The roles, responsibilities and job satisfaction of health advisers in

the UK and Ireland

Chris McGarvey

SSHA conference 2006

C.McGarvey (2006)

Objectives

• To describe current HA roles & responsibilities • To describe current levels of job satisfaction &

identify factors which positively or negatively influence this

• To determine the extent to which the SpN & HA roles overlap

• To determine the extent to which the SHS recommendations for HAs have been implemented

C.McGarvey (2006)

Methodology

• Questionnaire designed• 27 questions divided into three sections• Application to LREC• SSHA members (n=365) as target population • Pilot (n=7)• Questionnaires posted via Amicus • 169 questionnaires were returned

(46.3% response rate; 160 useable 43.8%)• Data analysed using SPSS

C.McGarvey (2006)

What is your job title?(n=160)

2%22%

55%

1%

7% 6% 7% principal

senior

HA

trainee

HA & SpN

HA & manager

other

C.McGarvey (2006)

Type of pay scale(n=147)

60%16%

5%

19%

nursing grade

AfC band

SMP band

A&C grade

C.McGarvey (2006)

Please state the grade or band of your post (Nursing grades)

(n=87; 59.2%)

1% 16%

54%

21%

2% 6% E

F

G

H

I

Unspecified

C.McGarvey (2006)

Please state the grade or band of your post (AfC band)

(n=24; 16.3%)

4%

63%

29%

4%

5

6

7

8

C.McGarvey (2006)

Please state the grade or band of your post (SMP grade)(n=8; 5.4%)

13%

38%49%

18

20

24

C.McGarvey (2006)

Please state the grade or band of your post (A&C grade)(n=28; 19.0%)

4%

39%

57%

5

6

7

C.McGarvey (2006)

How long have you been on this pay level?(n=156)

9%11%

22%

30%

13%

15% < 6 months

6-11 months

1-2 yrs

3-5 yrs

6-9 yrs

10 yrs +

C.McGarvey (2006)

How many years have you worked in your current post? (n=159)

15%

16%

33%

18%

18%<1

1_2

2_5

5_10

10+

C.McGarvey (2006)

Have your roles & responsibilities changed since you've been in post?

35%

65%

No

Yes

C.McGarvey (2006)

Ways in which roles & responsibilities had changed

• Increase in managerial responsibility (31%, n=35)

• Role has grown or developed

(20.4%, n=23)

• Increased workload & administerial duties (9.7%, n=11)

C.McGarvey (2006)

Do you have current professional registration? If so, is this with…

(n=170 responses)

70%3%

7%

4%16%

NMC

SCC

BACP

Other

Not answered

C.McGarvey (2006)

Does your clinic have any written protocols/guidelines specific to health adviser

activity? (n=157)

79%

21%

Yes

No

C.McGarvey (2006)

In the last 12 months, has your service conducted any audit or research to monitor/evaluate the effectiveness of HA interventions e.g. partner

notification outcomes? (n=159)

59%

37%

4%

Yes

No

Don't know

C.McGarvey (2006)

05

1015202530354045

Percentage of responses

Nos

. HA

sin

crea

sed

Rol

e of

HA

deve

lope

d

Pro

file

of P

N in

com

mun

ity

Don

't kn

ow

No

impl

emen

tatio

n

Responses to SHS

Have any of the following recommendations of the SHS (2001) been implemented? (n=221 responses)

C.McGarvey (2006)

'During the past 12 months, how much training have you

had, either paid for or organised by your employer? (Include only training away from your normal place of work, but it

could be on or off site)'

(n=158)

15%

8%

31%23%

23% None

1 day or less

2-4 days

5-9 days

10 days +

C.McGarvey (2006)

Working with SpNs

• 66% of respondents work alongside SpNs

• The only significant overlap in roles were:– HIV testing of low risk patients

(32.4%, p=0.005)– Provision of ongoing support for HIV patients

(18.0%, p=0.003)– Issuing medication under PGDs

(20.0%, p=0.001)

C.McGarvey (2006)

Respondents’ attitudes to & satisfaction with their jobs

• ‘I only work as hard as I have to’ 0.6% (n=1)

• ‘I work hard but not so that it interferes with the rest of my life’58.1% (n=93)

• ‘I make a point of doing the best work I can, even if it sometimes interferes with the rest of my life’41.3% (n=66)

C.McGarvey (2006)

Job satisfaction

• Sense of achievement derived from the work

(83.1% satisfied vs. 6.9% dissatisfied)• Amount of influence over their job

(57.5% vs. 21.2%)

and clinic policies

(55.0% vs. 20.6%)• Respect from line managers

(56.9% vs. 23.8%)

C.McGarvey (2006)

How likely is it that you will try to find a job with another organisation within the next 12 months?

(n=160)

16%

17%

37%

29%1%

very likely

likely

unlikely

very unlikely

not answered

C.McGarvey (2006)

In the last two years, my job satisfaction has…(n=159)

38%

26%

36%increased

not changed

decreased

C.McGarvey (2006)

Main reasons cited for increased job satisfaction (49.4%, n=85):

• Attaining a new position with an existing employer or moving to another

(18.9%, n=16)

• Having gained more experience, knowledge & confidence

(12.9%, n=11)

• Having increased responsibility, involvement & influence within the service (9.4%, n=8)

C.McGarvey (2006)

Main reasons for decreased job satisfaction (50.6%, n=87):

• Increase in patient & administrative workload (18.4%, n=16)

• Feeling unsupported (10.3%, n=9)

• Ineffective management or clinical leadership (8.0%, n=7)

C.McGarvey (2006)

Factors with potential influence on job satisfaction (1)

1. The balance & variety of HA workload

2. Work life balance

3. Clinical supervision

4. Working in a clinic where SpNs are in post

5. Having regular & dedicated clerical support for the HAs

C.McGarvey (2006)

Factors with potential influence on job satisfaction (2)

6. Having protocols & guidelines specific to HA activity in place

7. Working in a clinic that monitors & evaluates the effectiveness of HA interventions through research & audit

8. Feeling supported, that contributions are valued & that the HA role is respected & understood

C.McGarvey (2006)

Summary of Recommendations

1. Improving the profile of health advisers - State registration

- Presentations / communication

- Clear protocols & standardised practice

- Involvement in audit & research at local & national level

2. Regular & dedicated clerical support- Creation of administration assistant posts

- Template job descriptions

3. Locum health advisers

4. Health advisers in the community