News

There are plenty of challenges in providing high-quality, seamless patient and service user-centred care. Among them is a growing awareness that all staff need appropriate literacy, language and numeracy (LLN) skills to carry out new and changing roles with confidence and efficiency. LLN encompasses English for speakers of other languages, and LLN skills, also known as basic skills and skills for life, are essential in health and social care.

To address the national LLN gap, which is reflected in the UK's massive national health and care workforce, the government's Skills for Life funding rules entitle every adult without a level two qualification (GCSEs at grades A*-C or equivalent) to free LLN training. Added to this is an increased emphasis by the National Learning and Skills Council on user and employer-led LLN training and delivered in the workplace wherever possible.

But the first instinct of many employers, under pressure to implement national occupational standards, agenda for change and so on, is denial in the face of the unfamiliar. It's a perfectly understandable reaction which may in part be based on a misapprehension of what basic skills are.

Managers who have tried to address the issue are confronted by a baffling array of training offers, many of which fail to fully meet the needs of the organisation or its staff. And faced with the prospect of sitting in a classroom at a local college learning maths and English, many staff who lack level two qualifications will decline the training offer, and may even feel threatened by it.

But LLN is not just another initiative that can be opted into when all the others are done and dusted. It is all about the delivery of health and social care priorities and strategies. Substitute the words "communication" and "measuring and calculation" for literacy, language and numeracy and the message becomes very clear. All staff, whatever their role, need sufficient communication and calculation skills to understand and follow procedures correctly and safely, and to accurately interpret the needs of, and relay information to and about, the people for whose health and well-being they are responsible.

Research on behalf of the then Topss England (now Skills for Care) highlighted the problems with not engaging with the LLN agenda.(1) Managers interviewed for the research were clear that lack of basic skills in staff exposed a social care business to risk on three fronts:

• Breaches of health and safety or other regulations, inspection failure or even legal action.
• Poor quality care for service users.
• Difficulties with staff recruitment, retention, training and NVQ achievement.

The research concluded that "poor recording and reporting standards, not understanding written information and instructions, not understanding numbers and poor oral communication lead to poor handover at the end of shifts, poor quality records and paperwork, the risk of errors and accidents and a lower standard of care for service users".

The Health and Social Care Stakeholders' Forum of the National Learning and Skills Council is aware of the importance of LLN skills in health and social care, and of the difficulties providers in the public, private and voluntary sectors have in accessing appropriate training.

As part of a wider action plan, the forum is funding a project - Essential Skills for Health and Social Care - to develop a national framework for embedding LLN into health and social care strategies and organisations, and to ease employer and staff access to high-quality LLN training. Public sector union Unison, a member of the forum, is leading the project and drawing on the work of the growing network of union learning representatives.

During the first stage of the project, from October 2004 to January 2005, research consultants worked to identify the level and range of LLN provision in health and social care. Their report, Promoting Skills for Life in Health and Social Care, completed this month, sets out the national policy context, identifies existing good practice, and highlights the needs of, and issues for, employers and managers in the sectors. The steering group examines the recommendations in depth this month.

The second stage of the project involves two strands of activity:

• Making the case for embedding and mainstreaming LLN training within organisations. A series of free regional events will take this message to employers and other stakeholders in Birmingham (13 May), Leeds (20 May), Bristol (10 June) and London (17 June).
• Working with 10 partnerships across the country to test and evaluate models of good LLN delivery practice. The partnerships will include employers, training providers and funders and aim also to involve health and social care providers from the private and voluntary sectors as well as statutory services.

The partnerships will offer manager awareness training, LLN needs assessment, workplace training, developing individual learning plans linked to personal development plans, and national tests in literacy and numeracy.

Evaluation will be integral to the package, but there will also be an opportunity for employers to gain richer data about the impact of LLN learning by linking with researchers from the National Research and Development Centre based at the Institute of Education, in London. The centre is carrying out rigorous research into the longer-term impact on staff of workplace LLN learning in a variety of sectors.

There are many good reasons to engage in the LLN agenda, both for organisations and key staff who have missed out on the opportunity to develop their skills and build their confidence. Evidence is growing that they don't leave after acquiring LLN skills, but gain a new enthusiasm for their work, and respect for the employer who has shown it values them. With so much to gain, why not give it a try?

• For full details of and places at the free regional events, please contact Brenda Hurst at b.hurst@unison.co.uk.   If you are a health and social care provider who would like to know more about any aspect of the project, or if you have a good story to tell about the impact of basic skills learning on members of your staff, please contact the author.

Abstract

Literacy, language and numeracy skills (LLN) are necessary for staff in health and social care to carry out their roles effectively. This article looks at how health and social care organisations involved with the National Learning and Skills Council are developing a framework for improving the LLN skills of staff.

References

1. C Eborall, Basic Skills in Social Care, Topss England, 2004. Available at www.skillsforcare.org.uk

Further Information

• For a description and evaluation of employer and union learning partnerships, see Helen Rainbird et al, Learning Partnerships in Health and Social Care, Unison, 2001. No charge, e-mail k.carpenter@unison.co.uk
• For information on the work of the National Research and Development Centre for adult literacy and numeracy, including research in health and social care, go to www.nrdc.org.uk
• For a free employers toolkit that puts the business case for LLN in the workplace and provides guidance to embedding LLN into organisations, e-mail dfes@prolog.uk.com, quoting reference ETKV2-2004
• For a range of useful information and good practice examples in LLN provision, visit the Workplace Basic Skills Network at wbs.net@lancaster.ac.uk

Contact the Author

E-mail: b.weston@unison.co.uk, or phone: 020 7551 1676

Brenda Weston manages the Essential Skills in Health and Social Care Project at Unison Open College. Formerly a policy researcher and research unit manager, she has also been a social services planner, working in joint health and social services strategic planning teams and consulting service users about community care service development.