Published: 30/01/2003, Volume II3, No. 5840 Page 22 23

Graeme Betts says that specialist support workers for older people could be the basis for improving care and we should start from the user's perspective.

This has been addressed in a report investigating the requirement and training/educational needs of 'interprofessional practitioners' for older people from the perspectives of patients, carers and service providers.

1This intercollegiate project, funded by South Yorkshire workforce development confederation, provides both support and evidence for the recommendations made by Mr Betts.

The report recommends that we should 'nurture not invent' the increasing number of interprofessional support staff within community rehabilitation and intermediate care services. These staff have been developed over several years and have enabled the highly trained and often scarce professionals to use their time and skills more effectively.

The interprofessional roles have challenged professional bodies and health organisations in terms of grading, training and regulation. The problems have largely arisen due to the traditional uniprofessional structures at senior levels within health organisations. There are also significant problems with these staff being employed with very different terms and conditions, in both health and social care services. Professional bodies are aware of the needs of the interprofessional workers, but do not have the infrastructure to provide the breadth of support they require.

The views of clients and carers are that a skilled 'jack of all trades' is a top priority for improving their care. They feel that such a workforce would provide them with the essential missing links between the highly valued uniprofessionals within both health and social care and all other agencies contributing to meeting their needs. However, they also feel that the current interprofessional workers do not have sufficient clout or status, and suggest that recognised qualifications are required to win status and acceptance from other professionals.

Users and staff from multiprofessional teams have identified potential subject areas for education and training.

It appears that the time is now right to invest in curriculum planning that will provide long overdue recognition and a potential career structure for interprofessional workers.

Qualifications at different educational levels will contribute to widening access and support the concept of the skills escalator for the current and future workforce.

As Mr Betts suggests, many of the employment issues for these workers, may be best managed within primary care trusts.

However there will need to be true collaboration and commitment across provider agencies, health and social care professions, and higher education institutes to take this forward.

Fiona Shield Changing working practice co-ordinator Shropshire and Staffordshire workforce development confederation, Professor Pam Enderby Dean of the faculty of medicine Sheffield University

REFERENCE 1New NHS: New Workforce. A report on the roles and educational requirements of interprofessional practitioners for older people, October 2002.