Crossing professional and organizational boundaries: The implementation of generic Rehabilitation Assistants within three organizations in the northwest of England

Abstract

Purpose. New generic support worker roles are being developed within rehabilitation and intermediate care services throughout the UK, as a consequence of staff shortages and the policy drive to look at new ways of working to meet the needs of older people. This paper describes a joint project between a Primary Care Trust, an Acute Trust and Social Services in one region in the northwest of England. It aims to describe the process of introducing new roles within rehabilitation and evaluates the acceptability and integration within different settings.Methods. Thirty support worker staff from an Acute Trust, Primary Care Trust and Social Services were trained over a period of 18 months to become generic Rehabilitation Assistants (RAs). A total of 55 semi-structured interviews of patients, associated professionals and RAs were conducted to examine the acceptability and integration of the new role. The interviews were tape-recorded, concurrently transcribed, inductively analysed and categorized into themes.Results. Several factors appeared to influence the acceptance and integration of the new role, namely: Prior experience and the degree of role change, familiarity and inter-staff relationships, role distinction and contribution and resources and management. Despite many challenges, patients, professionals and the RAs reported huge appreciation of the new role.Conclusions. The evaluation demonstrates how an innovative, inter-organizational approach can deliver new solutions to address workforce issues. Further research is recommended nationally, to track the development and evaluate the effectiveness of similar roles.