Oxford School of Nursing and Midwifery

Brookes staff present study on assistant practitioner role

Friday, 09 February 2018

assistant practitioner

On Tuesday 23 January, staff from the Department of Nursing, Oxford University Hospitals NHS Foundation Trust and Oxford Health NHS Foundation Trust presented their joint research project on the role of assistant practitioners.

The assistant practitioner (AP) role is one that has, historically, been the subject of some discussion. Classified as a band 4 support worker, APs are expected to have more expertise than typical healthcare assistants, but still to work under the supervision of registered nurses (RNs). In many cases, this has led to valuable contributions to healthcare in the UK (especially when supervising RNs have recognised the potential of the role). But the role has often been the victim of a lack of clarity of purpose, with many seeing the function of the role as somewhat unclear.

Summarising the findings of a research study using focus groups, the presentation offered valuable insight into the role that APs could play in the context of healthcare. The study was jointly commissioned by the Oxford Health and Oxford University Hospital NHS Foundation Trusts. The participants were drawn from across a wide variety of health contexts (from acute, mental health and community settings), and from their contributions the researchers drew the following common themes:

  • APs could provide a valuable link to bridge the gap between healthcare assistants and registered nurses. Their increased knowledge allowed them to integrate well into teams and help to ensure important tasks aren’t dropped.
  • Problems fitting in have been identified, especially where registered nurses are distrustful of the role or unsure what their responsibilities should be.
  • Levels of skills, training and responsibility could fluctuate depending on area and staffing levels. While in times of short staffing, APs were given more training and responsibility, this trust and support felt like it was not present when more registered nurses were available.
  • This could be addressed with greater clarity on what an AP’s core competencies should be. APs would then have scope to diversify their skill set at a local level.
  • Due to the fact that accountability would usually sit with registered nurses - added to the confusion over AP duties - It was felt that some APs were not being utilised to their full expertise.

It was recommended that, in practice going forwards, many issues could be resolved with better demarcation of roles, clearer career pathways (at every level) and more time given for collaboration and supervision.

With the nursing associate (NA) role soon to be introduced, it is imperative that the lessons learned from the assistant practitioner role are put into practice. If NAs, APs and RNs all have their roles clearly defined, then there is the opportunity for them to complement and support each. Each role has clear individual value that they bring to the field of healthcare. So long as this is clear and integrated, then the way is paved for collective success.

The study was undertaken by Dr Cathy Henshall, Ms Andre Doherty, Dr Helen Green, Dr Liz Westcott, Dr Helen Aveyard and a publication is currently under review with BMC Health Services Research.