Workforce Introduction

In 2001, the Workforce Action Team [WAT], set up to consider the workforce implications of the Mental Health National Health Service Framework, [MHNSF], commissioned and received two pieces of work: the Capable Practitioner Framework [CPF] and the Mapping of Mental Health Education and Training in England.

The CPF described the capabilities that all staff should be expected to have and what would be expected by some specialists. The Framework was well received in the field and has been variously used to influence curriculum development, training needs analysis and personal development planning. It was, nevertheless, acknowledged to have limitations in content and application, which needed to be addressed.

The outcome of the national Mapping Exercise showed that there were significant gaps in pre and post qualification training of all professional staff in their ability to deliver the MHNSF. Significant omissions included: user and carer involvement, mental health promotion, values and evidence based practice, working with families, multidisciplinary working and working with diversity.

The shift in culture in services towards Choice and person centeredness is a key imperative. People who use services and their families continue to report not being listened to, being marginal to assessment and care planning and being rendered helpless rather than helped by service use. Tragic events, evidenced by the Bennett enquiry, illustrate that there is a significant need to ensure that all staff have training in what is described here as the Essential Shared Capabilities [ESC].

This document spells out these ESC. They have been developed in consultation with service users and carers, together with practitioners, and build on the CPF.

They are intended to make explicit what should be included as core in the curricula of all pre and post qualification training for professional and non-professionally affiliated staff as well as being embedded in induction and continuing professional/practitioner development.

There are already effective approaches to training and development on aspects of these ESC's. These will be identified and communicated to practitioners and localities via a Resource Library developed between NIMHE and SCMH. Where gaps are identified, new materials and curricula will be developed to ensure that that there are robust approaches for all ten Capabilities.

We need to ensure that these ESC are meaningful and implemented effectively. We are actively discussing a partnership approach, with a focus on CPD, between NIMHE and the NHSU.

We are establishing a National Network of Capability Development, to enable practitioners of different disciplines to interact, share and feed back on the ESC's themselves and the implementation process. We will, further, be running workshops in NIMHE Development Centre areas, to discuss with key stakeholders, how to make best use of the ESC's.

The ESC's will probably require alteration over time and we will be monitoring their use and influence on curricula. The link between them, National Occupational Standards and the Knowledge and Skills Framework is articulated in this document, to enable staff to make sense of these various initiatives.

This work has been conducted by the NIMHE/ SCMH Joint Workforce Support Unit. The implementation strategy has been devised in collaboration with the National Health Service University (NHSU).

Roslyn Hope
Angela Greatley
Director
Acting Chief Executive
National Workforce Programme
Sainsbury Centre for Mental Health
National Institute for Mental Health England

Methodology

The aim of the ESC is to set out the shared capabilities that all staff working in mental health services should achieve as a minimum as part of their pre-qualifying training. Thus the ESC should form part of the basic building blocks for all mental health staff whether they are professionally qualified or not and whether they work in the NHS, the social care field or the private and voluntary sectors.

The development of the ESC is a joint NIMHE and Sainsbury Centre for Mental Health Project. It builds on the work of the Sainsbury Centre's Capable Practitioner Framework copies of which can be downloaded from www.scmh.org.uk.

Whilst elements of the ESC can be found amongst a variety of capability and competency frameworks, from the Department of Health, Skills for Health, Professional Bodies and Academic Institutes, what they do not contain is that single, concise list of essential capabilities being asked for by staff and service users.

In 2003, a national steering group was established to guide the development of the ESC click here to see appendix B. The ESC were developed through consultation with service users, carers, managers, academics and practitioners. To facilitate this process a number of focus groups were held across England in order to sample opinion and seek feedback. In the main, they have what might be termed an "outward focus" and are explicitly and deliberately centred upon the needs of service users and carers.

The Ten Essential Shared Capabilities [53]

It is important to note that the ESC are not intended to replace the Capable Practitioner Framework, the National Occupational Standards nor the NHS Knowledge and Skills Framework. The ESC are complementary to these frameworks and provide the mental health specific context and achievements for education, training and personal development at pre-registration/qualification stage.

Working in Partnership

Developing and maintaining constructive working relationships with service users, carers, families, colleagues, lay people and wider community networks. Working positively with any tensions created by conflicts of interest or aspiration that may arise between the partners in care.

Respecting Diversity

Working in partnership with service users, carers, families and colleagues to provide care and interventions that not only make a positive difference but also do so in ways that respect and value diversity including age, race, culture, disability, gender, spirituality and sexuality.

Practising Ethically

Recognising the rights and aspirations of service users and their families, acknowledging power differentials and minimising them whenever possible. Providing treatment and care that is accountable to service users and carers within the boundaries prescribed by national (professional), legal and local codes of ethical practice.

Challenging Inequality

Addressing the causes and consequences of stigma, discrimination, social inequality and exclusion on service users, carers and mental health services. Creating, developing or maintaining valued social roles for people in the communities they come from.

Promoting Recovery

Working in partnership to provide care and treatment that enables service users and carers to tackle mental health problems with hope and optimism and to work towards a valued life-style within and beyond the limits of any mental health problem.

Identifying People's Needs and Strengths

Working in partnership to gather information to agree health and social care needs in the context of the preferred lifestyle and aspirations of service users their families, carers and friends.

Providing Service User Centered Care

Negotiating achievable and meaningful goals; primarily from the perspective of service users and their families. Influencing and seeking the means to achieve these goals and clarifying the responsibilities of the people who will provide any help that is needed, including systematically evaluating outcomes and achievements.

Making a difference

Facilitating access to and delivering the best quality, evidence-based, values-based health and social care interventions to meet the needs and aspirations of service users and their families and carers.

Promoting Safety and Positive Risk Taking

Empowering the person to decide the level of risk they are prepared to take with their health and safety. This includes working with the tension between promoting safety and positive risk taking, including assessing and dealing with possible risks for service users, carers, family members, and the wider public.

Personal Development and Learning

Keeping up-to-date with changes in practice and participating in life-long learning, personal and professional development for one's self and colleagues through supervision, appraisal and reflective practice.

Implementation Plan

Although the ESC have been well received, an implementation plan needs to be carefully thought out and executed if they are to become meaningful and influence the practice of individual staff. Click here to see the implementation strategy.

The ESC are aimed primarily at influencing the education and training provision within the mental health community. If they are to do this in any significant way then the whole range of activities within mental health education needs to be influenced.

It is important, therefore, that the ESC are adopted as a framework not only for the development of education curricula but also as a framework for Personal Development Planning [PDP], Training Needs Analysis (TNA) and Joint Education and Training Plans.

Consequently any strategy will need to be multi faceted and be aimed at a range of audiences, including individual clinicians, organisations, professional bodies and education providers.

Future Developments to Support Implementation

• A database of Training and Education resources and curricula will be made available on the NIMHE Knowledge Community web-site
• A National Electronic Network of Capability Development for practitioners, managers, educators and Users and Carers to feedback and share experiences to be made available on the NIMHE Knowledge Community web-site.
• Work with Workforce Development Confederations / Directorates to ensure that the commissioning of education and training is consistent with the ESC.
• A joint project with the NHSU to support NIMHE Regional Development Centres to explore local approaches to implementation, support education providers and provide examples of curricula that are consistent with the ESC.
• Work with the professional bodies to ensure that they support the ESC.
• A regional network through joint NHSU and NIMH(E) appointments that will lead on local implementation of the ESC (for CPD) within affiliate organisations, both health and social care.

Conclusion

The ESC offer an important step forward in ensuring a comprehensive and inclusive approach to education and training, linked to a common framework for personal development planning and training needs analysis. The ESC will therefore provide a strategically important integration of education and training with the effective delivery of these essential capabilities in the workplace.