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How healthcare assistants fit into a practice

The range of tasks HCAs can undertake is wide, writes Dr Ruth Chambers.

Healthcare assistants (HCAs) can prove a valuable addition to the practice team. Their numbers have burgeoned in recent years as practices have addressed the quality framework and recognised ways in which they can help achieve quality points.

Employing HCAs is more common at larger or more progressive practices or those run by primary care organisations or private providers.

Recruiting an HCA can facilitate increasing the range of patient services the practice offers. If suitably trained, they can relieve practice nurses of some tasks so that they can focus on clinical work where nursing skills are essential.

Pay and qualifications

For pay purposes, HCAs may be classed as 'general' healthcare assistant or 'senior' healthcare assistants graded as band two or three according to the Agenda for Change (AfC) criteria, assuming the practice has adopted AfC. You can expect a senior HCA to have, or be about to gain, an NVQ3 (national vocational qualification, level three) or equivalent.

HCAs are within the 'non-professional' NHS workforce because they do not have a degree qualification giving them professional status and are currently unregulated.

But calling them 'non-professional' can seem insulting given the typical HCA's range of expertise.

Providing an explicit job description and allowing an HCA protected time to gain NVQs means that they can transfer between health settings more readily, for example from working in a hospital to general practice.

Until recently, the individualised on-the-job training that HCAs received meant they were only really fit for the workplace that had trained them.

The practice nurses will need expertise and time to supervise and train the HCA. This in-house training can take place alongside any other accredited courses such as NVQs.

Clinical tasks

Clinical tasks performed by them in practices include phlebotomy, ECGs, BP monitoring, urine analysis and contributory checks at asthma and diabetes and other chronic disease clinics.

In an asthma clinic for example, they can give health advice and check that patients are correctly using inhalers.

They might take a lead on a clinical protocol such as the clinical team's hepatitis B status, checking personal records with each GP and practice nurse, organising hepatitis B status blood check and subsequent boosters as necessary. HCAs look after the treatment room, checking hygiene and ensuring the equipment is functioning.

They might extend their responsibility for health and safety from the treatment room to other parts of the practice. This could include taking a lead on dealing with body fluid spillages.

The DoH's Working in Partnership Programme aims to reduce demand on GPs.

One initiative is a tool kit of good practice for healthcare assistants.

- Dr Chambers is Professor of Primary Care, Staffordshire University and Director of Postgraduate GP Education, West Midlands Deanery.

- Phlebotomy.
- ECGs.
- BP monitoring.
- Urine analysis.
- Contributory checks at chronic disease clinics.
- Looking after the treatment room.
- Audit.
- Summarising notes.
- Data input and scanning hospital letters.

A few practices employ health- care assistants to undertake:
- Spirometry.
- Simple wound dressings.
- Assisting in minor operations.
- Hearing tests.
- Pregnancy testing.

- DoH tool kit: www.wipp.nhs.uk
- NVQ details from Qualifications and Curriculum Authority

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