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GPs told to prove staff are trained before receiving health checks payments

A CCG in Greater Manchester has stopped paying GPs for health checks unless they can prove that their staff has been properly trained.

NHS Trafford CCG said they asked GPs to ‘confirm their system of health care assistant (HCA) training’ after an HCA was found to be carrying out health checks but ‘did not know what cholesterol was’. 

Trafford Council, which originally commissioned NHS Health Checks, merged with NHS Trafford CCG in April.

GP leaders said the GPs have ‘a duty’ to ensure their employees are properly trained, but added that they must be ‘supported in order to do this effectively’.

According to local LMC minutes from March – first reported on by HSJ – Julie Hotchkiss, a public health official for Trafford Council, said: ‘All people delivering health checks must have proof that they have undertaken the training and are signed off to be competent to deliver them.’

She said practices have until the end of June ‘to ensure that all staff have completed all required training and are competent, and evidence sent to the health check facilitator’.

She told Salford and Trafford LMC: ‘Health Checks undertaken by staff members who are not registered with the health check facilitator will not be paid for.’

Ms Hotchkiss said this comes after ‘it was discovered that a health care assistant who had been delivering health checks for months did not know what cholesterol was, and it was therefore impossible that she would have been giving accurate advice to patients’.

She added that they would be issuing new guidance ‘spelling out the training requirements, which were not previously specifically defined although reference was made to national requirements’.

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This comes after NHS England announced plans last year to roll out health checks more widely by asking fire and rescue services to take blood pressure readings.

Dr Mark Jarvis, a local GP and medical director at NHS Trafford CCG and Trafford Together for Health and Social Care, said: ‘In order to ensure that a high quality of service is delivered to Trafford patients, and that they are receiving the best and most meaningful advice, GPs were asked to confirm their system of health care assistant (HCA) training and support to ensure they have the appropriate skillset in place to deliver the service.

‘The process for employing HCAs has not altered and practices should not have to deliver any extra training over and above what is already required, as nurses cannot delegate to HCAs unless they are confident that the HCA is competent to do the task.’

RCGP vice chair Professor Kamila Hawthorne said: ‘In the interests of patient safety, GPs, as employers, do have a duty to ensure that any person working within their practice team is properly trained and has the necessary competencies to undertake the role they are employed to do.

‘We also have a responsibility to members of our practice team to ensure that they are not asked to do work outside of their role due to clinical staff shortages. 

But she added: ‘It is important that GPs are supported in order to do this effectively.’

She said the RCGP and the RCN ‘developed a competency framework for Healthcare Assistants, that should assist with this’.

This comes as recent research revealed that the uptake of NHS Health Checks is on the decline, which researchers say could be due to poor resourcing of the programme or ‘inadequate’ engagement with healthcare professionals.

However, a study last year found that NHS Health Checks is proving a ‘remarkable success’ having prevented at least 2,500 heart attacks and strokes in England in the past five years.