title: Challenges and opportunities associated with the introduction of assistant practitioners supporting the work of registered nurses in NHS acute hospital trusts in England.
abstract: OBJECTIVE
  To understand the challenges and opportunities associated with the introduction of assistant practitioner (AP) roles supporting the work of ward-based registered nurses (RNs) in National Health Service (NHS) acute hospital trusts in England.
  
  
  METHODS
  Three case studies of NHS acute hospital trusts. This paper presents qualitative findings, drawing on documentary data sources and data generated through interviews and focus group discussions.
  
  
  RESULTS
  Introduction of APs into ward-based nursing teams has been variable, and often driven by external pressures rather than perceived organizational need. This, along with little national guidance, has created some confusion about the role, but at the same time has permitted flexible role development through 'negotiated compromise' at local level. While there are various areas of potential improvement in policy and practice, APs are generally perceived to have the potential to make a valuable contribution to patient care.
  
  
  CONCLUSIONS
  Findings from this study will help policy-makers, organizations and practitioners understand factors that enable and/or inhibit the integration of new assistant roles within existing occupational structures to develop innovative services and enhance patient care. These factors are important when considering how care will be delivered to maximize the skills of the entire nursing workforce.
authors: Department of Health Sciences, University of York, York, UK. karen.spilsbury@york.ac.uk
authors: Karen
authors: K
authors: Spilsbury
authors: Joy
authors: J
authors: Adamson
authors: Karl
authors: K
authors: Atkin
authors: Karen
authors: K
authors: Bloor
authors: Roy
authors: R
authors: Carr-Hill
authors: Dorothy
authors: D
authors: McCaughan
authors: Hugh
authors: H
authors: McKenna
authors: Ann
authors: A
authors: Wakefield
mesh_terms: D032022:Delegation, Professional; D004739:England; D017144:Focus Groups; D006779:Hospitals, Public / Q000458:organization & administration*; D006801:Humans; D008008:Licensure, Nursing; D009728:Nursing Assistants / Q000458:organization & administration*; D009741:Nursing Staff, Hospital / Q000458:organization & administration*; D019982:Organizational Case Studies; D024382:Professional Role; D036301:Qualitative Research; D013222:State Medicine