Table 2.

Population of the Calderdale Framework using new role data

Calderdale Framework	Role implemented
	PA	SPA	OTAP
1. Awareness raising → staff engagement
1.1 Managers and clinical staff engaged with processes	1	2	2
1.2 Whole team/service aware of and educated in the implementation process	1	2	0
1.3 A clear leader/clear leadership (“champion”) with skills to lead and facilitate the implementation process and “project manage”	2	2	1
1.4 Leader is supported by a project lead and others undertaking similar workforce change projects	2	2	0
2. Service analysis → potential to change
2.1 Frontline clinical staff identify and clarify the purpose of their service and all the functions that are carried out in order to deliver this service	0	1	1
2.2 Functions are broken into tasks and these are matched to patient needs	1	1	0
3. Task analysis → risk management
3.1 Open discussion with clinicians regarding suitability of tasks for delegation, identifying what and where risks will occur if delegating a given task (using the Calderdale Framework decision table and risk rating scale), and also how much training would be needed for each task	1	2	1
4. Competency generation → quality
4.1 Tasks accepted as suitable to delegate are written into a “competency” format, which sets out the performance criteria of the task	2	2	2
4.2 Clinicians agree on how task is to be performed, embedding best practice	1	2	1
5. Supporting systems → governance (is the workplace able to manage the new roles?)
5.1 Ensuring clinical supervision processes are in place	1	2	2
5.2 Ensuring reflective practice is encouraged for all staff (including assistants)	1	2	2
5.3 Ensuring personal development review processes are in place	1	2	0
5.4 Ensuring communication channels are clear and robust	2	2	1
6. Training → staff development
6.1 Training developed for both qualified and support staff	1	1	0
6.2 Support staff trained in competencies, each comprising a knowledge-based element and a practical element	2	2	2
6.3 Support staff also trained so they understood what feedback to give, when and how to give it, and when a task should be halted	0	2	0
6.4 Competence assessed prior to performing on a patient	2	2	0
6.5 Training in core competencies first. Once competent, then more specific competencies are introduced	2	2	0
6.6 Qualified staff were trained so all understood how the competencies were derived and what the support staff were competent to perform	0	2	0
7. Sustaining → embedding and monitoring
7.1 Resulting “framework” embedded into local induction and personal development review for new members of staff	0	1	0
7.2 Audit plan developed to monitor outcomes and use of competencies	0	2	0

Notes: 0, criterion was not met at all; 1, criterion was only partly met (where only part of the stage/process has been completed. For example, only a selection of staff were consulted with and engaged in the implementation process for the podiatry assistant role, champions were not identified, and project planning was not formally deployed); 2, criterion was fully met.

Abbreviations: OTAP, occupational therapy assistant practitioner; PA, podiatry assistant; SPA, speech pathology assistant.