Background From 2003 to Autumn 2005, the National Screening Committee established a diabetes screening programme in 24 general practices across England. An independent evaluation of the pilots was carried out and provides the context for this paper.Objective To examine the expanding role of healthcare assistants in a national evaluation of the feasibility of screening for diabetes in general practice.Design Qualitative case studies employing semistructured interviews. Sample Twenty-three staff working in general practice involved with a pilot diabetes screening programme in five general practices in four regions in England. Nine pilot programme facilitators from the nine English regions were also interviewed. Findings Pilot screening for diabetes in four case study general practices was carried out by healthcare assistants who had been trained to carry out this task according to a practice-specific protocol. Staff in these practices described this as the most cost-effective and efficient way of organising and recording screening. Healthcare assistants themselves had grown into, and enjoyed, the increased responsibility of their roles. The remaining practice employed a practice nurse to carry out screening. Conclusions Delegating protocol-based tasks to healthcare assistants was seen as beneficial to the practice and to the job satisfaction and self-esteem of healthcare assistants, and has the potential for further developments. However, evaluation of the effectiveness of screening and health promotion delivered by healthcare assistants is required before policy recommendations can be made.
Jane Carlisle, Julia Lawton, Elizabeth Goyder, Jean Peters, E Anne Lacey D