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Cameron gives lukewarm response on HCA regulation

Prime minister David Cameron has described the regulation of healthcare assistants as “complicated”, hinting that it unlikely to be implemented by the government, despite being one of the 290 proposals in the Francis report.

Mr Cameron reacted lukewarmly to the suggestion of mandatory regulation of HCAs today when answering a question from an MP following his statement to the Commons on the Mid Staffordshire Foundation Trust Public Inquiry report.

Recommendation number 209 of the inquiry report, published earlier today, advises that a registration system should be created for healthcare support workers in private or NHS organisations, working in the community, for agencies or as independent agents, to bring them in line with doctors and nurses.

Mr Francis has also recommended a common set of national standards for the education and training of this particular staff group.

The recommendation was endorsed by unions, including Unison and the Royal College of Nursing, who have been long-term supporters of the idea of HCA regulation.

However, the government has previously been reluctant to introduce it, favouring instead minimum training standards and a code of conduct.

Mr Cameron appeared to be continuing to back this approach when asked about HCA regulation by Sarah Wollaston, a former GP and now Conservative MP for Totnes.

Mr Cameron said: “The government has said that the idea of proper training standards is something that does need to be looked at and I agree with that.”

“The issue of registration is more complicated, possibly more bureaucratic. We’ll certainly look at it, but I think that needs close examination,” he said.

Readers' comments (30)

  • What would you expect from that jerk, all talk and no action, promises everything but delivers nothing.

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  • He has only had experience in PR before becoming an MP and boy, does it show.

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  • Susan Markham

    At last, vindication for what I have been saying for years. As much as HCAs and APs would love to call themselves “Nurses” (with a capital N) because they can take blood etc etc... the Francis report has finally named one of the many “elephants” standing in the room.

    If you are not regulated by a professional body that is internationally recognized – then you do not have the right to call yourself “Nurse!”

    Do a nationally recognized, standardized and regulated training, pass the exam, become registered with a professional regulatory body that is internationally recognized, pay an annual fee and THEN you can claim to be a Nurse (with a capital N!)

    If you cannot, or don't want to do this, then claiming to be a Nurse merely makes you part of the problem - which is the conspiracy to devalue the role of the Registered Nurse... as witnessed by the Royal Cornwall Hospitals Trust attempt at obfuscation by including assistant practitioners in its skill mix ratio figures.

    In reality I don't hold out much hope of many of the recommendations of this report being implemented... it simply goes against the government's hidden agenda of privatizing the NHS. It will be watered down and a few token gestures will be made but eventually I foresee that Nurses will end up becoming the scapegoats.

    BUT... I hope they nail that bastard scheme at the Royal Cornwall Hospitals Trust and fire the incompetents who devised the damn thing in the first place!

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  • A nurse is somebody who is trained to take care of the sick or the disabled. the dictionary definitions do not say a qualification has to be held nor does it stipulate the standard or length of training required so theoretically anybody, even after a few hours training who is fulfilling such a role can call themselves a nurse.

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  • tinkerbell

    i am hoping there will be criminal proceedings and these managers who put money before lives will be able to do some reflective practice from their prison cells.

    I am doubtful this will happen as the NHS is soon to become a profit driven enterprise.

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  • I am associate practitioner, I am also doing a foundation degree that will take me two years to complete. I did not have to do this degree to become an associate practitioner I choose to it. I know it want make me a Nurse with a capital N but I work just as hard if not harder than some Nurses with a capital N. I know when to call for help, how to get help,if i need it and what to do. I know my limits on what i can and cant do even though i know that i am capable of doing more. I also clean up the sh.. That some Nurses with a capital N want do. But as someone said that Still don't make me a Nurse with a capital N maybe a nurse with a small n then.

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  • When we look back through the years it appears rather obvious that a nurse 'Nurses' to heal the sick and quoting the NHS website on Nursing "To aid those perform tasks/actions they would undertake themselves but are no longer able too" not the actual quote but close, personally as an HCA I call myself a Nurse, actually I am about to go to university to study my degree. I think personally it all boils down the to the individual nurse in question, my cousins are nurses' themselves and they all 'muck in' shall we say with the jobs most nurses run a mile from, I think both are nurses, but HCA is not really a fitting name anymore, maybe Nurse Practitioner (NP) would be kinder than a derogatory Health Care Assistant.

    back to a view on the actual article in relation to regulation, I agree, HCA's should be regulated, when in contact with highly important information the only screening an HCA has are the interview(s) and CRB's

    and the above comment (the dig with the capital N for nurse thing) awesome, well done made me laugh.

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  • Nurse practitioner's are registered nurses with extra training, be it a masters degree or other training or qualification. Health care assistants do not have the knowledge or experience to warrant being called a nurse practitioner, or the accountability either. A lot of registered nurses, myself included do clean up s--t and vomit etc, and do not run away from it like some people posting here are saying.

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  • As with all jobs some are good at what they do some are not as good. I take great pride in the way I give care to the sick. I might not be a trained Nurse but I am working hard to try to achieve this foundation degree, I work full time and study full time. And I do think that all APs should be made to do this foundation degree, I want get paid any more for doing this. The only thing a AP can't do that, Trained nurse can is give drugs IV. All we are our cheep Nurses so why do so many Nurses not like APs. I understand that you have trained hard to become a trained Nurse, but without us you would not be able to do your job as good as some of you do.Not all APs and HCA think they are Trained Nurses.

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  • I think anons 7.49 and 9.38 are glad that there are no qualifications needed to become a HCA, or AP, certainly not in written English.
    Anon 6.59 what is the dictionary definition of an Associate Practitioner?
    I may carry a pair of scissors in my pocket that can cut hair, does that make me a hairdresser? Hmmm?

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  • tinkerbell

    i was often mostly the only RN on shift regularly and i was also the ward sister. I was totally hands on. I still got paperwork done but it was never more important than the patient. We had 20 patients, aggressive and violent and severely cognitively impaired, who all needed washing, dressing, feeding and time spent with them interacting with us and others.

    Without our hard working HCW colleagues there's no way i could have survived and neither would our patients. We worked mostly liked a well oiled machine.

    I am now working in the community and although i don't miss the demands of shift work and feeling permanently exhausted, i do miss my team and the way we bolstered and supported one another regardless of who was RN and who was HCW.

    It is no wonder that some HCW's feel they are not valued when we start discussing big N and small n. We are all members of a team and need each other to get the job done. We should all value one another whether we have a big N or not.

    I think HCW's should be regulated as should anyone who is involved in patient care.

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  • Susan Markham

    redpaddys12 | 6-Feb-2013 11:12 pm

    I am ROLF and pissing my diapers because you are so apposite.

    These under-achievers are certainly not Nurse (with a capital N) material.

    It would be nice if they even spoke English but how can they even fill in report forms?

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  • There used to be a discriptive word used for the unqualied helpers which was understood by patients and nurses. That word was "Orderly" or , particlarly in mental health environments " Attendants".

    Clearly there is a role fo the unqualified order
    ly and of course they should be regarded as a team member.

    Unfortunatly nurses allow/permit role "creep"/enhancement and forget the all important fact that anything an unqualified helper does for a patient is (or should be ) delegated by an RN who retains full responsibility/accountability for the task so delegated !

    A percieved "shortage" of qualified staff is no excuse for permitting the unqualified to undertake tasks for which they are not qualified to undertake.

    Attempts by "management" to dilute skill mix should be robustly opposed the only possible outcome will be poor patient care.

    Maintaining a clean environment. washing down commodes, helping identified patients to eat/drink, go to the toilet,and maintain personal hygiene are all appropriate tasks for the "helper".

    Nurses should oppose any extension of the helper role -- sick people need and deserve to recieve the majority of their care from an RN!

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  • Redpaddys you can carry sissors in your pocket, a good NUrse always do. As I said you get good and bad in every job a hairdresser,you get good and bad, just like Anyone that cares for the sick. You make me think that you don't support the staff that are of a lower grade than you. I hope this is not the case because good Nurse is a good team player that supports their staff know matter what grade they are. End of.

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  • I am fully supportive of the regulation and registration of the AP/HCA/AN jobs. But I do not think that it is merely the NHS that needs this regulation, it has to be in the private sector as well. Working in general practice I have had to attend care homes to see patients and see a transient nature to the care staff. One minute they work in one home, the next they are in another after leaving the first under a cloud! How can that be?? Possibly the managers gives good references to get rid in order for them to have no one looking into their homes and the other manager just filling gaps with whatever they can get!!

    But what has to happen in the NHS is that wards/departments are sufficiently staffed with appropriately trained staff and that the bullshit audits, unacheivable target chasing is gotten rid of and nurses can get back to what matters, caring for the patients!

    This government and the previous one have brought this into being! And all MPs need to back all health care professions and work with them and not against them and also to listen to them to put it right!

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  • it seems that qualification and regulation is needed for all carers and nursing assistants in healthcare and the job and working conditions need to be made more attractive to attract and retain the most suitable recruits, and reduce unqualified labour from abroad favouring foreign carers who have equivalent or higher training with certification in English instead which must be registered in the UK to give them the right to employment and practice.

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  • I think some of the comments regarding HCA's as "helpers" is rather under cuff!! Obviously made by a "qualified nurse" who has been around for many many years and a little protective/ frightened of being taken over, stuck in their ways, and not thinking about the patients holistic care package. In the team I work in we have no bandings on show and every member is as important as the next. For a qualified nurse to task a HCA with a job they have to rely and trust in this person to do it to the best of there ability, surely it would give the big "N" s more confidence if all the HCA's were regulated and additional checks made on them so they could feel confident that they are not possibly been struck of from somewhere else.

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  • Susan Markham

    Wow... well here's a post that I never thought I'd make....

    The Daily Mail actually got it right for once....

    Yeah I know what you are saying... “shut the buck up!” but it is true.

    They “DM” seems to have (temporarily) unleashed their former biased blinkered boundaries and had the balls to publish an article that attempts to seriously understand the issues raised by the Francis report.

    Harriet Sergeant seems to get to the testicles of this issue and does it more eloquently than I ever could.

    See...

    http://www.dailymail.co.uk/news/article-2274700/The-real-problem-destroying-NHS-Jobsworths-want-politicians-patients.html

    Absolutely diamond and spot-on... What I have been saying since 1974 when the Area Health Authorities and Regional Health Authorities were created. Ivory towers. Just ways to permit more wankers to suck a severe salary from the NHS.

    FYI – I hate the Daily Mail and all it stands for.... alas I have to give them Kudos for having the testicular fortitude to publish this piece.

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  • THANKYOU Tinkerbell. It is NURSES with all capitals that I love you value your staff.

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  • Anon 8.10am
    You must try harder. As for supporting the lower grades, well there are a few below me, both of the 'Professional' and the ( lets be kind) 'Corinthian' and I support all, I've got broad shoulders and a strong back.
    Now here's a thing you mightn't understand, and some other more qualified commentators should know, that the best areas actively encourage those HCAs that have the right gumption to pursue the training to become a Registered Nurse. Substandard areas send some lickspittles or cronies because it is their 'turn', but they don't always last the course. I am proud to say that I work in the former.
    As for creating a two-tier nursing system, well frankly that boat sailed a long time ago, we already have three. Those at the higher echelons no longer nurse, they manage policy. The Registered Nurse at ward level tries to nurse , but is hampered by policy. Finally, the HCA, who may not even know what the policy is, assists. With the health care.
    The role of the Assistant Practitioner is, quite frankly, an evolutionary cul-de-sac, rather like the appendix in Man, or as a cuter analogy, the Giant Panda ( does that mean there are Average Height Pandas, even Short-Arsed Pandas? [ cue the segway from the debate. The Haggis one was good, the rapping one better!]). All it does is move those who could have been excellent nurses into a job that is a dead end. If you are a HCA and want to better yourself, that is amazing, I would support you all the way, and give you all the help you need. I would never, ever encourage that kind of ambitious person to do a two year course which would mean they would still have to do a further two years to complete a three year nursing degree. Instead, you have a person who has all the workload of the HCA and the RGN whilst getting an extra 20p an hour and being just as stuck as if they had stayed HCAs. If any of you RGNs at the ward level encourage your HCAs to become APs instead of RGNs then you need your bums smacking, its like sending your friend into no-mans land.
    Being a British trained RGN means the world is your oyster, there are so many facets to the job, here and abroad; British trained AP, might stretch to Oyster card.
    The academic level you require to become an AP is certainly as high as that required to become an RGN, as any of you who, like me, have mentored APs will testify. I certainly don't think that it is a level below, simply because you don't have to be Bamber Gascoigne to pass the nursing degree in the first place, more like Paul.
    What I do resent is the fact that RGNs on here would be glad to work with someone who did virtually all the work that they did for half the money. What next, telling our Indian/ Zimbabwean/ Philippine Nurses that they'll all be downgraded or face forcible repatriation? What about the women and the homosexuals? ( Calm down, Redpaddy, UKIP ain't in power yet! Nobody get any bright ideas about voting for that shower, either!)
    P.S. before you all start calling me for ranting, remember this, I ONLY RANT IN CAPITALS, YOU GANG OF BAST....

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