Project Summary

In 2012, a standardised, robust training programme for all Healthcare Assistants was developed This is following negative CQC comments relating to observed behaviours and recognition of a lack of formal training for new HCAs (Healthcare Assistants) and has coincided with the government unveiling measures to support the training standards of HCAs on the 15th November 2011 in partnership with unions, employers, regulators, educators and others. (DOH, November 2011).

The Cavendish Report examined how HCA training and support needed to enable patient care of the highest standard to be delivered (March 2013).

A contribution to this consultation was submitted on behalf of NUH based on recent initiatives and recommendations for the future. This review outlines specific recommendations which are linked to NUH initiatives.

At NUH we believe our Healthcare Assistant Clinical Skills Academy addresses the training issues highlighted in the Cavendish Review and prepares our Healthcare Assistants to meet the many varied challenges their work will introduce to them. Compassion is at the heart of all we do and our Values based recruitment, introduced in 2012 enforces this standard.  The NUH HCA Clinical Skills Academy will offer these topics: HCA clinical skills academy schedule

Proposed education intervention

The NUH Clinical Skills Academy is accessed by all newly appointed non-registered Clinical Staff (HCAs, Clinical Support Workers, and Midwifery Support Workers).
This is a mandatory requirement prior to commencing in the clinical area.
There is also an ongoing initiative for all existing non-registered clinical staff to access the full programme

As part of the initiative to raise the standards relating to HCAs, literacy and numeracy entry criteria were raised in 2013. We now ask for all HCAs and clinical support workers to have a minimum standard of GCSE grades A – C in maths and English, or equivalent.

How did you address this issue?


A new approach to HCA recruitment and retention was established via an in-house training programme.

Interventions included;

The Recruitment and Selection Process -
•February 2013 – centrally coordinated approach to HCA recruitment introduced.
•Central adverts for HCAs, not specific to area.
• Values based recruitment-Robust short listing process – particularly in relation to compassion. Patient volunteer role at interview – role play as patient and candidate has to interact in relation to a given scenario. Objective is to observe empathy and compassion.

Establishment of an NUH HCA Clinical Skills Academy as per Cavendish Review Recommendation 1 with these topics:

This is also seen as a positive step forwards to manage clinical risk issues, particularly in relation to record keeping and communication.

Productivity and impact

Recommendations and ongoing work.

• Task group recently held first meeting to develop the NUH action plan relating to both the Willis and Cavendish reports. (Chair Theresa Walsh)
• Course accreditation – awaiting guidelines as recommendations suggest National accreditation is the way forward via Skills for Health.
• Recently introduced ‘Preceptorship’ for newly recruited HCAs. This initiative supports the Cavendish Review recommendation 6.13. “Setting high minimum standards with ongoing supervision” and also develop and promote robust process to ensure all HCAs are able to access Clinical Supervision sessions. This initiative is ensuring HCAs new to the organisation undertake the same support mechanisms as Newly Registered Nurses.
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• Develop systems to measure the impact on clinical care in relation to safe and effective practice. To include Ward Manager feedback. This supports the Cavendish review recommendation 5 :” Currently looking at tools used at Derby University to measure impact

• Actively monitor and adapt to National initiatives relating to HCA education, professional regulation etc. including the Cavendish review.

• Work ongoing in conjunction with H.R Managers to standardise job titles for non-registered Clinical Staff. The Cavendish Review recommends that:

“Employers should allow HCAs to use the title ‘Nursing Assistant on completion of the ‘Certificate of Fundamental Care’ where appropriate.”


• Ongoing review of the role of the HCA, establishing core roles and responsibilities transferable across all clinical areas at NUH.


• Develop a clear career pathway for non-registered Nurses -Currently looking at the pathway from Apprentice to band 4 Assistant Practitioner and beyond.

Next Steps:

The Cavendish review recommendations include initiatives which will impact in the near future on work at NUH relating to both HCAs and Student Nurses, and recommend that employers should seek to have nursing students and HCAs completing the ‘Certificate of Fundamental Care’ together. This is in response to recent announcements that student Nurses must have undertaken work as an HCA prior to commencing Nurse training. This is currently being piloted in Northampton and Derby Universities. At NUH, we have noticed a sharp increase in applications from candidates planning to undertake Nursing or Medical training in the future. We welcome these candidates as believe time working in the HCA role will have a positive impact on our Medical and Nursing workforce.
There are also recommendations to widen participation in recruitment to NHS funded courses.


Top Tips for Implementation
• The Essence of Care benchmarks as a minimum, provided an excellent starting point for the modules on the programme.
• The main challenge has been the high numbers on the course at times. 25 would be an ideal maximum but we pledge to Managers that a start date will never be delayed due to a place not being available on the course. This could contribute to high agency spend.
• We have learnt that previous experience in the Healthcare field is not necessarily a positive attribute. We have employed many HCAs since our initiatives began with no healthcare experience and who bring a passion for the role and invaluable transferable skills. We have recruited at least 2 in the last 2 years who have gained seconded, funded places to undertake their Nurse training via the Open University. One was a printer for many years and one from the retail trade.
• We recommend more networking between organisations, including Social Care sharing best practice. At NUH we have established excellent links with Health Education East Midlands.
• We recommend more locally arranged conferences to meet and share ideas and best practice, both for NHS staff and private social care organisations.
“I am finding the course really interesting and learning a lot, I am one of the ones who has worked at NUH for a long time and didn’t think I needed to know anything else – very surprised!”

Project Leads

Contact details for more information

-Theresa Walsh, Assistant Director of Nursing at Nottingham University Hospitals

-Email address – Theresa.walsh@nuh.nhs.uk

-Telephone number -0115 9691169 x 57148

-Website address for more information -www.nuh.nhs.uk

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