ABSTRACT
Including those working in general practice there are over 380,000 clinical support workers employed in the NHS. In recent years the size of the NHS clinical support workforce has grown at a faster pace than the general growth of the NHS workforce, although the proportion of support workers per 1,000 population in the UK is towards the lower end of international comparisons. In terms of gender the support workforce is female dominated. Support workers are more likely to work part time, have caring responsibilities and to have previously worked outside of health care, before beginning work in the NHS. The NHS pay structure and its job evaluation system should provide a clear career structure for support workers; however, there are gaps in Job Profiles and they are not consistently applied for support staff. Support workers provide in many settings the majority of face-to-face care. Despite support workers making up a quarter of the nursing workforce and being present in other occupations, very little is known about how they were deployed in the first three decades after the creation of the NHS and they were subject to very little policy. Concerns to improve the quality and efficiency of healthcare in the 1980s and 1990s placed a sharper focus of support roles including the introduction of new roles such as Healthcare Assistants and Assistant Practitioners but their deployment and development continued left to local employers meaning support workers continued to face barriers to their development such as a lack of access to education. Two formal support reviews of support workers were undertaken by Camilla Cavendish in 2013 and Lord Willis in 2015, which followed the Francis Inquiry in 2012 into the deaths at Mid Staffordshire. This resulted in the creation in 2015 of the NHS’s first dedicated workforce strategy for support workers, called Talent for Care. The failure to mandate Talent for Care meant it had limited impact and the issues support workers faced continued.
