HCA Competencies - Welcome to NHS West Cheshire Clinical ...

1 Healthcare Assistants (General Practice) Competency Framework RCGP General Practice Foundation / RCN | Competency Framework for Healthcare Assistants | Updated 20152 AcknowledgmentsOver the years, there have been a number of projects working on competence models for the General Practice Nursing team. This particular Health Care Assistant Framework began as part of one such project. In 2003 Avon Gloucestershire and Wiltshire Strategic Health Authority organised a group of personnel drawn from general practice, higher education institutes and the South West Deanery. Incorporating the job descriptions produced by Charnwood and North Leicestershire PCT and aligning it with the Knowledge and Skills Framework (Version 6) of the NHS, a Toolkit was completed and piloted in 2004.

2 In 2006 it was further developed and incorporated into the NHS Working in Partnerships Programme (WiPP) General Practice Nursing Project. In 2009 the HCA framework was hosted within the GPN Toolkit on the Royal College of Nursing (RCN) framework has now been updated and expanded by the development team below, three of whom were members of the original working party. We would like to acknowledge the work of all individuals and organisations involved in previous versions of the framework. Our thanks also to Plymouth University, General Practice Unit, for providing us with the resources to work on this project and to the Royal College of General Practitioners (RCGP) for providing the facility to further publish the framework through the General Practice Competencies must be considered in line with career and education frameworks as applicable in the relevant UK country, and there will be an exercise to clearly map them to these frameworks and standards across the work at levels 2 4 of the Career Framework and the Competencies within this document will not necessarily apply to every HCA or AP in every GP General Practice Foundation / RCN | Competency Framework for Healthcare Assistants | Updated 20153 Plymouth University General Practice Unit Development TeamDorf Ruscoe, Honorary Associate Professor for General Practice, Plymouth University Fiona Cook.

3 Senior General Practice Nurse and Nursing team leader, Okehampton medical centre and General Practice Lead, Plymouth UniversityJacquie Phare, Advanced Nurse Practitioner and Head of Nursing and Non Medical Prescribing Lead, Torbay and Southern Devon Health and Care NHS TrustGerry Hinton, Consultant in Management and Leadership and Formerly RCGP Leadership Programme, University of Exeter Tricia Smith, Practice Nurse Lead for Sentinel Healthcare CiC and Project Lead, GP Unit, Plymouth 2015 Our thanks also go to the following leading GPNs and Advanced Practitioners who have peer reviewed this framework and provided valuable comment and feedback much of which has been incorporated into this final version. Jenny Aston, Former Chair, RCN Advanced Nurse Practitioner Forum, Chair RCGP Nursing Group, General Practice FoundationEileen Munson, Chair of the Welsh Practice Nurses AssociationAnne Moger, Programme Director, General Practice Nursing, Health Education Thames Valley, Health Education WessexGill Heppell, Practice Manager, St Thomas Medical Group, Exeter Jane Warner, Nurse PractitionerTanis Hand, RCN Professional Lead for HCAs and APsDr Marina, Lupari Professional Lead for Primary Care & Community NursingRCGP General Practice Foundation / RCN | Competency Framework for Healthcare Assistants | Updated 20154 How can the framework be used?

4 Some examples are listed below: It provides a detailed picture of the role of the HCA working within the environment of General Practice. At this time it needs to be recognised that it may take some time to acquire all the Competencies . This will depend on various factors including existing levels of experience, working hours and the nature of the employing organisation. We recommend that the Competencies that are specifically related to initial responsibilities are given priority. It is anticipated the full range of Competencies relevant to the role in practice will be achieved within 18 months (full time equivalent) of commencing employment. Those HCAs working at Level 2 of the career framework will be required to have gained the knowledge, understanding and skills appropriate to their experience before the more complex activities are introduced.

5 They must be assessed as competent and this competence must be maintained and regularly confirmed by the registered nurses that they work alongside. It is designed as a self-assessment tool to help recognise current levels of competence and identify specific areas for further development. We recommend that this is completed at the outset of employment within the domain of general practice to ensure that gaps in knowledge and skills can be identified. Where appropriate individual Competencies are mapped against NHS Knowledge and Skills framework (KSF) During the preceptorship / training period it can be used to as a tool to review and demonstrate progress; to recognise the acquisition of specific skills and knowledge and to provide evidence of assessment of safe Clinical practice.

6 We suggest three and six monthly reviews with the senior practice nurse or practice trainer. The final assessment of competence may be carried out by a suitably qualified educator and / or health professional. On this occasion a record of how the evidence of competence was demonstrated and achieved should be included. It can form the foundation of a portfolio of continuing professional development to assist all practitioners to regularly review their level of competence and ensure they continue to work within their scope of their practice. The document can also inform and support the commissioning process; the design and delivery of education and training; workforce planning as part of recruitment, retention and progression (for example, job design, benchmarking candidates and the framing of interview questions); practice revalidation and evidence of meeting national quality standards RCGP General Practice Foundation / RCN | Competency Framework for Healthcare Assistants | Updated 20155 Assessment of Competence and ProgressionReviews conclude that it is essential that the method of assessment should match the nature of the competence.

7 A blended approach to assessment of self and of others is recommended. Examples of approaches include direct observation, video analysis, written evidence including reflection, specific case discussion and feedback from patients and colleagues. This optimises reliability and validity. Assessment of practice should combine the holistic approach with the need to achieve very specific Clinical skills. The Nursing and Midwifery Council (NMC) uses competence to describe skills and ability to practice safely and effectively without the need for supervision (Dolan 2003)A very well acknowledged and valuable concept is Benner s novice to expert model (1984) 1. Novice stage in skill acquisition where no background understanding of the situation exists, so that context-free rules and attributes are required for safe entry and performance.

8 Requires rigid protocols from which to work and can only work under Advanced beginner can demonstrate a marginally acceptable performance. The advanced beginner has enough background experience to recognise aspects of the situation, and can vary the approach used according to the needs of individual patients, although still requires Competent a stage in skill acquisition typified by considerable, conscious, deliberate planning. The competent stage is evidenced by an increased level of proficiency, the individual no longer requires supervision for routine tasks, but is aware of the limits of her/his knowledge and skills, and refers to others Proficient the proficient performer perceives situations as a whole rather than in terms of aspects, and performance is guided by maxims.

9 The proficient performer has an intuitive grasp of the situation based upon a deep background of understanding,, the individual is experienced in the field of work, competent to modify procedures appropriately to match differing circumstances, and able to advise others on how to perform Expert developed only when theoretical and practical knowledge is tested and refined in real-life Clinical situations. An expert has a deep background of understanding of Clinical situations based upon many past cases,, is very experienced, work has been tested in difficult situations and an expert is able to teach others, RCGP General Practice Foundation / RCN | Competency Framework for Healthcare Assistants | Updated 20156 When delegating activities to the HCA the practice nurse must confirm that the principles of appropriate delegation apply and they must be able to adhere to the NMC code in doing so To enhance clarity you may like to use different coloured ink for each entry.

10 Please remember to date the entries and for all parties to sign. In the assessment columns, we recommend you rate yourself 1 to 5 in accordance with the Benner scale above. Some current web links have been included, however these are not intended to be comprehensive and you should search regularly to identify and access robust sources to support your Communication with Patients 9 Communication within teams 10 3. Health, Safety and Security 13 4. & 5. Quality and Service Improvement 17 6. Equality and Diversity 19 Part 1 : Clinical Skills: Core Generic Competences 21 Venepuncture 21 Measurement and Investigations 23 Part 2: Therapeutic procedures For experienced HCAs working at level 3 of the career framework 24 Ear Care 24 Influenza, pneumococcal and shingles vaccinations 25 Vitamin B12 injections 26 Wound care 26 Minor Surgery 26 Part 3: Management of Emergency Situations 28 Part 4.