New training standards for healthcare assistants should be made mandatory as a step towards “inevitable” full registration of the care workforce, according to the author of a major review.
The next government must tackle the risks to patient safety from the lack of checks in place for HCAs, said Camilla Cavendish, who led a review into the training standards of care assistants in 2013 in the wake of the Francis report.
Ms Cavendish, associate editor of The Sunday Times, was speaking ahead of the introduction of HCA standards that came into effect on 1 April and which are based around the new Care Certificate.
Health Education England has drawn up 15 standards HCAs should achieve over 12 weeks, which should be delivered by NHS trusts and social care employers as part of their induction.
“We have ended up accidentally with two tribes of people trained in different silos”
The standards, completion of which contribute towards gaining the certificate, are designed to deliver a national minimum level of training for HCAs. They cover basic areas such as fluids and nutrition, privacy and dignity, patient handling, and infection prevention.
Achieving the care certificate is considered to be best practice by Health Education England and the Care Quality Commission will check on its implementation during inspections. However, it has not been made a compulsory requirement by the government.
Ms Cavendish said she agreed with comments made by Lord Willis earlier this month, in which he called on Health Education England to make the care certificate mandatory.
She described the standards and certificate as a “real move forward”, but acknowledged that they were not going to “solve every single problem”. HCAs could have “any numbers of pieces of paper”, she said, but what mattered was the “care that people are actually getting”.
On the full registration of HCAs – one of the recommendations in the Francis report that was rejected by the government – Ms Cavendish said it was important not to overestimate the safety net this could provide.
She noted that the fact nurses were registered and accountable to the Nursing and Midwifery Council had “not saved patients from appalling care” at Mid Staffordshire Foundation Trust.
Registration of HCAs would be a “huge bureaucratic task which would not necessarily create the utopia some of its advocates think it would”, she added.
However, despite this, she argued that HCAs would ultimately need to become part of a total registered nursing workforce.
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“The dividing lines are artificial and we have ended up accidentally with two tribes of people trained in different silos,” she said. “I actually think we need to move to a situation where there is one registered workforce and in the end that is probably inevitable.”
Ms Cavendish added that a future government “absolutely” needed to address the systemic gaps that could allow HCAs who had been disciplined or were guilty of misconduct to move freely between employers without being identified.
“There have been proposals for some time now for skills passports, references and ways to check up on people,” she said.
“It is completely critical, and until we can do that we can never reassure patients or do what the staff themselves want, which is to make sure no one who is underperforming can reappear somewhere else,” she said. “We don’t have that at the moment.”