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Regulation of HCA not a top priority for the NHS


The chief executive of the NHS has dismissed calls from two of the country’s most senior nurses for healthcare assistants to be regulated, saying “nurses would say that wouldn’t they?”.

During his evidence to the Mid Staffordshire Foundation Trust public inquiry last week Sir David Nicholson was asked to respond to the comments, widely reported in the national media, from Royal College of Nursing chief executive Peter Carter and Nursing and Midwifery Council boss Dickon Weir-Hughes.

Professor Weir-Hughes warned the country was heading for a “ghastly national disaster” without regulation.

Sir David said: “I’m not convinced that spending a huge amount of time and effort in [creating] the registration organisation, as opposed to putting the effort into training and education, might be a better way forward. And, of course, the nursing profession would say all of that, wouldn’t they?”

The inquiry is examining why appalling standards of care at the trust went unnoticed for so long and is considering whether regulating HCAs could help improve standards in future.

However, Sir David told the inquiry regulating such a huge and diverse workforce, whose roles ranged from “housekeeping to the direct care of patients”, was a complex task and was not of “top importance” at the moment when the NHS was going through major reform and financial challenge.

Inquiry chairman Robert Francis QC questioned his priorities, asking what could be more important than ensuring that the people “charged with feeding and providing basic care to our most vulnerable patients are fit and proper people to do that?”

Sir David said training and education was more important than regulation.

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Readers' comments (36)

  • I haven't got time to read all the responses because I am on the shop floor and not the higher echelons of power, so I apologise for any repetition, but shame on Sir David if these comments were reported correctly. It doesn't matter what status you are - we should ALL be regulated with everything that entails if we are looking after vulnerable people. How does it make any difference if you are an unqualified or qualified carer? The person on the receiving end just wants a good service. It is actually discriminative NOT to be. If I was a conscientious HCA I would WANT to be regulated.

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  • tinkerbell

    Anonymous | 3-Oct-2011 6:05 pm

    Well said you. End of.

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  • I am really concerned about regulating a workforce who are neither trained to a certain standard or hold any responsibility. As nurses we should be protecting our professional standards and abilities and not be campaigning for this. HCA's are already allowed to be members of the RCN and now the RCN want to make them full members. THEY ARE NOT NURSES! i hear so many saying "there is no difference" "we are all the same" etc. We are not. Doctors, Dentists, Radiographers etc would never allow it - so why do we?

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  • If the top nobs looked and corrected all the waste that occurs in the NHS they would have money to regulate the HCA's properly and not just with Mickey Mouse NVQ's. ANY idiot ccan come in off the street from any country and become an HCA and 'care' for the moster vulnerable. It is shameful.
    Start with millions of wasted unused medication. Heating on in hospitals with windows and doors wide open. A dozen secretaries when half the amount would do. Over-salaried NHS bosses etc....

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  • Yes I agree the same goes for an RN who may be struck off the register and begin work as an HCA. If people would actually listen AND hear that the Healthcare Assistants WANT to be registered/regulated for the safety of patients. These members of staff where I am employed are trained to a very high standard, doing more and more clinical and bedside roles of an RN i.e. cannulations, taking bloods, changing enteral feeds, ECG's, catheterisations, manual BP's, evaluations, even scrub and assisting surgeons.The Only duties they dont do are IV's and drug rounds. Not all are useless skivvies, majority are educated human beings.

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  • Well Said Louis!

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  • michael stone

    Anonymous | 2-Oct-2011 3:03 pm

    You are rigidly equating 'regulated' with a regulatory body such as the NMC.

    All I am saying, is the rules 'about who is responsible for the competence of the HCAs on any particular ward' must be CLEAR !

    Call it 'local-level but defined' regulation, if you wish to - but if an HCA makes a mistake because of inadequate training, that is not down to the HCA unless the HCA has been told to not attempt such a task - patients need to know who is culpable, in that situation. And if it is to be the nurses on the ward, those nurses need to know that, and also to be in charge of HCA training and tasking.

    It is about COMPETENCE and CLARITY.

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  • i'm an hca. before the man from the glucose meter company came to the ward and trained me, nurses never asked me to use the meter. after the training, i used the meter nearly every day. before the charge nurse elected me for two day phlebotomy training, i was never asked to take bloods. after the training i was asked to take bloods more often than the nurses. explain why do hca's need a regulatory body so that nurses can take their responsibilities seriously and manage the ward workload and skill mix properly? whenever i ask for an explanation, i'm told that because i'm an hca i wouldn't understand the answer, but i've been involved in management in non-medical settings, so perhaps it's because nobody has yet given me a rational and coherent account. as for de-registered nurses becoming hca's, surely if they pass their crb checks their experience should be welcomed. i currently work with a couple of nurse degree drop outs and they make damn good hca's.

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  • @ tinkerbell | 30-Sep-2011 9:50 pm

    surely, in ANY profession, if the person in charge asks a subordinate to carry out a task within their job description, and that subordinate "does their own thing" that would be a disciplinary matter. depending on the frequency or severity of the insubordination it may be a dismissal matter. i know this has happened to hca's, so the nursing profession is not somehow different to other professions in this regard. why is it that you, and the majority of respondants on this thread, are unable to understand the basics of management and delegation? is it a training issue? perhaps the money spent on creating an hca professional body would be better spent teaching nurses how to delegate.

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  • Anonymous | 7-Oct-2011 8:53 pm It seems you don't understand much about delegation, yes the HCA would be disciplined and even sacked, but the Staff Nurse would still be ACCOUNTABLE according to our code. Instead of using the money teaching Nurses how to delegate, it could teach you how to follow orders properly instead?

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