Tag Archives: Robert-Francis-Inquiry

Recognising the role and contribution of the intermediate level workforce in healthcare

In the wake of the scandal about healthcare standards at the Mid Staffordshire NHS Foundation Trust laid out in the Francis Report , the debate about the regulation and registration of the healthcare support workforce has been ratcheted up. The Times journalist Camilla Cavendish has been asked to undertake an independent review Ā in to the training and support of healthcare assistants, reporting to Government by the end of May 2013.


In this context a new report by members of the Work Futures Research Centre undertaken in collaboration with colleagues at the ESRC LLAKES Centre at the Institute of Education, London argues that the binary division between so called ā€˜qualifiedā€™ staff such as nurses, midwives, radiographers and healthcare scientists and ā€˜unqualifiedā€™ support staff is unhelpful and inaccurate.

Instead it reveals the increasingly important contribution being made to patient care by ā€˜intermediateā€™ level staff positioned between ā€˜registered professionalā€™ and ā€˜semi-skilledā€™ grades. It concludes that policy has been silent on the role of intermediate level workers in relation to patient safety, and asks whether there could be distinctive expectations about their contribution. It is clear that all healthcare staff have a role to play in patient safety and high standards of care.

The project, commissioned by the Gatsby Charitable Foundation has recently been completed and the final report is available to download here.

Key Findings

The research looked at intermediate level work in a range of occupational fields including midwifery support, radiography support, dental technicians, and healthcare science. Of special interest was the education and training of different professional groups and the thorny issue of registration.Ā  The project explored the views of a wide range of stakeholders and found that more accurate data on and better understanding of the roles undertaken by the intermediate workforce across the healthcare is needed to:

  • Help raise its profile and visibility
  • Help policy-making bodies monitor and plan for the size and development of this group
  • Provide the basis for developing a clearer relationship and alignment between qualification pathway and occupational level
  • Review the impact of the decline in the work-based education and training route for the availability of intermediate level posts and how and by whom they are accessed
  • Capture the contribution of intermediate level staff to patient care and safety
  • Explore how the regulation and registration of intermediate workers in specific occupational areas could better support and recognise their expertise


Full details:

Final report: ā€˜Technician and Intermediate Roles in the Healthcare Sectorā€™, Alison Fuller, Jill Turbin, Lorna Unwin, David Guile and Julie Wintrup. The Gatsby Foundation, University of Southampton and the Institute of Education, London, 2013.

Contact: Professor Alison Fuller, University of Southampton