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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)

  • " the nursing profession would say all of that, wouldn’t they?”

    The arrogant prat!!!!

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  • I agree with Mike !!

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  • well actually Sir David Nicholson, not all nurses are saying it so do not patronise us.

    I suppose "spending a huge amount" on anything isn't going to be "top importance". . . but being chief executive of the NHS he would say that, wouldn't he?

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  • michael stone

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

    Nobody has yet commented on that - but you are probably all nurses. The above is fundamentally right - but, unless people are regulated, nobody checks up on the quality of the training and education. THAT is why you need the regulation, to make sure HCAs are trained properly - and, to establish who 'higher up the food chain' is to be BLAMED if their training is inadequate !

    I'm not 100% sure if nurses would say it - I don't think Carter wants the RCN to have any involvement in the process, as HCAs are not nurses. But clearly nurses must support the training of HCAs if the HCAs are involved in care.

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  • David Nicholson's comments are astonishing. He counterposes "major reform" and "financial challenge" to regulation of HCAs as if they inhabit different universes.

    David Nicholson and his predecessors have driven grade mix often without any serious consideration as to whether the financial savings have been made without compromising standards of care.

    Now the chickens have come home to roost he appears to want to duck the issue (if you'll excuse a bad pun).

    Michaelm Stone is right. Training and education will only be taken seriously for HCA with the advent of regulation.

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  • Am I surprised, NO. Why does he not have the guts to say it straight He does not see the improvement of patient care and safety a priority over saving money

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  • John Howes

    At a time when the answer of many Chief Executives as to who does what with patient care is you get a bigger bang for your bucks with HCA's.

    The problem however, is that most employers will tell you that the Registered Nurse is accountable for supervising their performance; that said, the absence of regulation means for the most part the training is not subject to scrutiny and when the effluvia hits the fan it will not be the Chief Exec who will be in the spread zone!

    It will, in all certainty be a scapegoat who has; a) not been involved in the training, b)may be the most junior RN on shift and c)be the body offered to the NMC rather than the Chief Nurse, Matron or Ward Manager ( we called the Ward Sisters once) who will have assured anyone who doesn't have to deliver care that all is well.

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  • Can anyone give me some advice - I work with HCAs who frequently do not carry out the tasks they are given at handover, when confronted they just say "I'm not doing it, you do it". Most of the qualified staff just do all the work and leave them to sit around because we need the numbers. HCAs were supposed to lighten our load but they've just increased mine.
    I would welcome registration and training because then we might attract people who actually want to do the work.

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  • Steve Williams

    Omigosh... here’s yet another example of the Victorian parodies like - The Rt. Hon. Sir Joseph Porter, KCB, singing "When I Was A Lad" from H.M.S. Pinafore...

    Sir David Nicholson? Sir Doctor Peter Carter O.B.E? Lord Professor Weir-Hughes? Who are these self-ego-masturbators?

    When was the last time that any of these jolly Jack-Tars went to sea?

    Do they really get paid in millions for spouting this "nonsense" while dedicated Nurses in the UK are being institutionally abused?

    Too many experts up there on the “Poop-deck” and not enough hard-working “hands on-the-deck” for my liking!

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  • Steve, I always preferred A British Tar ... ;D

    Anonymous | 30-Sep-2011 4:52 pm well said I absolutely agree.

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