Perceptions surrounding the role of the hca in general practice
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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. My Background. Practice Nurse working with 2 HCA’s

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Perceptions surrounding the role of the HCA in General Practice

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Perceptions surrounding the role of the hca in general practice

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


My background

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


Perceptions surrounding the role of the hca in general practice

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


Objectives

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


Background

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


Method

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


Major themes initial analysis

Major Themes – Initial analysis

  • Essential / Needed

  • Individual – dependent

  • Hurdles / barriers

  • Pressures to develop HCA role

  • What is the role anyway?


Essential needed

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)


Individual dependent

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)


Hurdles barriers

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


Pressures to develop the role

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


What is the role anyway

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


Time line

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


Current status

Current Status

  • Completing analysis and major themes:

    perceptions vary between professional groups and within professional groups

    COMMUNICATION!


Current status cont

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?


Perceptions surrounding the role of the hca in general practice

Your Comments and Ideas are very welcome!


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