Perceptions surrounding the role of the HCA in General Practice

1. Perceptions surrounding the role of the HCA in General Practice Catherine Brant MA, BN, RGN Professional Development Nurse, South West Hampshire PCT’s and Practice Nurse, Nightingale Surgery, Romsey

2. My Background • Practice Nurse working with 2 HCA’s • Devised in-house training programme 5 years ago • Current role – see increasing numbers of HCA’s • Personal interest in development of the role

3. Aim To identify the views and perceptions of members of primary health care team about the current and future role of the HCA within General Practice

4. Objectives • To identify common themes about the perceptions of the role by all members of the PHCT • To identify perceptions of the role by those undertaking the role already • To identify areas of disparity about the perceptions of the role • To plan ways of addressing the issues raised by this work

5. Background • Role of the HCA in General Practice is relatively new • Numbers are increasing rapidly • The role is expanding • HCA’s are not regulated • Little national guidance available • Appears to be little consistency in role development

6. Method • Focus groups and one-to-one interviews used to collect data • Practice Managers, Practice Nurses, GP’s and HCA’s included • Modified grounded theory approach • Data transcribed and analysed • Major themes developed

7. Major Themes – Initial analysis • Essential / Needed • Individual – dependent • Hurdles / barriers • Pressures to develop HCA role • What is the role anyway?

8. Essential / Needed • “I don’t know how we managed before we had a healthcare assistant” (Practice Nurse) • “I think they’re fantastic, really good” (Practice Manager)

9. Individual - dependent • “some HCA’s have the personal qualities and the skills and the drive to take on, you know, bigger roles and to work under a bit more of their own initiative….but not everybody who applies as healthcare assistant particularly wants that” (GP) • “actually I’m quite happy just plodding along with what I’m doing and I know what I’m doing” (HCA)

10. Hurdles / barriers • Practical – room space, costs • Friction between staff colleagues “I wasn’t involved in recruitment or the interview and I have never seen her job description” (Practice Nurse) “practice nurses …closed to the idea of a healthcare assistant..” (Practice Manager) “I would be interested in doing it but I feel the nurse wouldn’t like me doing it” (Healthcare assistant) • Structural – lack of ed & training unregulated lack of national guidance lack of ‘rules’ conflicting national / local guidance

11. Pressures to develop the role • Increased workload in General Practice • Needs of the Practice • Financial benefits • Individuals (HCA’s) wish to move forward • Members of PHCT wish to move HCA role forward • Others are doing it so we can / should be too

12. What is the role anyway? • Conflicts of opinion within Practices - task-orientated or not? - remuneration • Supervision? • Management? • Where will it all end? - blurring of boundaries - awareness of limitations - role is infinite / finite - confusion re clinical roles - change is ongoing

13. Phase 1 Data collection Phase 2 Analysis Phase 3 Write-up/ publication Nov Dec Jan Feb Mar April May June July Aug Sep Time-line

14. Current Status • Completing analysis and major themes: perceptions vary between professional groups and within professional groups COMMUNICATION!

15. Current status cont. • More detailed analysis of differences in perceptions between professions and within professions and influence this may have on the role development • Planning ways of addressing the issues raised by this work - further data gathering? - mixed focus groups? - involvement of patients? - address some of the issues where possible e.g. lack of structured education and training, communication within Practices?

16. Your Comments and Ideas are very welcome!