A quality service requires … qualified people

With the new academic year coming up, we’ve spent a lot of time updating and tweaking our service to improve it for our clients. Fortunately, my university is not driven by the need to cut, so the feeling is one of improvement, not one of the bit by bit amputations many other services have to go through. Like career support in schools. To cut it short, schools have ‘gained’ the ‘freedom’ and the responsibility to find independent providers to cover their obligation to offer careers advice to students. At the same time, council based services like Connexions have been mostly cut to shreds. The national careers service is supposed to jump into the breach and give – mostly telephone, or online-based – support. So a young person needing advice, but not falling under a special needs provision, may never meet a qualified careers advisor face to face, well until they’ve joint a university where advice and guidance are much more coherent. Let’s just hope they get their study choice right. It depends on the financial situation of their school, and the level of commitment and qualification of staff involved. I remember when this happened, and how painful the transition was. Now I know that careers advice in schools never came with plentiful endorsement, but withdrawing it effectively strikes me as foolish. And so does Ofsted, the CBI and the CIPD.

To draw a bit of a parallel (and as it’s one, it’s going to be obviously a bit flawed), let’s just mull this simple sentence for a moment:

Getting careers education from a well developed online portal with some phone support sounds in principle reasonable. It will affect young people in big decisions in their life, and may influence their future significantly.

You’re still with me? Right, now replace the term ‘careers eduction’ in the first sentence of this paragraph with the word ‘sex education’, and mull again how reasonable this still feels. If so – we’re fine. If not, then read on.

This is nothing I’ve learnt recently – it was annoying when it was brought in, and it remains a frustration for the profession – and it’s unknowing victims. What is new to me is how flawed such a service – which is basically a cut price version of something that may have been flawed, but was overall just better – can affect the client: I’ve been always a big fan of NHS Direct – a phone based triage service for GPs and hospitals aiming to reduce the number of people who go to A&E unnecessarily, with a strong backbone of nurses who were able to give solid and credible advice. I have used it for myself and others – and have never been disappointed. Staff always were competent and reassuring.

Recenty, the service is being replaced by NHS 111, which hopes to provide the same service, only cheaper. The triaging is done by call centre operatives, and results have been mostly negative. Why? Because the service has been de-skilled (made cheaper), and the effect has been an actual increase of A&E referrals in some areas. I gave them a call on a minor matter (I wasn’t even sure whether I needed to go to the GP), and my experience was substantially weaker than NHS Direct before: It was like calling my phone provider, only worse. It was clear that the operator had no medical training, and read from a script. It may have been a well written script, but I couldn’t assess that as I had concentrate strongly to deal with the many mispronunciations that made the read out medical advice harder to follow. It was clear that the operator didn’t give advice, but worked off a call, void of any professional authority. It’s probably the equivalent of the apocryphal careers advisor who runs you through an assessment tool and then tells you to become a prison officer, or a research chemist, or a gardener in one session.

To summarise: The presumed need to make cuts has led to a de-skilling of the people involved, which has impacted upon the usefulness of the service. And this is a sobering experience.

September 10th, 2013 by