The Contributions of Non-Professionally Affiliated Staff

The non-professional affiliate staff are becoming relevant to every professional in mental health services because of shortages and the evolving new roles for professionals across the board. In the NHS, those non-professionally affiliated staff, who are engaged under the watch of rofessionals, can generally be referred to as Health Care Assistants (HCAs) but have also been known in the past as nursing auxiliaries, care assistants and health support workers. Various professionals have adopted different titles to reflect their professions e.g. OT Helper. In Social Services, community support workers have been a major staff group working with social workers and then multidisciplinary teams.

There are other non-professionally affiliated staff in mental health who do not necessarily have direct contact with patient but the role they play in service delivery are very relevant to the quality of service provided. These will include the secretaries, receptionists, and other administrative staff.

Generally speaking these groups of workers have no regulatory/professional bodies.

United Kingdom (UK) literature appears to support the introduction of non-professional affiliated role (Needham, 1996; Poole, 1998; Abbott, Johnson & Lewis, 2001). These may or may not have contact with the patient; nevertheless the essential role they play in care frees the professionals to focus on more patient specific engagement. The importance of HCAs in mental health is demonstrated by the fact that they constitute the largest number after professionally qualified nurses: 31,000 in 2003 working in mental health. It is therefore no coincidence that the focus of discussion of the role of non-professional affiliates in mental health will be significantly related to HCAs.

HCAs are health care staff who are not nurses but who are employed to perform tasks that were previously performed by nurses. Their primary role is to support nurses with the day-to-day tasks of patient care. Generally speaking, nurses in NHS have enjoyed high satisfaction with the ability of HCAs to perform tasks, communicate pertinent information and the time they release to undertake professional activities (McLaughlin et al., 2000). Notwithstanding this, there is still some considerable resistance in nursing to increasing HCA numbers and roles. Although, there has not been a specialty specific survey of mental health nurses on their perceptions of HCA performance,

anecdotal evidence suggests that while some may have concerns regarding the competence of HCAs to perform certain tasks, others value their involvement in mental health care. Spilbury and Meyer (2001) note that NVQ level-3 trained HCAs may even give better care than junior nurses.  Their introduction into services is sometime viewed with suspicion, as a way of diluting the workforce with a less expensive alternative (Meek, 1998). But more importantly, the service users’ evaluation of the role of the HCAs within a community mental health intensive care team demonstrated that a patient – centred approach related to the personal qualities of the non-professionally affiliated staff (Meek, 1998). HCA’s have got roles to play both in acute inpatient and community mental health settings.

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