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

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

Health Policy, 2009, vol. 90, issue 2-3, 286-295

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.

Keywords: Assistant; practitioner; Job; descriptions; Role; redesign; Role; confusion; Social; space; Role; ambiguity (search for similar items in EconPapers)
Date: 2009
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
http://www.sciencedirect.com/science/article/pii/S0168-8510(08)00232-7
Full text for ScienceDirect subscribers only

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:eee:hepoli:v:90:y:2009:i:2-3:p:286-295

Access Statistics for this article

Health Policy is currently edited by Katrien Kesteloot, Mia Defever and Irina Cleemput

More articles in Health Policy from Elsevier
Bibliographic data for series maintained by Catherine Liu () and ().