Two reasons why people work in the NHS is because they want to help others and enjoy their interaction with patients.
Another is wanting to fulfil their potential career-wise. So a general practice should encourage its healthcare assistants (HCAs) to do just that.
The consensus is that HCAs should be qualified to a minimum of National Vocation Qualification (NVQ) level 3. This should enable the HCA to undertake a broad range of clinical activities without direct supervision while still accountable to and supervised by a practice nurse or other health pro- fessional — a GP, for example.
Training priorities will depend on an HCA’s personal learning needs and the service needs of the practice. They can graduate from basic tasks such as routine urine and BP testing, measuring and recording blood glucose to providing smoking cessation services, wound care or spirometry. All this will contribute to boosting the standard of patient care covered by the quality framework.
The training needed for generic skills will depend on what is required for an HCA’s role at the practice, their current skill base and previous experience. Start by considering what training to provide during an HCA’s induction period.
For relating to patients, an HCA needs to know about best practice in confidentiality, consent, patient choice and communication.
They will have a lot of responsibility for safety in the practice so training should include preventing cross-infection, sterilisation of equipment, health and safety in general, disposal of sharps, keeping the treatment room safe and child-proofing equipment.
An HCA will need training in storage of vaccinations and other drugs, and stock rotation. Some HCAs will be responsible for maintaining office equipment as well as clinical apparatus.
One way to make training in generic knowledge and skills more systematic is to work out what is needed using the NHS knowledge and skills framework (KSF).
This has six core dimensions: communication; personal and people development; health, safety and security; service improvement; quality and lastly, equality and diversity.
You can organise the training in generic skills around these fields, according to a needs assessment that you undertake at induction and at regular intervals such as every six to 12 months, linked to annual appraisal and review of their personal learning plan.
Training can be in-house, organised by your primary care organisation (PCO) or other NHS trust as part of mandatory training, protected learning events or specifically for HCA groups. Or the training can be within the requirements of an NVQ run by your local NVQ assessment centre.
Some of the knowledge and skills that KSF’s need are covered by these six core dimensions — and some others will fall under number two or three of the 24 specific dimensions of the KSF (details at www. nhsemployers.org).
These might be covered under the themes of health and wellbeing, and information and knowledge (for information processing and record keeping).
NVQs are about work-based learning. One limiting factors in HCAs’ training is that access to an NVQ level 3 that has been individualised for a general practice setting so it is relevant to their everyday role is not easy.
Another is the availability of NVQ assessors to review and quality assure their learning in the practice. Your PCO or local NVQ assessment centre might employ practice nurses with an NVQ assessor award to act as part-time peripatetic assessors. Others from the assessment centre be available.
Nurses can train to be internal verifiers who moderate the assessments. The more the practice team is involved, the more this will keep HCA training costs down. Learning can be conducted in the workplace, and can reduce staff time spent out of the practice. It could be worthwhile talking to the local NVQ coordinator at the NVQ assessment centre about this.
Professor Ruth Chambers is director of postgraduate GP education, West Midlands deanery and Anne Longbottom is project manager, HCA tool kit
For further information about training programmes see the HCA tool kit at www.wipp.nhs.uk