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Lack of HCA regulation 'unacceptable', says Willis

The Willis Commission on Nursing Education is likely to add its voice to calls for the mandatory regulation of healthcare assistants, after its chair described the current situation as “unacceptable”.

Speaking last Friday at a nursing forum in London, Lord Willis of Knaresborough gave further indications of what the commission would recommend in its final report, which is due to be published in November.

The independent commission was set up in April by the Royal College of Nursing to look at the future of nurse education. 

Lord Willis said: “Over the last 10 years we have seen a shift in balance between registered nurses and healthcare assistants, many of whom are not properly trained.

“Vulnerable patients are being left in the hands of people who are not trained and not regulated,” the former Liberal Democrat MP told the event organised by Camden and Islington Foundation Trust. There “has to be a move” in the “direction” of mandatory regulation, he said.

Lord Willis also reiterated interim findings from the commission – revealed last month – that there was no evidence the moves to degree-only entry affected nurses’ ability or desire to care with compassion.

He said the skills nurses required now were “vastly different” than 10 years ago and the profession needed to be able to “meet that challenge”.

The minimum academic level for pre-registration education in England will be a degree from September 2013 – bringing it in line with Scotland, Wales and Northern Ireland.

Lord Willis also said he was “incredulous” there was funding available to help struggling medics but not nurses, and suggested the commission would seek to identify more support for student nurses, educators and their employers.

Additionally, he said the commission had found evidence of some education that was “looking to the past rather than the future”, adding: “The nurses of tomorrow will work in multi-professional teams, it’s really important we don’t create more silos in the system.

“There is a lack of recognition that if you want quality staff you have to invest in them each and every year,” he said.

Readers' comments (9)

  • HCAs should only carry out duties that they have been trained to do and must accept responsibility for those duties they perform. They should not be expected to perform tasks they are not competent to do and should not carry out tasks they are not competent in.

    All staff working with people need to be regulated and monitored. Those who give poor care should be held accountable, those who allow them to give poor care also need to be held accountable.

    Employers have a duty to ensure that ALL their staff, regardless of whether they have a professional qualification or not, are safe, competent and trained in their particular role.

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  • The answer to the never ending process of down skilling the Nursing workforce is not to regulate the uneducated.

    What is required is the implementation of minimal RN /Patient ratios which are regularly reassessed in relation to patient dependency

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  • I have and am currently priviledged to work alongside many great HCA'S. I believe we need regulation and a review of minimum standards for HCA'S. I know that the NVQ system, linked to KSF, was supposed to address the education side of this but it hasnt completley. As HCA'S are undertaking more complex roles and tasks formerly carried out by Registered Nurses we need a robust system in place. This is not just to ensure safety and well being of the Patients but also to give the HCA'S and Registered Nurses a framework to work to
    so everyone is clear on each others roles and responsiblities.
    And it will be interesting to see what the implications will be for Registered Nurses in terms of accountability and delegation.
    And I do agree with the statement
    “There is a lack of recognition that if you want quality staff you have to invest in them each and every year,”
    Staff obviously do a better job when they are equipped with the appropriate skills and knowledge and feel valued by recieving appropriate training.

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  • michael stone

    'Lord Willis also said he was “incredulous” there was funding available to help struggling medics but not nurses, and suggested the commission would seek to identify more support for student nurses, educators and their employers.'

    I'm disturbed by that as well - not necessarily surprised, because contrary to the beliefs of some, I do learn from these posts and

    'We don't get much support'

    is a common one, from nurses.

    This is off-topic, but a couple of days ago an RCP group said 'We need to close some hospitals, put more specialist hospital services together and keep more care out in the community as well' (my phrasing). The RCGP immediately said 'We can't have more care at the GP level, because we already don't have enough GPs and we couldn't do that'.

    Nobody agrees about anything ! Report, argument, another report, another argument, ad infinitum. Yaba yaba loads - improvement, usually not much. I seem to be a bit grumpy, today.

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  • As a current HCA, and hopefully student nurse, once i get onto a course, I would like to say, that i believe all HCA's should be registered, in line with Qualified staff.
    After all, we are privy to the same information and have the regular access to venerable people, so why are we registered?
    I believe, any HCA who is against being registered, has something to fear, for those of who practice within our capability’s, have nothing to fear.

    Also more funding for student nurses will be a good move forward.

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  • this is the same guy who did the investigation on nurses to discover whether they are too posh to wash.

    "“The nurses of tomorrow will work in multi-professional teams,..."

    what does he think they have been doing all this time up until tomorrow? I have been in a multidisciplinary team for the last 20 years.

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  • tinkerbell

    Anonymous | 24-Sep-2012 5:53 pm

    same here.

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  • it is the ward managers responsibility to ensure all the staff, of all grades, are safe and competent. it is up to them to delegate safely, know who can do what, who has received training in what skill and to ensure that their area is adequately staffed with the right skill mix.

    it is the Banks/HR responsibility to train up bank staff, they should receive certified training before they are able to work in the wards.

    It is also the HCAs responsibility to ensure they receive appropriate training and only undertake duties they are competent in.



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  • I am a former RN caring for my ex-husband in his own home. He is attended by 2 Carer's each morning and evening due to needing two people for lifting and other problems. The general standard of care is very poor with basic knowledge of nursing care leaving much to be deasire4d. I constantly teach the basics. Some Carer's are rough, some rude, some think they are nurses and resent my even being in the house. Our family could never leave my ex-husband alone with them as we do not trust them. This is sad becasue of the nice ones who attend and who try so hard to care for him. We have found that there is no-where to turn when there are problems as companies will not listen and only protect their own interests. REGULATION is the only answer. All untrained Care Staff e.g. Carer's, HCA's, Support Workers etc should be regulated to practice as untrained staff with a registration number. They would then be answerable for their own personal and professional behaviour like all the rest of staff who care for the sick. Patients and families would then have somewhere to go who will listen. It is negligence for the powers that be to ignore this vital issue.

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