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'HCA's are very much part of the nursing team'

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Dr Peter Carter on why it is time for us to extend the nursing family to include HCA's

Recruitingand retaining members and looking out for their professional interests have always been key priorities for the RCN. With a declining nursing workforce, an ageing population and fewer people choosing nursing as a profession, extending the nursing family to include healthcare assistants has never been more critical.

Too often, HCAs, or healthcare support workers as they are known in Scotland, feel undervalued. The difference they make to patient care frequently goes unrecognised and I constantly hear: ‘I’m just an HCA’. Why is it that so many do not have the respect of registered professionals?

Many of the issues we are facing, I believe, stem from the sticky issue of unregulated HCAs. As far back as 1919 there was a move to try and ‘define the boundary between unqualified assistants who were fit to practise and those who were not’. Sadly, nearly 100 years later, we are still faced with the issue of regulation for HCAs.

HCAs are very much part of the nursing team, dealing with important tasks such as bed making and feeding as well as more technical aspects of patient care such as taking blood samples, catheter removal, dressing and wound care. We must strive for mutual respect between HCAs and nurses in the workplace and focus firmly on teamwork rather than differences.

As part of the nursing team it is only right that they are regulated by the body that regulates nurses.

Nurses need to feel confident that when they delegate to an HCA, they are delegating to someone who has the education and training to do the job well. Patients also need to be fully confident that there are high standards of care across the professions. Put simply, they want to know who is undertaking which aspects of care and know that whoever is looking after them is competent to do so.

HCAs themselves want regulation. A recent Ipsos MORI survey of HCAs on behalf of the RCN found that 85% of HCAs felt they should be regulated and that 89% were prepared to pay something towards professional regulation. This would mean a code of conduct and training, which in turn would increase professional and public confidence, boost the esteem of HCAs themselves and further promote quality care.

There is much work to be done to raise the profile of HCAs within the healthcare system itself as well as outside it. Ask a member of the public if they understand the term HCA and chances are they won’t have a clue – yet many are still familiar with ‘auxiliary nurse’ and have a clear understanding of what that role entails. We need recognisable titles as well as recognition of the work HCAs carry out.

It is time for the nursing profession to show some leadership, to embrace their fellow HCAs, recognise they are part of the nursing family and advocate HCA regulation. Everyone should come together to set standards so we all speak a common language and agree what is an accepted standard in relation to the development of these roles.

The RCN believes all HCAs should be regulated in the interests of public protection and patient safety. Regulation of those working at levels 3 and 4 on the National Career Framework is the first step. These are the most senior healthcare assistants and are often known as assistant practitioners. The RCN firmly believes that they should be regulated by the body that professionally regulates nursing. This should then lead to the professional regulation of all healthcare assistants.

I recently attended an RCN branch organised conference aimed at HCAs held in Cornwall and it was inspiring to see and meet so many HCA RCN members speaking positively about their careers. The RCN welcomes HCAs as members of our college because we believe you add strength in the workplace and that is why we want to recruit and retain every HCA in every healthcare setting in the country.

We have a role to take that lead, put pressure on those in power and to drive up standards of care. The RCN is committed to providing a voice for HCAs, who rightly want to be regulated. HCAs should not feel like second-class citizens and it is up to us to make sure that they have a voice and that their needs are met.

Dr Peter Carter is RCN chief executive and general secretary

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