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Assistant or substitute: Exploring the fit between national policy vision and local practice realities of assistant practitioner job descriptions

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  • Wakefield, Ann
  • Spilsbury, Karen
  • Atkin, Karl
  • McKenna, Hugh
  • Borglin, Gunilla
  • Stuttard, Lucy

Abstract

Objectives To understand the extent to which the assistant practitioner role is described as 'assistive' in formal job descriptions and analyse whether the term 'assistive' has been stretched to encompass more 'substitutive' or 'autonomous' characteristics.Methods Sixteen AP job descriptions representing all clinical divisions across one UK acute NHS Hospital Trust were both macro- and micro-analysed for broad similarities and differences in line with Hammersley and Atkinson's analytical framework. The analysis specifically focused on how clinical tasks were related to clinical responsibility, from this the job descriptors were then indexed as belonging to one of five discrete categories.Results Our analysis revealed the following categories: fully assistive (n = 1), supportive/assistive (n = 7), supportive/substitutive (n = 4), substitutive/autonomous (n = 3) and fully autonomous (n = 1). From this, a number of anomalies manifest in the form of divergent organisational expectations regarding the AP role.Conclusions This study highlights a series of tensions extant between policy vision and implementation of the AP role in practice. Introduction of new healthcare roles requires compromise and negotiation, to shape and define what social space incumbents of these and existing roles will occupy. However the way in which new roles are defined will determine how they become embraced and embedded within future healthcare services.

Suggested Citation

  • Wakefield, Ann & Spilsbury, Karen & Atkin, Karl & McKenna, Hugh & Borglin, Gunilla & Stuttard, Lucy, 2009. "Assistant or substitute: Exploring the fit between national policy vision and local practice realities of assistant practitioner job descriptions," Health Policy, Elsevier, vol. 90(2-3), pages 286-295, May.
    • Handle: RePEc:eee:hepoli:v:90:y:2009:i:2-3:p:286-295
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    References listed on IDEAS

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    1. Roy Carr-Hill & Paul Dixon & Ian Gibbs & Mary Griffiths & Moira Higgins & Dorothy McMaughan & Ken Wright, 1992. "Skill mix and the effectiveness of nursing care," Working Papers 015cheop, Centre for Health Economics, University of York.
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