The immune system

This article considers the immune system. The reader is introduced to the immune system and how the body defends itself against infectious organisms, foreign cells and self-cells that have gone awry (such as, cancer cells). The article focuses on the organs of the immune system, and vaccination is briefly discussed. The healthcare assistant (HCA) and assistant practitioner (AP) must have an understanding of the immune system if they are to offer person-centred, safe and effective care and support to people. The article concludes with a glossary of terms and a set of questions intended to reinforce learning.

The endocrine system: regulator of body activities

The endocrine system has an important role to play in the regulation of body activities and does this in conjunction with the nervous system. This article offers the healthcare assistant (HCA) and assistant practitioner (AP) an overview of the anatomy and physiology of the endocrine system and its functions; key glands are discussed. An understanding of the endocrine system can help the HCA and AP offer people care and support that is informed. There are a number of conditions that might affect the endocrine system and result in a negative impact on a person's health and wellbeing. The article includes a glossary of terms and a series of questions that can assist in learning.

The brain: our control system

The largest and the most complex organ in the body is the brain. In this article, the healthcare assistant and assistant practitioner (HCA and AP) are introduced to the fundamental features that are associated with the anatomy of the brain. The body's central nervous system is made up of the brain, along with the spinal cord. This is the main control system for the body's functions and abilities, allowing conscious communication with the body and automatic operation of the vital organs, for example, the heart. In this article, specific functions of the brain are considered. The four lobes of the brain are reviewed and also the three coverings of the meninges. Having insight and understanding related to how the brain functions can help the HCA and AP offer people care that is founded on a sound knowledge base. A glossary of terms is provided and a short quiz has also been included.

An analysis of the views of different members of the inpatient team on the role of the physician associate on the general adult psychiatric wards

AimsPhysician Associates (PAs) are healthcare professionals who have a general medical education background, having completed a two-year postgraduate degree. Whilst the number of PAs employed in healthcare trusts continues to increase, the number working in mental health settings remains small.Mersey Care NHS Foundation Trust employed two PAs two years ago. In August 2019, a third PA was recruited to work at Clock View Hospital, a general adult inpatient unit.This analysis aimed to establish the views of different members of the team across the three general adult wards and the Psychiatric Care Unit (PICU) at Clock View Hospital on the role of the PA.MethodA sample of members of staff was identified from across the three general adult inpatient wards at and the PICU, comprising: senior doctors (Consultants and Specialty Doctor), junior trainees (Core Trainee and Foundation Trainees), Ward Manager, Deputy Ward Manager, Band 5 nurse and Assistant Practitioner. Each member of staff was asked to answer the question “On a scale of 1 to 10 (with “1” being completely unhappy, “10” being completely happy), how happy are you to have a PA working on your ward?” Each staff member was then asked to provide comments on their views on the role of the PA.ResultTwenty-three members of staff participated – 3 x senior doctors, 4 x junior trainees, 4 Ward Managers, 4 Deputy Ward Managers, 4 x Band 5 nurses and 4 x Assistant Practitioners. The respondents were distributed equally across the three general adult wards and the PICU. All 23 members of staff provided a score of 10 out 10 to the question about how happy they were to have a PA working on the ward. Many of the staff members provided some very positive comments on their respective views about the role of the PA at Clock View Hospital. No negative comments were provided by any members of staff.ConclusionIt is clear from the large sample of members of staff of different grade at Clock View Hospital that were surveyed that the PA has been a warmly received and welcome addition to the inpatient team and that the PA is viewed as having become an important and valued member of the inpatient team. This provides a strong argument for both Mersey Care NHS Foundation Trust, and other mental health trusts across the U.K., to consider employing more PAs to work in their inpatient units.

A survey of the level of knowledge and understanding of members of the inpatient team on the role of the physician associate on the general adult psychiatric wards

AimsPhysician Associates (PAs) are healthcare professionals with a general medical education background, having completed a two-year postgraduate degree. Whilst the number of PAs employed in healthcare trusts continues to increase, the number working in mental health settings remains small.Mersey Care NHS Foundation Trust employed two PAs two years ago. In August 2019, a third PA was recruited to work at Clock View Hospital, a general adult inpatient unit.This survey aims to establish what level of understanding different members of the inpatient teams across the inpatient wards have of the tasks PAs are permitted to undertake and those they are not.MethodA survey was designed, listing 37 tasks, e.g. completing an admission clerking. For each task, the participant was asked whether a PA is allowed to complete it or not, with three options provided – “can carry out the task”, “cannot carry out the task” and “do not know.” A score of + 1 was awarded if the correct answer was provided, –1 for an incorrect answer and 0 if the respondent didn't know. The highest possible score for a completed survey was + 37 points; the lowest possible score was –37 points.A sample of survey respondents was identified from the three general adult inpatient wards at Clock View Hospital and the Psychiatric Intensive Care Unit (PICU), comprising: senior doctors, junior trainees, Ward Manager, Deputy Ward Manager, Band 5 nurse and Assistant Practitioner.ResultTwenty-four members of staff completed the survey – 3 senior doctors, 4 junior trainees, 4 Ward Managers, 4 Deputy Ward Managers, 5 Band 5 nurses and 4 Assistant Practitioners. The respondents were distributed equally across the three general adult wards and the PICU. The highest survey score was 36 out of 37 (a Consultant); the lowest was 18 (a junior trainee). The lowest mean score was variable across the different grades of staff, with Consultants scoring highest at 29 and Assistant Practitioners and Ward Managers both scoring lowest at 25. There was little variability in mean score (only 2 points) across the three wards and PICU.ConclusionThe results from this survey demonstrate that different members of the inpatient team have a good understanding of what tasks PAs are and are not permitted to. There is still a need to provide further education to inpatient staff to ensure they utilise the PA at Clock View Hospital appropriately and that the PA is able to develop his skill set.

The respiratory system

Breathing allows oxygen to be delivered to internal tissues and cells where it is needed, as well as facilitating the removal of carbon dioxide. An overview of the respiratory system and its key functions is provided in this article. The upper and lower respiratory tracts are discussed. It is important for the healthcare assistant and assistant practitioner (HCA and AP) to develop an understanding of the anatomy and physiology of the respiratory system and how it functions if care that is provided is to be safe and patient-focused. At the end of the article, a glossary of terms is provided and, to aid recall, a short quiz has been included.

Bridging the skills gap: apprentice assistant practitioners having an impact in mental healthcare services. Part 3. The mentor experience

Understanding the relevance of the apprentice assistant practitioner (AAP) role in mental health is important for future developments within mental health services. This third article, in a series of four exploring the potential impact of AAPs in bridging the gap in mental health services, focuses on the experiences of the mentor role. Mentorship in the development of health service workers is crucial to ensure competent, confident and skilled staff at all levels. This small-scale study looks at the experiences of the mentor in general and more specifically the experiences of a small group of mentors supporting AAPs in mental health services. A questionnaire was sent to mentors at different stages of the AAP's journey and asked them to consider three broad themes: supporting the AAP, helpfulness of the AAP standards in mentoring; and the impact of the AAP in mental health services. The results show a positive response in general from the mentors and the use of apprenticeship standards to focus the mentorship of the AAP, as well as the potential benefits the assistant practitioner (AP) role has in both supporting services users and the service as a whole.

Genetics

The role of genes in explaining, investigating or treating disease has increased. This article provides a fundamental introduction to genetics. When the healthcare assistant and assistant practitioner (HCA and AP) have knowledge and insight regarding genetics, along with an awareness of the impact of genetic disorders on individuals, they may be able to offer effective support to people as their needs dictate. All kinds of disease can have a potentially devastating and challenging impact on the individual and their family; however, when there are genetic aspects also present, this very often complicates the picture. The article concludes with a glossary and a quiz.

The cell and tissues

This article, the third in the series, will focus on the cells and tissues. The previous article ( Peate, 2020 ) highlighted the need for the healthcare assistant and assistant practitioner (HCA and AP) to have an understating of homeostatic mechanisms, so as to offer people safe and effective care, but it is also important to understand cells and tissues. The cells are seen as the basic building blocks of all living things. The tissues are made from a group of cells that have a similar structure. In this article, the various components of the cells will be outlined and discussion concerning the tissues will also be provided. A glossary of terms is provided, along with a short quiz provided to help readers remember key points.