Skill mix: Using the assistant practitioner to drive efficiency

Abstract

This article outlines the development of the assistant practitioner role within a primary care setting and the experiences of 5 trainee assistant practitioners undertaking a foundation degree in health and social care delivered by the University of Bolton. The article will examine the changes in staff skill mix within general practice, and how the assistant practitioner role aims to contribute to the efficacy of services, improve patient access, and continuity of care. Furthermore, it will explore how it is offering career progression for healthcare assistants, in line with the Skills for Health (2015) skills escalator. A focus group methodology was used to gather the views of the trainee assistant practitioners at the end of their university programme and about to enter their new role. They were asked to reflect on the benefits of their learning and competency development, considering how their role has changed and will change in the future.

Unlicensed assistive personnel in ambulatory care

“…This was achieved by using UAP to complete a blend of clerical and clinical tasks 3,12-14. Common clerical tasks performed by UAP included chart preparation, restocking, and referrals 3,15-18…”

“…3,[12][13][14] Common clerical tasks performed by UAP included chart preparation, restocking, and referrals. 3,[15][16][17][18] Clinical tasks assigned to UAP varied widely, including height and weight measurement, 17 vital sign measurement, [14][15] ECG recording, 18 venipuncture/ phlebotomy, [13][14][17][18][19][20] urinalysis, 12 vaccination/injections, 10,13,18 ear irrigation, 21 wound care/ dressing changes, [13][14][15] instrument reprocessing, 10 and diagnostic testing. 11,14 In specialty settings, a wide variety of specialty-specific skills were noted, including foot care, 10 removal of peripheral IV catheters, 20 administering screening questionnaires, 19 various therapy services procedures, 22 and assisting with biopsies.…”

“…21 Examples of educational approaches ranged from fully employer-based training 12,[14][15]22 to blended job-based and formal education, [10][11][12][13]26 to carefully structured training for more advanced UAP roles, such as the UK's Assistant Practitioner (AP) role. 18,27,28 Two articles attested to the importance of dedicated time away from the distractions of patient care, even when education was employerbased. 12,14 In addition to initial training, ongoing professional education and competency verification was found to be important for UAP.…”

“…14,25 Organizations noted benefits in improved staff retention, staff satisfaction, and skill mix. 14,18 One article reported reduced organizational risk, reduced patient complaints, and reduced sick time after implementation of a carefully designed UAP role. 22 Others reported patient benefits from improved access to care.…”

Conceptualizing skill mix in nursing and health care: An analysis

“…It is important to acknowledge that many published papers on skill mix were excluded from this review as they did not include a definition of the concept and, on examination of the content, one must extrapolate what the term actually means (for example, Fulton et al, ; Powell, Brown, & Smith, ). Findings from this conceptual analysis were therefore used to inform the development of a conceptual model of skill‐mix dimensions, its attributes and the contextual factors that influence skill mix.…”