Case study - the assistant practitioner

Alison

Alison is an assistant practitioner working in short term intervention services in Cumbria. Her team provides a rapid response service to resolve crisis situations for people with complex acute needs, focussing on enabling people to stay in their own homes and avoiding unnecessary hospital and care home admissions.

Alison works across several disciplines including nursing, social work and physiotherapy, but her main role is occupational therapy. She leads a team of therapy assistants who provide support and functional assessments for patients and their home environment so that they might maximise their independence and safety, and remain at home in the long term.

In her nursing role Alison works closely with registered nurses, carrying out tasks such as wound care, venepuncture and observations. She also provides support to people with continence issues, working with the specialist continence team to provide bladder wash outs, scans, and continence assessments.

As a line manager to her team of therapy assistants Alison works on the team rota, staff recruitment processes, and carries out regular staff appraisals and supervision sessions. She works with her therapy assistants on personal development planning and ensures each assistant has their own competency folder to demonstrate their individual skills.

On her journey to her current role as an assistant practitioner Alison has undertaken a Level 3 NVQ in diagnostic and therapeutic studies, achieved a distinction in a foundation degree following the health and social care programme, and completed a unit on supporting and assessing learners in practice. She has also undertaken much informal training throughout her career by observing colleagues and by being mentored by registered professionals, who assessed and signed her off as competent to perform individual tasks.

Alison loves her role, as no two days are ever the same. She particularly enjoys supporting her patients to achieve their goals and making a difference to their lives. Her manager and colleagues see her role as ‘pivotal’ and ‘highly-skilled’. The fact that she works across disciplines ‘makes an enormous difference to good communication, holistic care and service development’. For Alison, the management side of her role is a new challenge but a vital learning experience, and she will continue to seek out new challenges and opportunities in the years ahead.

Key points: This is an example of how the assistant practitioner role can operate across the traditional professional boundaries. Alison combines her clinical skills and knowledge with her managerial roles and works closely with the registered professionals to provide a highly integrated service for their clients.

Lorraine

Lorraine is an assistant practitioner (AP) in a GP surgery in Kent. Having started off as a receptionist she became a health care assistant (HCA), and after about five years started her foundation degree in health and social care, successfully completing this and becoming an AP in 2011.

The surgery team consists of five GPs, three specialist practice nurses and one HCA. Lorraine’s role is varied and she performs spirometry, Doppler testing, ear irrigation, influenza vaccinations and B12 injections as well as the more routine general tasks in the surgery. She provides administration and support for the hypertension clinics and works closely with the lead GP on child protection issues.

Lorraine’s work is delegated by the registered professionals and she works within the practice protocols. However she has a certain degree of autonomy, in particular within the health promotion at the surgery, and has set up a weight management clinic, writing the protocol and designing a leaflet for the patients.

Lorraine is greatly appreciated by her colleagues and the patients, as one of the GPs said: “Lorraine presents a holistic approach that meets the needs and aspirations of the patients and helps them to meet their goals. By following guidelines and protocols she ensures that safety and quality are delivered but yet uses her unique approach with patients as she is able to speak their language”.

Rebecca, the HCA who has worked with Lorraine for two years said she would not have had the confidence or knowledge to have taken up the position without Lorraine’s constant support and encouragement.

Other colleagues tell us:

“Lorraine is very enthusiastic in her role as an AP and is wonderful with the patients, making them feel at ease and completely supported”. 

“Lorraine’s degree course has given her a greater understanding of the social aspects of care and she shares this with the whole team.  Lorraine always participates fully in our team meetings and willingly takes on tasks other than her clinics, such as writing new protocols and gathering information to improve our ways of working”.

 “Lorraine is a fantastic mentor and a great ambassador for our practice and all APs and HCAs”.

Key point: The role of assistant practitioner in general practice demonstrates the variety that the role can bring and the confidence that the staff and patients have in a person with these skills. In order to ensure the role works well it is essential to inform every member of the practice team about what an assistant practitioner can be involved in, and how the role complements and supports the registered practitioners.