Transitioning to Triumph: High-Paying Jobs for Care Navigators and Specialist Testers. #Employment
The 3 Es: Employment, ‘Ealth and Education
My previous posts have explored the challenge of creating hundreds of thousands of new high-paying jobs and explained why I believe this is beyond government. However, many building blocks already exist and people are working on small-scale pilots.
If we believe, give or take some serious scaling, that the problem of job creation is tractable, the next question is how to avoid low-paying jobs and target those where people thrive and pay loads of tax.
These ideas flow from considering the social determinants of health (see my article on health inequalities here). Those suffering the poorest health are often out of work or in low-paying jobs and have long-term conditions or poor mental health. Ethnicity is also a factor, although how all the elements connect is still poorly understood.
I’m taking two examples as evidence that communities of people with high-value skills exist and provide before-and-after snapshots to show what sort of solutions are possible. First, we’ll look for groups with expert knowledge but no way to turn it into income. Next, we’ll imagine what an employment solution might look like for such communities that currently don’t exist as a serious employment pool. Realising the vision would need investors and/or entrepreneurs to stimulate (largely non-existent) markets and create new jobs.
Example 1: Care navigators as a new role for carers and other health service users
In the broadest sense, there are over 10 million carers in the UK, including those who gave up work to look after someone they know well and who now understand the system well. They know whom to phone and when to call them to change an appointment or how to get in front of the right NHS member of staff. There are plenty of people in this category and the cost of failed or missed appointments is high, so what would happen if we could connect an expensive need in the system to the invisible skills acquired by having to negotiate the passage of a loved one through the system? Some patients might also be up to such tasks.
Let’s imagine providing care navigation services using people with a deep knowledge of the system. Let’s imagine care navigators working as and when they want to and being paid per successful appointment. Each navigator might manage a caseload of 5-50 patients for whom they would plan and negotiate effective pathways, ensuring that appointments were makable with all necessary supporting measures in place.
Care navigators would use a smart ‘phone, tablet or laptop to do for a dozen or more people a week what they were already doing informally for themselves or for someone close to them. Some of these positions exist as voluntary support and even in advocacy position within the NHS but their impact is episodic. What we need is systematic engagement that gets every patient to the right place on time, every time.
It is not hard to see how such a system could be configured to offer the best of permanent employment (pension, holidays, PAYE tax cover, insurance, etc.) and the best of a zero-hours contract (work when you like and take on as many patients or clients as you like).
At, £15-50 per successful appointment, the service would easily pay for itself with the NHS and with careful design could offer incomes up to £70k p.a., depending on how many clients each navigator wanted to take on.
The simplest business model would be as a direct provider to an ICS or government department. At the other end, the most advanced business models would track the benefits to the NHS of superior care coordination and take a percentage. When the service got very smart, it could be offered privately to time-poor, cash rich clients, those wanting private medicine or even planning health tourism. In doing so it would use a public sector need to nudge a private sector market into existence.
Example 2: Specialist Assistive Technology testers: high value jobs for selected disabled and impaired people
I ran a 10-year research programme across five universities in this area and have studied the MedTech challenge of testing technology to rigorous standards during the product development cycle. Testers with an appropriate impairment and the relevant product evaluation expertise would represent an unusual resource (here is one of our papers about users in the design cycle). The usual approach is to gather users in focus groups run by academics or consultants, having gained ethical clearance, or for ethnographers to observe users trying out the technology. This proposal would cut out the middlemen and turn those with impairment into their own academic researchers and consultants. Instead of patients being passive subjects of research: why not help them become active experts?
Imagine companies that would employ users and train them in formal evaluation methods, while skilling them to write professional reports. The company could provide marketing, transport and even technical writing support to produce evaluation reports that might sell for between £30k and £80k a pop. A substantial amount of this would become salary for the impaired personal, who might earn £50k-£100k p.a. by taking on 6 to 10 evaluations a year.
The accent would be on providing an elite service that delivered the highest quality analysis quickly and in a variety of formats. Testers might arrive at the client’s office in a chauffeur driven limo, be briefed and take prototype products away for evaluation – probably over several days using systematic and formal methods while also ensuring that products worked consistently in real life. About 4 weeks later, a report (and/or presentation) would be delivered (chauffeur driven, if necessary). This report would provide whatever regulatory or legal information the client would need to progress in their design cycle with sufficient evidence to go to market when required, along with a detailed set of recommendations for subsequent upgrades.
Getting started
What I have shown is where to look for expertise that could solve a real problem while propelling significant numbers of people from benefits onto salaries that deliver independence and tax revenues. If all this sounds a little too idealistic, the next post will dive into some of the questions that need to be answered in order to make one of these ideas work.
A first-pass look at the numbers for Example 2 suggests a start-up of around 15 people (at least half with serious impairment) turning over £1-2M p.a. with salaries north of £50k p.a. that offers expert services to the MedTech and Amenities sections could get up and running for an investment of around £700k, which it would clear with a good RoI within 3 years. Once the model has been proven, a few hundred new jobs generated over five years is a reasonable expectation.
If you are interested, let’s talk!