VOL: 97, ISSUE: 21, PAGE NO: 42
Gill Dunlop, RGN, D32/3/4, is NVQ care coordinator, Crawley College and Surrey and Sussex Healthcare NHS Trust
Shona Brown, BEd, is director of nursing and patient services, Surrey and Sussex Healthcare NHS Trust;Sandra Boyd, BEd, is programme manager, health and social care, faculty of service industries, Crawley CollegeProblems often prompt the search for new solutions so when, four years ago, our trust encountered nurse recruitment problems we reassessed our existing staffing and focused on an underused resource - nursing auxiliaries.
Problems often prompt the search for new solutions so when, four years ago, our trust encountered nurse recruitment problems we reassessed our existing staffing and focused on an underused resource - nursing auxiliaries.
However, to enable this group of staff to provide better support to RGNs - and safely - Surrey and Sussex Healthcare NHS Trust recognised that nursing auxiliaries would need new training. This had previously been provided at the discretion of the clinical leader and standards varied greatly. The trust also realised that offering transferable training, which was nationally recognised and offered opportunities for career advancement, would be advantageous in terms of staff morale.
The new approach to nursing auxiliary training resulted in a partnership between Crawley College and Surrey and Sussex Healthcare NHS Trust, which in turn led to the creation of the following:
- A strategic approach to training nursing auxiliaries across the trust;
- A new career structure for nursing auxiliaries achieving NVQs in care;
- An opportunity for auxiliaries with NVQ Level 3 to start preregistration education on sponsored places with the European Institute of Health and Medical Sciences (EIHMS) at the University of Surrey, Guildford;
- A prenursing programme for young people aged between 16 and 19 and an emerging strategy for effective work experience placements for those on access to higher education and NVQ courses.
The trust's training department approached specialist teaching staff in the faculty of service industries at Crawley College to explore a new model of training. Recognising the changing needs of employers, the trust developed a blueprint for an employer partnership that would enable training to take place in both clinical and college areas. This was used as a basis for negotiations between leading employers and the college, leading to the formation of the Mid Downs Care Partnership. This has since grown to include over 30 active partner members, two of them large NHS trusts.
The college and trusts negotiated funds to enable an NVQ coordinator to be put in post. The coordinator is now the link between education and service provision, a role that is invaluable in promoting the NVQ programme and recruiting from among staff currently working as nursing auxiliaries at grade A.
During NVQ assessor training, the coordinator supported the first cohort of 17 auxiliaries and assessors (14 RGNs and one physiotherapist).
Each trust ward and department chooses its prospective NVQ candidates and work-based assessors. The assessors have to be qualified health professionals willing to undertake NVQ assessor training and available to work with their candidate at least twice a week. Each participant must have worked for at least 18 hours a week at the trust for at least six months. Assessors are allocated no more than two candidates and they complete three half-day training sessions; the first is also attended by their student/s.
As the first candidates achieved their awards, and improvements in standards of practice were noted, interest in the programme grew.
The training consists of three half-day study sessions, initially followed by optional knowledge workshops available within the trust or at Crawley College. Many candidates can achieve the qualification without attending college. Each candidate is allowed one day a month to study.
Trust funding provides 50 NVQ places with two intakes a year. The recruitment is advertised in the trust newsletter, which is included with every staff member's payslip.
All NVQ candidates must have completed Level 2 before starting Level 3 and participants can work at their own pace - some Level 2 candidates with an experienced assessor have completed the award in only 12 weeks, whereas most candidates complete it within 18 months. The NVQ coordinator keeps meticulous training records, so any problems with assessor support can be identified quickly and remedial action taken.
Assessors are invited to attend assessment board meetings, which offer a forum for standardisation, quality control, ongoing training and discussion of issues related to assessments. Attendance at these meetings varies according to each assessor's work pressures. However, it is statutory to attend at least one assessment board meeting a year.
A large group of senior clinical nurses met to agree a clear strategy for taking the NVQ programme forward.
The group has produced a position paper on the role of nursing auxiliaries who have achieved Level 2 and Level 3 awards. Competencies for each level, reflected in clinical grades A and B, have been described and agreed within the trust.
Our experience suggests that NVQ training should be available to any auxiliary nurse who wishes to develop his or her skills and knowledge base. This should be identified at appraisal and commissioned through the trust's training needs analysis route. All recommended training will need to be approved by management owing to funding implications.
Successful Level 3 candidates who wish to start nursing education are encouraged to apply for a sponsored place at EIHMS. This opportunity is also available to those who have successfully completed the access course.
Auxiliary nurses receive a mid-B grade salary while they undertake the three-year programme: 80% is funded from consortium money and 20% comes from the trust.
The first six students started their studies last September - five are on the preregistration diploma programme and one is on the degree course. Once they have qualified, they will be contracted to work for the trust for two years.
The development of NVQs within the trust has provided a new career structure for nursing auxiliaries. The trust has kept the title nursing auxiliary, but has added a new title of 'senior nursing auxiliary' for those who have successfully undertaken further study.
Many Level 3 candidates have been with the trust for some years and they now have the chance to progress in their careers and gain increased job satisfaction.
Of the original cohort of 17 NVQ candidates, one failed to complete the course because she moved out of the area and one has left the trust's employment. Seven have started nursing education training at the local institute of higher education.
In the past few months, 12 fully funded places have been allocated to nursing auxiliaries for nurse training. Level 3 auxiliaries now take on tasks previously performed by RGNs, applying advanced skills such as peripheral cannulation, wound management and female urinary catheterisation. All tasks are carried out under the supervision of a nurse. The response from the candidates has been encouraging (see box).
Crawley College has now implemented a prenursing course, with placements in the trust's hospitals. The course is targeted at young people aged 16 to 19 who want to start nursing education, and it is proving popular. Students are taught essential caring skills and manual handling. During their clinical training they practise as members of the workforce under the supervision of a nursing auxiliary at grade A/B. By gaining NVQ Level 3 they can enter the nursing course at a more senior level.
One of the most valuable outcomes has been the positive collaboration between Surrey University, Crawley College and the trust. Our next step is to agree how we can achieve advanced standing for students. Those who complete the NVQ programme at Level 3 are recognised for their significant practical experience and have the potential to reduce the length of time they take to qualify.
The local partnership that developed to ensure nursing auxiliaries and therapy assistants achieved their full potential in caring for patients is playing a vital part by contributing to improved recruitment and retention of local people to the trust, as well as promoting careers in clinical practice.
The most satisfying aspect of the project is to see the personal and professional strides the auxiliaries have taken, their achievements and the pride they feel when they collect the awards. The benefits to the clinical areas are also being recognised and appreciated, showing that investing in people is the way forward if retention of staff is going to succeed.