Healthcare assistants (HCAs) work in hospital or community settings, such as GP surgeries, under the guidance of a qualified healthcare professional. The role can be varied depending upon the healthcare setting.
Most commonly, HCAs work alongside nurses and are sometimes known as nursing auxiliaries or auxiliary nurses. HCAs also work alongside qualified midwives in maternity services.
The role of Healthcare Assistant and specialists have been dealt with in Sections
Their specialties and status in PCT and GP surgeries have also been briefly mentioned.
Healthcare specialists in GP surgeries may include:
• Healthcare assistant to do the health checking of patients and in some cases for registration purposes to approve the patients. They do continual monitoring of patients. They may be full time or part time employees of the practice.
• Midwives may be employed part-time to do antenatal and post natal work with GP proving the lead.
• PCT’s may provide dieticians to visit GP surgeries to enable patients to be advised on their diets and health issues. Normally there is no charge for their visits to the surgeries.
• Surgeries may also arrange visits by Community and District Nurses as required and usually there is no charge for such visits.
• GPs will usually refer patients to Consultants in the Hospitals who may send the patients to healthcare specialists e.g. physiotherapists, audiology, mental health, foot care; and in special circumstances to practitioners of alternative medicines like Ayurvedic, Acupuncture, Homeopathy etc.
District Nurses, Health Visitors. Midwives and Counsellors
The details of the District Nurses under PCT should be displayed in notice board in the reception area or entrance hall.
If one of the doctors advises that patient’s problem could be helped by psychological therapy and, if patient agrees, referral will be made to the Specialist. Patient will be sent all information and assessment form to complete. Until patient returns the completed form, patient will not be given an appointment. These are a number of treatment options including CBT, group therapy and individual counselling available for a GP to prescribe.
These members of staff may be attached to the surgery to care for our patients, but employed by other NHS agencies. Surgery staff works closely with these members and share patient information to provide good continuity of care.
District Nurse Team
The details of the District Nurse Team under PCT should be displayed in notice board in the reception area or entrance hall. The name of the Lead Sister and where they are based should be clearly indicated with contact details. The team provides care in the home for those patients not able to attend surgery. Services include:
• Wound management and dressings
• Blood tests
• Leg ulcer care
• Incontinence assessment
• Provision of appliances
• Post-operative care
• Catheter care
• Terminal care.
They do not provide social care such as bathing and home care (see useful numbers page).
Their location in the same building means they liaise with our Practice Nurses and the GPs over patient care and have access to the computer system and staff to facilitate excellent communication.
The District Nurses are available seven days a week from 0830 to 1700hrs, including Bank Holidays. There is an evening District Nursing Service available from 1800 to 2230hrs.
Referrals to the District Nurse can be made directly by patients Monday – Friday and at weekends on … give telephone number (answerphone available).
To contact the District Nurses outside normal hours i.e. Evenings and Bank Holidays phone -… Contact number should be provided.
Baby Clinics and Child Health Surveillance
1 Baby Clinics
The baby clinic dates and times should be clearly stated and unfortunately these may not be a walk-in service.
PCT Health staff – Health Visitor and Nursery Nurse, may run these clinics. No doctor is usually present in the clinic. The surgery should indicate the telephone number to make appointments.
1 Child Health Surveillance
Eight-week baby checks and other child development assessments are performed. These clinics run on certain dates, morning or afternoons and usually by appointment.
When a baby is registered with the Practice, parent is advised to book the 8 week check and immunisation appointments.
Surgery coordinates the development checks with the Health Visitors who record the weight and length of babies in the red book.
Surgery nurse normally does baby immunisations on give dates and times indicating morning or afternoon. Refer to any schedule displayed.
Surgery finds this a convenient time as it coincides with the walk in baby clinic run by the Health Visitors and developmental checks. A parent is free to book at other times for maximum flexibility but please inform the receptionist that the appointment is for baby immunisation. See Section 2.5 for details of immunisations needed.
GP involvement in the care of pregnant women has declined significantly over the past 30 years and midwives are now the main health care providers for ‘low risk’ pregnancies. The role of GPs in maternity care could disappear completely, unless valid future responsibilities can be defined and clarified.
Midwives care for and support pregnant women, their partners and babies, before, during and after the birth. Some midwives give advice before a baby is conceived, but most will support the mother after pregnancy has been confirmed.
The work of a midwife includes:
· Monitoring the health of the mother and baby with physical examinations and ultrasound scans
· Counselling the expectant mother on issues such as healthy eating, giving up smoking, giving up drinking, domestic abuse, exercise
· Exploring the mother’s options for the birth, for example natural childbirth, pain controlling drugs, hospital or home delivery
· Looking after the mother and baby during labour and birth, and for up to a month after the birth.
· Advice on method of feeding baby, in particular encouraging and supporting women to choose breastfeeding. However, please support the mother if she chooses to bottle-feed her baby.
· Midwives run antenatal and parenting classes, which involves teaching.
In the current, cost conscious climate, the most effective solution would be for a pregnant woman to book in with a midwife, for the midwife to have her medical records on her first visit, and the midwife then informing the GP of the pregnancy of one of their patients. Where there are pre-existing medical problems, the woman should be referred by the midwife to the appropriate service, which may be the GP or may be other services.
Women in England currently have a choice to receive their care from their GP or a midwife. The midwife will explain this choice to them when they book their first GP involvement in the care of pregnant women has declined significantly over the past 30 years and midwives are now the main health care providers for ‘low risk’ pregnancies.
The role of GPs in maternity care could disappear completely, unless valid future responsibilities can be defined and clarified.
GP knowledge on maternity issues has fallen behind current evidence and a considerable amount of retraining will be required to enable them to fulfil their role in pregnancy in relation to the health of the woman and the baby who have medical needs. Even more training would be required if GPs are expected to deal with the pregnancy and birth and the post partum period, as a midwife would.
In the current, cost conscious climate, the most effective solution would be for a pregnant woman to book in with a midwife, for the midwife to have her medical records on her first visit, and the midwife then informing the GP of the pregnancy of one of their patients. The patient might be referred to by the midwife to the appropriate service (the GP or other services), only in case of any pre-existing problems.
GP involvement in the care of pregnant women has declined significantly over the past 30 years and midwives are now the main health care providers for ‘low risk’ pregnancies.
As soon as the patient finds out that she is pregnant she should make an appointment with a Doctor. At this initial appointment patient will be expected to provide the date of her last menstrual period. The Doctor will take a history and examine the patient including her blood pressure (no internal examination is required) then help her choose where she would like to have her baby. She could calculate her due date and gestation using the pregnancy dates calculator available with the GP in the surgery. It is possible these days using Choose and BOOK system to book directly with the hospital using their on-line booking.
The patient will be informed about booking appointments and ultrasound scans.
A Midwife from the Hospital (Link to Maternity Services Website), runs antenatal clinics every week at set times and dates. Antenatal care is shared between the Doctors and the Midwife. Surgery GPs do not perform home deliveries. The Midwife would be happy to discuss home delivery and other preferences.
Postnatal – Following the birth of your baby, all mothers should have a check-up at 6 weeks. All of GPs can undertake post-natal checks. This is a good opportunity to ask the doctor any questions the patient may have about her progress. The GP will discuss many aspects about the postnatal period, take blood pressure, perform any necessary examinations and discuss contraception.
GPs like to allow more time (20 minutes) for these appointments. Please ensure that receptionists are advised about the nature of appointment when booking.
The baby development checks are not part of the postnatal check. These are performed at the developmental clinic by appointment.
Allied Health Professions
A number of the professionals included below would be working more in Hospitals but some specialists do come to visit the surgeries by prior arrangement.
The Allied Health Professions cover a variety of roles; these are the six roles in most demand:
Occupational Health Therapists
Operating Department Practitioners
Speech and language Therapists.
The allied health professions (AHPs) offer a wide range of opportunities. As key members of today’s healthcare team, AHPs provide treatment that helps transform people’s lives. There are many roles within the allied health professions.
These range from treating a broken toe to assessing someone’s diet. Whether one is interested in science, the arts or physical movement, one will always find something suitable.
Health and social care today is about teamwork so AHPs will also be part of a team and may even lead one. This might mean working with other AHPs or other professionals such GPs, hospital doctors, teachers, or social workers for example.
AHPs often see patients and clients in different surroundings. You will find AHPs working in hospitals, clinics, housing services, people’s homes, schools and colleges to name but few. Not surprisingly, the academic requirements and training demands are high, but then so are the rewards, both in terms of job satisfaction and career prospects.
Professions regulated by the Health and Care Professions Council:
Chiropodists / Podiatrists
Hearing aid dispensers
Operating department practitioners
Prosthetists / Orthotists
Speech and language therapists.
Health professionals in the UK are expected to be ‘Fit to Practice’’. They are expected to meet certain requirements, but also to know their own limitations.