Authors: Bosley, Sara; Dale, Jeremy

Source: British Journal of General Practice, Volume 58, Number 547, February 2008 , pp. 118-124(7)

Publisher: Royal College of General Practitioners

Abstract:

The emergence of healthcare assistants (HCAs) in general practice raises questions about roles and responsibilities, patients' acceptance, cost-effectiveness, patient safety and delegation, training and competence, workforce development, and professional identity. There has been minimal research into the role of HCAs and their experiences, as well as those of other staff working with HCAs in general practice. Lessons may be learned from their role and evidence of their effectiveness in hospital settings. Such research highlights blurred and contested role boundaries and threats to professional identity, which have implications for teamwork, quality of patient care, and patient safety. In this paper it is argued that transferability of evidence from hospital settings to the context of general practice cannot be assumed. Drawing on the limited research in general practice, the challenges and benefits of developing the HCA role in general practice are discussed. It is suggested that in the context of changing skill-mix models, viewing roles as fluid and dynamic is more helpful and reflective of individuals' experiences than endeavouring to impose fixed role boundaries. It is concluded that HCAs can make an increasingly useful contribution to the skill mix in general practice, but that more research and evaluation are needed to inform their training and development within the general practice team.

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Keywords: family practice; healthcare assistants; health personnel; nursing assistants; nursing staff; primary healthcare; skill mix

Document Type: Research article

DOI: http://dx.doi.org/10.3399/bjgp08X277032

Affiliations: 1: Health Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry

Publication date: 2008-02-01

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• The British Journal of General Practice is an international journal publishing articles of interest to family practitioners and primary care researchers worldwide. The journal's 2010 Impact Factor is 2.07, making it the world's second most highly cited journal of general practice and primary health care.

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