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Exclusive: Nurse training review will focus on CPD and HCAs, says chair

Training for healthcare assistants and continuing professional development for nurses will be key focuses for a major new review of healthcare education standards in England, its chair has told Nursing Times.

The Shape of Caring review was set up in May by Health Education England and the Nursing and Midwifery Council to examine standards of pre- and post-registration nurse education and training. It will also consider the training of healthcare assistants.

“At the moment CPD has had a 40 watt bulb shining on it and I want to put it under the spotlight”

Lord Willis

Lord Willis of Knaresborough, the peer charged with leading the review, said it will look at the future needs of nursing staff, rather than being a “witch hunt” for what is wrong with the current system.

Speaking for the first time since his appointment, Lord Willis said he was not intending to repeat the work of recent, similar investigations – but would instead look forward at what the nursing workforce and the NHS needed in the future.

Lord Willis, who described himself as an “unashamed friend” of nursing, said his review would consolidate four reports published last year, including those by Robert Francis QC and Camilla Cavendish, and suggest practical ways to implement their recommendations.

“This is not about a witch hunt of current standards and practices, nor is it an attempt to re-run the plethora of reports and recommendations that have come out over the last five years,” said the former Liberal Democrat MP and head teacher.

“What it is an attempt to do is search out the needs of the profession over the next five, 10 or 15 years, and to ask the question ‘is our current training appropriate?” he told Nursing Times.

This is not the first time Lord Willis has examined nursing education. He led a review of pre-registration training in 2012, which was commissioned by the Royal College of Nursing.

Lord WillisLord Phil Willis

However, he said a key focus of the new review would be continuing professional development. He said NHS organisations did not take CPD as seriously as they should, adding that in future employers could be forced to focus on it more through the introduction of new systems for appraisal and revalidation.

“This whole business of preceptorship and continuing professional development is one that really does need a radical look at, because I haven’t met anybody who says it is satisfactory,” he said.

“At the moment CPD has had a 40 watt bulb shining on it and I want to put it under the spotlight,” he said.

There needs to be a “continuous programme” of education and training for nursing staff.

“That is a challenge for organisations, but one we can’t simply say because we haven’t got the resource we shouldn’t do this,” he told Nursing Times.

The peer said Health Education England and NHS England needed to use their powers to “drive the system” and, if necessary, universities that failed to meet quality standards should be refused funding.

“Health Education England, when it is allocating university places, has really got to be able to say we are looking for the highest quality and if you can’t meet our quality standards you won’t get the funding,” he said.

But he said he was more concerned about the practical placements that students take within hospitals and increasingly in other care settings.

“How do you ensure a consistency of standards within a variable setting so the student going into a care home gets the same quality of training as in an A&E? That’s a real challenge, and we don’t have an answer yet.”

“This is not about re-writing the standards for pre-education nursing”

Jackie Smith

But Lord Willis described healthcare assistants as the “biggest headache” for his review.

“They are doing fundamental jobs and every time I meet them and see what they are doing and how important they are, I come back really quite angered that they have no proper training and are taken for granted in a lot of ways,” he said.

“If this review is really going to have merit it has got to capture their needs,” he added.

A call for evidence will be launched at the end of July with a final report expected in February.

Speaking alongside Lord Willis at a meeting at the Royal College of Nursing’s annual conference last week, NMC chief executive Jackie Smith said the review was “fundamentally about building on what’s good” and not trying to “fix stuff that’s not broken”.

“This is not about re-writing the standards for pre-education nursing,” she said.

Readers' comments (26)

  • michael stone

    Making sure that HCAs are adequately trained before they start working, has been a demand from many and makes perfect sense (to me, anyway).

    As for nurses, it strikes me that nursing is now a rapidly-changing role, so an emphasis on CPD also seems to make sense (although a good foundation from Nursing Schools is clearly also necessary).

    But training costs (money or time) - so will all of this stuff come to pass, or not ?

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  • I agree that training is paramount when caring for the elderly or infirm but, no matter what training a person receives it depends on management ensuring that the level of care is consistent. Only today in the daily Mirror there is another case of abuse which management chose to ignore it was only when police became involved where the perpetrators suspended. This is disgusting so the manager should be prosecuted also for failing to protect people in their care.

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  • Junehelen 24-Jun-2014 13.55

    I agree with the comments made by Michael Stone above, I also feel that we have to make sure we have the right people doing the job, For the HCA role the recruitmnet process has to be reviewed to ensure people are aware what the job involves. A probation period should be in place, this gives every body the opportunity to terminate if not suitable saves money in the long term.

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  • It would also be good if HCAs in nursing homes were paid substantially more than a little over minimum wage. There really ought to be a set pay structure for them in line with NHS bandings.

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  • michael stone

    Julie Kahn | 24-Jun-2014 2:02 pm

    There does seem to be a particular problem with HCAs, especially I think in nursing homes: it seems that far too many HCAs in care/nursing homes do not really want to be doing the job (and, as you have pointed out, many dedicated and caring HCAs are very poorly paid, even if they do 'like the job').

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  • michael stone

    I hope the link works - people who are interested in the pay of HCAs and their working conditions, might be interested in the discussion at:

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  • As a HCA Band 3 in the community I find it very difficult to progress, I have been refused Band 4 training and secondment to train as a nurse 3 times in the last 3 years, there is no where else for me to go, I cannot take on any more responsibility at work as a Band 3. I really enjoy my job and would love to complete my nurse training, I have a family and a home to run and cannot give my job up to live on a bursary....I feel that there should be more support to help people in my situation to develop and train, as stated above there are a lot of HCAs in care homes that don't want to be there and their heart is not in the job but people who really do care about treating and looking after sick people seem to be stuck.

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  • Non- NHS care staff in the community receive even less training often only 3 days and a couple of shadowing shifts. The main entry qualifications are a car and a license.
    We need a national training scheme for all carers and preferably a living wage.

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  • My HCA training consists (at the moment) 14 or more different modules and all are up to date. But what I really need is a better pair of trainers or a foot care training, as I'm doing circa 2-4 miles per shift. :-) Seriously now, any new regulation causes less people to try the job, and HCA is not a rocket science. There will be even more responsibilities without any financial incentives. I don't want that.

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  • why don't we bring back all our long stay hospitals but run them as care homes staffed with an NHS MDT thereby meaning they will have access to education and training unlike our private health and social care colleagues? That way, we improve care for older people and raise the profile of the speciality. Good, specialist based care will reap rewards in terms of avoidable admissions etc

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  • CPD is important you say?

    Gosh and golly! But none of us ever noticed that! None of us spent years arguing with managers and HR about training for nursing staff. None of us spent hours upon hours in futile appraisals arguing for training to keep up to date, let alone improve our clinical practice. None of us ever attended meetings with trust high ups putting the business case for investing in further training for qualified nurses. None of us ever designed appraisal packages (pre-KSF) in order to provide evidence of the need for training for both qualified and unqualified staff.

    Just as well we have another high-powered report to tell us this, as we would never have known...

    How much did this one cost?

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  • Again a similar comment to another person I too work in a gp surgery as band 3 HCA and reach the limit of training within my band . I absolutely love my job and would do anything to do my training but can't due having bills to pay !

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  • michael stone

    BasketPress | 25-Jun-2014 2:00 pm

    Ah, but this is the NHS - knowing the blindingly obvious isn't enough: there has to be a 'report/review' to confirm the ruddy obvious, before 'the system/goverment' will admit that something exists !

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  • I totally agree with 'BasketPress' comments. Here we go again with yet another 'titled person' who is going to investigate and shine yet anothet light on what we already know! I don't think we need lights we need 'glasses' as we cannot obviously see clearly what is in front of us!
    I have just spent the morning as a nurse educator in 'end of life care', in various clinical settings. Yes lets have a ton more educational and training initiatives, but can we for once appreciate that skill mix and numbers are the main focus here to allow the ward staff to think objectively and to respond pro-actively for once, instead of crisis managing constantly and going into 'shock -syndrome' when once in a blue moon they have enough of both of these factors and cannot think straight!
    I am sure that the learned Lord Willis means well, but 'hey-ho' here we go again!

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  • I am a 45 yr old woman who is doing a foundation degree which is work based,I am only at university one day a week which at the end of two years I will be a band 4, which is the same as the old enrolled nurses, I can then go on and do 2 yrs nurse training full time, I am lucky as my children are all adults now and I have a supportive husband to support me through the next 3 yrs. Why can a person who has been working as a HCA for nearly 30 yrs not do say a work base training in hospital to become a registered nurse, instead of now a degree and essay writing

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  • You may ask why don't dental nurses train on the job and become dentists or o.t helpers train purely on the job to become honours degree educated Professional Occupational Therapist?
    You may achieve a Foundation Degree and that is to your credit, but you are not yet A trained Professional Nurse. It is a pity you cannot see the value of degree educated staff and research-based essays.
    There are some avenues to accrue qualifications for University e.g access courses at FE college or Open university distance learning etc.

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  • Anonymous | 26-Jun-2014 8:51 pm

    surely with all of your experience you should already know the answer to your own question!

    cf the comment from Anonymous below yours.

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  • Anonymous | 26-Jun-2014 8:51 pm

    I trained in the mid-80s under the old "apprenticeship" model; I already had a degree in another area before starting in nursing.

    The old model was highly lacking in any detailed examination of the theoretical underpinning of nursing/medicine. That had to change.

    It has, however it is still lacking in decent training in critical thinking or assessment of evidence - the number if times as a mentor or practice placement supervisor I heard "It says in this paper" without any checking to see if the paper was actually any good (frequently the papers were utter rubbish - did I mention that my degree was a science one?).

    Nursing has changed and continues to do so: training needs to reflect this and, yes, that DOES include research and essays and assessment of evidence and being able to construct a reasoned argument to support your clinical position.

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  • Oh, and I was a nursing assistant before I started my training...

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  • michael stone

    BasketPress | 27-Jun-2014 12:32 pm

    '"It says in this paper" without any checking to see if the paper was actually any good (frequently the papers were utter rubbish - did I mention that my degree was a science one?).'

    IF ONLY people would put some effort into 'deciding if the paper is any good', instead of just quoting the author's 'conclusions' !!! - and both of my degrees, are in a science: perhaps this 'looking at things critically' is a way of thinking more commonly present in people with a 'science background' ?

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