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Will recommendations for HCA training recreate the SEN role?

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24 February, 2014

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.


News: Views sought on plans to boost HCA training and careers


Will these plans result in a second level nurse role?

What training and education should healthcare assistants receive before they have contact with patients?

What is your response to this consultation?

Readers' comments (14)

  • The existing training will have to improve to equate to SEN training!!! SENs were in charge of the wards.

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  • SEN's were the epitome of caring, they were qualified in their own right, but they were very exploited and not paid for it, they weren't supposed to take charge of the ward as they weren't paid to, but they had to, and some of them were treated as dirt, and they are still about as many didn't do a conversion course, only they are known as RN Level 2, but all the jobs want a first level nurse.

    Anyway what I'm saying is, these assistant practitioners, met some great ones, but they aren't accountable for their actions, how can you expect someone to take blood etc yet not be qualified.

    Bring back the enrolled nurses and treat them right.

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  • Agree with above. SEN's used to do drug rounds, be ward leaders, etc, HCA's should never be allowed to do this unless they too go through the formal training.

    It is nursing on the cheap. If you are a HCA and want to further your career prospects, then get the appropriate qualifications and training. SEN's were able to upgrade their qualification status if they wanted to; but many were happy just being good nurses.

    The SEN training was originally stopped as nurse training was taken from the Dept of Health and given to the Dept of Education. The reason for this was 2 fold:
    1 - the Dept of Health budget could be cut, as it did not have to pay the wages of student nurses.
    2 - Nursing students would then have to fund their own nursing qualification, as it became an all HND/degree qualification, through grants and loans, and save the country a fortune. Which is why we are now having a problem with recruitment and retention. Thank goodness this mistake was addressed and now at least most nursing students get some kind of bursary; but this is still not anywhere close to what they would have got if they were paid as a student nurse.

    One of my best friends was a wonderful EN. She has just completed her return to nursing, and is now looking to do her conversion, which I have no doubt she will pass with flying colours. But she never felt inferior, and was better than many RGN's, just paid less.

    Many HCA's already make good, quality nurses, and the statement "including increasing the number of healthcare assistants that move into nursing" is a bit galling as many may already consider themselves to be nurses in the broader sense; and their contribution to the care of patients can quite rightly be considered as "nursing."

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  • SENs were entirely different from today's HCAs. They had an education in human biology, as well as training. They understood human anatomy, physiology and the changes and stresses brought about by disease and trauma in ways which HCAs just can't understand at present. SENs may not have been academically minded nurses, but they absolutely needed to know this stuff!

    Without a real nursing education with enough theoretical background, HCAs will continue to flounder when faced with work where understanding and interpretation of clinical data is required.

    Currently, too many HCAs are undertaking work well beyond their fundamental understanding and this places both them and their patients at risk.

    Many hard-pressed nurses forget that their HCA colleagues have not had their basic human biology education and their delegation of some clinical tasks can pose a high risk for patients, as well exploiting their HCA colleagues. We should value our colleagues for what they can contribute, but it's wrong to expect them to be the same as qualified nurses.

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  • I like the above comments and support and praise of SEN training with it's extensive knowledge base. I do get annoyed when I see comments aligning the two roles together, there is no comparison. I trained as an SEN originally, and had Senior SEN role, for which I had staff nurse status and pay and mentored students in GNC days. Although I say it myself I did a damn good job, as did most of my SEN colleagues. I then went on to covert in 1989. There are still SENs around in our Trust, although you would never know it. They are just as capable and knowledgeable as any RN, if fact some are better. Banding is no issue, and posts are on merit. I know one who has a band 6 role and does the job very well.

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  • I qualified as an SRN in the mid 1970s but will be forever grateful for all I learned from our SENs and auxiliaries. When I moved towards the end of my career into care of the elderly the teaching, help and support of the HCAs who had long years of experience in the area which I was lacking was invaluable and we can all learn from each other life long.

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  • I fully agree with the above comments. Seems we are yet again going full circle. SEN's were an important part of the team, then they were used and abused then got rid of. Let's do it right this time, train and treat and pay them properly, they will be back, maybe under a different name in the name of progress.

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  • HCA's aren't, nor will they ever be SEN's in exactly the same way as a nurse practitioner will never be a medical Doctor

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  • Hear, hear to all of the above, absolutley!

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  • Anonymous | 27-Feb-2014 12:30 pm

    quite a number of HCAs go on to become RNs as do RNs doctors!

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  • Anonymous | 2-Mar-2014 11:30 am

    They do: I was an Auxiliary before I did my training, but as an Auxiliary despite all the knowledge I had and the number of nursing tasks I undertook, I wasn't a nurse. Just in the same way many practitioners have a similar role as that of a junior doctor, but they're still not doctors.

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  • I agree with all of the above. I was a SEN for 15 years and converted to RGN, and have progressed up the ladder to a band 6, but I would love to be the hands on nurse that I was in the 1980s. As to qualifications the SEN's had theory/Practical blocks of education just the same as RGN's. But there was more indepth knowledge for RGN to work through. So if HCA's are going to be classed as SEN's by giving them extra training lets ensure it is at a NVQ level 5 or above, its ok to take a sample of blood but we need to understand the antomy and physiological knowledge behind it.

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  • dikod1

    The RGN had a dear friend in the SEN..because the SEN was an all-rounder. They would stand in for and be delegated to by the registered nurse and their relationship was clear.

    Thus the RN could focus upon ward management and not as now be chronically anxious about whether all the tasks are completed and documented.

    Most significantly however is that unlike today's Sr HCA's the EN was immediately accountable to the RN and was paid something between the care assistant and the RN, about £8 per hour). Today the Sr HCA earns a few pence an hour more that colleague HCA's who are on minimum wage. They very often have parallel and often identical responsibilities within "residential" services many of whose "residents" are indistinguishable from the RN's "patients" thanks to commonly inconsistent assessments. And, given the opportunities for Sr HCA's to develop specialist skills, eg taking blood, many HCA's far from wishing to support the RN are actually quite often resentful of them. This is the reality of developmental changes during the last 30 years. Instead of spending 3 hours struggling with the drug round the RN years ago could simply delegate it to the EN leaving the RN to coordinate the shift and to be aware directly of the care being delivered. Now, even if an Sr HCA is available, they are unable to administer "nursing" paracetamols to "nursing" patients. Therefore, the direct coordination and management of the shift is paradoxically left to the Sr HCA leaving the RN struggling to push round an overfilled drug trolley whilst hoping that everyone is doing what they should be. MOREOVER..forty years ago the RN delivered medication to the patient with a second carer looking on without a MAR sheet in sight or any need to sign anything, and, given that medications were not being individually prescribed, the drug trolley was far, far less packed with simple medications easy to find the round was never repeatedly halted because one patients senna or paracetamols had run out and consequently the round took about 20 minutes rather than three hours. The witness confirmed whether the patient had or hadn't properly received their medication whereas now, despite all the written paraphernalia of paper trail audits and the rest, there is no guarantee that the medication was not simply thrown down the sink.

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  • Ah the good old days. I can recall as a Youth Opportunities Programme forced labourer, the lunch drug round in a large long-stay hospital. Drugs were put on a tray in med cups (no names or if there were it was scrawled on pieces of scrap paper)> Guess which nervous 17 year old dropped the tray...

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