If your job is undergoing huge changes you need strong representation to ensure they are beneficial. Few professional groups face as much change as healthcare assistants but they are fortunate in having UNISON on their side.
The union is currently fighting for them on a number of fronts. With regulation on the horizon it is working to ensure the system protects the public but is also fair to HCAs.
Recognising the importance of training and career development for HCAs – and the lack of provision – it has not simply waited for employers and government to fulfil their responsibilities. Instead it has become an education provider. In partnership with other organisations it offers courses to satisfy the ambitions of HCAs who want to progress to professional qualifications and to meet the needs of those content to remain HCAs.
And Unison also works to protect HCAs against violence and aggression and ensure they are paid fairly.
As its general secretary, Dave Prentis (pictured) is ultimately responsible for the support Unison offers its 1.3 million members. While he is passionate about representing them all, he has particular reason to feel strongly about HCAs. He has experienced first-hand the difference they make to patients.
In 2000 Mr Prentis spent months in hospital after being diagnosed with cancer of the stomach and oesophagus. He was lucky to survive – after chemotherapy and major surgery to tackle the cancer he contracted an MRSA infection from which he was given little chance of surviving.
‘I had chemotherapy in one hospital and surgery in another, and the care I received did vary but healthcare assistants made a real difference to that,’ he says. ‘They are the people who make sure you get everything you need, and they are there when you’re feeling vulnerable, when you’re in pain. They help you through those times.’
In 2001, just months after recovering from his illness, Mr Prentis was elected to lead Unison. This year he is also president of
the TUC. He recognises that changes in the NHS and healthcare roles makes the future both challenging and exciting for HCAs. He believes its commitment to supporting their education and development is a crucial part of Unison role.
Mr Prentis dismisses the notion that his experiences as a patient should entitle him to special influence. However, they have given him all too real insight into the importance of enabling HCAs to develop their skills and competence. It is a real concern for him that they are often overlooked in favour of other professions.
‘Too often the NHS focuses on educating doctors, on educating nurses up to degree level, but they forget about the people who have the most contact with patients,’ he says. ‘When you go into hospital the first person you see is probably the receptionist.
Then you go onto the ward and it is often an HCA who you meet first and who you have most contact with. These people have a huge impact on the patient experience, and it’s vital that they have access to training so they can make it a positive impact.’
Unison’s strategy to make this training available is an obvious source of pride.
‘We at Unison are proud to represent HCAs and we are committed to ensuring they have the opportunities for training and development they need,’ he says. ‘We have a partnership with the Open University to provide great courses for them. We also
run a conference for HCAs, which is not just about providing education on the day, but carrying it forward,’ he says.
While he is to keen ensure his members have access to the training they need to do their jobs competently and to help them fulfil their ambitions, he also understands the wider importance of this work.
An alarming number of nurses are approaching retirement age, and the NHS faces a looming shortage. Mr Prentis sees HCAs as an obvious – and ethical – source of new recruits. Unison provides opportunities for them to progress towards nursing or other professional qualifications.
‘The NHS needs to develop these people,’ he says. ‘We recruit nurses from developing countries, we denude their health services of professionals they can’t afford to lose, when we have a dedicated workforce here and should be developing people.
‘Also, as nurses are becoming more highly educated, it’s HCAs who are picking up a lot of the tasks they used to do and it’s vital they have access to education and training.’
In such a situation one might expect employers and colleagues to value and nurture HCAs but this is not always the case.
‘Recognition of healthcare assistants by employers and other members of the healthcare team varies,’ he says. ‘In some places they really aren’t properly acknowledged but in many healthcare settings there are examples of good practice, where everyone is accepted as part of the team.
‘If everyone knows they have an important role – not just doctors and nurses but healthcare assistants and others such as cleaners, you can see the effect it has on patient care. They are all part of the healthcare team and they all have an impact on patient care. You need everyone to feel they are part of the team so that they are all pulling together.
‘If you ignore these people it’s like trying to improve standards of education by focusing on teachers but ignoring the teaching assistants. It won’t work unless you involve the whole team, and in the health service you can really see the difference in places where they do involve everybody – the care they provide is so much better.’
As healthcare becomes more complex, nurses are less able to undertake what were once considered to be core nursing tasks.
These are often seen as ‘routine’, or ‘basic’ care – ensuring patients are fed and washed, their beds are made and they are taken to appointments when necessary. But these tasks are also the human face of healthcare, which give patients comfort and reveal important information about their physical and emotional state.
‘When you’re in hospital you have a lot of needs,’ says Mr Prentis. ‘If you need a number of tests in different places you need to know that someone will make sure you’re where you need to be at the right time, and that you’ll be treated properly when you get there, and it’s largely healthcare assistants who do that sort of thing. They really are angels.
‘You’ll see the consultant every couple of days, the nurses are very busy, so it’s the healthcare assistants who are your main human contact. They provide most of the hands-on care, and they are also there to support you when you need it.’
Mr Prentis believes HCAs deserve greater recognition of their contribution to healthcare than they currently receive. A Unison survey published in July revealed that a large proportion of them feel undervalued – yet they are not looking for anything unreasonable.
‘I shared a taxi with some healthcare assistants on the way back from Unison’s HCA conference, and they were saying to me that all they really want is for people to say thank you for the work they do,’ he says. ‘They deserve people to say thank you but so often people don’t.’
An important part of Unison’s mission is to ensure HCAs do get that recognition and the support they need to provide excellent care and feel fulfilled in their work. And with Mr Prentis at the helm the union is determined to succeed.