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Francis report - NT response

Minimum training standards for HCAs

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The government will be introducing training standards for healthcare assistants that focus on 10 key areas of knowledge

Citation: Entwistle F (2013) Minimum training standards for HCAs. Nursing Times; 109: 14, 17.

Author: Fran Entwistle is assistant practice and web editor at Nursing Times.


The government has announced it does not plan to regulate healthcare assistants despite the recommendation in the Francis report to do so. It does, however, plan to introduce a set of mandatory minimum training standards and a code of conduct applicable to all HCAs who report to nurses, midwives and adult social care workers in England (Skills for Care and Skills for Health, 2013).

Skills for Care and Skills for Health were commissioned to publish the code of conduct and training standards. The code of conduct is based on the principle of protecting the public by promoting best practice. It aims to ensure HCAs are working to defined standards, providing high-quality, compassionate healthcare and support.

The training standards define the minimum knowledge workers must have. They focus on 10 areas designed to cover the key knowledge HCAs need and set out what should be included in their induction.


1. Understanding the role

All support workers should understand their own role and how it fits in with the team. It includes understanding of workers’ rights and knowing the aims of the service.

2. Personal development

HCAs need to be able to learn and reflect. This includes having a personal development plan and being given regular feedback.

3. Effective communication

These staff must be taught how to communicate effectively with their client group, and why this is important and what constitutes “good communication”. This includes recognising barriers to communication and knowing how to access information and support services, such as interpreters. This standard also covers an understanding of confidentiality.

4. Equality, diversity and inclusion

This standard relates to ensuring all HCAs have an understanding of how discrimination occurs in the workplace and steps they can take to reduce the likelihood of patients being discriminated against. It includes awareness of legislation and agreed ways of working that relate to equality, diversity, discrimination and rights.

5. Duty of care

This relates to knowing how duty of care contributes to safe practice, safeguarding and protection of individuals, including how to handle dilemmas. HCAs’ responsibilities with regard to complaints and adverse events are also covered.

6. Safeguarding

HCAs are to have a standardised level of knowledge of what constitutes abuse and how to reduce the likelihood of it occurring, including risk management and awareness of the relevant legislation. They will also be taught what to do if abuse is reported or suspected.

7. Person-centred care and support

This covers knowing how to work in a way that promotes patient-centred values. Including recognising steps that can be taken to promote dignity and individual preferences, and recognising how cognitive issues might impair an individual’s decision-making capacity.

8. Health and safety

HCAs must all understand their own and others’ responsibilities in promoting safety. This covers fire safety, moving and handling, food hygiene and understanding the importance of good nutrition and hydration in maintaining health and wellbeing.

9. Handling information

HCAs must know why it is important to have secure systems for storing information and be able to keep records up to date, complete, accurate and legible.

10. Infection prevention and control

This standard relates to having a basic knowledge of how infectious agents can enter the body and steps that can be taken to reduce the likelihood of this happening. This covers hand hygiene as well as principles for safe handling of potentially infected linen and clinical waste.

There has been a mixed response to the minimum training standards and code of conduct. Although they will standardise certain aspects of the role, they do not cover areas such as tissue viability and continence, and could perhaps go further in ensuring all HCAs have the same base-level of knowledge in more subject areas.

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