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Case Study – Northwest London Hospital NHS Trust

Creating career progression opportunities for healthcare staff to shape the workforce and promote patient-focused care

Shaping the workforce to allow services to become more patient-focused is critical for successful service provision. Managers at the Northwest London Hospital NHS Trust (now London North West University Healthcare NHS Trust), which acted as a National Demonstrator Site using Skills for Health competences, recognising a creative approach to workforce development as part of the solution.

The Trust realised freeing up nursing and professional groups, and developing the skills of existing healthcare assistants, would allow for greater workforce flexibility. A patient-focused approach is central when creating workforce development strategies, so a competency-based approach to role design was entirely appropriate.

Managers decided to develop a training programme to show how Healthcare Assistants can upskill to Associate Practitioner level, using Skills for Health competences to inform a tailored development package. The aim of the AP project was to develop practitioners who could apply their knowledge and skills to improve the patient pathway and reduce the length of their hospital stay.

The programme offered an opportunity for Healthcare Assistants to upskill and extend their responsibilities and practice beyond their current role. Candidates needed a minimum requirement of NVQ Care (Level 2 or 3) and a reference from their line manager to ensure they were suitable for the programme, which was developed and delivered in-house.

“It was a steep learning curve, but once we got to grips with the competences, they provided a focused approach to role development across a range of clinical areas. This flexibility to mix and match competences was beneficial and enabled us to use them for newly qualified and experienced staff.”

Goretti Dowdican-McAndrew, Head of Clinical Training & Education,
Northwest London Hospital NHS Trust


  • Improved patient focus supporting Line of Sight model
  • Enhanced skills mix within clinical areas
  • Development programme supports A&E targets
  • Evidence-based portfolio to support personalised learning
  • Improved career options for APs and further progression
  • Workbook developed with competences tailored for clinical areas

Nine HCAs have been working through a tailored competences package, with support of mentors and managers, across clinical areas, including A&E, theatres and admissions, urology investigation and the stroke rehabilitation unit.

The work will put the successful newly qualified APs on a career pathway for further progression, up to foundation degree level, and facilitate succession planning for other healthcare support workers. The programme has successfully enabled HCAs to upskill and enabled the Trust to target specific service areas that needed more input and support.

Managers are pleased that the project is supporting their work to meet the service needs of patients and to support HCAs who have the enthusiasm and willingness to upskill.

Skills for Health welcomes this success, which underpins the real benefits to patients of competence-based approaches to the design and re-design of roles and services.

As the Sector Skills Council for the UK health sector, we support the NHS, independent healthcare providers, and voluntary organisations. Our purpose is to help develop solutions that can deliver a skilled and flexible workforce to improve health and healthcare.

Our team of specialists here at Skills for Health has developed a bank of national workforce competences which describe the skills and knowledge required to carry out a task or function effectively. They are designed to underpin and be integral to accredited and non-accredited education and training programmes. Since competencies describe what individuals need to know and do, whoever is performing the task, they can be used in many different ways.