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RCN has 'urgent questions' on plan for students to spend year as HCAs


The Royal College of Nursing has described the government’s response to the Francis report as a series of “missed opportunities”.

It has criticised the government’s failure to support mandatory minimum staffing levels and the regulation of healthcare assistants and said there were “urgent questions” about plans to have student nurses working as healthcare assistants.

RCN chief executive and general secretary Peter Carter described the inquiry by Robert Francis QC as “comprehensive” adding there “was a great deal to welcome” in his report.

Mr Carter said: “We welcome the commitment to look at staffing levels. However the reality is that nurses continue to work with up to 11 patients each in older people’s settings, and with even higher numbers in care homes.

“Simply leaving the setting of staffing levels to local discretion clearly isn’t working and the time has come for mandatory, legally enforceable safe staffing levels. It’s what patients need, deserve and increasingly will start to demand.”

He added: “The inquiry was also clear about the need for a register of all healthcare support workers. We are disappointed the government has missed an opportunity to enshrine this in law.

“We have a number of urgent questions about the suggestion that all student nurses should first spend a year working as a healthcare support worker,” he said. “Who will train, employ and monitor tens of thousands of these support workers?

“How can the government deliver this radical change to nurse training on a cost neutral basis? And how will we ensure that the supply of nurses does not become restricted?”

But Mr Carter added: “Despite some real reservations, we are committed to working with the government to ensure Robert Francis’ vision for a patient centred NHS becomes a reality.”

In his landmark report, Mr Francis described the RCN as being “ineffective both as a professional representative organisation and as a trade union” at Stafford Hospital.

He recommended the RCN split its joint responsibilities, but the union has rejected the idea.


Sign our Speak Out Safely petition to support a transparent and open NHS. We are calling on the government to implement recommendations from theFrancis report that will increase protection for staff who raise concerns about patient care.


Readers' comments (7)

  • Andrew Kingsley

    'Mandatory legally enforceable safe staffing levels' - good call Peter - the levels will need to be developed for different patient mixes in the different specialties and also the community nursing teams need to have this approach too - the skill mix is also important with trained versus untrained needing some clarification - but in a national health service it seems entirely right and proper to have a baseline set which must not be breached below in order to get safe and equitable and sustainable care 24/7 - this is much more important I believe than the headline grabbing nonsense of the pre-reg HCAing - ensure the training includes good proportions of supervised practice in properly staffed teams in both hospital and community and the care and compassion will return as standard

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  • It is that easy - more nurses equals better care.

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  • The RCN leaves too much to chance. Spending a year as HCAs is a good way to teat the water for those people who have no aptitude for nursing. The nursing cadet scheme was very effective in this regard. Do we want an efficient, competent and effective workforce? Wake up!! Take measures to build this workforce with all stakeholders working TOGETHER!!

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  • I welcome the idea of having a legal number amount of trained nursed per pt , eg x6 patients per RGn minimum. I am very dissappointed that the HCAs are not going to have a regulated body that they can report to, oppportunity missed. In the mean time some HCAs continue working with bad attitudes unchallenged, not to say some RGN have not got attitude problems.

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  • Good that the Rcn was seen as ineffectual by Francis!

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  • Up to 11? What planet does he live on? Up to 16 is more like it.

    And the concept of 'skill mix' appears to have gone the way of hats.

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  • I cannot see why nurses should have to spend time before training learning to "care and be compassionate" if it is not required of all the clinical professional groups. Interviewing skills should be improved to select the right candidates.
    Very few nurses are deliberately cruel usually overworked and understaffing causes this burn out.

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