Workforce Transformation Catalogue 2019-2021

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Contents

Introduction 3

Overview 4

Purpose of Catalouge 5

Catalouge List 7

Funding & Support 8

Quick One Page Guide 9

Fellowships 11

Healthcare Assistants 18

Healthcare Coding 27

Bussiness Administrators 29

New to GPN 37

Nursing Degree 44

Apprentice Nurse Associate 62

Phramacy Technician 69

Physicians Assistants 71

Rotational Nurse 75

International GP Recurtiment 81

Return to Practice Nursing 86

Appendix 93

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INTRODUCTION On behalf of Waltham Forest Community Provider Network (Training Hub)/ Training Hub, I am delighted to introduce our very latest programmes designed to help build a resilient health & social care workforce. WF Training Hub & takes its responsibilities towards our primary health & social care workforce seriously. We encourage our colleagues to voice their opinions regarding how we plan to implement points from national stratergy including NHS Long Term Plan. GP Practice Workforce Report WF Training Hub has collaborated with Primary Care and Social Care Stakeholders to understand workforce gaps. Based on current statistical information taken from NHS digital and local data, WF Training Hub designed a Workforce Audit in Action for every Practice in the borough. The tool captures workforce profiling which helps us to understand the Primary Care workforce needs for Waltham Forest. To compliment this work we created individual tools like this Roles Catalogue and a Skills Matrix to support delivery of workforce transformation and development in real terms across the local health and care system. How can I use the Roles Catalogue to help my Workforce Planning? “Knowledge is indeed power”. The Roles Catalogue sets out how we aim to recruit new staff or train up existing staff developing and existing roles. The catalogue details various training opportunities - Nurse Associates, Nursing, Physicians Associates, Business Administration Medical Assistants, Pharmacists and Health & Social Care Assistants etc. WF Training Hub have been engaging stakeholders using a range of communications including guided conversations. In doing so the Hub hopes to assist the local health and spocial care system in delivering a resilient workforce for integrated health and social care. Building up community systems is central to the delivery of the “care closer to home” agenda. We truly value contributions people make through ongoing engagement with us. I hope you will find the information included here extremely useful, and that your experience is rewarding and enjoyable helping us to grow and support our local workforce. Keep engaged and link into the work that is taking place helping us transform the quality care given to all. Co-Chair for Waltham Forest Training Hub (Training Hub) Clinical Lead for Meds Optimisation and Workforce, ELCHP Dr Anwar Khan

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OVERVIEW Waltham Forest belongs to the Health Education North Central and East London (HE NCEL) Local Workforce Action Board (LWAB) overseen by HEE (Health Education England) who are responsible for the education and training of health workers at a regional level. Nationally and locally, it has been identified by HEE & LWAB that Workforce Transformation, education and training is needed to develop a workforce capable of ‘team-working across professional and organisational boundaries’ as a major priority to prevent fragmentation and duplication of care. Since summer 2014, WF partnered with North East London NHS Foundation Trust (NELFT) to host a Community Education Provider Network (CEPN/Training Hub). Training Hubs networks of education and service providers (NHS and non-NHS) based in the community. They are tasked with increasing capacity for future workforce training in the community and the development of the current and future workforce around the needs of a regionally defined population. They are tasked with increasing capacity for future workforce training in the community and the development of the current and future workforce around the needs of a geographically defined population. Hubs are required to ensure they are reflecting collaborative and multidisciplinary working in their investment plans. Local stakeholder partnership working is integral in the delivery of multidisciplinary Primary Care Workforce Transformation i.e. s, Community Networks & Professionals, Voluntary & Local Authority. Trainign Hubs provide a platform for multi-professional communities of educational practice in local geographies to develop high quality, locally-tailored education and training for staff in primary and community care. Training hubs, Advanced Training Practices, Enhanced Training Practices and Community Education Provider Networks can be used interchangeably to refer to ‘Training hubs’ activity. Key Purpose of Training Hubs The work of the Waltham Forest collaborative is split into three areas;

• Delivering training and development as an integrated Network across health & care • Workforce transformation support to Integrated Health & Social Care Partners • Providing training and support to develop current and new roles (recruitment &

retention tools, workforce planning and mapping) What next? The Training Hub in Waltham Forest is vision is clear; education delivery through collaboration & co-production with local stakeholders including Providers & Commissioners. Workforce schemes are needed to bring about this vision through one to one engagement with you. Why? Without all partners willing to contribute, we cannot build a resilient and supportive workforce system.

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PURPOSE OF CATALOUGE WF Training Hub is delivering a sustainability system that can enable our commitment to Workforce Transformation through investment, Training and Development. As part of our research we have looked at individual roles for Primary Care, linking this with those described in the GPFV. These roles are being designed to support the delivery of a transformed workforce across Primary & Acute organisations. Skills for Care are supporting delivery of many of the standards. Updates of these standards can be found on their website: http://haso.skillsforhealth.org.uk/ Step 1 – Identification of needs Working closely with our primary care team and social care partners we developed a Workforce dashboard and Toolkit which allows us to gain insight into workforce needs of each individual site and support plans for transformation and development. We delivered specific workforce information for sites pulled out from NHS digital quarterly workforce audit. Data was extracted from NHS digital and local sources. To provide some context, this was developed in preparation for a variety of placement schemes within Waltham Forest alongside recommendations from the NHS GPFV, Long Term Plan and Interim People Plan. Step 2 - Engagement Using data dashboard, Primary Care and Training Hub embarked on a series of visits to all 40 practices within Waltham Forest. These visits included conversations about enhanced workforce mapping and planning for the future. This is now being used to support 18 month workforce transformation engagement plan with sites but now this has been enhanced to also support PCNs. Step 3 – Recruitment & Retention The Training Hub continues support sites to embark on successful recruitment and return campaigns regularly to generate the right flow of personnel needed. WF Primary Care and WF Training Hub teams have been working with you to identify your needs. Training Hub will continue to work closely with sites across health and social care to recommend roles from the catalogue which can be used to develop existing staff as well as bring in new staff, advising on roles you might wish to consider recruiting and training. To date WF Training Hub has supported and delivered the following roles using the above mapping and engagement strategy to gain big wins

• 28 New to General Practice Nurses. We currently have 11 being trained by local our Lead Nurse Ruth Amartey and Nurse Facilitator Catherine Edmonds.

• 60 Mini-Rotations of New role Associate Nurses across Primary Care & Social Care most of whom will be graduating in January and June/July 2019

• 2-4 International GP recruits will be in post (2019) • 5 GPs in Portfolio Programme (Spin First Five)

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• 10 Practice based Pharmacists (Training Hub pushed this initiative with Medicines Team)

• 4 Associate Nurse Apprenticeships started at UEL Dec 2018, with 4 candidates on waiting list for next cohort

• Over 10000 CPD training & development places provided using our skills matrix including 120 trained Chaperones

• Aiming to support 20-40 HCA Apprenticeships and 20-40 Business Administrators (March 2020)

Forward Planning 2018-2020 The above is a full description of results of our workforce transformation strategy in action in “real terms” in the last 24 months. Our toolkit holds a variety of research data to support forward planning which identifies capacity and gaps in our current workforce. This toolkit has been used to determine how guided conversations can provide you with new ways of working ideas and considerations on roles at your sites. Skills Matrix (Electronic) By November 2019 the Training Hub will launch its digital Skills Matrix – Digital Training Hub which will include ongoing workforce transformation and e-learning access. This portal will be integrated and will include live workforce data dashboards for your sites. We have advised North East London stakeholders to invest in Workforce Planning Learning. This is something we will be championing in coming months including the delivery of a yearly primary care and social care workforce summit aimed at Managers and potential Apprentices and learners. The Pathway to progress With growing demands on Primary Care and Social Care, workforce transformation will be key to ensuring services can cope with growing new demands on the system. The Roles Catalogue aims to provide you with information on roles. These roles may be used to enhance current services and staff future services needed to meet local demands but more importantly, support retention. The individual roles and application processes are described within the catalogue, providing specific guidelines that should help to simplify on-boarding processes. The catalogue is based on the most up to date information available. The Training Hub will continue to engage and connect sites on delivering their workforce improvements including on-boarding for Apprenticeships and other programmes like Rotational Nurses, GP based Pharmacists, Business Administration & Management etc.

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CATALOGUE LIST Taken from the GPFV: https://www.england.nhs.uk/wp-content/uploads/2016/04/gpfv.pdf “The success of general practice in the future will also rely on the expansion of the wider non-medical workforce – including investment in nurses, pharmacists, practice managers, administrative staff and the introduction of new roles such as physician associates and medical assistants. The General Practice Forward View cannot be delivered without sufficient recruitment and workforce expansion. Therefore NHS England and Health Education England (HEE) have set ambitious targets to expand the workforce.” This catalogue contains a collection of roles that reflect the needs of East London, many of the roles are offered as apprenticeships. The below list is not exhaustive but aims to support the recruitment needs of Health & Social Care across North & East London in order to achieve a resilient Health & Care system improving quality and better integrated working. 2019-20 list Primary Care Pathways Timelines – Avaliable Programmes

• Advanced Clinical Fellows Programme Live

• International GP Recruitment (IGP) Live (New)

• Health Care Assistant (HCAs) Apprenticeship Live 2019

• Health Informatics/Clinical Coding Apprenticeship Live

• Allied Health Professionals (Physio, OTs) March 2020

• Business Administration Medical Assistant Live

• New to General Practice Nurse (GPN) Live

• Rotational Nurse Programme Live

• Return to Nursing Programme Live

• New to Practice Nursing – Foundation Programme Live

• Nursing Apprenticeship including placements Live

• Apprentice Nursing Associate (ANA) Live

• Pharmacy Apprenticeship Late 2019/ Early 2020

• Physicians Associate Apprenticeship 2020-21

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FUNDING & SUPPORT Apprenticeship Levy and why is it important? The Apprenticeship Levy is a UK Government employment tax that came into effect on 6 April 2017. It will be collected across the whole of the UK. All employers (public, private and third sector) with a pay bill of more than £3 million each year will pay the Levy. Training Hubs across East London are working very closely with Acute Trusts to get them to share their funding with smaller primary care and social care providers. As a result, Primary Care is benefiting from this as they will not have to pay the additional 5% for the apprentices training cost! This means staff get all their training fully funded with no cost to the employer! Salaries Organisations are solely responsible to ensure salaries of candidates recruited to a role (some roles are not funded by the Training Hub). Salaries There will be occasional full slalary support from Health Education England (HEE) & NHS England (NHSE) for some recruitment rounds i.e. current recruitment round for ANAs comes with £15-16k per site, International GP recruitment is a Fully Funded Programme 50-80k per IGP managed by FedNet, GPN programme has 50% salary costs covered. Sites can also contact local Training Hub for support. There is also the availability of Funding from HEE for staff who wish to do their Advanced Clinical learning providing they qualify. Clinical practitioners come from a range of professional backgrounds such as nursing, pharmacy, paramedics and occupational therapy. They are healthcare professionals educated to Masters Level and have developed the skills and knowledge to allow them to take on expanded roles and scope of practice in caring for patients. Other Very Useful links for Sites and Staff: Step into NHS - https://www.stepintothenhs.nhs.uk/ Career Pathways Tool https://haso.skillsforhealth.org.uk/pathways/ Managing Apprentice funding - https://www.gov.uk/guidance/manage-apprenticeship-funds Match roles to salaries/standards (where applicable) http://haso.skillsforhealth.org.uk/ There are various options with regards to funding for training which have been outlined in the below Quick How to Recruit/ Support Guide. The Guide can also help those intrested. The table below sets out clearly the support attached to each role, and helps you navigate quickly to gain an understanding of each role, levels etc.

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Quick One Page Guide Roles Recommended

Salary / Banding

Contract Type Salary Options

Education Funded Programme Options

Local Support

Recruitment Route Ref. page

Fellowships Band 7/8a Practice Contract but depends on Fellow Scheme

HEE/ Practice HEE / Training Hub Matrix Offer, Thursday Education sessions

HEE/ Training Hub

HEE/ Training Hub

London Leadership Academy Programme / HEE & Direct Recruitment

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Health Care Assistant (HCAs) Apprenticeship

Band 2 Practice Contract Honorary Contract

Practice Apprenticeship Levy, Training Hub Matrix Offer, Thursday Education sessions

Training Hub/ Lifetime

Training Hub/ Lifetme

Apprenticeship, Direct Recruitment/ Lifetime/ Barts

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Health Informatics/Clinical Coding

Band 4 Practice Contract Honorary Contract

Practice Training Hub Matrix Offer Apprenticeship Levy

Training Hub Training Hub Apprenticeship, Direct Recruitment/ Lifetime/ Barts

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Business Administration Medical Assistant

Band 3/4 Practice Contract Honorary Contract

Practice Training Hub Matrix Offer, Receptionist Training Apprenticeship Levy

Training Hub/ Lifetime

Training Hub/ Lifetime

Direct Recruitment towards a Medical Assistant role / Lifetime/ Barts

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New to General Practice Nurse (GPN)

Band 5 Practice Contract Honorary Contract

Training Hub (HEE) / Practice

Training Hub Matrix Offer, Thursday Education sessions

Training Hub Training Hub WF Training Hub 35

Nursing Degree Apprenticeship

Band 3-5 Practice Contract Honorary Contract

Practice Training Hub Matrix Offer, Thursday Education sessions Apprenticeship Levy

Training Hub & Apprenticeship Levy

Training Hub Apprenticeship, Direct Recruitment/ Lifetime/ Barts

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Nursing Associate Apprenticeship

Band 1-4 Practice Contract Honorary Contract

Practice Training Hub Matrix Offer, Thursday Education sessions Apprenticeship Levy

Training Hub & Apprenticeship Levy

Training Hub Apprenticeship, Direct Recruitment, Rotations Hosting through Training Hub

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Pharmacy Technician Band 3/4 Practice Contract Honorary Contract

Practice Training Hub Matrix Offer, Thursday Education sessions

Training Hub & Apprenticeship Levy

Training Hub Apprenticeship, Direct recruitment 66

Physicians Associate Band 7 Practice Contract Honorary Contract

Practice Training Hub Matrix Offer, Thursday Education sessions Apprenticeship Levy

Training Hub/ HEE

Training Hub Apprenticeship offered from 2020-21 Direct recruitment

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Rotations Nurse Band 5 Practice Contract Honorary Contract

Practice Training Hub Matrix Offer, Thursday Education sessions

Training Hub Training Hub WF Training Hub / Nursing Super hub 72

Return to Nursing Depending on Nurse Experience

Practice Contract Honorary Contract

Practice HEE, Via individual LETBs providing programme (see role profile)

HEE/ Training Hub

Training Hub Direct Recruitment 78

New to Practice Nursing – Foundation Programme

Band 5 Practice Contract Practice HEE Training Hub Training Hub Direct Recruitment 81

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CREDITS DISCLOSURE This catalogue is made available by Waltham Forest Community Education Provider Network (WF Training Hub) to act as a guide and point of reference with regards to the development of roles by HEE and Public Health England. Whilst every effort has been made to provide accurate and complete information, WF Training Hub assumes no responsibility for any errors or omissions. No liability is assumed for damages that may result from the use of the information contained within. The information contained in this catalogue has been collated from various online resources which have already been made available to the general public. References and credits: Content:

• Royal College of Nursing - www.rcn.org.uk • Health Careers - www.healthcareers.nhs.uk • Nursing Times - www.nursingtimes.net • London Leadership academy - www.londonleadershipacademy.nhs.uk • Health Education England (HEE) - www.hee.nhs.uk • Public Health England - www.gov.uk/government/organisations/public-health-england • Skills for Health - http://haso.skillsforhealth.org.uk/

Special thanks to (reviewers): Ruth Amartey, Lead Nurse (Training Hub), Advance Nurse Practitioner Munir Ali-Zubair, (General Practioner), WF Training Hub Clinical Leads Anwar Khan, (General Practitioner), WF Training Hub Chair & Chair Jo Barter, Apprenticeship Lead, North Central & East London Gareth Noble, Workforce Lead, North Central & East London Toyin Ajidele, Organisational Development & Workforce Transformation Programme Lead (Training Hub)

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Leadership Programmes The Fellowship Clinical Leadership Programme is designed to build training and development of senior clinical leaders by supporting them in a 12 month project-based attachment in a London NHS organisation, as well as providing them with educational training over the course of an academic year. Applications for Fellowships intakes usually take place between December/January months of the year. Latest advertised opportunities: Advanced Clinical Practice Fellow closing date 7th Dec 2018 Older Person Fellowships HEE Page Older Persons Fellowship at Kings College London (Fully Funded) Other Academic Clinical Fellows at UCL Toolkit Fellowships are a fantastic opportunity to undertake change work with the support of peers and experts in the field of complex change, systems leadership, effective teams improvement, and new models of care from the UK and Internationally. A candidate can join a community of leaders within London and connect to leaders around the globe, through modules, coaching, action learning sets, co-consulting, skills and practice workshops. The group work includes simulations and exposure to leading thinkers and practitioners. What sort of person is this targeted at? Fellowships are intended to help established clinicians make the leap into systems leadership. Whilst there are no hard and fast rules on who would make an ideal Fellow, typically this programme suits medics at the ST4/5 level and nurses and AHPs around the Band 6/7 level with a few year’s clinical experience behind them. You may already be aware of individuals within your organisation in whom you can see a potential leader of the future. Benefits at the end of Fellowships Programme:

• The knowledge, attitude, skills and change practices to lead the NHS of the future.

Fellowships

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• A wide network of crucial associates and alliances to learn from (peer to peer learning). • A deep understanding of new models of care, their benefits, challenges and

application. • Will have made an impact on healthcare through the delivery of real change. • Confidence, resilience and the ability to lead in times of uncertainty.

The programme offers Fellows a unique opportunity to develop the capability necessary for their future roles as clinical leaders, through working with medical directors (or equivalent) to lead the development of service changes that are part of the organisation’s forward programme. We welcome applications from experienced and dedicated clinicians, who have a proved interest in education and multi-disciplinary learning. The Fellowship is considered a prestigious post and is highly recommended for aspiring clinical leaders. The Fellowship includes a portfolio of project-based components. Benefits to your practice The Fellowship Programme offers your organisation capacity for real change work. Along with your Fellow, your organisation will have access to relevant learning materials provided during the programme. At the outset of the programme you will have a timetable of activities where you can find out more about the progress of the Fellowship group, and facilitate how best you can support Fellows to influence sustainable change. When the programme begins (after the first workshop in September) you will be asked to provide an induction for your fellows into your own organisation’s context. You can use this opportunity to provide feedback to your organisation and other leaders. Primarily this sets up the relationships and deep organisational understanding the Fellows need in order to do their change projects. Your organisation will be asked to release an hour to work with the Fellow and their coach to identify their learning and development needs in a contracting meeting, identifying how these relate to your expectations of the programme, and your sponsorship role with the Fellow. Service Improvement projects

Fellows will work with the medical director, equivalent clinical lead, or nominated deputy to lead the development of service improvement changes that are part of the organisation’s forward programme and aligned with the NHS values and the Five Year Forward View. Through this work Fellows will learn about change implementation and management across organisational boundaries within a local health economy. Supporting capacity building within the organisation for clinical leadership Working with the relevant departments within the organisation (Practice and/or sometimes ), the Fellow will develop a leadership and organisational skills development programme for trainee doctors and other healthcare professionals within the organisation.

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Developing the commissioning landscape Fellows will work with their organisations, where appropriate, to support the implementation of effective commissioning of local healthcare provision. The Fellowship also includes: Clinical commitment Post holders may continue to undertake a limited amount of clinical work commensurate with their level of experience and appropriate to their training status. The extent and nature of this work is to be negotiated locally and will include appropriate and clearly identified clinical supervision. The clinical component of the post will not exceed an average of three sessions per week and in order to assist with orientation to the new role, Fellows will not be expected to undertake clinical duties in the first four weeks of taking up their post. Other organisational opportunities The organisation (your practice) will provide a number of other developmental opportunities e.g. attendance at board meetings, working with multi-professional teams, project management experience, and exposure to organisation financial management. Support programme The post will be supported by a formal programme of learning with other Fellows commissioned by the London Leadership Academy, the Local Delivery Partnership of the NHS Leadership Academy, and will include taught elements supported through action learning sets and opportunities for coaching and mentoring. Collaborative working and knowledge sharing is encouraged, a dedicated learning environment will be provided. Other national and regional opportunities In addition to participation in the support programme provided, the post holder is expected to attend national and regional events appropriate to the role. Main duties and responsibilities The post holder will be expected to undertake the following duties:

• To attend and lead all relevant project meetings within the employing organisation. • To provide clinical leadership for agreed projects. • To liaise and engage organisation and other sector colleagues as appropriate.

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• Provide timely and effective clinical advice and leadership working with managers and staff.

• Provide written reports on project progress, including risks and issues. • Attend educational modules and development opportunities associated with the

Fellowship. • Attend the relevant coaching and learning sets. • Participate in all aspects of the Fellowship scheme and its evaluation. • Act as an ambassador for the Fellowship scheme and promote medical leadership.

The duties and responsibilities outlined above are not intended to be exhaustive, may vary over time and are subject to management review and amendment. Appraisal The Nominated Sponsor (Medical Director or equivalent) will supervise the Fellow; including setting objectives and agreeing a personal development plan. These will be regularly reviewed. Where possible, Fellows’ development needs will be met through the organisation in conjunction with opportunities provided by the bespoke support programme. Programme Modules may comprise of: New Models of Care Focus: Understanding the Context for Leading Change, Developing and implementing new effective models of care. This module provides an understanding how new models of care are developed and implemented, from teams to systems. It includes developing personal capacity for leading as peers in inter-disciplinary teams, and with citizens. There are two three-day workshops, the first of which is followed by a one-week induction in your own organisation and health system. Formative assessment is through a reflective learning assignment after the first workshop, and a summative assessment by a presentation and viva to your sponsor and the course director. Core Concepts of Quality Focus: Introducing the concepts of Patient Flow, Improvement Science, Systems Leadership and Coproduction. This module provides a grounding in the key concepts of quality that are in practice in the NHS. Formative assessment is through a presentation in your action learning set, and the summative assessment by way of a 4000 word assignment. Leading Change Projects Focus: Leading complex change in systems in real-time. This module provides tools and techniques in designing, implementing, and reviewing a change project. You are supported in your application of learning to your change projects by the co-consulting sessions and coaching with programme faculty as well as facilitated action learning sets and two skills workshops on negotiation and conflict management, and resilience. The Formative assessment is through one 2000 word project plan, which is then incorporated into a final 4000 word summative assessment report of the project. Coaching: Each Fellow has 3 hours of coaching, the first hour is with your sponsor to establish learning goals, the

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following coaching sessions relate to your personal leadership competence in their leadership tasks.

Length of Programme (Darzi Fellowship) The programme is usually full-time for one year, and whilst in post Fellows are expected to undertake a main project, with a central focus on service improvement and/or systems change and to spread the learning from the Fellowship across the organisation involved. It is envisaged that Fellows will spend around 50% of their time working on their project within their host organisation and around 50% undertaking development activities. Funding Model & Salary cost (Darzi Fellowship) The funding secured will pay the tuition fees for the Fellow at our selected training provider - LSBU and an award to the host organisation (practice) of up to £55k – this may be used to fund full salary support based on the AFC 8a, cover travel or conference expenses and/or allow for project-related funds to be available to the Fellow. HEE can commit to support 30% of salary costs (gross + on costs), along with Postgraduate Certificate costs and related education, training and programme delivery costs for each Fellow. The Host employer [practice, Trust or other] will contribute 70% of the salary and on costs as above. The above reflects the breakdown of the working week. Unit cost is £100k with HEE bearing central administrative costs, academic programme costs and 30% of salaries as detailed. Proposed Contractual Position The GP practice will be considered the primary employer – holding a contract for each Fellow, for the duration of their Fellowship. To allow the Fellows to complete the GP and non-Trust phases of their Fellowship, each Fellow will hold honorary contracts with each partner organisation - to cover their time in that Practice. Indemnity during these phases will not be the responsibility of the employing Trust. A memorandum of understanding will exist between HEE and the employing Trust/Practice, to manage the expectations of each party and ensure appropriate programme delivery.

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ips A typical example of what a programme schedule might look like:

Image taken from London South Bank University

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Example of Fellowship Structure

• Two days per week in a primary care setting (four sessions). Core primary care work is central to the Fellowship.

• Two days per week (four sessions) in a setting relevant to their specialist clinical field of study.

• One day per week (for the life of the fellowship) in academic study including academic learning sets, Master classes and personal study meeting.

• Completion of a PgCert in Health and Well-being.

Application timescales The HEE local team is leading on these programmes. Fellowship numbers are usually limited and the timeline to the commencement of the chosen training provider’s programme in April is tight. The process:

• Confirmation of which organisations/projects will receive a Fellow in late December of the year.

• Advertising of the fellowships commencing in Sept- January of a new year. • Invitations from training provider calling on an engagement event in mid-January for

sponsors, potential applicants and anyone interested in the programme. • Hosting of an assessment centre in early February to select the cohort of fellows. • Recruitment of fellows – March/April. • Fellows will start in post with their host organisations in late Jan - early April of the

year. • Courses usually commences in the month of April but this can change. • Conclusion of programme - month of August the following year of the programme.

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Healthcare assistants (HCAs) are hugely valued members of the nursing team. Although there are a wide range of titles used to describe these roles, we have chosen to encompass all of these under the titles of HCA. Healthcare assistants working in the community work across many healthcare disciplines including midwifery, mental health and learning disabilities. They work across the whole life course from birth to end of life, supporting registered nurses in the delivery of nursing care. They may be based in community setting, health centres or in General Practices. In a health centre and GP surgery, healthcare assistants carry out the following duties:

• Infection control, cleaning equipment • Assist in chronic disease reviews • Public Health / Prevention • Blood Pressure checks • Spirometry • New patient and NHS health checks • Restock consulting rooms • Manage practice specimens • Deliver health promotion or health education advice/information • Basic wound care • Dressings & Hygiene management • Adult immunisations (once trained) – influenza, pneumonia, shingles • Phlebotomy and IM injections • ECG’s

Healthcare assistants need to have the following skills and qualities:

• Kind and caring • Cheerful and friendly • Willing to be hands-on with patients • Able to follow instructions and procedures • Able to work in a team. • Able to use their own initiative

They also need to have the following:

• Communication skills (including listening) • Organisational skills • Observational skills

Health Care Assistant Health & Care Hybrid Apprenticeship

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Training Training will include basic nursing skills appropriate to employment setting and training to meet the 15 standards required by the Care Quality Commission as set out in the Care Certificate. The apprentice may complete a regulated vocational qualification during the on-programme phase of their apprenticeship. Employers expect good literacy and numeracy and may ask for GCSEs (or equivalent) in English and maths, however numeracy and literacy can be developed to level 1 or 2 during the apprenticeship. Additional modules may also be completed depending on local needs i.e. integrated care working. Candidates may be offered the chance to study for qualifications such as:

• The CACHE level 2 Certificate in Healthcare Support Services. • The CACHE level 2 or 3 Diploma in Clinical Healthcare Support.

HCAs are invited to join the Royal College of Nursing (RCN) as health practitioner members. The RCN runs training events and conferences so HCAs can update their skills and network with others doing similar work. In Waltham Forest training is available both face to face and online as part of the skills matrix. Salary Healthcare assistants can work various hours or shifts depending on the needs of the practice. HCAs are paid on the Agenda for Change (AfC) pay system at band 2 or equivalent. With further training and experience a HCA could then apply for posts at band 3 or equivalent, or may want to progress to become a nursing associate. Support Healthcare assistants (HCA), work under the guidance of a qualified healthcare professional, usually a nurse. Sometimes staff working in HCA roles are known as nursing assistants. Pathway / routes into a HCA role There are several routes for recruiting a HCA into practice. A practice may decide to recruit a HCA through the apprenticeship scheme or may develop existing staff to HCA roles. After a candidate has completed their training they may stay on in your practice or they may consider applying for further development or senior HCA roles or indeed move on to become a senior clinician i.e. Associate Nurse, Podiatrists, Nursing, Physicians Associate etc. Healthcare Assistant - Apprenticeship standard The Healthcare Assistant Apprenticeship has been approved for delivery by the Government. This means that employers can work with training providers and organisations which provide apprentice end point assessment to prepare for delivery. The Skills Funding Agency hold registers for approved training providers and approved end point assessment organisations.

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Settings who put staff forward for apprenticeships will be supported by their local Training Hubs. How does it work? During the Apprenticeship, the employer must ensure that the apprentice is given education and training opportunities to develop the knowledge, skills and behaviours described in the Healthcare Assistant Apprenticeship Standard. The time taken to complete the Apprenticeship will vary but it must last for a minimum of 12 months. The government requires that a minimum of 20% of the apprentice’s time must be protected and away from the immediate demands of the job in order to develop the required knowledge and skills. Employers may contribute to how this is delivered. Before going forward for the end point assessment the apprentice must: • Meet the 15 standards required by the Care Quality commission as set out in the Care

Certificate. • Achieve level 1 maths and English. • Before going forward for the end point assessment the apprentice must have attempted

Level 2 maths and English. • Complete an evidence portfolio. The apprentice documents their knowledge and skills

development as well as their approach to the workplace (the values and behaviours). Evidence must be gathered following completion of their programme of training and development and during the 3 months leading up to the planned date of the end point assessment.

Once the apprentice, the employer and the training provider are confident that the apprentice is competent, the apprentice reaches the gateway to the end-point assessment. An independent assessor will then assess the apprentice. The independent assessor must not have been involved in any on-programme training, development or programme reviews of the apprentice. The end-point assessment conducted by the independent assessor is made up of three parts:

1. 60 minute multiple choice test to assess the apprentice’s knowledge from across the Standard.

2. 90 minute practical observation: the assessor observes the apprentice in the course of their normal work.

3. Evidence portfolio and final interview: The evidence portfolio created by the apprentice is assessed and the final interview takes place between the assessor and the apprentice towards the end of the assessment, which must be carried out between 30 – 60 minutes.

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Assessment Flowchart

Registration

• The apprentice registers for the apprenticeship Programme with their employer

On-Programme

• Meet the 15 standards required by the Care Quality comminssion [as set out in the Care Certificate]

• Achieve Level 1 English and Maths• Attempt Level 2 English and Maths by sitting the test• Complete qualifications specified by the employer • A portfolio of evidence completed during the final 3 months

Gateway

• the employer decides the apprentice is ready for the end point assessment and notifes the Independent Assessor

Test• The apprentice completes a multiple-choice test

Practical Observation

• The independent Assessor carries out a practical observation of the apprentice

Portfolio & Interview

• The Independent Assessor grades the apprentice

Certification

•The apprenticeship is complete•Successful apprentices claim their apprenticeship certificate

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1. Fill in the apprenticeship application form and send to the Training Hub.

2. The apprentice registers for the apprenticeship programme with their employer. (Training Hub will provide guidance for this process).

3. The apprentice completes the agreed period of on-programme training.

4. The apprentice has sufficient experience, knowledge and skills (including maths and English requirements) and reaches the gateway where they become eligible to attempt the end point assessment.

5. The apprentice undertakes the end point assessment with an independent assessor

who will oversee the multiple choice test, undertake the practical observation, review the evidence portfolio and lead the final interview. The sequencing of the end point assessment components is determined by the employer and assessor to ensure best fit with local needs.

6. The independent assessor judges whether the apprentice has passed or failed the end

point assessment at the end of the final interview. If the apprentice is successful, the final grade is determined by the independent assessor.

On-programme Training, Development and Assessment Apprentices usually take 12 months to complete this apprenticeship during which they participate in training, development and on-going review activities. These typically include:

• Induction which is specific to their workplace and at a minimum meets the 15 standards required by the Care Quality Commission [as set out in the Care Certificate].

• Study days and training courses. • Mentoring support. • Completion of workbooks or a portfolio through which the apprentice gathers evidence

of their progress. • Structured one to one reviews of their progress with their employer and training

provider. • An apprentice may complete a regulated vocational qualification during the on-

programme phase of their apprenticeship.

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APPRENTICESHIP STANDARD FOR HEALTHCARE SUPPORT WORKER (HCSW) Typical job titles: Healthcare Assistant, Healthcare Support Worker, Nursing Assistant, Nursing Auxiliary

Occupational profile: Healthcare support workers (HCSWs) work as part of a team providing high quality and compassionate care to individuals1. You will carry out well-defined routine clinical duties2 like monitoring an individual’s conditions (by checking things like blood pressure, temperature or weight), checking on their overall progress, comfort and wellbeing. Depending on where you work, you may also help them to eat, drink, wash, dress or go to the toilet. You will prepare individuals for healthcare activities carried out by other members of the healthcare team, looking after them before, during and/or after those activities in line with their care plan. You will also carry out non-clinical duties and, depending on where you work, this could include things like keeping records, making beds, tidying up your work area, returning or cleaning the equipment used during a clinical activity. You will be able to address straightforward problems in your day to day work, reporting concerns and changes to the appropriate person in a timely manner. HCSWs work in a range of healthcare settings3 and your team may include workers from both health and social care. You will report to a registered healthcare practitioner who will directly or indirectly supervise your work. Responsibilities and duty of the role: You will be able to work effectively as part of a team. You will always act within the limits of your competence, knowing who to ask for help and support if you are not sure. You will work within agreed ways of working, following the relevant standards, policies and protocols used in your workplace including the Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England. During the first part of this apprenticeship you will be supported to achieve the Care Certificate4 which forms part of your induction and covers the fundamental skills needed to provide quality care. Additional information: There are no entry requirements to the apprenticeship but employers may run their own selection process. Apprentices without Level 1 English and Maths will need to achieve this level and take the test for Level 2 English and Maths prior to completion of their Apprenticeship.

Level: 2 Duration: 12 to 18 months Review Date: after 3 years

VALUES You will be caring and compassionate; honest; conscientious and committed

BEHAVIOURS You will treat people with dignity, respecting individual's diversity, beliefs, culture, values, needs, privacy and preferences; show respect and empathy for those you work with; have the courage to challenge areas of concern and work to best practice; be adaptable, reliable and consistent; show discretion; show resilience and

Skills You will be able to: You will know and understand: 1. Communication

• communicate effectively with individuals, their families, carers and healthcare practitioners using a range of techniques, keeping information confidential

• handle information (record, report and store information) related to individuals in line with local and national policies

• why it is important to communicate effectively at work; how to communicate with individuals that have specific language needs or wishes; ways to make yourself understood; how to reduce problems with communication;

• legislation, policies and local ways of working5 about handling information; how to keep information confidential; why it is important to record and store patient information securely and what to do if you think information is not secure

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2. Health intervention

• support individuals with long term conditions, frailty and end of life6

care • identify and respond to signs of pain or discomfort • promote physical health and wellbeing of individuals • assist with an individuals’ overall comfort and wellbeing • support individuals with activities of daily living7

• recognise deteriorations in health, long term conditions, physiological measurements, skin integrity and report

• how to do routine clinical tasks (eg check blood pressure, temperature, weight etc) delegated from a registered nurse or other healthcare professional

• the signs and symptoms of a person who is experiencing pain or discomfort • how to promote a person’s physical health and wellbeing • how to support a person’s comfort and wellbeing • the importance of hydration, nutrition and food safety • what the activities of daily living are and which ones you are expected to support in your role • the signs of a person whose health and wellbeing is deteriorating; and how to report changes

and deterioration

You will be able to: You will know and understand: 2.1 Person centred care and support

• demonstrate what it means in practice to provide person centred care and support

• what it means to give ‘person centred care and support’; why it is important to get consent, even when it is difficult; why it is important to get people actively involved in their own care; why it is important to give people choices about their care; and why treating people as valuable and unique individuals makes a big difference in how they

2.2 Dementia, cognitive issues, mental health

• promote mental health and wellbeing • recognise limitations in mental capacity and respond appropriately • recognise and respond to signs of poor mental health for example

dementia, depression, anxiety or other cognitive issues • recognise and report any deterioration in an individual’s mental

health

• the main forms of mental ill health and their impact on people’s lives; and how to promote mental health and wellbeing

• the possible signs of limitations in mental capacity and what to do when you notice them • the possible signs of mental health, dementia and learning disability in people ; why

depression, delirium and the normal ageing process may be mistaken for dementia; the importance of early diagnosis in relation to dementia and other cognitive issues

• how to report changes or deterioration 2.3 Basic life support

• perform basic life support for individuals using appropriate resuscitation techniques and equipment

• how to perform basic life support

2.4 Physiological measurements

• undertake a range of physiological measurements using the appropriate equipment including height, weight, temperature, pulse, breathing rate and blood pressure

• the range of physiological states that can be measured including body temperature, weight, height, blood pressure, pulse and breathing rate

• the normal range of physiological measurements 3. Personal and people development

• take responsibility for, prioritise and reflect on your own actions and work

• work as part of a team, seeking help and guidance when you are not sure

• maintain and further develop your own skills and knowledge through development activities; maintain evidence of your personal development and actively prepare for and participate in appraisal

• your role and the responsibilities and duties of your job; why it is important to work in ways that have been agreed by your employer and to follow standards/codes of conduct;

• working relationships and the importance of working well with other people; who or where to go for help and support about anything related to your work

• the importance of personal development and how to reflect on your work ; how to create a personal development plan

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4. Health, safety and security

• maintain a safe and healthy working environment • take appropriate action in response to incidents or emergencies

following local guidelines

• legislation, policies and local ways of working which relate to health and safety at work; your responsibilities, and the responsibilities of others, relating to health and safety at work

• what to do in situations that could cause harm to themselves and others; how to

4.1 Duty of Care • follow the principles for implementing a duty of care, always acting in

the best interest of individuals to ensure they do not come to harm • the meaning of ‘duty of care’ and why it is important; what support is available when

you come across a difficult situation or when someone makes a complaint 4.2 Safeguarding • follow the principles of safeguarding and protection • legislation, policies and local ways of working about ‘safeguarding’ and protection

from abuse ; the signs of abuse and what to do if you suspect abuse; and how to reduce the chances of abuse as much as possible

4.3 Infection prevention and control

• use a range of techniques for infection prevention and control including waste management, hand washing and the use of Personal Protective Equipment (PPE)

• legislation, policies and local ways of working that help to prevent infection; the meaning of ‘risk’ and ‘risk assessment’; the importance of good personal hygiene and hand washing ; how to select the right PPE (such as gloves, aprons and masks); how infections start and spread; the importance of cleaning, disinfecting and maintaining a clean workplace to reduce the risk and spread of infection; and the meaning of

4.4 Moving and handling

• move and position individuals, equipment and other items safely • why people and objects need to be moved safely; how to move and position people safely; how to move and handle equipment and other objects safely; agreed ways of working when moving people and know how to identify any risks

5. Equality and diversity

• follow the principles of equality, diversity and inclusion • equality and diversity legislation, policies and local ways of working; why equality is important and how discrimination can happen at work

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The career progression of a HCA:

*Apprenticeships provide a great opportunity for staff to advance in their career but also become more well-rounded as a health professional no matter the role they end up in. Additional Benefits for Apprentices 30% off adult-rate Travelcards and Bus & Tram Pass season tickets link below: https://tfl.gov.uk/fares/free-and-discounted-travel/apprentice-oyster-photocard#on-this-page-4 Council tax reduction link Below:

https://www.gov.uk/council-tax/who-has-to-pay

NUS Apprenticeship card ( discounts in high street stores, supermarkets, online shopping etc) link below: https://www.apprenticeextra.co.uk/

http://apprenticeshipconnect.co.uk/apprentices/apprentice-discounts

HCA*on completion of HCA apprenticeship

Nursing Associate*on completion of Nursing Associate apprenticeship*other Allied Health Professional

Registered Nurse*On completion of Nurse Degree apprenticeship*other Senior Allied Health Professional

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Clinical coders are responsible for making a full and accurate computer record of a patient's stay in hospital. They translate diagnoses and treatment into alphanumeric codes. They liaise with clinical professionals, including doctors, nurses and other staff to ensure that patients' diagnoses are recorded accurately. They will also be involved in reviewing data. Some will work as tutors and deliver training to staff on using clinical coding. The working life in clinical informatics will involve looking at how information and data can help patients and the delivery of care. This could include:

• Analysing information about falls on hospital wards to prevent further incidents. • Helping to develop electronic patient records that link across community and hospital

settings. • Running systems that store and share X-rays, ultrasound and magnetic resonance

imaging (MRI) scans. Clinical informaticians are usually qualified health professionals such as doctors, nurses or allied health professionals with an interest in technology, research and audit. There are also a number of roles at a more junior level where clinical experience isn’t necessary. Personal characteristics and skills Candidates will need to be interested in finding ways of improving health services through the imaginative use of data and information. A range of skills are needed for a career in clinical coding/ informatics including:

• Communication. • Information gathering. • Organisation. • ICT. • Numeracy.

Candidates will also need to be enthusiastic, have the ability to work accurately under pressure, using their own initiative and ability to work within a team.

Health Information/ Clinical Coding IT/ Coding Apprenticeship

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Entry requirements Entry requirements will differ depending on the type of role being developed. It may be possible to enter an entry-level post with no formal qualifications, but GCSEs or equivalent qualifications are an advantage. Health informatics apprenticeships are also available. Salary Clinical informatics/coders in the NHS will usually work standard hours of 37.5 per week and are covered by the Agenda for Change (AfC) pay scales. Their banding/salary depends on the level of the role. Training and personal development of clinical informatics staff is crucial for health and healthcare in the UK, to deliver its digital modernisation programme. As with any profession, you’ll need to continue developing your skills and knowledge to progress in your career. There are a number of entry level points depending upon experience, knowledge and skills. The Health Informatics Career Framework (HICF) can help you decide the level for you. It can also help you to identify the career path you might take and development needed to progress. The NHS has developed a number of opportunities to support progress in a clinical informatics career. These include:

• Undergraduate and postgraduate courses.. • Accredited short courses. • Seminars. • Distance and eLearning programmes. • Mentoring, work shadowing and placements in other departments to build up the

necessary. • Experience to gain professional recognition.

Many of these will count towards your professional development and may lead to a formal, professional qualification. If you are employed by the NHS and wish to undertake further training, you should speak with your line manager. Discussion around training and development opportunities should form part of an appraisal. This role has been approved for development however the exact go-live date/ launch of the standards from HEE and Public Health England has not been revealed yet. Please refer to the following link for further information on the standards, competencies and apprenticeship launch. Skills for Health - http://haso.skillsforhealth.org.uk/

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Following a workforce audit in Waltham Forest, the collated data suggests new approaches are needed to address workforce challenges which show that GPs spend 11% of their time on administrative tasks. If these tasks are were to be carried out by dedicated administrators such as medical assistants, it would be the equivalent of 1,400 more full-time GPs. HEE are piloting the Medical Assistant role in general practice which is a major programme across the country to deliver the General Practice Forward View. Waltham Forest staff have requested support and training into pathways that combine their admin and health care skills. The Medical assistant pilot was developed to address:

• How to introduce and develop the role of the medical assistant in primary care clarifying the drivers, barriers and challenges.

• Better use of talents in the wider workforce through evaluating the impact on participants of learning and utilising the new skills of the medical assistant role.

• Help receptionists to play a greater role in signposting patients and handling paper work to free up clinician workload and efficiency.

The Medical Assistant role will allow current staff to work towards a level 2-3, progressing towards training and supported educational packages such as level 4 (see Competencies). Delegates will be enrolled onto the Business Administration Apprenticeship with the prospect to include elements of some care navigation.

Business Administration Medical Pathway Business Administration Apprenticeship

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Administrative Key Skills (may include, but not limited to):

*The role involves advancing key skills to support progression to management. They can vary from practice to practice depending on location, size, and specialty.

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Duration Business Administration medical pathway apprenticeship should take 12 to 18 months to complete. Local Training Hub will work with Partners to ensure this can be 12 months. Level This apprenticeship standard is at Level 2 and 3 Qualifications Where a business administrator has not already achieved Level 2 English and Maths, they must do so before taking the end-point assessment. Career progression The administration role may be a gateway to further career opportunities, such as management or senior support roles as well as other junior level clinical roles. This qualification could lead to a progression pathway into more clinical roles i.e. becoming Medical Assistants. Role of WF Training Hub in supporting these roles

• Support the development of the role as part of your wider workforce initiatives. • Identification of practices and organisations interested in the development and

implementation of this role across NCEL. • Assist with the introduction of this role; initiate recruitment and engagement with the

evaluation process. • Work with local systems to determine funding mechanisms.

Additional Benefits for Apprentices 30% off adult-rate Travelcards and Bus & Tram Pass season tickets link below: https://tfl.gov.uk/fares/free-and-discounted-travel/apprentice-oyster-photocard#on-this-page-4

Council tax reduction link Below:

https://www.gov.uk/council-tax/who-has-to-pay

NUS Apprenticeship card ( discounts in high street stores, supermarkets, online shopping etc) link below: https://www.apprenticeextra.co.uk/

http://apprenticeshipconnect.co.uk/apprentices/apprentice-discounts

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Competencies and Core Functions at Each Care Navigator Level (Entry level Apprenticeship Training or equivalent expected before Level 1) COMPETENCY LEVEL 1 LEVEL 2 LEVEL 3 LEVEL 4

Effective communication

-Telephone skills -Listening skills -Recording and responding to information and requests -Proactive patient contacts -Understanding cultural needs

-Understand and able to use common health and social care terminology -Able to communicate in multiple formats in order to engage a variety of patients / clients / agencies / professionals

-Skills in enquiry and interpretation of information to identify areas of concern or risk -Able to give and receive feedback -Able to negotiate with colleagues; patients and external providers

-Skilled in negotiation and planning at strategic level -Able to lead teams in patient / client care

Managing information

-Managing complex information and requests -I T skills :- Appointments / diaries/ prescriptions / medication / registrations Information governance -Managing documents and data -Accountability -Follow-through -Effective handover -Attention to detail

-Collating data -Writing reports -Managing databases -Understanding basic principles of audit -Able to take minutes in meetings -Able to develop monitoring systems -Understanding of the Data Protection Act -Able to implement action points from care plans

-Able to use risk analysis software -Able to develop, implement and monitor care plans with patients / clients -Able to receive and priorities referrals

-Able to monitor standards; and carry out quality improvement projects -Able to plan services and manage budgets -Able to evaluate outcomes of organisation activities in providing care for vulnerable groups

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COMPETENCY LEVEL 1 LEVEL 2 LEVEL 3 LEVEL 4

Protecting patients

-Health and safety at work -Basic life support -Safeguarding children and adults - level 2 -Recognising and alerting appropriate others to emergencies - physical, social and mental health -Confidentiality

-Managing vulnerable / distressed people / mental health patients/ carers, through communicating with in and outside own organisation -Able to respond appropriately in crises -Safeguarding children and adults - level 3 -End of life care - level 2 -Mental health training - level 2 -Understanding of potential problems and barriers to care associated with disability, learning disorder and dementia

-Understanding principles of assessment for vulnerable patients -Understanding the impact on health of long term conditions including mental health -Able to manage a caseload of stable patients/clients with long-term conditions

-Able to manage complex care needs -Knowledge of local and national public health issues -Able to receive and manage complaints, referring to clinicians or senior management where necessary

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Organising and networking skills

-Understanding the organisation, protocols and procedures -Organisation security -Understanding the organisation within the broader concepts of health and welfare services -Awareness of local services and how to access them

-Able to access local resources and signpost appropriately from a range of options -Updating local services register -Understanding local health and social care policy -Able to give presentations within own organisation

-Able to write reports; make case for change and generate proposals -Able to produce and present reports and audit in strategic meetings -Understanding of multidisciplinary team working and able to network across traditional provider boundaries (including voluntary sector) -Able to chair multi professional meetings and reviews

-Able to recruit and be responsible for induction of junior non-clinical staff -Able to contribute to strategic planning at managerial level -Skills in project management

Motivation and supporting skills

-Able to demonstrate empathy and compassion -Able to deal with distressed patients /clients and manage conflict -Recognition of mental health impact on welfare

-Able to co- ordinate meetings / arrange case reviews and understand their functions -Able to run defined group sessions (e.g. carers groups) -Understanding of health promotion, purpose, methods and impact -Motivational interviewing skills

-Skills in education and training for patients and level 1 and 2 care navigators -Skills in advocacy and enabling for patient / clients -Understanding of social care and personal budgets -Motivational interviewing skills

-Able to mentor junior staff, offering advice on role responsibilities and career development within the organisation. -Able to debrief with junior staff -Able to coordinate and run appraisal system for non- clinical staff

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Developing effective relationships

-Commitment to person-centered working -Reliability -Honesty and integrity -Team-working

-Ability to engage patients in discussion to encourage healthy choices -Able to manage regular contacts and reviews, supporting patients and carers -Team-working - decision-making and responsibility

-Able to facilitate supportive working environment for all staff including volunteers -Able to supervise junior staff -Able to provide emotional support for distressed patients / carers -Able to support vulnerable patients post hospital discharge

-Able to supervise junior staff -Able to manage workforce capacity / line management / dispute resolution

Self-awareness -Prioritising -Time management -Stress management / resilience -Making judgments -Defining boundaries -Personal support

-Able to monitor impact of own work -Knowing own limitations and how to debrief - Resilience

-Self-confident in relating to colleagues and patient /clients -Self-directed in seeking learning opportunities for development -Able to reflect on own work and learning

-Able to reflect on own practice and that of others -Able to use tact and diplomacy in dealing with sensitive issues

Ethical practice -Understanding stigma and discrimination in social and health care -Understanding own prejudices

-Understanding of legal, ethical and regulatory principles of the health and social care system

-Able to act as a role model for junior staff -Understanding of cultural needs of specific populations

-Able to evaluate proposals for new developments within ethical principles

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General practice nurses (GPN) work in GP surgeries as part of the primary healthcare team, which may include doctors, pharmacists and dieticians. In larger practices GPNs may be one of several practice nurses sharing duties and responsibilities. In others they might have sole responsibility for nursing duties within their practice. General Practice nurse care varies from practice to practice but may involve:

• Delivering advice and treatment for patients with long term condition. • Conducting electrocardiograms (ECGs). • Managing minor and complex wounds including leg ulcers. • Travel health advice and vaccinations. • Administering childhood immunisations and advice. • Family planning & women’s health including cervical smears. • Men’s health screening. • Sexual health services. • Smoking cessation.

Entry requirements To become a GPN you must be a qualified nurse registered with the Nursing and Midwifery Council (NMC). GPNs may also have direct supervision responsibility of other staff in the practice such as healthcare assistants. Route into General Practice Nursing in Waltham Forest The New to General Practice Nurse Training Programme is sponsored through the Training Hub, Health Education North Central and East London (HE NCEL) and Health Education England (HEE). Through a rigorous recruitment campaign, a selection of new Trainee General Practice Nurses are allocated to practices within Waltham Forest for the 11 months and 27 days of the training programme, which usually commences in the month of January. Trainee GPNs may have come directly from an acute or community setting into practice or they may be new nurse graduates. For many this will be their first experience in General Practice. On completion of their training the Host Practice will have an opportunity to employ the GPN, however there is no obligation to do so if there is no vacancy within the practice. The Training Hub will support the newly trained GPNs to secure a post across Waltham Forest. Whilst on the programme the trainee GPN will gain invaluable knowledge and experience needed to fulfil the role, initially under supervision of a clinical/nursing member of staff. They

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will also complete academic modules related to Primary Care, preparing them to work autonomously and make clinical decisions whilst providing care for the Practice’s patients. The aim is to increase the number of highly skilled, well supported GPNs in Waltham Forest, addressing current and future workforce needs in Primary Care. Activities for the Nurse may include:

• Working alongside a practice nurse, observing and participating in care under direct and indirect supervision.

• Observing and understanding the role of the reception/administration team. • Observing other clinicians: GPs, health visitors, midwives, HCAs and clinical specialist. • Home visits with health care professionals. • Engaging with patient participation groups. • Understanding communication between primary and secondary care, and the interface

between these services. • Using a hub and spoke approach; it would be valuable to spend time with other

professionals who work closely with the practice e.g. local pharmacists, podiatrists and optometrists or other allied health professions – Training Hub hope to introduce this model in the near future.

Other benefits to the Trainee On successful completion of the programme the GPN will have achieved either;

• BSc Professional Practice (General Practice Nursing) • Postgraduate Diploma in General Practice Nursing

GPN may choose to complete MSc General Practice Nursing as a ‘top-up’ programme. Support A trainee GPN must be assigned a supervisor/mentor from within the allocated practice. Further support is also provided to both the GPN trainee and nurse mentors through provision of clinical training from the WF Training Hub training hub. Trainees will have robust appraisal/progress meetings to support ongoing learning. The trainee and mentor are expected to, and should be released to attend all Waltham forest Practice Nurse Forums. Responsibilities and Expectations of Host Practices Training Hub will recruit trainee nurses and allocate them to a Host Practice. Host Practice will be expected to:

• Employ the nurse on Agenda for Change at Banding 5.5 salary (Training Hub will contribute match funding).

• Support the nurse for 19 hours per week in practice. The remaining 18.5 hours will be marked for training and academic attendance.

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• Provide the nurse with basic training on EMIS or equivalent as part of standard practice

induction and full training on specific templates that are used within the practice.

• Enable mentors to liaise with the education providers. Practice will also be expected to be aware of:

• The limitations of the nurses – the trainee GPN may have had little or no experience in primary care and are therefore limited in what they can do. The GPN will initially need direct supervision after attending study days for specific clinical procedures. This is to ensure they become competent and confident before performing procedures autonomously.

• Course days – as part of the programme, GPNs are expected to attend the entire

specified course including the enrolment process. Course modules will vary and practices need to be flexible as the days at the HEI may change.

• Mentors time – mentors will be required to give the nurses the appropriate amount of

designated time for supervision and completion of the relevant documentation. Mentors may also require support from their peers and may from time to time attend/liaise with the peer support groups set up by the local Training Hub.

Assistance to achieve the expectations will be provided with the salary support funding from their local Training Hub via the . There will be a reporting mechanism between each individual practice and the Training Hub. Responsibilities and Expectations of Nurse Mentors *Changes to mentorship will be introduced by 2020 in accordance with the NMC All registered practitioners have a responsibility to support learners. It is a rewarding experience and one of the best ways of keeping professional practice up to date and of a high standard. Within the practice, the nurse mentor is expected to:

• Be a registered practitioner who has successfully undertaken a mentor preparation programme recognised by the NMC. This would include information about the role of the mentor, the supervisory and assessment aspect of practice and meeting the needs of students when concerns arise.

• Attend all necessary updates and meetings in order to be conversant with the trainee’s particular programme, and at a minimum a yearly half/whole day mentor update delivered by the higher education institution.

• Evidence effectiveness of their mentor role through participating in Triennial Review to

enable them to remain on the live Mentor Register.

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• Receive and act on trainee feedback to ensure continuous improvement of the trainee’s experience in practice.

• Demonstrate empathy, persuasion and negotiating skills when conveying highly

complex information in hostile environments where there may be challenging attitudes and behaviours posing barriers to understanding and co-operation.

• Facilitate the practice experience needs of the trainee GPN and provide one to one

support and mentorship of the nurse assigned to them.

• Act as an excellent role model to colleagues to ensure high standards of care, including supporting clinical innovation, excellence in clinical practice and to shape the future of the profession.

• Act as an advocate for the service and role, demonstrating delivery of national and

local requirements through the relevant service model and within a transformed service.

• Promote and share evidence based practice within the team and with partners.

• Ensure there is flexibility for the trainee to attend the course days and enrolment

process at their education provider.

• Allowing the trainee to practice in a safe and supportive environment.

• Being mindful of the trainee’s limitations, especially at the beginning of the programme.

• Must complete all relevant competency documents as provided by the education provider.

• Liaise with the education provider to:

- Gain an understanding of the modules that will be covered throughout the

programme and how they might complement the modules in a clinical setting. - Gain an understanding of the purpose of the Practice Assessment Documents

(PADs) to include advice for effective and timely completion. - Provide the nurse with an appropriate selection of patient consultations so

competencies can be achieved, which mirror their course programme where possible.

- Open and clear communication styles. - Keeping the nurse up to date with practice developments that could affect their

employment or progress on the programme.

Responsibilities and expectations of the Trainee General Practice Nurse Nurses will be employed in a practice for 19 hours a week and assigned a mentor before they start the programme. It is expected that they will demonstrate willingness to develop their skills

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and knowledge in general practice whilst combining clinical learning and applying theory learnt during academic course. Nurses will also be expected to:

• Attend all the course days as delivered by their education provider.

• Complete all the module competency documents and assessments in the designated time.

• Keep their mentor updated after each course day to share learning and agree

appropriate clinical experience to compliment learning.

• Get fully involved in “practice life” and contribute when appropriate.

• Be aware of own limitations; only working autonomously once competent and confident to do so, have a wiliness to ask for assistance and advise when necessary.

• Be prepared to attend an additional mentorship module as provided by their education

provider, which will enable them to become the mentors of the future. Responsibilities and Expectations of London South Bank Universities London South Bank University will be responsible for providing the education provision for the ‘new to general practice nurses’ for 2019-20 programme year, as well as an additional mentorship module. They will:

• Allocate a separate day for the enrolment process. • Provide all the nurses with their Practice Assessment Documents (PADS) on the first

course day, or at the earliest possible opportunity. • Liaise with the nurse mentors to:

- Share the details of the modules and discuss how to complement the modules in a clinical setting.

- Explain the purpose of the PADs and provide possible advice for effective and timely completion.

- Liaise with the nurses to ensure clear and coherent expectations for the educational provision provided to them.

Funding The funding allocated to practices in Waltham Forest is solely being provided to support the trainee’s learning and to allow them to have protected time to learn as well as their salary at the practice.

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Practices agreeing to employ a new nurse for 11 months 27 days and for committing to provide a suitable learning environment will receive the following:

• A trainee GPN working for 11 months 27 days (19 hours per week in practice, of which the remaining 18.5 hours will be marked as attendance with the training provider)

• WF Training Hub currently provides Practices with £16,316 (Band 5.5) as a contribution towards full salary for the trainee. However this is reviewed on a year by year basis.

• Mentorship training or updates for your existing GPN. • All university tuition fees will be paid directly to the Education Provider by HE NCEL.

To provide the allocated funding to the host practices, Waltham Forest has implemented a way of managing its outgoing finances from the Training Hub budget in order to honour its partnership agreement with each practice, and ensure funds are released in a timely fashion. A sample of how the finances are spread out throughout the year can be seen below. For a practice receiving a funding amount of £16,316 as a salary contribution inclusive of on-costs the payments are paid quarterly.

4 monthly plan Salary AND On-cost fees Quarter 1 £4,079

Quarter 2 £4,079

Quarter 3 £4,079

Quarter 4 £4,079

Total: £16,316 Contracts Whilst on the programme, the practice is fully responsible for each allocated trainee and payment for their salary. WF acts as provider of the contract, the Practice acts as the supplier whilst the trainees are seen as the employee of the practice. For this programme, a service level agreement is drawn out between provider (WF ) and the supplier (Practice). An Honorary contract is usually drawn out between employee (Trainee Nurse) and employer (GP Practice).

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As of September 2017 the government has confirmed that students will be able to start degree-level nurse apprenticeships. It is announced that £4.5 million of funding will be given to universities to develop and launch new courses. The nursing degree apprenticeship will enable people to train to become a graduate registered nurse through an apprentice route. Apprentices will be released by their employer to study part-time in a higher education institution and will train in a range of practice placement settings. They will learn at HEI approved by the Nursing and Midwifery Council (NMC) and will be expected to achieve the same standards as other student nurses. Anyone can become an apprentice nurse, providing they meet the entry requirements for the degree programme as set out in the standards, and their employer believes they are capable of the academic learning required to become a degree registered nurse. The standards for nursing apprenticeships are as follows: The Profile: A career in nursing is dynamic and exciting with opportunities to work in a range of different roles as a registered Nurse. A nursing career will mean working with a variety of service users, families and carers, and with a range of health and care professionals and other agencies. A Nurse might be working in: a hospital, someone’s home, the community, social care or public health. Registered nurses are a key part of the multidisciplinary teams that meet the health and care needs of patients and service users. Nurses will be at the centre of teams that can include other health and social care professionals. The current Nursing and Midwifery Council (NMC) standards comprise a common core of skills and knowledge for all nursing students, with specialisms in adult nursing, children’s nursing, mental health and learning disabilities. The apprentice must meet the 15 standards required by the Care Quality Commission [as set out in the Care Certificate]. Responsibilities and duty of the role: Responsibilities will include use of their expertise to assess, plan, implement and evaluate care, putting the needs of patients and service users at the forefront. The nurse will be responsible and accountable for their own work and for reviewing the effectiveness of their actions. They will be expected to demonstrate leadership qualities whatever their role and may manage and lead colleagues. Nurses will be responsible for ensuring their own knowledge and skills are up to date, and support the development of learners and new entrants to the profession. Every nurse must uphold the NMC Code of conduct and meet the NMC requirements for continuing registration.

Nursing Degree Apprenticeship

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Roles and Responsibilities In Summary

Entry requirements for the role: The NMC approves institutions that can provide nurse education and sets standards for programmes that lead to registration as a nurse in the UK. NMC standards also incorporate the requirements of the EU directive that governs the free movement of nurses within the European Economic Area. HEI usually set the entry requirements. You are likely to need three A-levels or equivalent qualifications at level 3, plus supporting GCSEs including English, maths and a science. Prior to commencement, apprentices will have their numeracy and literacy skills assessed by the NMC Approved Education Institution to ensure the apprentice has the necessary skills at a minimum of Level 2 to meet the requirements of the programme. Qualifications: A Degree in nursing e.g. Bachelor of Science in Nursing, Post-Graduate Diploma in Nursing.

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p Professional Registration: On completion of the apprenticeship the apprentice will meet the qualification requirements to apply for registration with the Nursing and Midwifery Council. Level 6 Duration: Typically 48 months. Review date: After 3 years. Apprentices: complete the Core and one option. Values: You will be caring and compassionate, honest, conscientious and committed. Behaviours: You will treat people with dignity, respecting individual's diversity, beliefs, culture, needs, values, privacy and preferences. You will show respect and empathy for those you work with, have the courage to challenge areas of concern and work to evidence based best practice. You will also be adaptable, reliable and consistent, show discretion, resilience and self-awareness and demonstrate leadership. Standards for Competence for Registered Nurses (2015) are published by the Nursing and Midwifery Council. The skills and knowledge listed below are taken from that document. Essential skills clusters support the achievement of the standards for competence. These are:

• Care, compassion and communication. • Organisational aspects of care. • Infection prevention and control. • Nutrition and fluid management. • Medicines management.

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DEGREE APPRENTICESHIP - REGISTERED NURSE

Occupational Profile: A career in nursing is dynamic and exciting with opportunities to work in a range of different roles as a registered Nurse. Your nursing career will mean working with a variety of service users, families and carers, and with a range of health and care professionals and other agencies. You might be working in: a hospital, someone’s home, the community, social care or public health. Registered nurses are a key part of the multidisciplinary teams that meet the health and care needs of patients and service users. You will be at the centre of teams that can include other health and social care professionals. The current Nursing and Midwifery Council (NMC) standards comprise a common core of skills and knowledge for all nursing students, with specialisms in adult nursing, children’s nursing, mental health and learning disabilities. The apprentice must meet the 15 standards required by the Care Quality Commission [as set out in the Care Certificate]. Responsibilities and duty of the role: You will use your expertise to assess, plan, implement and evaluate care, putting the needs of patients and service users first. You will be responsible and accountable for your work and for reviewing the effectiveness of your actions. You will be expected to demonstrate leadership qualities whatever your role and you may manage and lead colleagues. You will be responsible for ensuring your own knowledge and skills are up to date, and support the development of learners and new entrants to the profession. You must uphold the NMC Code and meet the NMC requirements for continuing registration. Entry: The NMC approves institutions that can provide nurse education and sets standards for programmes that lead to registration as a nurse in the UK. NMC standards also incorporate the requirements of the EU directive that governs the free movement of nurses within the European Economic Area. Qualifications: Degree in Nursing. Prior to commencement apprentices will have their numeracy and literacy skills assessed by the NMC Approved Education Institution to ensure the apprentice has the necessary skills at a minimum of Level 2 to meet the requirements of the programme. Professional Registration: On completion of the apprenticeship you will meet the qualification requirements to apply for registration with the Nursing and Midwifery Council. Level 6 Duration: Typically 48

months Review date: After 3 years Apprentices: complete the Core and one

option

Values: You will be caring and compassionate, honest, conscientious and committed

Behaviours: You will treat people with dignity, respecting individual's diversity, beliefs, culture, needs, values, privacy and preferences. You will show respect and empathy for those you work with, have the courage to challenge areas of concern and work to evidence based best practice. You will also be adaptable, reliable and consistent, show discretion, resilience and self-awareness and demonstrate leadership

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Standards for Competence for Registered Nurses (2015) are published by the Nursing and Midwifery Council. The skills and knowledge listed below are taken from that document. Essential skills clusters support the achievement of the standards for competence. These are i) care, compassion and communication, ii) organisational aspects of care, iii) infection prevention and control, iv) nutrition and fluid management and v) medicines management

Core Domain You will be able to: You will know and understand: Leadership, Management and Team Working

• Be professionally accountable and use clinical governance processes to maintain and improve nursing practice and standards of healthcare.

• Respond autonomously and confidently to planned and uncertain situations, managing yourself and others effectively

• Create and maximise opportunities to improve services and demonstrate the potential to develop further management and leadership skills

• How to act as a change agent and provide leadership through quality improvement and service development

• How to systematically evaluate care and ensure you use the findings to improve people’s experience and care outcomes

• How to identify priorities and manage time and resources effectively • How your own values, principles and assumptions may affect your

practice. • How to take the lead in coordinating, delegating and supervising

care safely and managing risk either working independently or as part of a team

• How to work effectively across professional and agency boundaries • When and how to communicate with a and refer to other

professionals and agencies respecting the choices of service users and others

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APPRENTICESHIP STANDARD FOR REGISTERED NURSE Option 1 – Adult

Domain You will be able to: You will know and understand: Professional Values

• Promote the rights, choices and wishes of all adults and, where appropriate, children and young people, paying particular attention to equality and diversity and the needs of an aging population

• Work in partnership to address people’s needs in all healthcare settings

• Apply current legislation to all service users especially the protection of vulnerable people, including those with complex needs arising from ageing, cognitive impairment, long-term conditions and those approaching the end of life

• Current legislation as it applies to all service users including protection of vulnerable adults and those with complex needs arising from ageing, cognitive impairment, long term conditions and those approaching the end of life. This legislation would cover areas such as safeguarding, equality and diversity, handling information and data protection

Leadership, Management and Team Working

• Provide leadership in managing adult nursing care, understand and coordinate inter-professional care when needed, and liaise with specialist teams

• Take the lead in responding to the needs of people of all ages in a variety of circumstances including situations where immediate or urgent care is needed

• Models of inter-professional care and the role of specialist teams

• Your leadership role in disaster management, major incidents and public health emergencies and respond appropriately according to your level of competence

Nursing Practice and decision making

• Make accurate assessments and start appropriate and timely management of those that are acutely ill, at risk of clinical deterioration, or require emergency care

• Deliver medical and surgical nursing interventions to respond to adult’s full range of health and dependency needs

• Theories and models of nursing assessment • Early signs of illness in people of all ages • Theories and concepts of medical and surgical nursing • How treatment goals and service user choices may change

at different stages of progressive illness, loss and bereavement

• The range of invasive and non-invasive procedures, medical devices and current technological and pharmacological interventions

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• Recognise and respond to the changing needs of adults, families and carers during terminal illness.

• Safely use invasive and non-invasive procedures, medical devises, and current technological and pharmacological interventions

• Work in partnership with people who have long term conditions that require medical or surgical nursing, and their families and carers, to provide therapeutic nursing interventions, optimise health and wellbeing, facilitate choice and maximise self-care and self-management

• Work with the midwife and other professionals and agencies to provide basic nursing care to pregnant women and families during pregnancy and after childbirth.

• Respond safely and effectively to an emergency to safeguard the health of mother and baby

• How to work in partnership with people who have long term conditions that require medical or surgical nursing, and their families and carers, to provide therapeutic nursing interventions, optimise health and wellbeing, facilitate choice and maximise self-care and self-management

• Normal physiological and psychological processes of pregnancy and childbirth

Communication and Interpersonal Skills

• Listen with empathy and respond empathetically and positively to people of all ages who may be anxious, distressed or facing problems with their health and wellbeing

• Promote the concept, knowledge and practice of self-care with people with acute and long term conditions using a range of communication skills and strategies

• The signs and symptoms of anxiety or distress • Common long-term conditions • How to promote self-care to people with acute of long-term

conditions • The theories and concepts that underpin self-care

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Option 2 - Children

Domain You will be able to: You will know and understand: Professional Values

• Deliver child and family centred care; empower children and young people to express their views and preferences; and maintain and recognise their rights and best interests

• Recognise, respect and respond to the individuality of every child and young person

• Act as an advocate for the right of all children and young people to lead full and independent lives

• Work in partnership with children, young people and their families to negotiate, plan and deliver child and family centred care, education and support

• Offer advice and support on parenting in health and illness

• Your role as an advocate for children, young people and their families, and working in partnership with them.

• The laws relating to child and parental consent, including giving and refusing consent, withdrawal of treatment and legal capacity

• That all children and young people have the right to be safe, enjoy life and reach their potential.

• The parent’s or carers primary role in achieving and maintaining the child or young person’s health and wellbeing

Leadership, Management and Team Working

• Listen and respond to the wishes of children and young people and influence the delivery of health and social care of children and young people.

• Work with other agencies and services ensure seamless and well supported transition to adult services

• Empower and enable children, young people, parents and carers to influence the quality of care and develop future policies and strategies

• Ensure that wherever possible care is delivered in the child or young person’s home, or in another environment that suits their age, needs and preferences

• Use effective clinical decision making skills when managing complex and unpredictable

• Health and social care policies relating to the health and wellbeing of children and young people

• The role of other agencies and services in providing services to children and young people

• How to empower and enable children, young people, parents and carers to influence quality of care and influence the development of policies and strategies

• Where and when to seek extra help or advice to manage situations safely

• The range of issues that may arise during transition from children’s to adult services and how to respond to these

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situations, especially where the views of children or young people and their parents and carers differ

• Work effectively with young people who have continuing health needs, their families, the multidisciplinary team and other agencies to manage effective transition from children’s to adult services, taking account of individual needs and preferences

Nursing Practice and decision making

• Care safely and effectively for children and young people in all settings, and safeguard them.

• Deliver care to meet essential and complex physical and mental health needs

• Use recognised, evidence based, child-centred frameworks to assess, plan, implement, evaluate and record care, and to underpin clinical judgements and decision making

• Carry out comprehensive nursing assessments of children and young people, recognising the particular vulnerability of infants and young children to rapid physiological deterioration

• Include health promotion, and illness and injury prevention in nursing practice. Promote early intervention to address the links between early life adversity and adult ill health, and the risks to current and future physical, mental, emotional and sexual health of children and young people

• Use numeracy skills for medicines management , assessment, measuring, monitoring and recording which recognise the particular vulnerability of infants and young people in relation to accurate medicines calculation

• Biological, psychological and social factors throughout infancy, childhood and adolescence

• Pharmacology, anatomy and physiology, pathology, psychology and sociology, from infancy to young adulthood

• Recognised, evidence based, child-centred frameworks • The vulnerability and how to recognise the rapid physiological

deterioration of infants and young people • The central role of the nurse in preventing maltreatment, and

safeguarding children and young people. • When and how to identify and refer those at risk of

experiencing harm • The particular vulnerability of infants and young people in

relation to accurate medicines administration • Types of negotiation skills

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• Use negotiation skills to ensure the best interests of children and young people in all decisions including the continuation or withdrawal of care.

Communication and Interpersonal Skills

• Communicate effectively with children, their parents and carers

• Work with the child, young person and others to ensure they are actively involved in decision making, in order to maintain independence and take account of their ongoing intellectual, physical and emotional needs

• Use play, distraction and communication tools appropriate to the child’s or young person’s stage of development including those with sensory or cognitive impairment

• Ensure that where possible children and young people understand their healthcare needs and can make or contribute to informed choices about aspects of their care

• How to take account of each child and young person’s individuality, including their stage of development, ability to understand, culture, learning or communication difficulties and health status

• All aspects of development from infancy to young adulthood, and identify each child or young person’s developmental stage, in order to communicate effectively with them.

• How to use play, distraction and communication tools in the nursing care of children and young people appropriate to their stage of development taking into account of sensory of cognitive impairment

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Option 3: Learning Disability

Domain You will be able to: You will know and understand: Professional Values

• Promote the individuality, independence, rights, choice and social inclusion of people with learning disabilities and highlight their strengths and abilities at all times whilst encouraging others to do the same

• Facilitate the active participation of families and carers

• Promote the autonomy, rights and choices of people with learning disabilities and support and involve their families and carers, ensuring that each person’s rights are upheld according to policy and the law

• Promote the health and wellbeing of people with learning disabilities by focusing on and developing strengths and abilities

• How current legislation applies to all service users, paying special attention to the protection of vulnerable people, including those with complex needs arising from aging, cognitive impairment, long term conditions and those approaching end of life

• Understand how to exercise professional advocacy, and know when it is appropriate to refer to independent advocacy services to safeguard dignity and human rights

• That people with learning disabilities are full and equal citizens

Leadership, Management and Team Working

• Exercise collaborative management, delegation and supervision skills to create, manage and support therapeutic environments for people with learning disabilities

• Take the lead in ensuring people with learning disabilities receive support that addresses their physical, social, economic, psychological, spiritual and other needs when assessing, planning and delivering care

• Provide direction through leadership and education to ensure that your unique contribution is recognised in service design and provision

• The collaborative management, delegation and supervision skills used to create, manage and support therapeutic environments for people with learning disabilities

• How people with learning disabilities receive support to addresses their physical, social, economic, psychological, spiritual and other needs when assessing, planning and delivering care

• Your unique contribution is recognised in service design and provision

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Nursing Practice and decision making

• Improve and maintain the health and independence of people with learning disabilities through skilled direct and indirect nursing care.

• Provide direct care to meet the essential and complex physical and mental health needs of people with learning disabilities

• Recognise and respond to the needs of all people who come into your care

• Use structured, person-centred approaches to assess, interpret and respond therapeutically to people with learning disabilities, and their often complex, pre-existing physical and psychological health needs.

• Work in partnership with service users, carers and other professionals, services and agencies to agree and implement individual care plans and ensure continuity of care

• Lead the development, implementation and review of individual plans for all people with learning disabilities, to promote their optimum health and wellbeing and facilitate their equal access to all health, social care and specialist services

• Work in partnership with people with learning disabilities and their families and carers to facilitate choice and maximise self-care and self-management and co-ordinate the transition between different services and agencies

• The health and developmental needs of all people with learning disabilities, and the factors that might influence them.

• The impact of different forms of learning disability on capacity to make health related decisions and self-manage care

• The range of essential and complex physical and mental health needs that can be experienced by people with learning disabilities

• How to recognise the range of needs that people in your care may experience

• Models and theories of person centred approaches to assessment of people with learning disabilities

• How to work in partnership to agree and implement individual care plans and ensure continuity of care

• How to implement and review plans that promote optimum health and wellbeing and facilitate equal access to all health, social acre and specialist services for people with learning disabilities

• How to facilitate choice and maximise self-care and self-management and co-ordinate the transition between f services and agencies

Communication and Interpersonal Skills

• Use sophisticated communication and interpersonal skills and strategies to work with people of all ages who have learning disabilities and help them to express themselves

• Ensure people with learning disabilities and their families and carers, are fully involved in decision making

• How to communicate and negotiate effectively with other professionals, services and agencies.

• The range of person centred alternative and augmentative communication strategies and skills

• How to make relevant information accessible and understandable to people with learning disabilities

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• Use the full range of person-centred alternative and augmentative communication strategies and skills to build partnerships and therapeutic relationships with people with learning disabilities

• Make relevant information accessible to and understandable by people with learning disabilities, including adaptation of format, presentation and delivery

• Use a structured approach to assess, communicate with, interpret and respond therapeutically to people with learning disability who have complex physical and psychological health needs or those in behavioural distress

• Recognise and respond therapeutically to complex behaviour that people with learning disability may use as a means of communication

• The structured approaches to assessment and communication with people with a learning disability who have complex physical and psychological health needs or those in behavioural distress

• How to recognise and respond to complex behaviour that may be used as a means of communication by people with learning disabilities

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Option 4: Mental Health

Domain You will be able to: You will know and understand: Professional Values

• Work with people of all ages using values based mental health frameworks, using different methods of engaging people and work in a way that promotes positive relationships focussed on social inclusion, human rights and recovery, that is, a person’s ability to live a self-directed life, with or without symptoms, that they believe is meaningful and satisfying

• Address the potential power imbalances between professionals and people experiencing mental health problems, including situations where compulsory measures are used, by helping people exercise their rights, upholding safeguards and ensuring minimal restrictions on their lives

• Promote mental health and wellbeing, while challenging the inequalities and discrimination that may arise from or contribute to mental health problems

• Engage in reflection and supervision to explore the emotional impact on self of working in mental health

• How current legislation applies to all service users, paying special attention to the protection of vulnerable people, including those with complex needs arising from aging, cognitive impairment, long term conditions and those approaching end of life

• Mental health legislation and how it relates to care and treatment of people with mental health problems

• The inequalities and discrimination that may arise from or contribute to mental health problems

• The value of your own mental health and wellbeing. • How personal values, beliefs and emotions impact on

practice, and how your own practice aligns with mental health legislation, policies and values based frameworks

• How working in mental health can have an emotional impact on self

• How to reflect on practice and engage in supervision

Leadership, Management and Team Working

• Contribute to the leadership, management and design of mental health services and work with service users, carers and other professionals and agencies to shape future services, aid recovery and challenge discrimination and inequality

• How your values, beliefs and emotions affect your leadership

• How to shape future services, aid recovery and challenge discrimination and inequality

• Models of clinical supervision within values based frameworks

• Theories and models of best practice in mental health care and treatment

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• Promote and participate in clinical supervision and reflection, within a values based framework

• Raise awareness of mental health, and provide advice and support in best practice in mental health care and treatment

• Contribute to the management of mental health care environments by giving priority to actions that enhance peoples safety, psychological security and therapeutic outcomes, and by ensuring effective communication, positive risk management and continuity of care across service boundaries

• How to enhance safety, psychological security and therapeutic outcomes

• Positive risk management and how to ensure continuity of care across service boundaries

Nursing Practice and decision making

• Use a range of evidence-based psychological, psychosocial and other complex therapeutic skills and interventions to provide person centred care and support across all ages, in a way that promotes self-determination and aids recovery.

• Promote improvements to in physical and mental health and wellbeing and provide direct care to meet both the essential and complex physical and mental health needs of people with mental health problems

• Promote mental health, help prevent mental health problems in at risk groups, and enhance the health and wellbeing of people with mental health problems

• Help people experiencing mental health problems to make informed choices about pharmacological and physical treatments by providing education and information on the benefits and unwanted effects, choices and alternatives. Support people to identify actions

• Range of evidence based individual and group psychological and psychosocial interventions to carry out systematic needs assessments, develop case formulations and negotiate goals

• Range of evidence based individual and group psychological and psychosocial interventions to develop and implement care plans and evaluate outcomes in partnership with service users and others.

• The benefits and unwanted effects of pharmacological and physical treatments and the range of choices and alternatives

• How to recognise the health and social factors that can contribute to crisis and relapse management in a way that ensures safety and security and promotes recovery

• Evidence based models of risk assessment, suicide prevention, intervention and self-harm reduction

• Positive risk-taking and how to ensure that this is balanced with the need for safety

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that promote health and help to balance the benefits and unwanted effects

• Provide support and therapeutic interventions for people experiencing acute mental health problems

• Work positively and proactively with people who are at risk of suicide or self-harm, and use evidence-based models of suicide prevention, intervention and harm reduction to minimise risk

• Promote the self-determination and expertise of people with mental health problems, using a range of approaches, using a range of approaches and tools

• Maximise service user involvement and therapeutic engagement, using interventions that balance the need for safety with positive risk-taking

Communication and Interpersonal Skills

• Practice in a way that focuses on the therapeutic use of self

• Draw on a range of methods of engaging with people of all ages experiencing mental health problems, and those important to them, to develop and maintain therapeutic relationships

• Work alongside people, using a range of interpersonal approaches and skills to help them explore and make sense of their experiences in a way that promotes recovery

• Use skills of relationship building and communication to engage with and support people distressed by hearing voices, experiencing distressing thoughts or experiencing other perceptual problems

• The therapeutic use of self • Principles and theories of therapeutic relationships • How to use interpersonal approaches and skills to help

people explore and make sense of their experiences in a way to promote recovery

• Signs and symptoms that may be experienced by those with mental health problems

• How to facilitate therapeutic groups for people experiencing mental health problems and their families and carers

• How abuse and trauma impact on people’s wellbeing and the development of mental health problems

• Reflect on your own mental health and know when to share aspects of your own experience to inspire hope while maintaining professional boundaries

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• Facilitate therapeutic groups with people experiencing mental health problems and their families and carers

• Use interpersonal skills and interventions that help people disclose and discuss their experiences as part of their recovery

• Use your personal qualities, experiences and interpersonal skills to develop and maintain therapeutic, recovery focussed relationships with people and therapeutic groups

• Foster helpful and enabling relationships with families, carers and others using communication skills that enable psychosocial education, problem solving and other interventions to help people cope and to safeguard those who are vulnerable

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Assessment Flowchart

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On-programme Training, Development and Assessment Apprentices will take typically take 48 months to complete this apprenticeship during which they participate in training, development and on-going review activities. These include:

• Induction which is specific to their workplace and it is highly recommended that at a minimum this should meet the 15 standards as set out in the Care Certificate

• Degree in Nursing approved by the Nursing and Midwifery Council and delivered by an Approved Education Institute (AEI), which will include:

1. A minimum of 2300 practice hours and 2300 hours of theory. 2. Formal programmes of lectures, seminars and workshops. 3. Workplace support (NMC Mentor) in a range of practice settings in

accordance with the NMC guidelines. 4. Completion of portfolios, essays, reflective accounts and projects through

which the apprentice gathers evidence of their progress. 5. Undertaking activities to demonstrate they have met the NMC Essential

Skills Clusters. 6. Passing through the three NMC progression points. 7. Access to facilities, resources and placement opportunities as required

by the NMC standards.

• Full details of the NMC requirements can be seen in the NMC Standards for Pre –registration Nurse Education (2010).

• Highly recommended structured one to one reviews of their progress with their

employer and training provider/AEI. Additional Benefits for Apprentices 30% off adult-rate Travelcards and Bus & Tram Pass season tickets link below:

https://tfl.gov.uk/fares/free-and-discounted-travel/apprentice-oyster-photocard#on-this-page-4

Council tax reduction link Below:

https://www.gov.uk/council-tax/who-has-to-pay

NUS Apprenticeship card ( discounts in high street stores, supermarkets, online shopping etc) link below: https://www.apprenticeextra.co.uk/

http://apprenticeshipconnect.co.uk/apprentices/apprentice-discounts

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The Shape of Caring Review held by Health Education England (HEE) in 2015, highlighted a gap in the skills and knowledge between Registered Nurses and Health Care Support workers. The Government introduced the nursing associate role with a view to bridging the gap. The nursing associate role is a stand-alone role regulated by the Nursing and Midwifery Council (NMC). On successful completion of training the nursing associates will be invited to register with the NMC on the nursing associate part of the register. Whilst they are not nurses, the role will have a protected status, and as such only registrants are able to use the title ‘Nursing Associate’. The training can be used as a progression route into registered nursing. What the role looks like The nursing associate will be trained across the board encompassing Primary Care and Secondary Care settings. Training will cover the entire life course, providing care for patients from birth until old age. Learning will be on the job during employment, along with formal academic education leading to a foundation degree. On completion apprentices may then progress on to become a registered nurse either by completing a degree-level nursing apprenticeship or by taking a shortened nursing degree at university. Nursing associates will be equipped with the knowledge, skills and behaviours that enable them to support the delivery of nursing care in and across a wide range of health and care settings. The nursing associate will work within all aspects of the nursing process, providing high-quality holistic and person-centred care to individuals, under the leadership and direction of registered nurses. Registered Nurses and Nursing Associates It is intended that nursing associates contribute to the delivery of patient care. The registered nurse will still have responsibility as the primary assessor, planner and evaluator of care. Accreditation bodies are looking at ways to ensure new roles complement existing ones, and also provide pathways into nursing and other clinical professions. The role of the NMC • The NMC will serve as the legal regulatory body for the nursing associate role. • The NMC will set the educational standards for the nursing associate programme. • The NMC will set the standards which need to be met in order to enter the register as a

nursing associate. • Nursing associates will be invited to register with the NMC on the nursing associate part

of the register once training is successfully completed.

Apprentice Nursing Associate (ANA)

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Programme Approach The Nursing Associate Training Programme is outcome-based with certain requirements to be met: Apprentices must experience placements in each of the three health and care settings: hospital; at home; and close-to-home settings. While their primary training placement (and employment), will be based in one setting, they must have at least one training placement in each of the other two settings. This is to ensure that the apprentice experiences a wide range of learning opportunities and contexts to deliver the required learning outcomes. All placements should support trainees with learning activities designed to achieve the desired learning outcomes. The apprentice must successfully achieve the described outcomes on the basis of appropriate tasks and assessments meeting specified criteria. Successful completion of the programme will be based on achieving all learning outcomes. A blended learning approach is used with teaching, learning and assessment activities aligned to the learning outcomes. A creative and flexible approach is encouraged to recognise and promote inadvertent outcomes that support the overall aim of the programme in developing compassionate, competent and confident nursing associates and motivated, autonomous, lifelong learners. Outcomes are not regarded as the threshold for obtaining a pass, but rather they are intended to encourage the highest levels of achievement for all. Generic Characteristics of the Qualifying Nursing Associate A qualified nursing associate has the following characteristics:

1. Knowledge and critical understanding of the established principles in their field of study, with awareness of the limits of their knowledge.

2. Knowledge of the main methods of enquiry into the subject and the ability to use established techniques to undertake critical analysis of information to propose solutions.

3. The ability to critically evaluate the appropriateness of different approaches to solving problems and to apply these in a work context.

4. The ability to apply knowledge and skills to new situations, including in the workplace. 5. Effective communication skills in a variety of forms, for a range of audiences.

At level 5, the qualifying nursing associate will have the qualities necessary for working in situations that require personal responsibility and decision-making. They will be able to undertake further training, develop existing skills and acquire new competencies. This level 5 descriptor in terms of personal responsibility and decision-making is distinct from the requirement at level 6 (graduate nurse); which highlights qualities and skills necessary for employment requiring decision-making in complex and unpredictable contexts.

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Transferable Skills Outcomes It is expected that all Nursing Associate Programmes will ensure that qualifying nursing associates have gained, and will be able to demonstrate, a range of transferable, generic skills, attitudes and capabilities that will promote and sustain lifelong learning. This will include study and research skills, independent learning, digital literacy and reflective practice. These transferable skills should be embedded in the programmes developed by each AEI. Employability Outcomes On qualification, the apprentice will be eligible for employment as a nursing associate on agenda for change band 4 or equivalent. Nursing associates must be registered with the NMC. Entry Requirements • On entry the apprentice should demonstrate ability to work at level 2 literacy and

numeracy. • On enrolment they will be employed in a health or care role. The employee must provide

a learning environment where the apprentice can be supervised by a registered nurse or other appropriate health or care professional.

• Individuals will need to demonstrate the ability to study a programme at academic level 5.

• Individuals will need to demonstrate the appropriate values and attitudes for the

programme in line with HEE’s value-based recruitment programme. Employment and Placement Settings Apprentices will be employed in one of three heath and/or care settings. The primary placement will be in the setting where the trainee apprentice is employed. The apprentice should also experience at least two substantial external placements: one in each of the other two settings, to demonstrate breadth of experience and to achieve specific learning outcomes. Time Allocations The apprentice will be expected, over the two-year programme, to have approximately 3,375 hours (or 50% of their time, whichever is greatest) devoted to structured learning activities. This is not to draw a false distinction between ‘work’ and ‘learning’ as it is recognised that learning occurs throughout working practice. Apprentices must be released for at least 20% of the programme for academic study. The NMC requires apprentices to have protected learning time.

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Structured learning activities should include:

• Formal learning that is face-to-face or online. • Reading and study periods. • Self-directed learning – mix of practical and online. • Educational supervision and mentoring. • Assessment activities. • Teaching within the workplace. • Action learning sets. • Informal learning, for example, through blogs and social media. • Simulation. • Shadowing.

Completion of Training On successful completion of a programme, the apprentice will receive level a 5 qualification from the awarding organisation. Supervisory Arrangements The nature of supervision varies depending on the context, competency and activities being carried out by the apprentice. Supervision is primarily concerned with:

• Sharing, demonstrating and providing support. • Confidence-building. • Encouraging and developing reflective practice. • Developing appropriate skills and competence. • Supporting learning. • Providing any required guidance, signposting and information. • Helping the apprentice nursing associate to make progress.

Supervision must be ongoing and appropriate for the experience, level of competency and confidence of the apprentice and the context they are working in. Apprentices should have:

• Appropriate supervision in all work-based contexts. • Appropriate supervision or mentoring across the whole programme that will monitor

and direct progress over time. Such supervision will provide proper support to help the apprentice make the necessary clinical and educational progress.

Supervision may be provided by an appropriate manager (an occupationally competent person in a position to supervise and/or delegate to support workers) or registered healthcare professional (a registered health or care professional from any profession). For the purposes of this document, the term supervisor is used to cover both health and social care.

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Types of supervision, in the workplace: Direct supervision – The supervisor takes direct and principal responsibility for the apprentice, observing at all times when the supervisee is providing clinical care, according to the supervised practice plan. Direct supervision should be maintained until the apprentice is assessed as being safe, confident and competent to work autonomously. Indirect /remote supervision – where there is reliance on processes to provide guidance and support without the supervisor being present. This requires the apprentice to:

1. Have had appropriate training. 2. Have been assessed as competent to perform the task safely and effectively without

direct supervision (competence – knowledge, skills, attitudes and ability to practice). 3. Know their limitations. 4. Know when and how to seek advice from the supervisor.

Phased sign-off may be appropriate in staged movement from direct to indirect supervision. While retaining accountability, registered nurses may delegate specific tasks or areas of work to the apprentice that are within their competence and confidence. Hosting opportunities for General Practices Becoming a Host site for mini-rotation Bart’s health have Nursing Associate apprentices being trained in secondary care settings. As part of their training, apprentices are required to complete placements in and around the community. Apprentices are required to spend approximately 18 hours in ‘care close to home’, comprising time in a clinic style environment. LSBU is leading their academic training and suggest apprentices spend time in the following clinics:

• Leg Ulcer clinics. • Doppler diagnostic clinics. • Diabetes clinics. • Respiratory clinics. • Pulmonary rehab clinics. • Therapy clinics. • Specialist falls clinics. • Coronary heart disease clinics. • Long term conditions centre (regional specialist centre for amputees). • Walk in centre.

WF Training Hub would like to encourage primary care and social care stakeholders to support the facilitation of hosting placements, as this would provide valuable learning for students, inspiring them to seek employment in primary care once qualified. This opportunity will also provide a taster for General Practices who anticipate training their own staff on apprenticeships in the future.

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Activities Involved in a mini-rotation Engaging with the request to host mini-rotations is a gateway to gaining first-hand understanding of this new and exciting role. You will be able to shape the nursing associate to fit in with the services you provide and fill gaps you may have in your services. Hosting opportunities aim to encourage you to ‘grow your own’, by offering existing staff the opportunity to undertake a nursing associate apprenticeship once you have grasped an understanding of how this will benefit your practice.

1. WF Training Hub will work with Primary Care to identify hosting arrangements for one to two week hosting arrangement across health & social care settings.

2. WF Training Hub will give options to host sites. 3. Apprentices will keep a record of their time spent in the community. There is no

requirement for them to be formally assessed by a mentor during these 18 hours. The emphasis is on the trainee to collate their time spent during these placements.

4. You may choose to split the placement, providing opportunities across your service; maximising learning opportunities for the apprentice. Additional Benefits for Apprentices 30% off adult-rate Travelcards and Bus & Tram Pass season tickets link below:

https://tfl.gov.uk/fares/free-and-discounted-travel/apprentice-oyster-photocard#on-this-page-4 Council tax reduction link Below: https://www.gov.uk/council-tax/who-has-to-pay NUS Apprenticeship card ( discounts in high street stores, supermarkets, online shopping etc) link below: https://www.apprenticeextra.co.uk/ http://apprenticeshipconnect.co.uk/apprentices/apprentice-discounts

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Medicines are the most common treatments offered to NHS patients. Pharmacy technicians work as part of a pharmacy team under the direction of a registered pharmacist. Pharmacy technicians work as part of healthcare teams in hospitals, community pharmacies or within Primary Care. The work includes:

• Medicines management. • Manufacturing. • Aseptic dispensing. • Quality control. • Training and development. • Procurement. • Information technology. • Clinical trials. • Medicines information. • Supervision. • Management of staff.

Entry requirements To practise as a pharmacy technician you will be registered with the General Pharmaceutical Council (GPhC), after completing an accredited qualification such as:

• BTEC National Diploma in pharmaceutical science. • NVQ/SVQ level 3 in pharmacy services. • National Certificate in pharmaceutical science.

The entry requirements will vary depending on the course provider. However, as a guide employers usually ask for at least 4 GCSEs (A-C), including English, maths and science or equivalent qualifications. Showing an understanding of pharmacy and how it benefits patients, and spending some time with a registered pharmacist, to gain an understanding of the role will benefit you application. Skills and personal characteristics Pharmacy technicians need to be:

• Accurate and methodical. • Responsible. • Have ability to pay attention to detail.

Pharmacy Technician

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• Ready to refer to the pharmacist when necessary. • To have understanding of laws and guidelines on medicines. • Able to read and carry out instructions. • Interested in people’s health. • Willing to work with all types of people. • Able to explain clearly to members of the public. • Communication skills including listening. • Good customer skills. • Science skills. • Good dexterity skills • IT skills. • Organisation skills. • Training and development skills.

Training to become a pharmacy technician usually takes two years. It combines practical work experience with study, either at college or by distance learning. Courses cover:

• Human physiology. • Disease management. • Actions and uses of medicine pharmacy manufacturing. • Pharmacy Law.

In order to practise in Great Britain, pharmacy technicians must be registered with the General Pharmaceutical Council (GPhC) and have satisfied the Council’s detailed requirements. Registered pharmacy technicians have to keep their skills and knowledge up to date with annual continuing professional development (CPD). Once qualified, many pharmacy technicians join the Association of Pharmacy Technicians (APTUK). The APTUK runs courses, conferences and seminars where pharmacists can exchange ideas and update their skills. Pay and conditions Pharmacy technicians working in the NHS will work standard hours of around 37.5 a week which may include shifts. Newly qualified pharmacy technicians will usually start in the NHS at band 4 of the Agenda for Change (AfC) pay scale or equivalent. Terms and conditions can vary for pharmacists outside of the NHS, including those working in high street and retail pharmacies or for other employer providers of NHS services. Where the role can lead With experience candidates could specialise in a particular area of practice such as mental health, oncology, paediatrics, medicines management, manufacturing, quality control, education and training, information technology, supplies & procurement, clinical trials or medicine information services.

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Physician associates are collaborative healthcare professionals with a generalist medical education, who work alongside doctors, GPs and surgeons in providing medical care as an integral part of the multidisciplinary team. Physician associates are dependent practitioners working with a dedicated supervisor, but are able to work independently with appropriate support. What do physician associates do? Physician associates work within a defined scope of practice and limits of competence. They:

• Take medical histories from patients. • Carry out physical examinations. • See patients with long-term chronic conditions. • Formulate differential diagnoses and management plans. • Perform diagnostic and therapeutic procedures. • Develop and deliver appropriate treatment and management plans. • Request and interpret diagnostic studies. • Provide health promotion and disease prevention advice for patients.

Currently physician associates are not able to:

• Prescribe. • Request ionising radiation (e.g. chest x-ray or CT scan).

How physician associates fit into the NHS workforce Physician associates are dependent practitioners, however they can practise independently and make decisions with collaboration and support form clinical supervisors; meaning having access to someone who can discuss cases, give advice, and review patients as necessary. Physician associates can be found working in GP surgeries, Accident and Emergency departments, and inpatient medical and surgical wards throughout England and Scotland. In a GP surgery, physician associates see patients of all ages for acute and chronic medical care. Physician associates can refer patients to consultants in emergency care when clinically appropriate. Other duties include home visits, prescription reauthorisation, review of incoming post and laboratory results. The physician associates role can will contribute to reaching practice Quality Outcome Framework targets. Why the physician associate is not a registered or protected title Physician associate is a new role in the UK with statutory registration still being sought, therefore the title ‘physician associate’ is not a protected title. The faculty of physician

Physician Associates

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associates at the RCP, along with the universities involved in training physician associates, continues to work toward registration of the profession in order to protect the title. Physician supervision Physician associates will require a certain amount of supervision in their medical practice. This will vary somewhat dependent on a number of factors including the type of past health care experience and years of experience they have. A new graduate will require much more intensive supervision compared to an experienced physician associate. Can physician associates prescribe in the UK? Physician associates are currently unable to prescribe medications in the UK. As physician associates are not yet licensed or regulated, they are limited with regards to requests for x-rays and other ionising radiation requests. Professional indemnity insurance to practice in the UK Physician associates require professional indemnity coverage. The cost of this coverage is typically paid for by the employer. Professional indemnity may be acquired from the Medical Protection Society (MPS), Medical Defence Union (MDU) and Medical and Dental Defence Union of Scotland (MDDUS) for those physician associates working in general practice. Physician associates and other hospital staff employed by a secondary care trust may typically have some form of indemnity provided through their employing trust; this must be discussed with the employer. Additional coverage through the Medical Defence Union or other provider may be advisable depending on the physician associates roles and duties. Salary The newly qualified physician associate post has been evaluated under Agenda for Change at Band 7. Higher level physician associates (usually requiring a minimum of five years’ experience and a relevant Master’s Degree) have been banded at AFC 8a. What clinical experience do physician associates have before training? All physician associates hold at least bachelor's degree usually in a life science field. Most physician associate programmes require at least a 2:1 honours degree for entry into the postgraduate diploma course along with some prior health or social care experience. Physicians’ associates require some prior experience; often coming from occupations such as nursing, health care assistants and paramedics. Other backgrounds include:

• Athletic Trainer. • Cardiac physiologist / technician.

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• Care Home / Nursing Home Assistant / Home Health Assistant. • Clinical Laboratory Technician • Counsellor / Psychologist. • Health Care Administrator. • Health Educator. • Herbalist. • Laboratory Worker / Technician. • Midwife. • Occupational Therapist. • Operating Theatre Assistant. • Osteopath. • Pharmacist. • Phlebotomist. • Physiotherapist. • Podiatrist. • Radiotherapy Technician. • Respiratory Therapist. • Scientific Researcher.

Specialties Physician associates are working in a wide variety of specialties and settings. Most physician associates only work in one specialty but may work in more. Specialties include: Generalist specialties: Educators Emergency medicine General practice Community medicine Public health Adult medical specialties: Acute Medicine Cardiology Care of the elderly / geriatrics Dermatology Endocrinology Gastroenterology General internal medicine Genitourinary medicine / sexual health Haematology Infectious diseases Lymphoedema Nephrology Neurology

Psychiatry Rehabilitation medicine Respiratory medicine Paediatric specialties: Critical care General paediatrics Surgical specialties: Breast surgery Maxillofacial surgery Colorectal surgery Neurosurgery Orthopaedic surgery Otolaryngology Paediatric surgery Plastic surgery Spinal surgery Trauma and orthopaedics Urology Vascular surgery

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Tasks and procedures Results of the 2014 PA census survey show physician associates perform the following medical tasks or procedures. Tasks/procedures are listed in order of frequency (most frequently performed at the top of the list). Task / procedure Take medical history Perform physical examination Patient education Interpret/obtain ECG Venepuncture Psychiatric assessment IV cannulation Arterial blood gas Urinary catheterisation Suturing NG tube placement Joint aspiration / injection Nerve blocks Cervical smear Incision and drainage of abscess Dislocation Reduction

Fracture reduction Casting / splinting Mole removal Skin biopsy Surgical first assisting Lipoma removal Chest tube insertion Foetal heart tones Contraceptive implant placement and removal General new-born examination IUD removal Intubation FAST ultrasound for trauma Lumbar puncture Haematoma blocks

Paracentesis Thoracentesis Fitting of diaphragm IUD placement Pulmonary lung function tests Central line insertion Arterial line insertion Bier blocks Port placement Participate in cardiac catheterisation Cardiac stress testing Perinatal care Antenatal ultrasound Skin cancer removal DEXA scanning OGD

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Newly qualified nurses often feel ill-equipped to meet the clinical demands faced once employed into a role, with the first six months being reported as particularly stressful. Whilst preceptorships provide support for newly qualified nurses, quality and consistency vary across different clinical areas and is also dependent on how and whether the employer delivers this. Experienced nurses also face difficulty developing the skills needed to move from secondary to primary care. Whilst nursing education provides principles and knowledge that underpin the care provided by nurses across the board, the practical skills required for transition may be complex and daunting. In order to meet the changing needs of patients and service provision, new and innovative ways of recruiting and retaining staff are essential. Planning and developing for health and social care requires a workforce strategy that facilitates adaptation, so staff can access support, enabling them to develop and enhance their careers. The benefits will be a well-educated, highly motivated nursing workforce which will enhance service provision. WF requires NHS provider organisations and services to evidence that their workforce is:

• Provided with appropriate support to enable them to maintain and develop competencies in order to advance to their full potential.

• Able to demonstrate continuing professional development. • Able to access opportunities to develop collaborative team working.

What is the Rotational Nurse Programme? Waltham Forest aims to create a clear career structure by advocating development of new and existing roles and creating flexible career pathways, whilst reflecting the changing needs of patients and services delivery. In shaping the nurses of the future we have introduced the Rotational Nurse Programme which will provide opportunities for newly qualified and long-serving nurses to experience clinical practice across acute, community and general practice settings. The principles of the nurse rotation is to provide a flexible workforce with transferable skills, knowledge and experience which will serve to improve the continuity of care, give a holistic approach to the patients journey and enhance the quality of care overall. Aim of the role The rotational nurse will hold an eighteen month contract encompassing placement within an acute setting, a community setting and a primary care setting, rotating every six months. The acute setting will be within Bart’s Health services, the community setting will be within NELFT and the primary care setting will be within a General Practice within Waltham Forest. This will mean the nurse will work across Waltham Forest, Havering, Redbridge, Barking and Dagenham boroughs.

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As a registered nurse, during each placement the rotational nurse will be responsible for patient care in accordance with the setting. Specific teaching and training will be provided enabling the nurse to develop and demonstrate the competencies required for each specific setting. The nurse will be expected to work in partnership with the multi-disciplinary team and other stakeholders in order to provide an excellent standard of care. Objectives The objectives of rotation vary depending on the organisation, service and workforce need. They include:

• Improved recruitment and retention. • Improve and expand skills base and knowledge to meet patient needs. • Build team networking across departments. • Transferable skills and cross-cover working. • A culture of organisational challenge, learning and improvement. • Succession planning and career development. • Meet individual nurses’ development needs. • Raise awareness of opportunities in the wider organisation. • Provide a platform for nurses to experience different nursing opportunities.

The Rotational Nurse programme has the potential to address the current barriers that prevent nurses from exploring posts in primary care. It encourages occupational flexibility and fluidity for nurses; enabling them to explore nursing opportunities across the patient life-course and helps them to grow an understanding of a broader spectrum of nursing care. Benefits and Pathways for rotational programmes The Rotational pathways will be part of the broad spectrum of learning and development opportunities offered to the nurses recruited, aligned to the needs of the individual and the service. Benefits of rotation include:

• A nursing workforce that has the right knowledge and skills to deliver high quality patient centred care in any setting.

• The development of a generalist workforce. • Transferability of the workforce, with staff having the knowledge and skills to work

across boundaries. • An opportunity to broaden the skill ranges of staff in areas outside of their normal

practice. • A nursing workforce that is responsive to the needs of patients across all healthcare

settings. • To offer both newly registered and experienced practitioners a structured and varied

experience. • An opportunity to improve working relationships across services and organisations. • The potential to develop career pathways, opportunities for succession planning and

support personal and professional development.

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• Helps achieve the strategic aims for nursing within Waltham Forest, which includes collaboration with the Higher Education Institutes.

The rotations programme has been developed within the North East London Super Training hub which is supported by NCEL Health Education England HEE and links together with the WF Training Hub and the BHR Training Hub. The pathway for the eighteen month nurse rotation will be arranged in six monthly placements as follows:

Competencies for the rotational programme The competency framework designed for this programme will allow the nurse to expand their level of knowledge and skills in considering the wider picture, including understanding the adult in the context of their family and the community. It is expected that the nurse will undertake a number of task and activities, working to increase their level of competence, whilst adhering to the NMC code of conduct in line with the principles of accountability. The competencies for this programme have been designed to support, assist, encourage and develop the nurse’s skills in being a competent accountable practitioner. Working in the different settings will help the nurse to develop a holistic view of the patients’ journey and an understanding of how healthcare professionals across these settings contribute to the health and wellbeing of individuals within the community. These skills will support new ways of working to provide safe and effective care which meets defined needs of patients and their families. It further develops the nurse’s ability to be self-directed throughout their professional careers and supports lifelong learning, and continuous quality improvement in care delivery. The nurse on the rotational programme is expected to complete preceptorship competencies in accordance with their employing organisations policy for new nursing staff.

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Competencies for the nurse to meet whilst in your practice: • Immunisation. • Cervical cytology. • Health promotion. • Care of the deteriorating patient. • Care in the community setting. • Secondary care. • Stroke care in Primary and Secondary settings. • Mental health. (Mental Health Act) • People living with dementia. • Safeguarding vulnerable adults. • Commissioning for quality. (care quality indicators) • Care planning. • Evidence based assessment skills.

Each nurse on the programme will be allocated a mentor during each six month placement period but will be required to self-assess their progress in each placement. WF Training Hub and its stakeholders will support the training for the nurses and the mentors for the duration of the rotation. How the contracts are held The Service level agreement is provided through NELFT in collaboration with WF Training Hub, BARTs, Barking Havering & Redbridge and Waltham Forest Primary Care. Each employer (NELFT, BARTs and the GP Practice) will hold a contract for each rotational nurse. To allow the nurses to rotate across the three placement areas each nurse will also hold an honorary contract with the other two placement areas. Salary Cost Practices must commit to providing a suitable learning environment for the rotation nurse. GP Practices acting as the employer host for the eighteen month rotation programme will be solely responsible for the full salary costs of the employed nurse; for the duration they have agreed. The salary for the role is AFC Band 5 or equivalent. Training Cost Each Nurse on the programme will need to have an allocated mentor during the entire eighteen month rotation placement. WF Training Hub and its stakeholders will support the training for the nurses and mentors for the duration of the rotation. Support and Mentorship The Nurse on rotation will be supported by a senior nurse within the Practice. Nurses on rotation must engage in communicating any changes to the senior nurse on a daily basis in

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order to aid care planning. They will work closely with team members, regularly discussing and delivering reports and evaluating patient care. Person Specification Rotation Nurse Band 5 Essential Desirable Measurement Demonstration of Trust Values

Putting people first

Application Form Interview

Prioritising quality

Application Form

Interview

Being progressive, innovative and continually improve

Application Form Interview

Being professional and honest

Application Form

Interview

Promoting what is possible, independence, opportunity and choice

Application Form Interview

Qualifications NVQ level 2 or equivalent standard of literacy and numeracy

Application Form Assessment

Registered Nurse (general)

Application Form

Evidence of other post registration education and training

Application Form Interview

Evidence of personal development

Application Form Interview

Completed study at Diploma/Degree level

Application Form

Experience Commitment to working as part of a multi-disciplinary team

Application Form Interview

Able to deliver core service requirement

Application Form Interview

Knowledge An awareness of NHS Plan, NSF and clinical governance priorities

Application Form Interview

Key issues in service area

Application Form

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Good understanding of Clinical Governance

Application Form Interview

Knowledge of services provided by other agencies

Application Form Interview

Knowledge of health promotion approach

Application Form Interview

Knowledge of research methodology

Interview

Understanding of and ability to carry out audit

Interview

Knowledge of guideline development

Interview

Skills Basic awareness of IT and IT skills

Application Form Interview

Good interpersonal and organisation skills

Interview

Time management skills

Interview Assessment

Excellent verbal and written communication skills

Application Form Interview

Ability to innovate and motivate

Interview

Ability to manage work as a team member

Interview

Ability to undertake mentorship/preceptorship

Interview

Value service users as partners in health care provision

Interview

Commitment to the provision of high quality care

Interview

Commitment to the future development of the service

Interview

Other To be aware and demonstrate the Trust Values

Application Form Interview

To be able to travel efficiently throughout the area

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Background - National The International GP Recruitment is an NHSE led programme established in August 2017 in line with the GP Forward View to recruit GPs internationally to work in general practice, particularly in areas where there is a shortage of GPs. Initially this will focus on doctors from the European Economic Area (EEA) whose training is recognised in the UK under European law and who get automatic recognition to join the General Medical Council’s (GMC) GP Register. The Royal College of General Practitioners (RCGP), working with the General Medical Council, are reviewing the curriculum, training and assessment processes for GPs trained outside the EEA, beginning with Australia, to identify whether the GP registration process can be streamlined for those doctors whose training is seen as equivalent to the UK GP programme. HEE’s role within this programme is to support NHSE with the training and educational support of programme recruits. These are:

• Recruitment • Approval of practices • Training and educational support

Initial reports back from participating regions have indicated a lower number of applicants to the programme than expected.

More information on the national programme can be found on More information on the national programme can be found on https://www.england.nhs.uk/gp/gpfv/workforce/building-the-general-practice-workforce/international-gp-recruitment/.

London Region The London region plans to recruit 313 international GPs (IGPs) in four phases. Sustainability and Transformation Partnerships (STP) allocations are outlined in the table below. Current plans see North East and South East London begin the recruitment process in mid-June, with North Central London following shortly afterwards - the table is organised to reflect this timeline.

In February 2018 4 of the 5 participating regions secured a recruitment supplier to support the programme. A delay is the appointment of the recruitment company for London has placed the region approximately three months behind the other regions participating in the

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IGPR programme. The recruitment agency who will act as the London supplier is Head Medical the leading UK-based specialist in international medical recruitment. An induction meeting was held between Head Medical, NHSE, HEE, South East and North East London on 14 June 2018.

The first and second interviews (video interviewing) for cohorts 1 and 2 of the London programme began July-September 2018.

Other key milestones include the Community Education Partnership Networks (Training Hub) to support practice approvals (see section 4 below) (25 July 2018), practice visits to non-training practices for approval to participate in the IGPR programme (July-October 2018), and the Clinical Supervisor training event (TBC).

Model Some areas have opted for individual employment model with their Practice. In North East London however the approach is a federation employment model so that IGPs can potentially be rotated in a hub & spokes model across other Practices. They will however have always have a base GP satellite site they are working from.

Education HEE is responsible for the educational governance of the IGPR programme.

IGPs will be supported throughout the IGPR programme by HEE, the chart below helpfully outlines the educational support that the IGP will be in receipt of throughout the programme.

Local Training Hubs are engaged with this programme supporting Practices with their journey towards becoming a training practice and supporting learners including IGPs.

IGP Preparatory Phase The aim of the preparatory phase is for the IGP to maximize their exposure to UK General Practice, and for their supervisors to assess the doctor’s needs in order for them to successfully complete the I&R scheme and achieve inclusion onto the MPL. During this period:

• IGPs will undertake a period of observer-ship within a GP practice, supported by their assigned clinical supervisor;

• A weekly HEE training course, will support the IGPs training, this will include contextualised language and clinical skills training as well as consultation skills.

• There will also be a separate English language training designed to support those IGPs with IELTS below 7.5

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Observership During the observership, direct clinical activity with patients will be restricted; IGPs will focus on learning about the structure and functions of local general practice guided by their supervising GP and other clinical staff as appropriate

• Tasks during the observership will be limited to: • Observation of consultations and clinical procedures • Observation of On-call activities • Regular de-briefs • Opportunity to lead consultations under direct observation. The supervising GP must

always take clinical responsibility for the consultation • Attendance at clinical and MDT meetings, in practice and locality and Training Hub • Self-directed study, with needs identified and documented • Observation of secondary care clinics in order to meet identified learning needs

How does a Practice Get Involved? Non Training GP Practice Where your practice is not already approved as a training practice, information gathering will be required to ensure your practice has the appropriate educational, organisational and pastoral support for hosting an IGP.

To participate in the International GP Recruitment (IGPR) programme your practice will need to work with the London Health Education England (HEE) office and local Community Education Provider Network (Training Hub) to be approved as training environment. In addition to this you will need to have a GP in your practice trained as a Clinical Supervisor (CS).

Once you have indicated your interest to participate in the IGPR programme to your local STP IGPR office, they will be able to signpost you towards the appropriate HEE and Training Hub contact who will work with you to arrange a visit to your practice.

Ahead of your visit you will be asked to fill in the practice approvals application form which is attached at APPENDIX A of this document. The Training Hub IGPR leads will be able to support you through the process of completing this document and answer any questions you may have.

The Training Hub IGPR leads will then assess the evidence you have provided to ascertain your ability to meet programme criteria based upon HEE Quality Standards.

The Training Hub leads will visit your practice on an agreed date to assess the readiness of your practice to host a learner.

Once your practice has completed the readiness assessment and committed to signing the three way learning agreement your practice’s name will be shared with HEE who will work with local leads to identify placements for the international GPs.

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Training GP Practice Where your practice has already been approved as training practice, minimal information gathering will be required for you to participate in the IGPR programme. Your practice will need to work with Health Education England (HEE) London and your local IGPR office to ensure you have identified the IGP’s Educational Supervisor (ES) and undertaken an HEE IGPR briefing. HEE London also request that you read the HEE guidance on Supporting Safe Transition For Internationally Educated Health Professionals (IEHPS) Working in the NHS in London. Clinical Supervision Each IGP should have a named Clinical Supervisor (CS) for each placement who is responsible for ensuring that appropriate supervision of the IGP’s day to day clinical performance occurs at all times, with regular assessment and feedback to both IGP and educational supervisor.

The GMC definition of a CS is 'A trainer who is selected and appropriately trained to be responsible for overseeing a specified trainee’s clinical work and providing constructive feedback during a placement’.

Educational Supervision The GMC definition of an Educational Supervisor (ES) is 'A trainer who is selected and appropriately trained to be responsible for the overall supervision and management of a specified trainee’s educational progress during a training placement or series of placements. The Educational Supervisor is responsible for the trainee’s Educational Agreement.'

Costs A standard International GP training phase period salary equivalent to £3000 per month (net) during the preparatory phase, followed by a salary equivalent to £3500 per month (net) for I&R scheme period, until the participants have gained entry to the National Medical Performers List (salary for this period is funded by NHS England).

Access to employer contribution pension during the three year IGPR Programme. NHS England will fund pension contributions and other on – costs during the preparatory and I&R phases. These costs will be reimbursed to the Employing Organisation. The Employing Organisation is responsible for meeting these costs once the participant completes the preparatory and I&R phases

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Access to benefits to at least the minimum statutory pay and benefits requirements e.g. maternity pay, for the duration of the three year IGPR Programme (the benefits for this period are funded by NHS England).

Placements also get monthly payment for around £6-700 to host an IGP.

HEE are hosting a session for interested Practices. Clinical Supervisor training dates will now be held on:

• January (22/1/19) • April (2/4/19) • June (5/6/19)

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In September 2014, a commitment to recruit more nurses and provide more training was announced. There are many nurses who have taken a break from nursing and may now want to return to the profession. In order to return the nurse will need to complete a number of practice hours and meet a number of requirements to re-register with the Nursing and Midwifery council (NMC). A structured programme to help nurses wanting to return to practice can provide a manageable route back into nursing. The return to practice programme is a combination of classroom and placement based learning. Hours on placement will be negotiated on an individual basis, according to what is needed to meet NMC requirements. The programme can take from six to twelve months to complete and is a good way to build the skills and knowledge needed so the nurse can feel confident to return to the role. For a proportion of the programme the nurse will be taught at a university, with tutors supporting their learning experience. The nurse will be required to attend clinical placements where a mentor will work with them, teaching competences in clinical skills and evidencing completed competences and achievements. Throughout the programme Nurses will develop a portfolio, demonstrating their skills, which will be sent to the Nursing and Midwifery Council to record the completion of their return to practice programme and re-registration. Eligibility - Lapsed NMC registration for UK Nurses. - DBS check and have satisfactory occupational health clearance. - An approved placement to undertake this programme. Funding & courses All courses are fully funded and candidate will not have to have to pay any course fees as a returner. The funding is available for nurses who currently reside and work in England. Nurses from outside England are welcome to apply for non-funded programme. Additional financial support from HEE will be available to provide a one off contribution of £500 to nurses returning to practice to assist with costs and expenses. Each local education and training board (LETB) will have more information on financial support available to all candidates. Other questions you may have are answered at http://comeback.hee.nhs.uk/Find-Out-More

Return to Nursing Programme

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Often Return to Practice placements may lead to a permanent position within that organisation. Local LETB will have further information on the opportunities available in the Waltham Forest area. Part-time return to practice courses will also be available. With support from local LETBs, and following successful completion of the return to practice course, candidates can search for employment that meets their requirements. Hours Flexible working for nurses is an option. Each candidate is encouraged to discuss this with their local LETB when applying for a course and subsequent employment on an individual basis. Benefits This programme offers easy access to nurses who want to return to practice after having a lapse in registration or a break from nursing. The programme provides the nurse with up to date, evidence based practice skills and knowledge allowing them to feel confident to re-join the profession. Testing on Literacy and Numeracy skills Candidates considering accessing a Return to Practice Course and are concerned about their literacy and numeracy skills, can access the SNAP testing tool to develop and improve their existing skills. The tool can be accessed at www.snap.nhs.uk In order to use the tool, candidates will need to register as detailed below:

• Click on ‘Register’ and then ‘Healthcare Professional’ • Select ‘National Return to Practice campaign’ from Organisation drop down menu • Select ‘Nursing – Return to Practice’ from Directorate drop down menu • Select ’RTP Applicants’ from Department options

All candidates will then be asked to complete a short registration form to create a personal username and password. After completing the form candidates will receive a message confirming that their registration is awaiting approval and will receive a further message within a few days to inform them that their registration is complete. How to embark on the programme Candidates are encouraged to apply directly through the HEE website using the following links and to also find out more about the courses available in their area. http://comeback.hee.nhs.uk/Find-Out-More and http://comeback.hee.nhs.uk/Apply

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Information on ‘return to practice’ programmes City University London Contact officers: Sarah Storer, Lecturer +44(0)795 176 0141 +44 (0)7951 760 141 sarah.storer.1@city.ac.uk Ben Teh, Programme Leader Email address: b.teh@city.ac.uk +44 (0) 1708 743 251 +44 (0) 795 724 1582 Course dates: The course runs three times a year in the autumn, spring and summer terms. http://www.city.ac.uk/courses/cpd/return-to-practice-nursing Please contact info@ncel.hee.nhs.uk Local website: http://ncel.hee.nhs.uk http://ncel.hee.nhs.uk/our-work/nursing-return-to-practice/ All other enquiries Email: ReturnToPractice@wm.hee.nhs.uk RTP National Line: 0121 695 222

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Waltham Forest Training Hub have celebrated successful implementation of the New to General Practice Nursing programmes over the past three years supported by funding from HEE. A forth wave of General Practice Nurse Trainees for the year 2019-2020 which is part-funded, hopes to provide the same success.

In order to build a sustainable workforce in the area of general practice nursing and to ensure we can meet the growing demand for enhanced and extended care provision, WF Training Hub are investigating alternative training options to make the journey into practice nursing more accessible.

We want to encourage newly qualified nurses to choose general practice nursing as a first career choice, and also want to make entry into practice nursing accessible for nurses in secondary care. We aim to demonstrate that all nurses entering primary care can obtain the skills, knowledge and aptitude necessary to undertake the role in a relatively short period of time. GPs can be confident that recruiting a nurse, inexperienced in general practice is a feasible option as WF Training Hub will support fast-track training and development of their nurses.

Foundation programmes

Foundation programmes into primary care nursing are available from all seven Higher Education Institutes (HEIs) serving London. The HEIs programmes vary; offering Level 6/7, 20-60 credits and last around 6 months. Foundation programmes broadly offer ‘start up’ skills based training for newly qualified nurses (NQNs) and/or new to employment in General Practice. At the end of the programme the nurse meets Level 5/6 competencies (HEE GPN framework) including cervical sampling, childhood immunisations and travel vaccinations and will be ready to work autonomously as part of the General Practice team.

The Training Hub will assist GPs who recruit nurses ‘new to general practice’, to secure funding and provide guidance so the employee can undertake the GPN foundation training. Funds will also be made available to support mentorship of the new nurse.

General Practice Nursing Training Programme: Foundation – Programme guide outlines:

General Practices’ role

To enable this to work effectively practices will need to:

• Inform Training Hubs of GPN vacancies. • Recruit nurses who have an interest in attending the programme and developing their

skills. • Support current GPNs who are new to the role to attend the programme. • Liaise with Training Hubs to identify trained and qualified nurse mentors.

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Once the nurses have been recruited and are on the programme, practices are expected to:

• Release their GPN to all HEI training days and clinical supervision sessions. • Pay a band 5 salary range, dependent on experience. • Employ for a minimum of 2 and maximum of 4 days per week (one day a week to be

allocated to the designated course days). • If the GPN is already employed by the practice for 5 days a week, allow them to

attend the required weekly course day in addition to the initial enrolment day. • Provide with basic training on EMIS or equivalent as part of standard practice

induction. • Provide with full EMIS (or equivalent) training on the specific templates. • Provide with access to all statutory and mandatory training. • Enable mentors to liaise with the education providers to:

Gain an understanding of the modules that will be covered throughout the programme and what would complement the modules in a clinical setting.

Gain an understanding of the purpose of the assessment documents to include advice for effective and timely completion.

Community Education Provider Networks (Training Hubs) role

It is expected that Training Hubs will:

• Identify practices with qualified mentors who want to participate in the programme. • Support practices to fill their nurse vacancies, ensuring practices are aware of the

programmes available to up-skill those with little or no general practice exposure. • Provide the mentors and practices with as much information as possible about the

programme and employment terms of the nurses (including this document) to enable them to know what is expected including: Salary guidance – Agenda for Change (AfC) band 5 (see link below):

http://www.nhsemployers.org/your-workforce/pay-and-reward/agenda-for-change/pay-scales

Hours - minimum of 2 but ideally 4 days in practice per week (plus study days).

study days Additional mentorship module after completion of the course.

• Identify existing general practice nurses who are new to their role and required

training. • Liaise with practices to determine which HEI education provider is best suited. • Provide regular, clear and open communications. • Provide HEE and Higher Education Institute (HEI) providers with the names and

contact details of nurses and their assigned mentor/practice. • Provide the participating practices with training grant funding, received from HEE.

This money can be used by the practice towards the mentor’s time with their mentee and to release the nurse to attend the educational programme.

• Produce an SLA between the Training Hub and practice, detailing the above as well as any expected reporting mechanisms.

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• Ensure there is a mechanism for the mentors and educational providers to liaise together so there is harmonised training with no duplicated sessions. Act as main point of contact for nurses and practices with queries and

questions. Set up mentor peer support groups to allow for sharing good practice and

general peer support.

General Practice Nurses (GPNs)

GPNs will already be employed in a practice (for between 2 and 4 days a week) with a named mentor before they start the programme.

GPNs are expected to:

• Attend all the course days as delivered by their education provider • complete all the module competency documents and assessments in the designated

time • Keep their mentor updated after each course day to share learning and agree

appropriate clinical experience to compliment that learning. • Get fully involved in “practice life” and contribute when appropriate. • Be aware of own limitations, working in line with the NMC code of conduct and not

expected to work independently without approval from their mentor.

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Foundation in General Practice Nursing Process Map

HEE co-ordinates with education providers for provision of Foundation programmes

Training Hubs identify GP practices/ GPNs wanting to participate on Foundation

Training Hubs liaise on the uptake of GPN Foundation training places between

General Practices Education

providers (HEIs) HEE

Trainee GPN employed in General Practice/Starts Foundation programme

Training Hub provide audit of GPN numbers to HEE for

interim

GP Practices invoice their local Training Hub for

training and mentor costs

Trainee GPN completes induction and enrolment

Process to start

HEIs provide ‘actual’ GPN enrolment numbers to HEE

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An Introduction to the Apprenticeships & the Apprenticeship Levy Background Information Apprenticeships are training courses that are mainly taught in the workplace with a guideline of 20% formal off the job training. From April 2017 new policy framework will authorise apprenticeships at all education levels and bring in a structure of training, end point assessments and an accreditation body. Training will be conducted by an external provider such as a college or other education provider. Employers and the Government will co-invest in apprenticeships. Some employers will contribution to an Apprenticeship levy. All employers with a payroll over £3million will be subject to the levy from April 2017. They will pay a 0.5% tax on payroll which they will be able to claim back as digital vouchers for Apprenticeships. The Levy is paid whether or not an employer takes on apprentices. Levy funding can only be used to pay recognised training providers to deliver training, education and assessment required to deliver apprenticeships. Funding pays for training and assessment only, not salary costs. The employer will need to negotiate with training providers to determine the exact cost of training and assessment, if the cost exceeds the funding band allocated by the Skills Funding Agency, the employer will be required to pay the additional cost. It is recommended that employers carry out a tendering process in relation to this. These financial aspects provide the focus for the timing of this project. Existing apprenticeship programmes across the STP have shown that apprenticeships can offer sustainable routes into careers in health and social care, and this new funding can be deployed to expand these opportunities and develop a bespoke trained workforce for the health sector in crucial roles. Whilst apprenticeships have traditionally focused on lower banded roles, the creation of degree level apprenticeships allows for recruitment and career paths into roles such as registered nursing and physicians associates. Given current recruitment issues and the uncertain impact of the abolition of the nursing bursary, these new routes into healthcare can serve as a sustainable source of recruitment and retention of workforce in primary care. The Government have set out a Public Sector apprenticeship target, for workplaces to recruit 2.3% of its workforce into apprenticeships. This target is assessed as an average of apprenticeship starts against established staff numbers in the years 2017-20 and will amount to a target of at least 2000 for Public Sector bodies in the area, in additional to apprenticeship starts in non-statutory Social Care. Government guidance sets out a range of other changes to apprenticeship including approving the creation of degree level (level 6 & 7) apprenticeships. Apprenticeships will therefore be options at all levels of the workforce in terms of training. They generally consist of workplace based assessment supplemented by classroom teaching and an end point assessment by an

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independent body. Apprenticeships last at least a year, and up to four years in some cases, and are available to existing and new staff. Payments from the Digital Apprenticeship Service are determined by funding caps tied to the training standard being used. This ranges from Band 1 (£1,500) to Band 15 (£27,000) for the total time of the relevant apprenticeship. Science and technology engineering and mathematics (STEM) subjects attract the highest banding. Apprenticeship levels Apprenticeships are available at four levels:

• Intermediate apprenticeships - follow work-based learning towards level 2 – equivalent to 5 GCSEs A* - C.

• Advanced apprenticeship - follow work-based learning towards level 3 – equivalent to 2 A-Levels.

• Higher apprenticeships - follow work-based learning towards levels 4, 5, 6 & 7 – equivalent to a foundation degree and above.

• Degree apprenticeships - follow work-based learning towards levels 6 & 7 – equivalent to a full bachelor’s or master’s degree.

T Levels T Levels are a new technical based qualification being introduced between 2020 and 2022 in England. The aim of the new T Levels is to improve the teaching and administration of technical education. The T Levels will be a Level 3 qualification on the Regulated Qualifications Framework. APPLICATION PROCESS To apply for any of the apprenticeship roles in this catalogue please contact the Training Hub team. For application for any of the other roles in the catalogue please email the Training Hub team for further information and advice on the application process. Email: wfccg.wfcepn@nhs.net

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CONTACTS Email: wfccg.wfcepn@nhs.net Telephone: 0236882624 Website: https://www.walthamforesttraininghub.com/ Waltham Forest CEPN/ Training Hub Kirkdale House 7 Kirkdale Road Leytonstone E11 1HP