Immunisation Training Standards: Part III – Immunisation Training for Healthcare Support Workers (HCSWs)

Welcome to Part III of our series. Today we will examine the training standards for Healthcare Support Workers (HCSWs) and how the administration of immunisation differs for this group of practitioners.

In addition to part III, let’s also take a quick look at the impact of lock down on clinical training.

In Wales, Scotland, Northern Ireland and England we are experiencing a range of forms of ‘lock down’. Whilst many other industries are able to transition to home working, healthcare has its limitations. At Health Academy, we do not believe that any form of ‘lock down’ should compromise care. Health Academy is led by clinicians that have worked in the NHS throughout the pandemic, therefore, we appreciate the challenges and will be remaining open throughout any form of ‘lock down’. We will continue to provide high quality clinical training, including both theory and practical elements.

Background to the Standards

The National Minimum Standards and Core Curriculum for Immunisation Training of Healthcare Support Workers document sets out a recommended minimum framework for developing training to meet the needs of HCSWs administering influenza, shingles and pneumococcal vaccinations to adults and the live attenuated intranasal influenza vaccine to children. We are currently waiting to see if the document will be amended to allow HCSWs to administer Covid-19 vaccines for when the need arises.

Can non-registered healthcare staff actually administer vaccinations?

Yes they can  – depending on their experience and qualifications. It is recommended that only HCSWs who have achieved education and training to Level 3 of the Qualifications and Credit Framework (QCF) or equivalent in England and Wales with at least 2 years’ experience as a HCSW should be considered for training in vaccine administration. HCSWs working at this level are likely to be at Level 3 or above of the NHS Career Framework or the NHS Wales Skills and Career Development Framework for Clinical Healthcare Support Workers.

Can HCSWs give vaccines on a Patient Group Direction (PGD) like Registered Health Care Practitioners?

No, not currently.

PGDs allow registered health care practitioners to administer certain ‘prescription only’ medications without being prescribers. The PGD must be written and signed by a doctor and a registered pharmacist. The administering practitioner must then read the PGD and also sign to confirm that they have read and understood it. They are then authorised to administer the medication or vaccine without the prescriber being present only if the patient falls into the categories as outlined in the PGD.

The Medicines Act does not allow HCSWs to administer Prescription Only Medicines (POMs) under a PGD as they are not included in the list of authorised persons. An authorised person is one who is professionally regulated – HCSWs therefore have to use a Patient Specific Direction (PSD) or signed prescription as authority

How can HCSWs give vaccines?

HCSWs administering injectable influenza, shingles and/or pneumococcal vaccinations can only do so under a Patient Specific Direction (PSD). A Patient Specific Direction (PSD) is a written instruction, signed by a prescriber for medicines to be supplied and/or administered to a named patient after the prescriber has assessed the patient on an individual basis. PSDs are tailored to the needs of individual patients and it is the prescriber issuing the PSD who takes responsibility for the instruction.

NOTE: The government has announced legislative changes that are currently in the process of being put in place. These will introduce further mechanisms of administration of vaccines for HCSWs – Health Academy will update when these have been finalised.

Can a HCSW administer a vaccine that has been supplied to a patient under a PGD?

A registered healthcare professional can supply non-injectable medicines under a PGD and give these to the patient for self-administration or for administration by another person e.g. HCSW. The HCSW is not administering under a PGD, nor are they being delegated the task of administration under the PGD – the PGD is purely for the supply of the vaccine. This means that a HCSW could administer the live intranasal flu vaccine to a child to whom the vaccine has been supplied by a registered healthcare professional under a PGD. Injectable vaccines cannot be supplied in this way so a patient cannot be provided with inactivated flu, shingles and/or pneumococcal vaccine under a PGD and give these to a HCSW for administration.

Does Training Differ for HCSWs

The specific training for HCSW,  whether it is foundation training for new immunisers or annual update training for experienced immunisers, will be the same for HCSWs as it is for registered healthcare practitioners. Where the difference arises in the training pathway is that the HCSW must have been delegated the role of immuniser by a practitioner on a relevant professional register, for example, the Nursing and Midwifery Council (NMC) or the General Medical Council (GMC). This delegating professional has the professional responsibility for ensuring the HCSW has met the necessary standards of competency.

Will the HCSW require supervised practice?

As with registered healthcare practitioners, a period of supervised practice to allow acquisition and mentor observation of clinical skills and application of knowledge to practice when the practitioner is new to immunisation is strongly recommended. In addition HCSWs actively involved in immunisation services must have an identified supervisor and supervision from this person must be ongoing. The supervisor must be a registered, appropriately trained, experienced and knowledgeable practitioner in immunisation. The supervisor should ensure the HCSW’s immunisation practice meets national standards and reflects current national policy.

Finally …

Next week in Part IV of our series ‘Understanding Immunisation Training Standards’, we will take closer look at training staff to give the Covid-19 vaccine.

Many thanks to everyone for the positive feedback we received about Part I and Part II of this series, we really appreciate your comments. If you missed these, you can catch-up below

If you missed Part I or Part II of this series, simply click on the links below to catch-up:

Part I – What is your understanding of immunisation training standards?

Part II – Immunisation training standards: Training Pathways

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