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Compulsory certificate of care for HCAs


A new national certificate for care workers will be introduced in an attempt to drive up standards, health minister Earl Howe has announced.

The decision follows a recommendation by Camilla Cavendish in a review set up in the wake of the Mid Staffordshire Foundation Trust scandal.

She found there was no minimum standard of training for healthcare assistants before they could work unsupervised and recommended at least two weeks of initial training.

Lord Howe said that government would make a full response to her July report at a later point but they had already asked Health Education England to lead work “to develop a certificate of fundamental care”.

He said: “We want to call this a Care Certificate. Our goal in introducing the Care Certificate is to ensure that healthcare assistants and social care support workers receive high quality induction in the fundamentals of caring.

“This should ensure they understand the skills requirement and demonstrate the behaviour needed to deliver compassionate care.”

He added: “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 high quality care and support.

“We will work with the Care Quality Commission to incorporate the requirement for staff to hold a Care Certificate into their guidance.”

He said the government was still open minded about taking the further step of regulating care workers but did not think it was “appropriate” at the moment.

During report stage debate on the Care Bill, peers accepted an amendment moved by Lord Howe that would allow the government to appoint someone to “set the standards which persons undergoing the training in question must attain”.

Shadow health minister Lord Hunt of Kings Heath “very much welcomed” the development of a certificate of fundamental care but called for the government to go further.

He told peers: “I have long thought that the regulation of support workers was necessary, desirable and inevitable because they play such an important role in the caring of so many people.”

Robert Francis QC, chairman of the public inquiry into the failings at Mid Stafford, recommended a registration system for healthcare support workers, but Lord Howe said there were several problems with the approach.

He said: “We need to bear in mind that statutory regulation is not just about training - it is a much broader process.

“Currently we don’t view that as appropriate or proportionate for healthcare assistants and social care workers.

“Let us remember that statutory regulation involves setting standards of conduct, protecting commonly recognised professional titles, establishing a list of registered practitioners - quite an onerous process - providing a way in which complaints can be dealt with fairly and appropriately, allowing a regulator to strike off an individual from the register. It is a complex business - we should make no mistake about that.”

Liberal Democrat Lord Willis of Knaresborough described the announcement of the Care Certificate as a “major breakthrough in terms of the training of healthcare support workers”.

He said: “There is no doubt the overwhelming case to be able to appropriately train the 1.3 million healthcare support workers who do such fantastic jobs in care homes, in domiciliary settings as well as in terms of our hospitals is something which has been a national scandal so far.

“These are a hugely important part of the workforce and to actually have them recognised is important.”

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Readers' comments (21)

  • I have worked as a nurse, but have been off work with depression, have tried numerous times to apply for health care assistant jobs, but nobody will take me on saying I am too over qualified, just don't want the damn responsibilty, don't think the care certificates would say much about the caring or compassion side of the person.

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  • I think the over-qualified excuse is just that - an excuse. The job spec for any post states what is an essential and what is a desirable criteria for the role. Being over qualified from another field - ie a PhD in Chemistry might be a bit to swallow, but a former RN qualification should never be considered over qualified for an HCA post, particularly given the obvious moves to upskill HCAs to something approaching RN in lots of practical areas.

    I wonder if this is more to do with your past health issues than anything else. If you are a Union member, it might be worth asking them. Word of advice, if you have mentioned ill-health on any part of your application form other than the Occy Health form you have opened the door for the appointing Officer to draw an inference and contrive an alternative way of not appointing you.

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  • I think the above is right, when there is such a shortage of nurses you would think that employers would welcome you with open hands, get hold of the union or get the GP to write that you are fit to work, you are being honest which an employer should be glad about.

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  • HCA must have a pin no same as RN , bcz some of the HCA said in my ward you do it you do it you do it to everything and said to the staff nurse. I DON'T HAVE to loss a pin number it is you responsibilities. They don't understand we all there for the patient.
    surprise!!! they leave while a staff nurse handover patient care. IT is sad the nurse suffer with so many tasks.

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  • its ok bringing another care certificate out?
    but!! a big but it is learnt, written,and showed in pracise then! not used so then what justifies this certificate because lots will say I have the paper I can do it this testing needs to be continued on a 6-12 month review so the is no bad habits it wont work

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  • I wouldn't care to be looked after by somebody with no training or qualification. the very idea appals me! there is too much which can go wrong and besides many unskilled workers are also very poor communicators and have no idea how to talk to patients or answer their concerns.

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  • I welcome this announcement. I am currently a HCA and feel disgusted at how little training I received prior to being expected to provide care. I had no training in providing personal care or feeding patients. This training would not only set a minimal standard but also help to weed out some HCA's who are not fit for the job. HCA's port folio of acceptable tasks is forever increasing and it is not uncommon for them to be taking bloods or carrying diagnostic procedures that used to be the job of techs or nurses.

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  • So, to recap. We had Enrolled Nurses and got rid of them. Now we will register HCAs after appropriate training. Seems we have gone in full circle in the name of progress instead of admitting it was a stuff up to remove EN's...

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  • does this mean hca will get a pay rise?

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  • Instead of yet another certificate why not make an NVQ in health and Social Care compulsory for all HCAs?

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  • Anonymous | 23-Oct-2013 5:25 am

    Why should they? RNs are being downbanded and devalued left, right and centre. Most are working using skills, qualifications and expertise way above their level of pay.

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  • I think that somebody needs to do their homework better! Community Carers have to conclude a comprehensive induction programme and complete their Skills for Care Certificate, all of which takes approx 3 weeks.

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  • Alicia Wright | 23-Oct-2013 12:22 pm


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  • ENs did 2 years training, not 3 weeks, no comparison! They had exams to pass, written and practical, by external examiners. They administered medications, except for CDs, but could do a course to cover that; were in charge of wards, in fact did very little that was different to a SRN/RN. Existing ENs in our trust work at band 5, with a high level of expertise. However, I do support a national level of training and registration for HCAs.

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  • Its not rocket science. A course would have to be based on the practicle side of practice. Stop trying to make the argument that HCAs are just about ENs - they aren't.
    HCAs are unregulated & unregistered. NVQs should be compulsary and at least a basic certificate should be a bit more robust than a week or two training.

    Most HCAs are fantastic and deserve the support & recognition, but (as with any proffesion) you get the terrible ones who let the side down...surely some recognized training will help raise standards?

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  • michael stone

    The problem - and this new approach might solve it - is surely what was highlighted above:

    'Tony Wallace | 22-Oct-2013 6:16 pm

    I welcome this announcement. I am currently a HCA and feel disgusted at how little training I received prior to being expected to provide care. I had no training in providing personal care or feeding patients.'

    HCAs, even if in theory working under supervision, should be trained to a basic standard in their tasks: otherwise, it is unfair on the HCAs, and unfair on the people the HCAs are caring for.

    I also think HCAs should, like everyone else, be able to improve their skills, and receive recognition for becoming more capable as they do that.

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  • I work as a nurse in a community team. All our HCAs complete an induction, and are given a set of competencies which they have to complete. They are all expected to attend relevant training courses, not just mandatory ones. Being a HCA is a good job, apart from the money.

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  • Anonymous | 25-Oct-2013 1:57 pm

    sounds very reasonable and the same rules and standards should apply to all which does not seem to be currently the case although all patients have the right to the same accessibility and quality of care.

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  • My concern would be the loss of less academic minded HCA's. Nursing and Caring should be about just that, Nursing and caring!! not on the basis of someones ability to read and right around the subject. The push for Degree level nursing doesn't seem to be raising the care standards, in fact i think its damaging a job i love. Compassion and respect cannot be learnt in a book, it has to be experienced by dealing with people, and being allowed to react in an appropriate way without the fear of being reprimanded. All this will do is train a generation of HCA's that think they are to qualified to do the job they applied for.

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  • "read and right"?! Surely, reading and WRITING to a basic level must be compulsory.

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