There is an urgent need to regulate assistant practitioners because they are being increasingly used as substitutes for registered nurses, a major review has warned.
But the report authors said there was a particularly “urgent need” to regulate HCAs working in band 4 assistant practitioner roles as they are used as a “substitute” for nurses rather than as a supporting and supervised role, as originally intended.
“A decision needs to be made as to whether this [regulation] should be as a senior support worker or as a second level qualified nurse,” the report states, before further decisions about assistant regulation can be made.
There have been long standing arguments over which body or organisation should be responsible for HCA regulation. The review recommends that the task should be led by the NMC as a large percentage of the assistant workforce is allied to nursing.
NMC chief executive and registrar Dickon Weir-Hughes said the report “makes clear the risks associated with patient safety if healthcare support workers continue to remain unregulated”. The report says the lack of regulation poses a risk to the public and there is a strong case that safety would be improved by its introduction - although it is “not possible to demonstrate unequivocally”.
It says the lack of regulation means it is hard for employers to check if new HCAs have previously been dismissed for poor misconduct. There is also evidence of HCAs undertaking tasks they are not trained to do in anunsupervised setting.
The review rejects a voluntary,employer led model of assistantregulation - such as that piloted in Scotland - on public safety grounds.
However, Nursing Times understands a voluntary system could be a likely first step.
The Department of Health’s arm’s length bodies review, published last week, proposed to extend the remit of theCouncil for Healthcare Regulatory Excellence, which oversees the NMC. Its new role will allow it to set standardsfor and provide quality assurance of “voluntary registers” held by regulators and professional bodies.
CHRE chief executive Harry Cayton told Nursing Times a register would be “easier to create” for HCAs than full blown regulation and could be a first step towards a more formal system.
Responding to the NNRU review, Royal College of Nursing policy director Howard Catton said: “The report presents an overwhelming care for moving ahead with the regulation of HCAs on the grounds of patient safety, quality and professional practice.”
Unison assistant national officer Jennifer West welcomed the review but warned that how HCA regulation was funded remained a major issue. She said: “It must be remembered that they are on a lower pay band to other nursing professionals. This must be taken into account when setting regulation fees and making decisions about who should pay them.”
Professor Weir-Hughes told Nursing Times earlier this year that he was “single minded” about ensuring HCAs were regulated nationally.
Should the NMC regulate health care assistants?