Plans for a voluntary system of registration for health care assistants have been attacked as being too weak to significantly improve patient safety.
A government plan, drawn up in response to growing national concern over safety standards, would see HCAs who have completed basic care training being allowed to opt-in to a voluntary register.
But it is not yet known where the register would sit, and there are no plans yet to monitor standards or a fitness-to-practise system.
The proposals would see a code of conduct introduced, with training standards roughly equivalent to an NVQ level two introduced for entry-level staff.
Nursing Times understands ministers have rejected calls to introduce statutory regulation of HCAs because regulation costs would fall on the often low-paid assistants and it would be difficult to determine who should regulate them.
The news comes in the wake of a string of care scandals uncovered by bodies including the Care Quality Commission and as research shows HCAs increasingly taking over from nurses in supplying many care tasks.
A Department of Health source said ministers were “concerned” about HCA standards and had asked for “urgent action to be taken”.
However, Royal College of Nursing head of policy Howard Catton said their plan “absolutely doesn’t go far enough”.
He told Nursing Times: “What we have seen over recent weeks is a growing and powerful consensus for some kind of regulation for HCAs. The government and the Council for Healthcare Regulatory Excellence are the only two bodies saying they don’t want to move to a statutory approach.
“This plan absolutely doesn’t go far enough and is too weak. A voluntary approach is too weak and won’t maximise patient safety.”
An Oxford University study last year found individual HCAs did twice as much direct care as nurses.
Co-author Ian Kessler said: “Codes of conduct and recommended core training are all very well but without any meaningful form of enforcement, trust and individual compliance becomes problematic, as does tracking individuals who might have left a trust under a cloud and popped up elsewhere.
“How will any of this be enforced?”
Professor Kessler’s research showed nurses were concerned about them being accountable for the HCAs they delegated tasks to.
James Buchan, of the School of Health Sciences at Queen Margaret University, Edinburgh, said: “The question of who would pay for regulating a large and sector transient workforce was always going to be in the mind of government, particularly at this time of cost-containment. Regulation of HCAs would have contributed to patient safety but was going to be a complex challenge, even at the best of times.”
Gail Adams, Unison’s head of nursing, said: “We continue to support statutory registration, as we have done for more than 10 years.
“But I am confident that this work is a step on the road, anything that increases the standardisation across the sector is going in the right direction.”
She predicted the inquiry into care standards at Mid Staffordshire Foundation Trust would “something absolutely definitive on this issue”.
At the moment there is no standardised qualification or registration for HCAs working in the NHS.
The government said it anticipated the work would be completed by September 2012 with the new standards available from 2013.
The DH has approached Skills for Care and Skills for Health, which represent employers on training issues, to draw up the code of conduct and training standards.
Skills for Health’s director of standards and qualifications Anne Eaton said discussions were at an early stage but the entry-level standard would likely include health and safety and communication skills, with higher standards for band-three HCAs whose work involved blood pressure measurement, basic dressings and helping with the administration of medication.