How did we get here? Explaining the persistent barriers NHS clinical support workers can face in England

Abstract

Despite being the employees who often have the most direct contact with service users, NHS clinical support workers, such as healthcare assistants and maternity support workers, have long experienced a range of barriers to their effective deployment and development. These include a lack of standardised entry requirements, inconsistent task deployment and truncated career progression pathways. These have a detrimental impact on service delivery, including patient satisfaction. The degree to which local employers are able to determine the recruitment, deployment and development of support workers is a key reason why these issues endure; however, this article suggests that a deeper reason is the existence of a segmented labour market in the NHS, with support workers existing in a secondary market. This duality resides in the socio-economic differences between registered and non-registered staff. Recent NHS support workforce strategies present an opportunity to finally address the issues support staff face.