Development of the Assistant Practitioner Role at 5 Boroughs

Student nurse helping older lady

08 / 1 / 2014 4.59pm

The organisation

5 Boroughs Partnership Foundation Trust provides treatment, support and guidance for people affected by mental ill health and learning disabilities.

The trust provides services for people of all ages and offers day care, in-patient care and community services. Recently merged with Knowsley Community Health Services, the trust now provides health and social care services to people of all ages living in the borough of Knowsley.


5 Boroughs Partnership Foundation Trust has supported the development of assistant practitioners since 2005. The opportunity to develop this group of staff emerged after a skill gap was identified between Bands 3 and 5.

What they did and why

Initially the organisation carried out a study of the use of the assistant practitioner role which highlighted the benefits of a skills mix in the workforce. The study looked at how the allied professional role was being used. It drew on findings from Sibbald et al (2004) and the taxonomy of workforce skill mix research, which determines the use of roles under the headings ‘delegation’, ‘substitution’, ‘enhancement’ and ‘innovation’. The study identified that the roles were being used in all four ways, in line with service need. 

An assistant practitioner working group was established to develop standardised roles across nursing and allied health professions in both community and clinical settings, for staff working with adults, children and families.

Developing the role in children's services

The trust decided to use the assistant practitioner role within its children's services as a means of formally developing its staff in Bands 3 and 4, enabling them to contribute further to improved services and improved patient care.

The workforce lead and managers in the service met to review the benefits of the assistant practitioner role. Having done this, they developed a business case which was considered and approved by the senior management team. Find out more about making the case for assistant practitioners in your trust.

Staff were engaged in the development of the role addendum for universal child health services which accompanies the detailed job description.

Results and next steps

At the beginning of 2014, the trust employed 31 qualified assistant practitioners, seven in their second year of study, and five first year trainees.

The assistant practitioner role supports the skill mix of the nursery nurses and senior support workers in school health and allows for cost effective, quality service provision in relation to the needs of children and their families.

The model is quite innovative as the role cuts across the traditional boundaries of the support worker.  This new way of working is helping to drive forward the integration of the universal child health teams. This will help the service provide a seamless transition for children and families moving between health visiting and school health services whilst providing greater flexibility to deliver services across the healthy child pathway.

Staff are now able to access a two year foundation degree programme combining one day at university and one day of work based learning per week, supported by the service. This enhances their core skills beyond their original professional qualification in previous roles such as nursery nurses. The intended outcome will be a workforce with the right skills to meet the demands of the children and families across the borough.

In response to the Government’s Health visitor implementation plan, all Band 4 roles within universal child health services (as part of workforce development and service planning), comprising health visiting and school health, will hold the assistant practitioner foundation degree. The assistant practitioner will be a core part of the team, delivering services for children and young people aged between 0 and 16 by 2015.

The North West modernisation hub is currently sponsoring projects to examine the impact of the development of these roles on the delivery of services and on service users. The work is being managed in two phases by seven participating trusts, with some initial findings anticipated during autumn 2014.

In early 2014, the online role submission process was made ‘live’ for new developments for a September 2014 cohort at 5 Boroughs. Following successful submission, any posts will be advertised internally to staff who were then selected using an assessment centre process involving group assessment activities and an individual interview.

Further information 

Kerrie France, Business Manager Universal Child Health Services 

Sue Watson, Workforce Lead, Nursing and Governance Directorate


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