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'Caution' urged over HCA regulation


NHS Employers director Dean Royles has urged “caution” over calls for the regulation of healthcare assistants, saying “you can’t regulate for a smile and a kind word”.

Mr Royles has written a comment piece for Nursing Times setting out his opposition to regulating HCAs, ahead of an expected debate on the issue in the House of Lords.

He said: “We must remember that regulation only ever considers minimum standards and the NHS must strive to achieve more than just the basics.”

Regulation could also have “unintended consequences”, he warned, as it might leave trusts unable to deploy staff flexibly to meet patients’ needs.

“We also need to be clear that regulation cannot capture the friendly tone of a doctor or the simple effort a nurse makes to ensure his or her patients are as comfortable as possible in their hospital beds,” Mr Royles said.

Unlike registered nurses, HCAs do not have to comply with a statutory code of conduct such as that produced by regulator the Nursing and Midwifery Council.

But following a wave of scandals allegedly involving HCAs there is growing pressure to introduce tighter regulation.

Mr Royles said HCAs have been “the backbone of the NHS” and remain “an essential part of the patient experience where care and compassion matter most”.

But, he argued: “You can’t regulate for a smile and a kind word”.

He added: “We would urge caution around the regulation of support workers until we are clear how this would benefit patient safety and care.”

Mr Royles’ views contradict those expressed by the Royal College of Nursing, Unison and the Prime Minister’s Commission on the Future of Nursing and Midwifery.

However, the Department of Health has said it does not think statutory regulation is necessary and that a system of voluntary regulation could potentially be established instead.


Readers' comments (6)

  • Mr Royles says

    “We must remember that regulation only ever considers minimum standards and the NHS must strive to achieve more than just the basics.”

    Indeed. But when not even the basic standards are being met in some work environments why is regulation not part of the solution?

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  • when you all work as a team? and dont pick what you want to do and expect someone to do your dirty work?

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  • michael stone

    The solution to this HCA things is simple - keep it 'local' but enforced, and use the equivalent of a Pilot's Log Book.

    Give every HCA the equivalent of a 'log book' in which brief details of 'certified training' are listed (this would need to be recorded electronically, but could also exist as a physical copy). So if an HCA is trained in taking blood, the nurse (or whoever) trained the HCA, and 'certified the HCA as competent' records the new competency, and the nurse's name as the trainer/certifier, in this 'log book'. You do NOT include things such as 'a caring attitude' !

    Any other person, who wishes to know what a given HCA is deemed able to do, can simply check the 'log book'.

    Ruddy simple !!!! Why do people make these things, so complicated ?

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  • HCA's work with vulnerable adults or children. I just do not understand why there is NO regulation for them. We hear often that vulnerable people are abused by HCA's.

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  • I am a HCA and can safely say that i have never known any HCA to be abusive. As a matter of fact a lot of HCAS show more compassion than registered nurses! Also our at work place we do have a system of competencys, and a HCA can only perform a task when they have been signed of by a registered nurse.HCAS are the backbone of the backbone of the NHS as Mr Royles stated.I have to wonder, Is this really about regulating HCAS to protect patients or is it just plain snobbery? I read in another article that HCAS are uneducated and do not even have basic qualifications such as GCSEs many HCAs are educated and have degrees other subjects and could go on to do their training to become a registered nurse if they wanted to. The fact is most don't want to because of the way things are at the moment and feel they'll never get a job at the end of the training.

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  • well i am a HCA and all HCA from the trust i work for are being retrained due to picking up bad habits from the trained staff so i think maybe trained staff should be assess on how they train HCA if they are responsible ,,, so lets not put the blame on the HCA,s for bad practice ,,,,,, smile and a kind word i think we are more than that alot more ......................

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