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Exclusive: Senior HCA ‘bridging’ role will be piloted next year

  • 26 Comments

Plans for widespread changes to the way nurses and care assistants are trained are underway, with new standards for a senior healthcare assistant “bridging” role due to be piloted next year.

Student nurses could also in the future have a reduced number of placements during undergraduate training, but be assigned a caseload of patients to follow for longer as they access care across a range of settings.

“There’s an opportunity here to see if there is a core caring role we can have national standards around”

Lisa Bayliss-Pratt

A move away from one to one mentoring for student nurses is also being considered in a bid to decrease the large amount of nurse mentors and ensure undergraduates learn from only those who are considered to be “quality educators”.

The “bridging” role was proposed earlier this year by a major review of nursing education and training, which identified a gap in career development between HCAs and registered nurses.

The Shape of Caring review, chaired by Lord Willis of Knaresborough, recommended national workforce planning body Health Education England look into the position, and also whether those that had completed the training for it could then be fast-tracked through a nurse degree.

Up to a 1,000 HCAs are expected to take part in testing competencies for the senior HCA position at around 30 sites in England during 2016.

In an interview with Nursing Times, HEE’s nursing director Lisa Bayliss-Pratt said the core competencies were expected to cover those required for holistic care.

“This role needs to be seen as forward thinking and be seen as part of the future, not the past”

Lisa Bayliss-Pratt

It would be different to the kind of work carried out by senior HCAs already employed in some organisations – usually at Agenda for Change band 4 level and known as assistant practitioners – which often addressed a specific skills gap within the trust, such as phlebotomy.

Opportunities to “bolt on” additional therapy skills were also being considered, said Ms Bayliss-Pratt. “When I’ve spoken to many directors of nursing, if you look at the frailty pathway of an older person for example, actually they don’t just need nursing care – they also need therapeutic interventions.

“There’s an opportunity here to see if there is a core caring role we can have national standards around, and then bolt on competencies to enable people to give basic occupational therapy advice, basic chest physiotherapy to help alleviate an older person’s breathing problems, and exercises to help people become more mobile,” she said.

Health Education England

Lisa Bayliss-Pratt

Due to the range of proposed competencies and skills, until the piloting had been completed it was still undecided as to whether or not the role should be registered with the Nursing and Midwifery Council, she said.

Physician associates – a new support role for doctors imported from the US – are not regulated and “yet if you think about the interventions they do and the way they work they seem to be incredibly successful”, she noted.

Ms Bayliss-Pratt also stressed the proposed role would not be equivalent to a state enrolled nurse – phased out during the 1990s – because trainees would need to meet a set of nationally agreed competencies.

Trainees would also be provided with “clear progression points” along the way and the role would not be a “default” for those who failed to gain a registered nurse qualification, as the SEN was, she said.

“This role needs to be seen as forward thinking and be seen as part of the future, not the past,” she said. “The SEN role was about bedside nursing but didn’t have an academic component. This would have an academic component.”

Discussion around the need for the return of an SEN-style role has increased noticeably in recent months, were especially prevalent in the run-up to May’s general election.

Ms Bayliss-Pratt said HEE was looking at a work-based learning programme that would be around two years in length for entry level care assistants, but those already working in nursing support roles would be able to complete it in less time.

As previously reported by Nursing Times, the body is also investigating how those HCAs who have achieved the core competencies for the bridging role would then be able to complete a nursing degree in less than the usual three years.

When asked by Nursing Times how HEE would fund the senior care assistant training and whether it would commission course places as it does with universities for nursing degrees, Ms Bayliss-Pratt said it was too early to say.

“What we do know is we can’t afford not to invest in our nurses and care workforce”

Lisa Bayliss-Pratt

However, she did confirm that plans were being made “in line with the anticipation that we won’t have as much money” following the government’s next spending review in November.

Concerns have been raised that HEE budget will no longer be ring-fenced following the government announcement , which will set out savings it needs to help eliminate the national budget deficit by 2019-20.

“What we do know is we can’t afford not to invest in our nurses and care workforce,” added Ms Bayliss-Pratt. “However bad the hit is, we are trying to come up with solutions, opportunities and return on investment.”

 

Lisa Bayliss-Pratt

She was appointed as director of nursing at Health Education England in 2012 and in this role she is responsible for leading national policy, workforce planning, and multi-professional education and training commissioning for the non-medical healthcare workforce.

Key achievements include establishing the Shape of Caring Review, development and piloting of pre-degree care experience for aspirant nurses and leading the ‘return to practice’ initiative.

She is a trustee of the Foundation of Nursing Studies.

 

  • 26 Comments

Readers' comments (26)

  • HCSW

    If you really want to become an RGN, it is possible. It just takes time, about 5 years: GCSE, Access Course, UCAS application, bit of luck and the secondment.

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  • It sounds like we are returning to the 'card carrying' auxilliarys of the 1970s and 80s.

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  • Is this not going back to a two tiered nursing system? Sounds like somebody is panicking due to the shortage of qualified nurses now and in the future, as thousands are due to retire in the next 5 years. We can make do with a cheaper alternative, will probably just have 1 qualified nurse per ward in the future managing support staff! Do we actually need qualified nurses anymore as the support staff take on more of a nurses role?

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  • "Ms Bayliss-Pratt also stressed the proposed role would not be equivalent to a state enrolled nurse – phased out during the 1990s – because trainees would need to meet a set of nationally agreed competencies."

    - SENs had to meet competencies.

    "...the role would not be a “default” for those who failed to gain a registered nurse qualification, as the SEN was, she said."

    - this was the case up until 1983, after then students who failed their RGN final exams had to sit and pass the SEN exam to be able to register as a nurse.

    “The SEN role was about bedside nursing but didn’t have an academic component. This would have an academic component.”

    "Ms Bayliss-Pratt said HEE was looking at a work-based learning programme that would be around two years in length for entry level care assistants,"

    - SENs who applied for that level of training (rather than SRN/RGN) had to pass ward based assessments and a final exam at the end of a two year work-based training to gain the qualification.


    Don't undermine a role and training that produced a committed, caring, experienced and knowledgeable workforce who were "at the bedside" where nursing needs to be.

    Isn't this senior HCA role to be "at the bedside" to cover for the shortfall in "academic" nurses who are being moved away from it? A lot of original SENs fast-tracked to RGN training over the years following the ceasing of the SEN training.

    What I'm trying to say here is...this is nothing new...

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  • If HCA are being upskilled, who will perform essential care that is so lacking these days i.e making sure patients are given food and drink, wash and dressed with dignity/respect, taken to the bathroom/toilet? Many complaints arise from the lack of essential care.

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  • I have read this article and then read it again...have the powers that be taken leave of their senses!!...the only reason that any of this is being considered is to save money...it can be covered with a veneer of 'up-skilling' 'bolt on competencies' and blah blah blah...but why then am I having to work towards revalidation (which is okay) whilst my 'skills' (not tasks!!) are being given away to unregulated individuals (no disrespect intended)...I am a senior Nurse and clinical educator...by all means have a look at Nurse education/training but don't give it away...the public deserve better than that...

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  • HCAs will perform traditional nursing skills, nurses will be managers of HCAs. HCAs will demand a wage-rise in line with their responsibilities. Nurses will require a managerial-wage. The NHS will then have to find a cost-effective solution to the high cost of HCAs and will design an assistant HCA-role. There will be outcry, because the assistant is taking on responsibilities previous done by HCAs, but without the underpinning knowledge of A & P, and Pharmacology. There will be meetings, public consultations, etc, etc.

    It really is about money. Perhaps people cannot earn more money. Perhaps a different economic system is necessary, otherwise all that will happen is a different job title will be given, and the same problem will emerge farther down the line.

    In the end, we will constantly have uneducated solutions to economic problems. Then seek to educate them because something was missing. Then...again...and again. Penny dropped yet? We cannot solve this problem without solving the economic one. If we stock the NHS full of trained people from less wealthy countries, then we, in effect, require poor countries otherwise we are really up the shoot. That is a disgrace.

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  • Agree completely with all the comments above. This is madness and driven only by money. How dare anyone sit "up there" and fiddle with roles and titles whilst collecting a six-figure salary! The nursing shortage will NOT be solved by this kind of nonsense.

    I said six months ago that NHSE would attempt to redefine "nurse" and "shortage" to try to wriggle out of a problem of their own making. We can't let it happen!

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  • I completely agree with the previous comment but another perspective on this could view it as another of the government’s attempts to de-professionalise elements of the workforce (look at medicine) and to weaken anything that vaguely looks like a trade union)

    – yes it is blatantly about money, but also about having a malleable workforce (oh sorry the term is flexible) that can be shifted at will to cover gaps, and that will not question the values and underpinnings of the care system that is emerging in this country (and that are convenient scapegoats - e.g. blamed for all the wrongs as in the interpretations of the Francis report) .

    But (and it’s a huge but) one needs to consider what we may end up with if we go down the line of bolt-ons, quick degrees and quick fixes,( all based on huge assumptions i.e. having caring experience or being a HCA first means you’ll be a better nurse- no disrespect meant, but while that may indeed be the case for many individuals, the causal link is simplistic in the extreme and does not follow for everyone and there is also the need to take into consideration enculturation, socialisation, and so on) if we are not careful we may end up with a nursing workforce that does not have the enquiring , questioning, analytical mind-set needed to challenge some of the issues we see on a day to day basis (rationing, inappropriate care, patient safety issues, disadvantaging of certain groups etc etc). It is difficult enough now for nurses to challenge and question decisions and practices!

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  • Anonymous | 21-Oct-2015 2:56 pm

    perfectly put

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