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Exclusive: Call for focus on HCA standards ahead of crucial review


Healthcare support workers need consistent training, professional development and better workforce planning, academics have warned, ahead of the imminent publication of a major review.

Sunday Times journalist Camilla Cavendish is expected to publish the findings of her independent review into the training and support of HCAs later this week. She is expected to recommend a series of national measures to improve standards and training for support workers.

Ahead of the review’s publication, academics have shared the findings of their own analysis on HCA education with Nursing Times.

A six-point plan that should be adopted by the NHS to ensure patients receive the best care from HCAs has been drawn up jointly by the Institute of Vocational Learning and Workforce Research, based at Buckinghamshire New University, and the Royal College of Midwives.

It calls for greater consistency in the qualifications that support staff have access to and more “robust” workforce planning, including clear role boundaries and grading for HCAs. There also need to be improved continuing professional development for support worker roles and clearer career progression pathways from bands 1-4 into pre-registration nurse education.

Institute director Richard Griffin said more could be done to develop HCAs. Developments like the Cavendish Review “provide a great opportunity to address long-standing problems, such as lack of clarity and understanding about health support worker’s roles”, he said.

RCM chief executive Cathy Warwick added: “The NHS must ensure all its staff have the right knowledge, values and skills to deliver safe, compassionate and effective care. Support workers are an integral part of the workforce and must be well-educated and developed.”

Following the care failings identified at Mid Staffordshire Foundation Trust, there have been renewed calls to improve both the training and regulation of HCAs.

In his public inquiry report on Mid Staffordshire, Robert Francis QC recommended that a register of HCAs be created, as well as a national code of conduct, training standards and a distinguishable uniform.

Training standards and a code of conduct have subsequently been published by Skills for Health. But ministers have consistently rejected mandatory HCA regulation, despite calls from Unison and the Royal College of Nursing.

Ministers have effectively blocked Ms Cavendish from making recommendations on regulation by not including it in the terms of reference for review.

RCN head of policy Howard Catton said: “We know that the terms of reference for this review prevent Cavendish from recommending mandatory regulation – that is a shame.”

But he said the review was still a “decisive moment” for HCAs. “[It] ends the invisibility and neglect of this vital workforce and unambiguously recognises the contribution these staff, in their hundreds of thousands, make to patient care on a daily basis,” he said.

Ms Cavendish is expected to focus on areas such as recruitment and training, support and supervision, and public confidence and assurance.

Mr Catton added that the RCN hoped the review would include proposals on how HCAs should interact with registered nurses, as well as improving their education and support.

Head of nursing at Unison, Gail Adams said she hoped the review would address the “inconsistency in training and staff experience”.

“I hope she will recognise the vital importance this amazing group of staff play in delivering care to some of the most vulnerable in our society,” she said. “If we don’t invest in our staff patient care suffers.”


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Readers' comments (7)

  • I have always known that HCA play a vital part in patients' care and was always suprised that chief nurses did almost nothing in bringing this part of the workforce up to the right standard.
    In fact even senior nurses need to understand that basic care is the foundation of the rest of the care.
    On the wards there is never enough carers to do basic care, and nurses fill in a big chunk of their time in this area.
    Also when caring work is being talked about then, in the same breath there is the importance of talking about going on to be a nurse as if being a carer is only a transition stage to better things. Why? Is it not good to be a carer?
    Rather it should be : there is the option if one wants to ..
    When I started nursing HCAs used to be focused on patients care. Now with the removal of the housekeepers carers spend more time in the ward kitchen toasting bread, making tea etc instead of getting patiens ready for breakfast. They spend a lot of time in the busy period for toileting after lunch getting menu sheets ready for their patients especially on elderly wards.
    Water jugs washed filled and distributed by the house keepers now done by the HCAs.
    None of the chief nurses had the intelligence to actually look into the so called 'little unimportant jobs' and see how time consumining they are and measure how much time the HCAs actually have to spend with the patients.
    This study if done considering ALL the jobs that has to be done on a daily basis will show light on why we need to look at this area very closely.
    I believe nurses should also do basic care but their time should not be largely taken up with it.

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  • "Ministers have effectively blocked Ms Cavendish from making recommendations on regulation by not including it in the terms of reference for review."

    They should just have told her what to write as well why they were at it.

    Would've saved everyone a lot of time.

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  • tinkerbell

    everyones being stitched up like kippers.

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  • i am already trained up to a level if i have to be trained any more thay will have to up my band of pay i am doing band three/four

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  • I want to say a lot but I can't say it.....

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  • anonymous ] 9-jul-2013 9:29 pm
    why not!! this lot has been under cover for years they just something for nothing and people will rebel because they have had enough beeing used.

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  • @Jodie's mate | 9-Jul-2013 12:09 pm

    they may have told her what to write but didn't tell her what to say...

    Sarah Montague speaks to Camilla Cavendish about her healthcare report, published today (bbc radio 4, today programme)

    (available to listen on catch up for six more days from the date of this post)

    "my view on that is that we saw terrible things happen at mid-staffs where nurses were registered, and i don't think that registration on it's own actually solves this problem, i think what we need is proper leadership and management, which is in every care home and every hospital, where employers are held responsible for the quality of those staff and they're held responsible for meeting certain basic standards of competence and caring and i think that's more important than actually just registering on it's own."

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