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The decision to appoint a health care assistant Hilary Andrews Helen Dyer Vanessa Whillier Woodlands Health Centre. The decision to appoint a health care assistant. Do I need an HCA? How do I know I need an HCA?. Increased pressures in general practice. QOF targets Pressure of work on staff
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The decision to appoint a health care assistantHilary Andrews Helen DyerVanessa WhillierWoodlands Health Centre
The decision to appoint a health care assistant • Do I need an HCA? • How do I know I need an HCA?
Increased pressures in general practice • QOF targets • Pressure of work on staff • Maintenance of morale • Staff retention.
Subjective v. objective measurements of workload • WiPP Workload Analysis Tool • QOF targets • Staff turnover • Activity data.
Woodlands Health Centre • In 2002 Senior Practice Nurse due to retire • Possibility of employing HCA? • Employed an ‘independent’ advisor to report on: • Nursing activity data • What was happening elsewhere • Current skill-mix and future skill-mix options.
Inability to recruit experienced nurses or GPs to the team • Unsuccessful advertisements • Inappropriate applicants • Nurses inexperienced in general practice.
Skill-mix Is the right person for the task undertaking that task? • At Woodlands in 2002 over 3 nursing hours a week were spent on non-nursing housekeeping tasks • Thistlemoor Practice, Peterborough • The Ridge Medical Practice, Bradford.
Skill-mix • Magic formula? • Skill-mix audit • Skills needed by a practice team must meet the needs of the patients in that practice • Problems of ‘role’.
Common concerns • Delegation • Accountability • Regulation.
Woodlands Health Centre • Nurses well qualified, innovative and motivated • Nurses undertaking some long-term conditions management • Nursing hours below the national average • Skill-mix not apparent • Identified tasks suitable to be undertaken by a HCA • Identified the time needed by a HCA to undertake these tasks • Identified 6 skill-mix options • Recommendations for HCA supervision, induction, training and development.
Woodlands Health Centre • Continual evaluation of nursing team and workload • 2003 and 2005 compared • In three years • 64% increase in nursing hours yet only a 44% increase in nursing budget • Increased from a team of three qualified nurses to a team of six including two HCAs • QOF targets • 99.5% of clinical indicator points met.
HCAs • Effective and valued addition to the practice team • Increased overall efficiency of team • Value for money • Wish we’d thought of having one sooner!
The decision to appoint a health care assistant Do I need an HCA?