Assistant Practitioners: Issues of Accountability, Delegation and Competence

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Assistant Practitioners-Issues of
Accountability, Delegation and Competence

• Hazel Mackey
• North Staffordshire Combined Healthcare NHS Trust
• United Kingdom

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An Assistant Practitioner is
Hazel

• A support worker, who through extra education and
  training, is able to practice autonomously,
  making clinical decisions and instigating
  treatment based on those decisions, and is
  accountable for his/her own practice.

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Aims
Hazel

• To devise new ways of working in Occupational
  Therapy
• To improve patient care
• To allow staff to deliver the care their
  qualifications and expertise deserve
• To enable career progression both within and
  across professions.

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Principles
Hazel

• Assistant Practitioners are not replacements for
  qualified staff
• Work in conjunction with senior OT Staff
• Regular supervision
• Active education and training plan
• Appointment to post is open and transparent
• Equity in roles and responsibilities.

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Level 4 Training
Lorraine

• The ability to perform a range of complex,
  technical, or specialised work activities, with
  considerable degree of autonomy and
  responsibility.

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Where
Hazel

• Discharge Planning
• Equipment Provision
• Social Reablement

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Public Accountability

• Requires that public bodies give an account of
  their activities to other people and provide
  justification for what has been done.
• Criminal
• Civil
• Contractual
• Professional

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At present Support Workers are not
professionally accountable, although a recent
consultation on regulation of Support Staff
indicates this will change. (Department of
Health 2004)
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Accountability and Vocational Qualifications

• The acquisition of a Vocational Qualification is
  not a permit to practice but merely identifies
  the holder as competent to undertake a range of
  duties in a care environment.
• Decisions as to who should do what remain with
  the Manager (Clinical).

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Assistant Practitioners and Accountability

• An Assistant Practitioner is accountable for
  their practice if they
• Have the ABILITY knowledge, skill, values
• Have RESPONSIBILITY for task
• Is given the authority to do the job delegation
  and job description.

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Delegation

• There is a distinction between Delegation, the
  transfer of responsibility for the performance of
  an activity from one person to another while
  retaining accountability for the outcome and
  Assignment, which is the downward or lateral
  transfer of both the responsibility and
  accountability of an activity from one individual
  to another.

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Vocational Qualifications and Delegation

• The introduction of Vocational Qualifications
  allows professional staff to assess the
  competence of staff and then to use their
  judgement to determine the most appropriate
  person to deliver care.

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Competence

• Different definitions
• behaviour what people can do rather than what
  they know
• Behaviour / task / situation / applied knowledge
• not an expert.

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Training for Qualified Therapist
Hazel

• Delegation skills / awareness
• Supervision
• Content of support worker qualification
• Career development opportunities.

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Conclusion

• At national level need to clarify supervisory
  and accountability issues
• Changes required to undergraduate Professional
  Training
• Professionals need career advancement
  opportunities too
• Need increase in scope and relevance of training
  for assistant practitioners.