Last week the media reported the apparently novel news “discovered” by the Cavendish review that most hands-on nursing care is provided by unregulated healthcare assistants (page 2).
The review into the role of healthcare support workers, carried out by The Sunday Times journalist Camilla Cavendish, was prevented from looking at regulation of these staff by its terms of reference. HCA regulation was recommended by Robert Francis QC and is widely seen as a move that could have the greatest impact on standards of care. However, it was rejected by the government.
The Cavendish review is making noises about standardising training. It contends that, if HCAs get a thorough grounding in the “fundamentals” of the job, the public’s receipt of consistently compassionate, high-quality care will dramatically improve.
No surprises there. As nurses have taken on more of doctors’ responsibilities, the work traditionally done by nurses has drifted into the job description of HCAs. So let’s hope the proposed “nursing assistant” title does not confuse people further.
We do not want the Cavendish review to make it easier for the government to replace more nurses with cheaper, unregulated nursing assistants
However, the nursing profession must be careful not to relinquish too much of its role to others. Nursing is not just a set of tasks to be completed, and nurses can contribute enormously to patient outcomes and safety by maintaining their involvement throughout the patient pathway.
What we do not want this review to do is make it easier for the government to replace more nurses with cheaper, unregulated workers. This would undermine the profession’s standing.
While it is right that trusts are assured of HCAs’ competence, they must respect nurses’ three years of training (four in Scotland) and continuous professional development. That cannot be easily substituted.
Nurses have knowledge, skills and expertise, much of which they can share with HCAs to improve care. But much of their work can only be done by a qualified, regulated nurse.
I know of HCAs with huge talents in providing compassionate care and superb clinical skills. But let’s not allow anyone to suggest that a few days’ training will make it safe for HCAs to take on the more difficult aspects of nursing.
The public will always need nurses, and nurses should never allow themselves to be talked out of their role or substituted.
Strengthening the nursing workforce with training is to be applauded. But replacing nurses is most definitely not.
Jenni Middleton, editor
email@example.com. Follow me on Twitter @nursingtimesed