The Changing role of Health Care Assistants (HCAs)

UK Health Care Assistants (HCAs) are unregistered staff who work alongside qualified nurses and Allied Health Professionals in the delivery of patient care.

This work occurs in a range of contexts including hospitals, local clinics, residential and domiciliary care. Over the past decade, expansion in the role of both junior doctors and registered practitioners has led to substantial developments in the HCA role.

HCAs are now expected to work more autonomously and to undertake activities that require a high level of skill and knowledge. Difficulties around nursing recruitment are expected to reinforce this trend for the foreseeable future.

Learning Opportunities for HCAs

Unfortunately, the educational opportunities that exist for the estimated 1000 HCAs within Oxfordshire are fragmented, often lack formal accreditation and offer inadequate support to individuals.

This inhibits efforts to raise skill levels among HCAs, reduces the mobility of HCAs between Oxfordshire healthcare organisations and makes it much harder to achieve a new skills mix.

Oxfordshire-wide educational pathway for HCAs

Oxfordshire Health Care Assistant Training School (OHCATS) will change this situation.

Building on existing pre-nursing programmes, OHCATS will offer a comprehensive skills escalator / educational pathway open to all HCAs in Oxfordshire from induction level, through intermediate and advanced levels, allowing progression into professional education.

OHCATS aims

• To implement an educational pathway that takes the HCA from novice to expert practice and which supports a clear county-wide career structure for this group of staff.
• To break down boundaries across the Oxfordshire health community by ensuring acute and primary trust collaboration in the development of HCAs.
• To provide a dual educational focus whereby an individual’s clinical and personal learning needs are assessed and addressed. This will be achieved by exploring an individual’s learning experiences, attitudes towards learning and basic skills needs when they enter their organisation.
• To strengthen the relationship between classroom and work-based learning to help reduce the division between theory and practice and to provide learning that is meaningful to the individual.
• To support achievement of Open College Network and NVQ accredited pathways that allow the individual to choose the assessment programme that is most suited to their developmental and career goals.
• To link educational programmes provided ‘in-house’ with the Oxfordshire Health Care Apprenticeship programme (pre-nursing course), for those who wish to enter higher education.

Training Programme structure

There will be a three-stage approach to HCA education.

As an HCA develops their skills, knowledge and experience they will progress from induction (core skills and knowledge) to the intermediary programme. This programme will focus on enabling people to broaden their knowledge in core aspects of their role as well as encompassing more advanced clinical skills.

Those who continue to develop and wish to attain a higher level of practice will be able to enter an advanced programme that will focus on the requirements of a more senior HCA role.

Each programme will be mapped to both NVQ and OCN frameworks, requiring the HCA to demonstrate their learning through a portfolio of evidence.

Achievements to date

These include :

• Enthusiastic endorsement by NHS organisations in Oxfordshire – five PCTs, mental health trust, Nuffield Orthopaedic Centre and Oxford Radcliffe trust
• Partnership with Oxfordshire County Council’s SEEDA-funded lifelong learning programme, Oxfordshire Skills for Health to support Skills-for-Life development
• Strategic Health Authority commissioning of five-year business plan
• Support from SEEDA for two clinical educators
• Detailed planning underway with trust and professional leads for nursing and allied health professionals
• Audit underway into existing HCA workforce and predicted growth over next five years