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HCA training criticised as out of date and parochial


One of the country’s senior nurses has warned that training for healthcare assistants is “Victorian” and puts patients at risk.

Writing in Nursing Times this week, Queen’s Institute for Nursing director Rosemary Cook warns that the education and regulation of HCAs must be made “standard and compulsory” urgently.

No one would argue today against regulation and high quality training for nurses - so why are HCAs still fighting for this right?

She compares the inconsistencies in HCA training to those experienced by nurses 100 years ago.

She writes: “With nurse education now based in higher education, and all nursing courses soon to lead to a degree level qualification, it would appear that we have solved the problems that the Victorian approach threw up: inconsistency in approach, parochialism of outlook, variation in inputs and serendipity of outcomes.

“But we are recreating exactly these issues in relation to the preparation of healthcare assistants.”

Unison head of nursing Gail Adams said: “No one would argue today against regulation and high quality training for nurses - so why are HCAs still fighting for this right?

“Survey after survey shows that HCAs also see regulation as an important step in the right direction,” she added.

However Matthew Hamilton, director of policy at the Councils of Deans of Health, defended the quality of education provided to HCAs.

He said: “Universities give a good education for healthcare assistants, demonstrated by the fact that many of them go on to become registered nurses. We’re very proud of that.”

Ms Cook’s comments follow a review in August, carried out by the National Nursing Research Unit for the Nursing and Midwifery Council, which also said there were strong patient safety grounds for regulating all HCAs.

A Department of Health spokeswoman told Nursing Times that the government would be looking at regulation in “more detail” next year, including that of HCAs.

In Scotland, all new HCAs will be required to achieve a set of induction standards and to comply with a code of conduct from 31 December.

The Council for Healthcare Regulatory Excellence has previously suggested it may set up a voluntary register for HCAs.

HCA training criticised as out of date and parochial


Readers' comments (23)

  • register for h c a's bring it on because some hca's come into the job thinking they are nurses and know nothing so it needs somthing set and if hca's dont meet them thay are out?

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  • HCAs should have standardised training across the NHS but I am not sure that universities are the right people to deliver it. We have a clinically based NVQ III programme for our HCAs to achieve - training and assessment is done both within a classroom environment and in practice on the wards. This ensures that they are trained and assessed by practicing practitioners and keeps the main focus on practice rather than theory.
    University education is often theory led and may be off putting for the very people we want to attract to 'care' for our patients.

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    Bravo it is time someone realised that nursing should be taught in hospitals not universities
    I also realise for the third time in nursing history we are going to have that much needed SEN back on our wards. Bring it on the sooner the better. We also need to realise that not all HCAs have the ability to pass exams and they are only working to support their family's .So a choice of further training is needed here

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  • how is this going to happen with gov cut backs and where is the money coming from!! yes we have workers that the job is to support family like everyone else be this is where mistakes are made and even more money has to be paid out in comp!!

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  • It's long overdue but HCA's face preudice from the very people they support, Nurses. How often are they still referred to as "untrained" staff even while at NVQ2 level. No, not all HCA's can pass exams but that does not mean they all can't, after all how many Nurses on the wards started out as an HCA. Nurses want want their role to evolve but seem to be unable to see the irony of many of their attitudes to HCA role development. If you want a review of roles within the NHS it has to be ALL roles

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  • What is this all about? HCA's are NOT trained. They LEARN tasks. If they want to be a nurse then do a nurse training. If they are registered then why not just have an alternative pathway to actually become a nurse (not SEN but something that leads to a proper and useful qualification.) As for saying that putting nursing into higher education has ironed out inconsisitencies in training is a complete load of rubbish. There are still huge differences in what some 'so called' Universities teach, train and turn out in the way of supposedly trained nurses. We have students from two Universities at the hospital where I work and they are polls apart in their knowledge, skills and attitude. One long standing University provide intelligent, keen, motivated and well informed students. The other, a converted polytechnic, provides ill informed, under supported and in some cases pretty sub-standard students. The second can't attract the good students and the first can take the cream. So no in equality there then? These educators need to stop pretending they know what they are doing and look at what happens once these nurses set out into the real nursing world. SUI's, poor care, rudeness and all sorts of other things which our patients have been complaining about. Well, what is the solution? Use HCA's instead. Yes, so much cheaper and easily exploited. It is also a lazy way of pretending to be a nurse. Now you want them to be registered? It is the death sentence for real nurses and it will be our own fault.

    If we start registering UNTRAINED HCA's they will replace us. They are already 'trained' in too many 'tasks'that should be done by trained nurses. This causes holistic care by trained nurses to go out of the window and things get missed. Of course, it reflects the nurse training of 100 years ago but where do you draw the line in 'training and registering)? We need to improve the REGISTERED real nurse training not start a whole new second class 'nurse' our of HCA's.

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  • As a community based HCA I genuinely support nurses in their interventions. I am not trained to diploma, or degree as I would struggle with full time commitment to the course without bursary funding !!
    However, nurses are accountable to their PIN and take decisions based on their accumulated knowledge, skills and dip training. I stand in awe to some of our nurses as they are committed to CPD and delivering top quality palliative care. As a team in the community we work well, and yes our nurses do help parients meet their personal hygiene needs, as washing a patient themselves is integral to any assessment of patients needs.
    I do feel there ought to be a register of HCA , as this could keep standards up and promote our staus as key team members. It would also protect patients from poor HCA practitioners, that by themselves make the rest of us look like heartless fools.

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  • I started out years ago as an auxillary nurse, I was given more respect then from the trained staff than I do now.
    I agree we should be accountable for our own actions, but we should not be labled "just an HCA".
    I also dont agree with the nvq's, just because someone has done level 1,2,3, does it make them a better hca, some people yes others no it seem to be a power thing towards other hac,s that have not done nvq's
    Over the years I have found that patients talk more to the hca than they do the trained staff as they feel like what they are saying is falling on deaf ears.
    What has happened to good old fashion nursing, where we all had time for the patients, to listen to them and give them a hand to hold. Is to much to ask to still do the things that mean so much to someone.

    We dont ask for much as HCA's what we do ask though is to be part of the team that we work with instead of being a dogs body.

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  • To all the HCA's that have undergone any training and strive to develop themselves while carrying out full time employment on a very low wage, I commend you for your hard work. As a qualified nurse ( who was once an Enrolled nurse as well who had under went worth while training for 2yrs one year leess than the Registered nurse) take my hat off to them for all the hard work and excellent care. As a nurse I am offended by the coment written by other nurses on this site. what about our code of conduct where we need to be careing and proffessionnal to all patient and staff .i take it that this nurse dose not follow suite. I would like to sent my appologes to all health care that read this and ensure that they are aware thast all qualified nurse do not fel the same and are aware that the HCA is an integral part of the nursing team both on the ward and in the community. JB

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  • I fell thatthese types off comments could be seen as beeing very negative not only to HCA but also any one who has undertaking the Enrolled nurse training .
    this type of feed back only fules the fire that will allway be between HCA and registered nurse - We need to rember that in the long run we are there as a caring proffession . where is ther care...

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