Seconding health care assistants to a pre-registration nursing course: Evaluation of a novel scheme

Abstract

Traditionally in the United Kingdom, reliance has been placed on unqualified support workers, such as student nurses, to deliver a high proportion of patient care. However, the move of nurse education into higher education and the accompanying supernumerary status of student nurses in the 1980s resulted in a shortfall of staff to deliver that care. The government has made a number of suggestions for increasing recruitment. One possible solution regarded as very promising is to encourage health care assistants (HCAs) with at least 12 months' experience in the National Health Service to enrol on existing pre-registration programmes, providing them with financial incentives to do so. Very little literature directly concerned with training opportunities for HCAs could be traced, but it was evident that financial constraints and family commitments had, in the past, operated as disincentives to training, although some HCAs would otherwise be keen to register. In 1999 one of the workforce development confederations in London responded to government policy by seconding HCAs onto a pre-registration programme operated by the local university. Plans for evaluation were made at the outset. Interviews were conducted with two consecutive intakes of secondees at three time intervals: after three months; after 12 months and during the final placement of the 36-month course. Interviews with other stakeholders were conducted just before the course ended. A qualitative approach was taken and the data were analysed employing the sequence recommended by Miles and Huberman (1994). Evaluation highlighted important features of the secondment process contributing to its success and indicated pitfalls attached to introducing such schemes. It is recommended that evaluation should be extended to explore how the new staff nurses prepared by this novel scheme continue to develop their career trajectories. Given the emphasis now being placed on the 'skills escalator' model of staff development in the NHS, such approaches will assume even greater importance in future, and more extensive evaluations will be needed.

Locally targeted initiatives to recruit and retain nurses in England

“…Some helped plan courses or contributed to teaching. Some universities and trusts operate programmes to enable existing HCAs to attain registration (Gould et al. 2004).…”

Seconding healthcare assistants to a pre-registration nursing course

“…As indicated in the comments above, the secondees made full use of the university academic support services. The earlier evaluation had indicated that they had also received a great deal of support from their personal tutor (Gould et al, 2004). In contrast, the secondees coped well in their clinical placements compared to traditional students, especially during the 18-month common foundation programme:…”

“…The findings from a major acute London trust which has been operating the scheme since 1999 have indicated that secondees and other stakeholders are satisfied with the scheme (Gould et al, 2004). However, only a small number of eligible HCAs have been willing to undergo secondment.…”

“…This fear was considered by the secondees to have been the reason preventing their colleagues from applying for secondment. Moreover, uptake of the scheme had been lower than anticipated (Gould et al, 2004). Fear of failure might also have contributed to reluctance to participate in evaluation, given the time-consuming nature of the interviews and the inevitable focus of the discussion.…”

Learning to Support Children With Complex and Continuing Health Needs and Their Families

“…HCSWs often provide a great deal of the day‐to‐day support for children with complex and continuing health needs (Hewitt‐Taylor, 2004). Their precise role in health care varies according to the organization for which they work and their level of training and experience; but a considerable amount of nursing care in England is carried out by HCSWs in both hospital and community settings (Gould, Carr, Kelly, & Brown, 2004; Ormandy, Long, Hulme, & Johnson, 2004; Spilsbury & Meyer, 2004). HCSWs working with Clinovia complete a formal induction and training program and are assessed against competencies in all the areas in which they provide support.…”