Nursing roles

Healthcare assistants (HCA) are an essential part of NHS support roles, as well as being part of the nursing team HCAs work with doctors, and other healthcare professionals. They have a lot of contact with patients.

In Health centres and GP surgeries, you may:

  • Sterilise equipment
  • Do health checks
  • Restock consulting rooms
  • Process lab samples
  • Take blood samples
  • Do health promotion or health education work

Entry requirements

There are no set entry requirements to become a healthcare assistant, employers expect good literacy and numeracy and may ask for GCSEs in English and maths. They may ask for healthcare qualification, such as BTEC or NVQ.

Employers usually ask for:

  • 2 or more GCSES at graces 9 to 3 (A* to D), or equivalent for a level 2 course.
  • 4 or 5 GCSES at grades 9 to 4 (A* to C), or equivalent, for a level 3 course.

How to become a healthcare assistant

You can get into this job through:

  • A college course
  • An apprenticeship
  • Working towards this role

You could do a college course, which may help you when looking for work, courses include:

  • Level 2 Certificate in Work Preparation for Health and Social Care.
  • Level 2 Diploma in Health and Social Care
  • Level 3 National Extended Diploma in Health and Social Care

Most health and social care courses include work placements, which is a good way to get experience

You can also get into this job through an intermediate apprenticeship as a healthcare support worker.

Local apprentice scheme here

Skills and knowledge

You’ll need:

  • Patience and the ability to remain calm in stressful situations
  • Sensitivity and understanding
  • To be thorough and pay attention to detail
  • The ability to work well with others
  • The ability to accept criticism and work well under pressure
  • The ability to work well with your hands
  • Excellent verbal communication skills
  • Customer service skills
  • To be able to carry out basic task on a computer or hand-held device

Career path and progression

With experience you could train new healthcare assistants.

With training, you could become an assistant practitioner in chiropody or podiatry, occupational therapy, radiography or physiotherapy. You could also apply to train as a nurse, radiographer, dietitian, midwife or social worker.

Greater Manchester Health and Social Care Partnership (GMHSCP), Greater Manchester Health and Social Care Partnership, working in collaboration with Heywood, Middleton and Rochdale (HMR) Primary Care Academy and Salford Primary Care Academy have launched a new Foundation Health Care Support Worker (HCSW) programme.

If you have staff who would benefit from this upskilling opportunity and would like to register for this programme or if have a question about the programme please email lgmch.hmrpcaworkforcedevelopment@nhs.net.

This programme is part of GM’s Nursing Career pathway and other opportunities include:

  • HCA level 3 Apprenticeship
  • HCA Enhanced upskill programme
  • Trainee Nurse Associate
  • Nurse Associate Foundation
  • GPN Apprenticeship

Eligibility

Permanent staff currently working within a practice or across a Primary Care Network (PCN).

Educational framework

  • 6hr accredited e-learning programme
  • Core clinical skills
  • health screening awareness
  • Chronic Disease specific: Hypertension and Cardiovascular
  • ECG
  • Blood pressure
  • Urine dipstick etc

The content of each module is delivered via a blended mix of online self-directed study and a series of live taught webinar sessions:

  • Support to complete the Care Certificate
  • Phlebotomy training

Each candidate will receive support for 12 months from a Clinical Skills facilitator. Functional Skills Support although not mandated for this programme is also available.

Additional support

Funding is available to support backfill for the individual to complete the e-learning programme and phlebotomy training.

Practice / PCN commitment?

The employer will support the completion of the Care Certificate. It is also the expectation that candidates will be released to complete the training.

Please note that Greater Manchester Workforce Bank provided through Lantum now includes reception staff and so it will be possible to access staff to support backfill at http://info.lantum.com/greatermanchester_pm.

Nursing associate is a new role within the nursing team, nursing associates work with healthcare support workers and registered nurses to deliver care for patients and the public.

Nursing associates work across all four fields of nursing: adult, children’s, mental health, and learning disability.

Your skills and responsibilities will vary, depending on the care setting you work in. You’ll need to demonstrate the values and behaviours of the NHS constitution and a knowledge of physical health, mental health and illness prevention.
Your duties are likely in include:

  • Undertaking clinical tasks including venepuncture and ECGs
  • Support individuals and their families and carers when faced with unwelcome news and life-changing diagnoses.
  • Performing and recording clinical observations such as blood pressure, temperature, respiration and pulse
  • Discussing and sharing information with registered nurses on a patients’ condition, behaviour, activity and responses
  • Ensuring the privacy, dignity and safety of individuals is maintained at all times
  • Recognising issues relating to safeguarding vulnerable children and adults

Routes to becoming a Nursing Associate

The infographic below produced by NHS Employers highlights the different routes to becoming a Nursing Associate. Download the Routes to becoming a Nursing infographic.

Routes to becoming a Nursing Associate

Entry requirements

  • GCSEs grade 9 to 4 (A to C) in maths and English, or functional skills level 2 in maths and English as a minimum
  • You also will need to demonstrate your ability to study to level 5 foundation degree level and commit to completing the Nursing Associate Apprenticeship programme
  • Some places are available through direct application to universities. Applicants accepted onto courses this way will need to fund their own training.

Training and development

You will undertake academic learning on day a week and work based learning the rest of the week. You’ll be employed in a specific healthcare setting such as an acute, community or mental health hospital or a GP practice but also gain experience of other healthcare settings.

You will develop an understanding of all elements of the nursing process and of caring for individuals with particular conditions such as dementia, mental ill health and learning disabilities/difficulties.

Where the role can lead

The nursing associate role is employed across health and care services. Qualified nursing associates can also go on to train as a registered nurse by putting their training towards a shortened nursing degree or completing a  degree-level nurse apprenticeship

How we regulate nursing associates

The part of the nursing register for nursing associates open in January 2019, this has allowed the NMC to being accepting people to begin accepting people onto the register to enable them to practice as a nursing associate in England. It also allows the NMC to investigate concerns about a registered nursing associate’s conduct or practice, where this is considered impaired and take action to improve care and keep the public safe if needed.

To do this, the NMC sets the following standards:

Nurse associates are broadly regulated in the same way that nurses are, which includes registration, revalidation and fitness to practice.

Additional information regarding the nurse associate framework can be found here: https://www.nmc.org.uk/globalassets/sitedocuments/standards-of-proficiency/nursing-associates/nursing-associates-proficiency-standards.pdf

The nursing associate apprenticeship standard is available to employers and the apprenticeship levy can be used for training fees.

The GP assistant (GPA) is a role that was created in order to relive some of the administrative pressure on GPs. These assistants would be a cross between a healthcare assistant and a doctor’s PA which could provide a short term injection of support for general practice.

GP Assistants (also known as Medical Assistants) support doctors in the smooth running of their surgery by handling the routine administration and some basic clinical duties enabling the GP to focus on the patient.

As a GP Assistant you will be trained to help with:

  • Sorting all clinical post and prioritising
  • Extracting all information from clinical letters that need coding
  • Dealing with all routine clinical post directly e.g. DNA letters, 2WW etc
  • Arranging appointments, referrals and follow up appointments of patients
  • Preparing patients prior to going in to see the GP, taking a brief history and basic readings in readiness for the GP appointment.
  • Dipping urine, taking blood pressure, ECGs & phlebotomy
  • Completing basic (non-opinion) forms for the GP to approve and sign such as insurance forms, mortgage forms e.g. ESA113
  • Explaining treatment procedures to patients including arranging follow up appointments.
  • Helping the GP liaise with outside agencies i.e. getting an on call doctor on the phone to ask advice or arrange admission while the GP can continue with their consultation
  • Support the GP with immunisations/wound care

How is the GP Assistant framework delivered?

The GPA framework is an experiential course that is led by a GP at your practice. They will work through the competencies within the framework with you in a tutorial and you will write up your evidence of your understanding for them to mark.

We will provide you with an on line facility called the Learning Assistant where the framework will be stored and you will upload your written evidence to this portal. Your GP mentor will have their own log in and will use this to mark your work. We will have sight of your progress throughout and we will externally verify your evidence via this portal.
 
You will need to dedicate one full day a week to the framework. Half a day working through the competencies on the online portal and writing up your evidence and half a day gaining hands on experience with your GP mentor. You may find your GP mentor may second you to the practice nurse to help you train in areas relating to simple clinical duties such as blood pressures but they will ultimately be responsible for signing you off as competent. This can take time and we recommend that this is done weekly also and not left to the end of the framework. We would expect work to be sent back on occasion for revision so timings are important. We will offer an element of funding to the practice for this mentor/marking time.

You will need to be supported by a GP who will act as your mentor. Assuming you meet the entry criteria (detailed below) your GP mentor can put you forward for the GP Assistant Certificate. 

The workbook syllabus has been created by GPs, Practice Managers and Nurses. The level 4 certificate has been accredited by University of Chester.

The aim of the framework is to support a standardised approach to practices upskilling their team.

What are the entry criteria?

Places will be allocated on a first come first serve basis and will have to be shared equally across all CCG areas within the North West. There will be a short interview over the telephone to ensure that the learner, workplace and support are fully aware of the framework requirements. Candidates can be put forward by the GP who will be mentoring them and the Practice Manager.

We would expect that the candidate is already considered competent in good patient care from their experience as members of a GP practice and be DBS checked to an enhanced level

The candidates must have a named GP mentor who will be responsible for support them through their competencies. Should a GP mentor not be able to guarantee regular tutorials then this framework is not achievable.

Nurses are an important part of delivering care in general practice. An increasing shift of care from hospitals to general practice provides nurses with a really exciting career choice.

General practice nurses work in GP surgeries as part of the primary healthcare team, which might include doctors, pharmacists and dietitians. In larger practices, you might be one of several practice nurses sharing duties and responsibilities. In others, you might be working on your own, taking on many roles.

You could be involved in most aspects of patient care including:

  • Obtaining blood samples
  • Electrocardiograms (ECGs)
  • Minor and complex wound management including leg ulcers
  • Travel health advice and vaccinations
  • Child immunisations and advice
  • Family planning & women’s health including cervical smears
  • Men’s health screening
  • Smoking cessation
  • Screening and helping patients to manage long term conditions

General practice nurses may also have direct supervision of healthcare assistants at the practice.

The short film below published by Health Education England showcases a day in the life of a general practice nurse, including the array of activities and procedures their day may include. The film is especially designed for pre-registration student nurses and those who may wish to transition into general practice from other areas.

Entry requirements

You must be a qualified and registered adult, child, mental health or learning disability nurse to work in general practice. You’ll also either need to undertake further training and education or be willing to after being appointed.

Some employers may ask for knowledge or experience in specific areas e.g. health promotion or working with patients with long term conditions. We recommend that registered nurses check with local employers and training providers to see what is on offer

Education and training roles

Education, training the professional development of the next generation of nurses is vital to the delivery of patient care. Nurses can get involved through a number of roles:

  • Preceptors
  • Mentors
  • Practice educators
  • Lecturers

In addition t the above routes, there are also a number of apprentice schemes with available funding, more information can be found here https://www.nhsemployers.org/news/2020/08/new-funding-to-support-nursing-apprenticeships

As well as providing the care that a nurse practitioner is able to offer, advanced nurse practitioners (ANP) will have a prescribing qualification and master’s level training. A qualified ANP is also able to:

  • Take a full patient history
  • Carry out any physical examination
  • Use their knowledge to identify a likely diagnosis
  • Request appropriate tests to aid diagnosis (blood tests, x-rays, scans)
  • Refer patients to an appropriate specialist (in the practice or hospital)
  • Prescribe medicines and non-medical treatments
  • Arrange follow up and ongoing management

Return to nursing

If you have previously been a registered nurse and wish to return to the profession, then you may need to undertake a return to practice programme. The programme provides a platform to work with other professionals to update your skills and knowledge, so that you can return to work in nursing with confidence

The return to practice course for General Practice Nurses is offered at a number of universities and incorporates the existing return to practice course (required by the NMC for re-registration) and an Introduction to the role of GP Nurse.

Your placement will be with a general practice and the course will be funded and supported exactly the same as the existing return to practice course with a bursary of £500 for “out of pocket” expenses, and support from a mentor in your placement and practice facilitators from the delivering university.

The course will be open to all previously registered nurses with relevant experience in all fields of nursing, and of course, previously registered practice nurses are very welcome to apply for this bespoke course too.

North west – return to practice programme

The return to practice programme is a combination of classroom and placement based learning. Hours on placement will vary and depend on how long you have been off the NMC register. These will be negotiated with you on an individual basis. The programme will take approximately three to six month to complete. Depending on clinical placement hours required and the length of time out of practice and length of time previously in practice. The courses will also be flexible to fit around existing commitments, such as childcare.

Advanced clinical practitioners come from a range of professional backgrounds such as nursing, pharmacy, paramedics and occupational therapy. They are healthcare professionals educated to a Master’s level and have developed the skills and knowledge to allow them to take on expanded roles and scope of practice caring for patients.

Advanced clinical practice (ACP) is a defined level of practice within clinical professionals such as nursing, pharmacy, paramedics and occupational therapy. This level of practice is designed to transform and modernise pathways of care, enabling the safe and effective sharing of skills across traditional professional boundaries

Advanced clinical practitioners are healthcare professionals that work at a level of advanced clinical practice that pulls together the four ACP pillars of clinical practice: Leadership, management, education, and research.

Advanced clinical practice is delivered by experienced, registered health and care practitioners. It is a level of practice characterised by a high degree of autonomy and complex decision making. This is underpinned by a master’s level award or equivalent that encompasses the four pillars of clinical practice, leadership and management, education and research, with demonstration of core capabilities and area specific clinical competence.

Advanced clinical practice embodies the ability to manage clinical care in partnership with individuals, families and carers. It includes the analysis and synthesis of complex problems across a range of settings, enabling innovative solutions to enhance people’s experience and improve outcomes.

The ACP definition has been developed to provide clarity for employers, service leads, education providers and healthcare professionals, as well as potential ACPs practising at an advanced level. This is the first time a common multi-professional definition has been developed which can be applied across professional boundaries and clinical settings. The definition serves to support a consistent title and recognises the increasing use of such roles in England.

Over a number of years, the role of nurse has evolved within primary, community and secondary care. Nurses have in many ways been the pioneers of enhanced and advanced roles within many clinical settings. The NHS needs a workforce that is fit for the future and nurses with advanced clinical practice knowledge and skills will be able to both lead and work within and across teams to provide excellent care for people.

This framework provides clarity around the core capabilities required by advanced level nurses working in primary care/general practice and will promote a high standard of care for those utilising the services. It will allow nurses to showcase their advanced level knowledge, skills and behaviours which will be essential in the development of the multi-professional teams to provide excellent prevention and care for people accessing their services.

Further information

Sign up to the Health Education England (HEE) ACP newsletter at www.hee.nhs.uk/our-work/advanced-clinical-practice/acp-newsletter

Read an ACP case study