HCA recruitment, induction and development in Liverpool

carer and older person

23 / 12 / 2013 11.08am


The Willis Commission, Francis inquiry, and Cavendish report all highlighted the need for consistent and high quality training of the support workforce in order to drive up standards in NHS patient care.

NHS Employers recently went to Liverpool Heart and Chest Hospital (LHCH) to meet Mary Douglas and Steven Colfar (head and deputy head of learning and development respectively) to talk about how it is responding to this challenge, and improving patient care through its healthcare assistant (HCA) development programme, and a focus on values.

Read on to find out more about LHCH's:

  • Organisational values
  • Recruitment of people with the right values
  • Induction programme with a focus on compassionate care
  • Six month development review
  • Apprenticeship programme: Formalising the qualification for HCAs 
  • Talent management and career development
  • Evaluation and lessons learnt
  • Further information 

Organisational values

LHCH became an NHS Foundation Trust in December 2009.

The hospital’s mission is to provide “Excellent, compassionate and safe care for every patient, every day”.  In the 2012 Care Quality Commission National Inpatient Survey which uses feedback from patients and their families, LHCH scored among the top rated hospitals for 'overall patient care'.

Driving up skills, creating job opportunities and offering career development are also key priorities for the trust. The specialist hospital trust understands what a key part its support workforce can play in achieving these aims, and has made a commitment to invest in its HCAs.

LHCH has introduced an HCA career pathway which aims to:

  • Provide a supportive induction and orientation programme for HCAs;
  • Empower HCAs to accept responsibility and accountability;
  • Identify learning needs and develop action plans within a specific timescale;
  • Consolidate competencies and learning through regular mentor contact;
  • Facilitate reflection and evidence-based care;
  • Link into the trust’s development review framework;
  • Provide opportunities for future development and progression;
  • Develop competent HCAs able to give high standards of personalised care;
  • Support staff through the trust’s staff experience vision, which pledges to equip staff with the necessary skills to do their jobs effectively.

It hopes to achieve these, by taking several approaches:

Recruitment of people with the right values

LHCH has applied a shift in its recruitment of support workers, to focus on the values, attitudes and behaviours of the candidates, rather than solely their competences. Previous care experience is no longer a requirement for appointment, but if a candidate demonstratesthat what is important to them aligns with the patient centred approach of the trust, they will score well.

Read more about recruiting the right people into the NHS on our recruiting for values web pages.

Induction programme with a focus on compassionate care

The trust has introduced a four day HCA development programme for all new support workers. As they work through it, HCAs learn interactively about fundamental care linked to the 6Cs, clinical skills, OSCE assessments, and scenario judging. As well as positive care, new support workers look at poor care elements. Trainers work with them to consider what each person would do if they observed poor care, instilling in them a sense of duty to report anything that may jeopardise patient safety. Each HCA is given a competency workbook to work through to record the development of their skills.

Six month development review

After six months, HCAs are reviewed, using a personal development review (PDR) on their practical ability as well as the values and behaviours they have exhibited. Increasingly, LHCH is using assistant practitioners (APs) to be a core group of assessors wherever possible.  To prepare them for this, they have access to a one day mentor preparation programme used in the Merseyside area called ‘Supporting Learners in Practice'.

Apprenticeship programme: Formalising the qualification for HCAs

LHCH, along with other trusts in its former SHA region (NHS North West), has made an ‘apprenticeship promise’ to support all band 1-4 staff to achieve at least a level two qualification. Each HCA that passes the first stages, described earlier, is given the opportunity to do an apprenticeship in health and social care.

In order to avoid unnecessary retraining, each person starts their apprenticeships at different points, according to their ability and previous achievements.  So, an HCA could start on a standard or advanced apprenticeship programme.

As LHCH is a small trust, training is delivered through an external provider, 'Total People', which supports the Trust on a full range of apprenticeships.  Steven Colfar oversees tight quality management and regular reports between the trust and the education provider.

Talent management and career development

The next stage of the HCA development programme is a talent management process. Having obtained their apprenticeship, and demonstrated that they provide compassionate care to patients, HCAs are given an initial information, advice and guidance session, and consider opportunities for widening access and career progression based on their performance, values and behaviours. Outstanding support workers can be put forward for nurse training secondments.

The trust is proud of some really positive successes in terms of staff joining the hospital at entry level, and working their way towards nurse training. Adela Emery joined the trust as a domestic worker and is now undertaking her nursing degree. Read Adela’s story here.

Evaluation and lessons learnt

A four stage evaluation of the programme is underway, and data realisation will take some time, but after just one year, the benefits of the programme are already becoming clear.

As well as contributing towards the trust’s social responsibility by enabling young people and school leavers to follow a career pathway to pre-registration nursing, Steven Colfar and Mary Douglas have also noticed a really positive response from staff to the opportunities it offers them. We know – from studies such as those conducted by Michael West - that more engaged and satisfied workers will provide better care. Providing development opportunities for staff is a valuable strategy in this sense.

The work has not been without its challenges. One of these has been that the advanced apprenticeship does not provide enough accreditation to get into pre-registration nursing courses in most universities. Working with their local university, LHCH looked into developing a bridging module for their advanced apprentices to enable access to the degree. During this process, the university gained assurance of the value of the learning the trust was providing, and agreed to accept the advanced apprenticeship qualification as sufficient entry requirement to the degree. Close partnership working resulted in a positive solution.

Further information

To find out more about LHCH’s work, please contact Steven Colfar by emailing steven.colfar@lhch.nhs.uk.

Access more information, guidance and case studies to help you develop this pare of your workforce on our support workforce pages.

Read about the Cavendish report and its implications for employers.


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