Investigation: Many HCAs start work on wards without training
A quarter of trusts allow healthcare assistants to start work on the wards without undergoing any training for the job, an investigation has found.
Senior nursing figures described the finding as “shocking” and “worrying”, coming a year after the Francis report highlighted the impact of poorly trained, unregistered nursing staff on patient care.
All hospital trusts were asked how many hours training their HCAs had done before their first shift. Of the 104 that responded, 26 said HCAs were not required to have any formal training before starting.
Of these, 12 did not expect HCAs to have any formal training beyond being mentored on the ward or being given supernumerary status – usually for about two weeks.
Five said their HCAs always had an induction, but received no specific training in their support role. Three trusts stressed they encouraged ward managers to organise training for new HCAs as soon as possible.
One acute trust nursing director said even if new recruits had previous care experience, managers could not be sure of the quality of any training. She said: “Trust induction is usually just a box ticking exercise that all staff go through. To just employ somebody off the street without any training is truly shocking.”
Royal College of Nursing head of policy Howard Catton said it was “worrying and surprising” that some trusts were still not ensuring HCAs received training before starting on wards, given the focus on the issue over the past year.
He said evidence on the quality of preceptorship for newly qualified nurses suggested other staff had too little time to properly supervise them, which raised questions about whether mentoring and supernumerary status were appropriate for HCAs.
There were also marked variations between trusts where HCAs were expected to attend some formal training, the investigation by Nursing Times’ sister title HSJ found.
Time ranged from one hour and an induction at Mid Yorkshire Hospitals Trust – although its HCAs work alongside a mentor – to three weeks at Southport and Ormskirk Hospital Trust, North Tees and Hartlepool Foundation Trust, Northampton General Hospital Trust and Great Ormond Street Hospital for Children Foundation Trust.
Last February Robert Francis QC called for the full regulation of HCAs. The government has consistently rejected the idea and instead commissioned Sunday Times journalist Camilla Cavendish to review HCA training and supervision.
Her report, published in July, uncovered a lack of “compulsory and consistent” training and recommended the introduction of a national certificate of fundamental care that all staff should complete before working unsupervised.
The idea was backed by ministers and Health Education England has been asked to lead its development.
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