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Compulsory care certificate brings HCAs a 'step closer' to regulation


Plans to introduce a compulsory “care certificate” for all healthcare assistants are likely to take years to implement but could be a step towards full registration, Nursing Times has been told.

Last week, health minister Lord Howe moved an amendment to the Care Bill, currently going through parliament, which would make it mandatory for anyone working in health and social care to have a certain level of training.

The amendment hands the power to set training standards to Health Education England. It was backed by the House of Lords but must still win approval in the Commons.

The Care Quality Commission will check HCAs have the required training and take action against hospitals, care homes and other providers that employ HCAs without a certificate.

Royal College of Nursing chief executive and general secretary Peter Carter welcomed the move and said it moved HCAs a “step closer to mandatory regulation”.

“We have long highlighted the variations in training received by healthcare support workers, and the resulting variations in the level of care received by patients, and this Care Certificate will hopefully do much to alleviate these concerns,” he said.

During the Care Bill debate, Lord Howe said the government was still open-minded about regulating care workers but did not think it was “appropriate or proportionate” at the moment.

Gail Adams, head of nursing at Unison, which has more than 100,000 HCA members, told Nursing Times the certificate could pave the way for regulation as any future system would need to be based on common standards and training. However, she said it was extremely unlikely under the current government.

The idea of a certificate of fundamental care was put forward by The Sunday Times journalist Camilla Cavendish in her review of HCA training and support earlier this year.

Ms Adams said there was still a lot of difficult detail to work out, including designing a programme suitable for both health and social care. “We want something that’s not open to local interpretation because, if it is, we’ll be no further forward,” she said.

She called for it to be introduced over five years with a “twin-track”

approach of training all new starters at the same time as rolling it out among existing staff, many of whom already have training.

“Having a five-year strategy is not about delaying the rollout, it’s about making it sustainable,” she said.

Paul Jebb, assistant director of nursing at Blackpool Teaching Hospitals Foundation Trust, told Nursing Times there would need to be “some way of assessing and recognising the existing workforce”.

He said: “There will be a lot of experienced HCAs going through the process. It will not be a quick fix and won’t happen overnight.”

Nursing Times understands the government wants to avoid existing HCAs going through unnecessary repeat training and has asked HEE to find a way for them to show they meet the new standards.

HEE has been asked to ensure the certificate is flexible enough to be used in health and social care and to build on the national minimum training standards published by Skills for Health and Skills for Care this year.

These focus on issues such as communication and the principles of patient confidentiality, rather than the practicalities of giving care. More details about the timescale for implementation are expected soon.

A DH spokeswoman said: “The care certificate will provide clear evidence to employers, patients and service users that the person in front of them has been trained to a specific set of standards, and has the skills, knowledge and behaviours to ensure that they provide compassionate and high quality care and support.”


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Readers' comments (4)

  • We'll there you have it: it's the end of nursing as we know it. As soon as these HCA's are registered you will find the number of RN posts decrease significantly as Trusts take advantage of new cheap labour. The most disgusting aspect - as far as I'm concerned - is that the nursing profession has been brought down by those who are supposed to champion it e.g The RCN, NMC et al.

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  • I do think it is important to have national standards for anyone who works with vulnerable people. I don't think it makes a mockery of being a registered nurse, I would hope it would enhance the team and most importantly improve patient care. Part of me thinks this is a lot of work which could easily be avoided. When I first qualified pretty much every HCA I worked with had or was working towards an NVQ 2 then 3 in health and social care. This seems to of been ditched, by my trust at least. This is a nationally recognised qualification so why not use this? You know exactly what your getting then.

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  • Unfortunately, the government is looking at ways of breaking the strangle-hold RN's have on the NHS, regulating and then registering HCAs is one of the ways to do it. After all, private companies are more likely to bid for contracts which have a very flexible (in terms of pay) workforce. The current model isn't an attractive proposition.

    It won't be immediately apparent, but HCAs roles and responsibilities will increase steadily over time, yet their wages won't reflect this new level of responsibility. HCAs will welcome the elevation of status as they will feel they no longer have to do the 'donkey work'.

    RN's will welcome the support, initially, but in 10 years time when your HCAs are doing medicines, IVs, cannulating, inputting data into medical records, doing ward rounds etc., and you're the only RN on duty taking overall responsibility, please do think on and realise we did this to ourselves!

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  • anon 6.56 - RNs roles and responsibilities have increased steadily over time yet our wages don't reflect this new level of responsibility either.

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