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Views sought on plans to boost HCA training and careers

Health Education England has launched a major consultation on ways to develop band 1 to 4 NHS staff, including increasing the number of healthcare assistants that move into nursing.

The Talent for Care document, which calls for the views of nurses and other healthcare professionals, highlights the plight of low-paid support workers, with wide variations in training opportunities across the country.

It also says there is a “mismatch” between the training and support NHS organisations claim to offer and the experiences of staff on the ground, which has contributed to “some serious failures in care”.

Feedback from the consultation will help create a national strategy for bands 1 to 4, which will include minimum training standards for HCAs, the development of formal career paths into band 5 posts and beyond, and more opportunities to access registered training courses like nursing.

Health Education Wessex and Health Education South London will be taking the lead on plans to support the progression of HCAs into nursing.

According to Health Education England, band 1 to 4 staff make up about 40% of the NHS’s 1.3 million workforce and are responsible for about 60% of direct patient contact.

However, this group, which includes clinical support workers and nurse associate practitioners, only receive around 5% of the national training and education budget.

Health Education England said it wanted to see an increase in the proportion spent on band 1 to 4 staff of 1% each year over five years.

Extra funding would also be sought from sources including the EU, trusts, local enterprise partnerships and via joint work with organisations, such as the National Skills Academy for Health.

Health Education England is staging four regional events to discuss the Talent for Care strategy. The closing date for feedback is 24 March.

In July last year a government commissioned review has recommended that all HCAs should complete a “Certificate of Fundamental Care” before they can look after patients unsupervised.

Cavendish Camilla

Cavendish Camilla

The review, which was carried out by the Sunday Times journalist Camilla Cavendish, also said HCAs who completed the certificate should be allowed to use the term “nursing assistant”.

The idea was backed by ministers and Health Education England has been asked to lead its development.

A recent investigation found a quarter of trusts still allowed HCAs to start work on the wards without undergoing any training for the job, as reported by Nursing Times earlier this month.

All hospital trusts in England 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.

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.

Readers' comments (14)

  • So, Enrolled Nurses were got rid of and now we find that HCA's need training. Seems we are on the inevitable merry go round under a different guise. The whole exercise has been a very expensive waste of time and money. As we start again, I suggest we call them Health Care Assistants and train them appropriately so they may assist a range of health professionals such as Physio's and OT's as well as Nurses.

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  • Enrolled nurses did 2 years of training, and was a quicker option to boost the number of trained nurses, I was lured into that in 1973. I converted later but wouldn't change it for the world. You were taught the practical side of nursing, including drug rounds, but were also in charge of the ward. You were a good highly skilled all rounder.
    I don't see any new idea(s) of training will ever be as intense as Enrolled Nurse training, to give anyone under band 5 the knowledge and skills of an EN.

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  • Anonymous | 20-Feb-2014 9:40 pm

    Did you mean to use the word 'lured'?

    It seems strange, in the context of:

    '... and was a quicker option to boost the number of trained nurses, I was lured into that in 1973. I converted later but wouldn't change it for the world.'

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  • I work as a HCA & have done for since 1982 on and off. I am fed up of others speaking as if HCA's have only been in health care in recent years, & we somehow replaced the SEN. This is not the case doesn't anyone remember the Nursing Auxiliary ??? We worked alongside the SRN & SEN then as now we are last in the queue when it comes to training opportunities and it is about time this changed especially as our role has expanded over the years. It is high time we got the training we deserve instead of being thrown in at the deep end & expected to pick up the knowledge & skills on the job. Some trained staff value our input, others don't but we are often the backbone of a unit when it comes to getting the bread & butter work done, And quite often we pick up on important changes in the condition of patients, & dare I say sometimes notice things that have been missed by the trained staff, Indeed we often play our part in helping newly qualified nurses get to grips their role when they start working as RN's & require support to get them used to the change from student to Staff nurse.

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  • I work as a HCA & have done for since 1982 on and off. I am fed up of others speaking as if HCA's have only been in health care in recent years, & we somehow replaced the SEN. This is not the case doesn't anyone remember the Nursing Auxiliary ??? We worked alongside the SRN & SEN then as now we are last in the queue when it comes to training opportunities and it is about time this changed especially as our role has expanded over the years. It is high time we got the training we deserve instead of being thrown in at the deep end & expected to pick up the knowledge & skills on the job. Some trained staff value our input, others don't but we are often the backbone of a unit when it comes to getting the bread & butter work done, And quite often we pick up on important changes in the condition of patients, & dare I say sometimes notice things that have been missed by the trained staff, Indeed we often play our part in helping newly qualified nurses get to grips their role when they start working as RN's & require support to get them used to the change from student to Staff nurse.

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  • michael stone

    Anonymous | 22-Feb-2014 10:33 pm

    I liked your post, and HCAs should be adequately trained: otherwise it definitely isn't fair on HCAs, nor is it sensible.

    'It is high time we got the training we deserve instead of being thrown in at the deep end & expected to pick up the knowledge & skills on the job.'

    Training and learning on the job, both are sensible, surely: but being thrown into the job without any training, in a healthcare enviroment, just isn't right !

    Your point about SEN and Nursing Auxiliary is interesting - yes, lots of people mention SENs in connection with HCAs. But I can't help feeling that modern healthcare is more 'mingled' in terms of 'who does what' than it was say 40 years ago - nurses now do things junior doctors would have been doing in the past, etc, and if HCAs do receive more structured training and more up-skilling, might some HCAs be doing things in 10 years time, that currently are only done by nurses ?

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  • Yes Michael I agree that training & learning on the job are important, and many learn best by experience gained on the job. But of the 104 trusts mentioned who were surveyed, 26 still think it is acceptable for HCA's to do their first shift on a ward without any formal training before they start. This was not acceptable 30yrs ago & it is not acceptable now. In fact studies done over 30yrs ago said it unacceptable, why has nothing been done ?? why does it take a major scandal to get the issue into the spotlight??? Because the Qualified Staff are listened too Support workers aren't !!!

    I

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  • PS and I'm sure many other trusts still offer poor, very short or virtually non existant training to their HCA's before they do their first shift, Perhaps ok if you have some previous experience but totally unacceptable for those who have never provided direct care to patients before

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  • michael stone

    Anonymous | 23-Feb-2014 10:05 pm

    I agree with you.

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  • where I work I know of a health care assistant that works on her own in assessment area where they get pt from gps to assess she does the bloods venflons ecg sometimes she can have 10 pts or more to look after with no help from a s/n she will have input from a dr at some stage

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  • michael stone

    Anonymous | 26-Feb-2014 11:00 am

    That seems to fit with the end of my michael stone | 23-Feb-2014 12:49 pm
    comment. What matters, in the end, is if she is doing that competently.

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  • yes very much so but when shes not in eg on hols they cover her with a staff nurse it shows how good she is,but I think she should be paid a higher band for what see does

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  • michael stone

    i definitely agree that as HCAs become better skilled and take on more complex tasks, their pay should improve as well - but I'm not at all familiar with the intricacies of NHS pay, so I don't really know how that works (I know the goverment wants to pay as little as possible overall for the NHS, but that isn't exactly the same thing).

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  • Anon 20th Feb I am nearly at the end of a 2 year Assistant Practitioner course and would like to advise you that it is very intense and feel that this course has given me the knowledge and skill to rival that of the enrolled nurse.

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