Open a door to a new beginning

Healthcare assistants and support workers are often vital cogs in the NHS machine, providing much hands-on care and allowing higher grade staff to concentrate their unique skills where needed.

But there can be frustrations for support staff who might want to move forward or gain skills. Agenda for Change bands one to four - who are 40 per cent of the NHS’s workforce and provide 60 per cent of the care - get around 5 per cent of NHS continuing development spend, and it is notoriously difficult for them to move upwards in their career.

Some may be happy to remain with what they are doing but others will be looking for new opportunities.

• Opportunity knocks for HCAs

New opportunities

One route is to gain access to one of the registered professions such as nursing. But the Cavendish review into healthcare assistants, published last year, highlighted some of the issues they faced - such as getting information about and accessing courses, especially as many of them won’t have the A-levels which are now required for many degree courses. Historically, HCAs have been able to train to become state enrolled nurses as a diploma level qualification.

But even if support workers can get on to such courses there are practical barriers. “Few experienced carers will take the financial risk involved in entering a full-time degree,” said the Cavendish review. “They need affordable part-time study courses.”

Many support workers are in their 30s and 40s with families and mortgages (the average age is 45) and need an income. Traditional nurse training with three years at a university often simply won’t work for them. But there are other options: each year a few healthcare assistants manage to complete nurse training while remaining with their trust and working a couple of days a week in their old roles.

‘It is making these opportunities clear for people who might want to progress and supporting them’

NHS Employers’ director of employment services Sue Covill says: “It is making these opportunities clear for people who might want to progress and supporting them.” But she adds it is important to think about other HCAs who might not want to become nurses but just want to be the best HCA they can.

“It is really important that employers continue to invest in employees who don’t want to go into a different role.’”

It is a considerable investment by their employers - even with support in meeting the costs of backfill - but often gives them a highly skilled nurse who is familiar with their organisations and loyal to the area. “It is really helpful that people who want to go into nurse training have different options for working their way through,” says Ms Covill.

Enormous variation

Health Education England welcomes the opportunities for bands one to four to progress - including into nurse training - but points out there is often local variation in what is available for them. One of the themes of its proposed national strategy - The Talent for Care, which is being consulted on - is supporting them to progress into registered professions if it is right for them.

It stressed the need for an implementation programme which would support this and has asked for feedback on the barriers preventing staff progressing. As part of its work it is aiming to establish a baseline for the number of bands one to four entering professional training in 2013 and to “significantly improve” on this in 2014.

But there is enormous variation among healthcare assistants and support workers. Not all want to progress to a registered profession, for example, but even within those who do, there will be differing abilities and skills. Some may be ready to move on to a nursing degree while others may need support to meet the Nursing and Midwifery Council’s minimum entry requirements or to gain confidence in their academic ability.

Many will want part-time learning, combined with continuing in their present role, and almost all will require a package of support which means they do not lose out financially by going down this route.

‘Nearly 90 per cent of students complete their course - significantly higher than many traditional courses’

Since 2006, The Open University has helped more than 1,000 healthcare support workers to become registered nurses by offering various options for those who are ready to move straight on to the pre-registration nursing programme and for those who need a little help in returning to study first.

All entrants have to meet the Nursing and Midwifery Council’s minimum entry requirements - including level 2 numeracy and literacy - and that can be an initial challenge to some applicants.

Some may wish to do a certificate of higher education in healthcare practice - which can lead to a foundation degree; both of these can be stepping stones to a pre-registration degree in nursing. The certificate can lead to direct entry to stage 2 of the pre-registration nursing degree, subject to successful selection and meeting the NMC’s minimum entry requirements.

Once these minimum requirements are met, the selection process is very much values based, and is done with the involvement of both employers with input from patients and service users. Crucially, applicants are not asked for a clutch of high grade A-levels.

Flexible learning

Like all nursing students, those on the OU pre-registration nursing degree have to be supernumerary for the 2,300 hours of learning in practice. In effect, this means they will do the degree course over four or more years, spending perhaps two days a week in their support worker role and the rest as a combination of academic study and placements as a student nurse. This would normally be in their own organisation but might be on a different ward or unit to ensure they get the required range of experience.

Nearly 90 per cent of students complete their course - significantly higher than many traditional courses, which can see a quarter of students leave.

Many trusts have been able to get the financial support of their local education and training boards to put HCAs through this programme. Places on the OU programme are also being commissioned by the Scottish Government, the Northern Ireland Department of Health, Social Services and Public Safety, the States of Jersey and the independent sector.

In total, more than 100 healthcare organisations are involved in employer partnerships to deliver the programme with the Open University.