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Recruiting healthcare assistants in general practice

HCAs could be a bonus to your practice, say Dr Ruth Chambers and Anne Longbottom.

Last month, the Working in Partnership Programme (WiPP) launched the 'Healthcare Assistant Tool Kit', which was developed to support the recruitment, training and integration of healthcare assistants (HCAs).

Some HCAs are employed by primary care organisations, but more and more HCAs are employed directly by GP partnerships.

They have been a feature of the hospital workforce for many years, but in the past three to four years GP interest in employing HCAs has soared.

HCAs do not have professional registration so the practice must have a system in place to supervise their work before it can employ them to undertake clinical tasks.

Supervision

The practice nurse or GP supervising the HCA takes professional responsibility for the HCA's actions. They are accountable for the appropriateness of the clinical tasks that are delegated to the HCA.

It is therefore essential that the HCA's supervisor ensures that the HCA is capable of doing the clinical work and has sufficient support available, even when the primary supervisor is absent.

You need a corporate agreement in your practice that describes the HCA role, underpinned by rigorous protocols that apply to whoever is supervising the HCA. These need to be specific and kept up to date.

Your HCA-to-be could be working in another health setting - your local hospital or in community care. Or they might be employed by another practice and be seeking opportunities in a practice that invests in their personal development.

Career progression

Perhaps you are already employing a potential HCA as a receptionist or cleaner and are ready to support their career progression, either part-time serving a dual role or as a full-time HCA.

All these routes should provide a relatively smooth transition to the HCA role because they will already be familiar with the NHS ethos of patient care - preserving confidentiality, record keeping and consent.

Alternatively, you might opt to take on an HCA recruit without any previous NHS experience. This will require a longer induction period before you can be confident that your HCA can work to the practice's clinical protocols.

Pay bands

The GMS contract and the Royal College of Nursing encourage practices to adopt Agenda for Change terms and conditions for HCAs and nurses employed in general practice.

This means that an HCA would be employed on band two or three; usually band three once they have attained NVQ level three.

By then they will be able to undertake a broad range of clinical activities without direct supervision. Pay scales range from £12,177 to £15,107 for band two and £12,853 to £16,799 for band three.

The WiPP tool kit for employing HCAs is available on their website. There you can download a job description and person specification for the post (www.wipp.nhs.uk).

You must also aim to undertake a criminal record bureau search and an occupational health check - including review of their hepatitis B and immunisation status if needed - just as you would for any other clinical post.

- Dr Chambers is director of postgraduate GP education at the West Midlands Deanery and Anne Longbottom is project manager for the HCA tool kit

CHECKLIST FOR RECRUITMENT OF AN HCA

Premises - Have you enough space in your surgery for an HCA to see patients, access computer records and be supervised, all at the same time?

Equipment - Have you enough spare equipment for the HCA to be seeing patients while the rest of the practice team are doing clinical work too?

Workforce planning - Will the skill mix of the team be balanced with an additional HCA?

Supervision - Do you or your practice nurses have the capacity and enthusiasm for supervising the HCA?

Business planning - Are the salary costs of the HCA at least covered by the additional clinical or administrative services, or substitution for a trained nurse?

Training - Can you arrange in-house training in basic HCA tasks and can they access NVQ training or other suitable courses?

Employment - Ensure the job description, person specification, and terms and conditions are agreed by the practice manager, supervising nurse and GPs.

Induction - Can you cater for a new recruit with no NHS experience; or one with transferable skills and experience from another health role?

Insurance - For instance, check your public liability insurance covers your new employee.

CASE STUDY - HCAS HELP IMPROVE ACCESS

From receptionist to fully fledged HCA 'Both our existing HCAs were initially employed as receptionists. They have gradually developed their role from part-time phlebotomists/receptionists to their current roles as full-time fully integrated members of the nursing team. They have a wide range of competences and have been key to enabling the practice to meet access targets by shifting work to the most appropriate practitioner and freeing nurse time to manage the chronic disease element of patient care.' Bristol-based practice.

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