to develop understanding of how to effectively implement and evaluate blended role interventions.

Background It draws on a Greater Manchester Integrated Care System (GM ICS) pilot that has re-designed NHS adult community nurse and adult social care worker roles so that care workers take on tasks more typically conducted by community nurses, for example, insulin injections. Sometimes referred to as delegated healthcare, the GM ICS pilot uses the term blended roles .

While all 10 GM boroughs have been tasked with implementing blended roles, progress has been varied.

Rochdale Metropolitan Borough Council and Tameside Metropolitan Borough Council have been in the vanguard and their interventions are a central element of this research.

Senior leaders from other GM boroughs will also be involved as the inclusion of different sites provides important insights into contextual variability.

The research is academically led and operates as a collaboration between universities, GM ICS, the NHS and local authorities.

Research questions and objectives The research questions comprise: 1) How has implementation of blended roles been experienced by H&SC commissioners/providers, workforce and those using ASC services in the GM ICS? 2) How can blended roles be effectively evaluated?

These questions inform the following research objectives: 1) To develop a logic model that: identifies the resources needed to effectively implement blended roles investigates the activities required to effectively implement blended roles identifies the intended short-, medium- and longer-term outcomes of blended roles 2) To establish an evaluation framework that identifies appropriate measures and data sources 3) To produce a toolkit that guides implementation and evaluation of blended roles Methods There are five workstreams (WS) using realist evaluation techniques : rapid evidence review (WS1); stakeholder interviews (WS2,3); development of an evaluation framework (WS4) and tool kit (WS5).

WS1 Rapid Evidence Review We will conduct a rapid evidence review of research on H&SC role re-design and delegation, covering clinical effectiveness and workforce and care recipient impacts.

WS2 H&SC workforce interviews Interviews will be conducted with five H&SC workforce groups: GM ICS senior leaders; NHS/ASC commissioners and workforce leads; ASC providers; community nurses and care workers. C. 70 interviews, face to face or virtual, will be held.

Workstream 3 Care recipient interviews We will interview around 20 care recipients/family members who have received care in blended roles interventions. WS4: evaluation framework WS4 undertakes an evaluability assessment. It will establish an evaluation framework based on a logic model developed through WS1-3.

WS5: Tool kit development WS1-4 findings will inform development of a toolkit, using the logic model to support implementation and guide evaluation of blended roles. Timelines The project will run from October 2024-to September 2026. Impact and dissemination Blended roles could have benefits for workforce, care recipients and clinical effectiveness.

The toolkit will support implementation and evaluation of blended roles interventions, offering policymakers and practitioners a robust evidence base.

We have strong stakeholder networks which, in combination with holding workshops for policy makers and practitioners, will ensure effective dissemination and wide uptake of the toolkit and findings.