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NMC considers opening register to healthcare assistants


The Nursing and Midwifery Council is considering opening a new section of the nursing register for so called “associate nurses”.

This would be the new name given to advanced healthcare assistants who are often called “assistant practitioners” but are not qualified nurses.

At a meeting of the NMC last week, the regulator agreed to draw up plans that would allow these healthcare assistants onto the nursing register and, possibly, to require them to hold a relevant national vocational qualification and receive specified training from their employer.

An NMC team is to look at training requirements and other measures that would be needed for the support roles.

The council is also proposing that all HCAs should practise only “under the direction and supervision of a registered nurse or midwife”.

However, Unison said the plans did not go far enough.

The union’s head of nursing Gail Adams said: “It’s a missed opportunity. It’s not going to address the public protection issues - there haven’t been sufficient discussions with employers to date over whether this is the right direction.”

She welcomed the move towards registration of assistant practitioners but said they were a small proportion of the healthcare assistant workforce, of which Unison represents 100,000.

In June, Nursing Times revealed that a Department of Health-funded study had suggested healthcare assistants now spent twice as much time on direct patient care as nurses.

The authoritative study from University of Oxford academics found that half of healthcare assistants entered the role with ambitions of becoming a nurse and many performed complex procedures such as female catheterisation, taking bloods and carrying out ECGs.


Readers' comments (39)

  • Sigh, and here we go again, round and round in circles.

    I wish they'd stop talking and actually bloody do it!

    I'm not so sure about the terminology 'associate Nurses', but all HCA's DO need to be on a seperate part of the register to make them registered and accountable for all their actions and their practice.

    It should also clearly state that complex procedures such as female catheterisation, taking bloods and carrying out ECGs should only ever be undertaken by registered, qualified Staff Nurses!

    There is room for a 'bridging role' (call it any one of a thousand names here) where BASIC (and I cannot stress that term enough) Nursing tasks are undertaken by HCA's with appropriate qualifications and accountability. But that should never mean that any HCA can be allowed to perform these tasks as it seems to be the direction trusts are taking. It is after all cheaper to employ a HCA, let them do everything eh?

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  • As a recently qualified Assistant Practitioner who has been mentored, supervised and deemed as compentent in female catherisation, venepuncture and ecg practices. I would welcome the recogntion by the NMC. Workforce developement is something that like it or not is going to happen and it should all be about patient care being delivered by competent individuals. All the team I work are happy for me to carry out the procedures as they know I am competent and work within my competence .

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  • Mike, HCAs have been taking bloods and doing ECGs for years and are generally very good at it. Phlebotomists are not trained nurses and they make their living taking bloods. As for female catheterization being complex? I think that speaks volumes. I am a male nurse who did my first female catheter as a student on a bed bound 22 stone lady in the community. In first time. Maybe you need to brush up on your anatomy?

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  • Oh my God! It is the NMC as in Nursing and Midwifery Council... are HCAs Nurses... NO!!!!!

    We are selling ourselves down the river we continue to moan because people do not treat us as professionals and yet we do not think that our governing body should just be for Nursing and Midwifery professionals- why dont they join the GMC??? Because they are not physicians the same as they are not Nurses!!!

    Why don't they start a new registering body????

    I despair!

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  • So no one else thinks that after years of talk that this is the NMC out to make money? It will be interesting to see how much they decide to charge as a registration fee, and what the effect will be on the already burgeoning numbers of competence/misconduct hearings that are already paid for from registration fees.

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  • Anonymous | 14-Dec-2010 10:08 am, actually I am up on my anatomy, skills, legislation and everything else it takes to perform numerous skills such as catheterisation. I'm a QUALIFIED staff Nurse. I am also registered and accountable for those skills, it's kind of a prerequisite of being one of those aforementioned qualified staff Nurses. You are right in the fact that HCA's have been doing it for years, doesn't make it right. At the end of the day HCA's are being asked to do more and more clinical skills simply as a cost cutting measure. They are not qualified staff Nurses, and if they want to perform these tasks they should become one. I don't care how much HCA's scream they are competent at performing these tasks, they are not qualified, registered and accountable in the same way a professional staff Nurse is and should not be performing these roles, it is as simple as that. To give you one example, I know of one place (I won't say where) that refuses to hire more Staff Nurses because it is too expensive, but hires HCA's and deems them competent to give out medications after a 6 hour course??!!! Never mind all the other tasks they are expected to do without the slightest comprehension of the A&P, the theory, etc etc behind those tasks. This is WRONG!!!! It is not fair on the HCA, and it is unsafe for the patient. Simple as that.

    Health Care ASSISTANTS (the clue is in the job title there) are there to perform the necessary basic tasks, bedmaking, dishing out meals, cleaning, etc etc etc. The bottom ranks are necessary in any and every profession. Many people are capable of being more, and there should be a proper route for them to progress, if not to a fully qualified staff Nurse, then at least to an intermediate role with recognised and uniform qualifications that has specific BASIC tasks (such as obs) as its remit. For those that are capable, then they should be able to train as a Staff Nurse.

    NHS Nurse, I really see your point. I also agree wholeheartedly that HCA's are NOT Nurses. However I think the NMC could have the registration of HCA's with the proviso that it is a very distinct and seperate part of the register. Calling them associate Nurses as this article suggests is not helpful to anyone.

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  • Oh Mike
    I really see a slippery slope- they should not join the NMC reg. How distinct can the part they join be??

    We would be dumbing down our profession- again I ask why dont they join another reg such as GMC, BPA or HPC?? The answer we all know is because the other professionals would not have it!

    They should have their own register I wouldn't want to join another professions registering body why do they want to join ours??

    what a week
    -HCAs on our reg with some stupid trumped up name
    -nurses being asked to give up holidays
    -2 year pay freeze

    It will seem we will just lie down and take it!

    remember people this is only the tip of the iceberg

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  • I am a HCA currently doing the second year of a foundation degree to become one of these unqualified and un trained assosciate nurses. What is everybodys problem ? I am trained, have gained skills just the same as any student nurse - i have to be assessed and signed off for these skills, i understand A&P, do bloods, ECGs, basic obs, understand dressings, leg ulcers etc and without having these skills i know from experience that at times patients in my area of practice would not have had the care they are entitled to because the registered staff were too busy , not enough time etc. I am accountable and responsible for what I do and have no problem with acccepting that. Someone talked about dumbing down our profession - from where i stand surely the issue is to ensure that patients receieve the best possible care that we can give them and the only way we can do that is by having all staff whatever their title -trained to the highest possible standard - ask any HCA who cares about what they do and they will vote for registration - we are not afraid to be responsible or accountable for what we do -Why shouldnt HCAs do more demanding roles , after all if we have been trained to carry out the same tasks what is the difference between a registered trained member of staff and HCA who has received the same training but is not allowed to be registered ????????

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  • As ever put the word 'HCA' in the tittle of an article and wait for the 'imflamatory response'. Thank Goddness I dont work with Registered Nurses that are so spiteful in their comments as I often see here. I can only imagine that it is because some Registered Nurses must feel their role so threatened that they speak like this. Why don't they talk about that instead of trying to keep HCA's in their place or in the bottom ranks as one comment says.

    Be honest please what are the real concerns, patient care?, safety?, dumming down? Those I can understand. Or is this just professional snobbery? What would you like a register for experienced HCA's to be called 'To thick to train as a nurse register'?

    I am due to qualify as an AP and welcome registration or regulation from the NMC. I think we need to educate some qualified staff on what AP training involves and for some of them to realise that the qualification (Foundation Degree) is academically equivalent to a Diploma which many Nurses have. However our training is for a supportive role, but we should be able to complement each other.

    Some Nurses may want to throw up their hands in horror at the idea of the NMC regulating us, however some of us who have worked hard to gain qualifications and have also given many years of care to patients also feel like giving up with such negativity projected towards our role.

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  • Why don't we confer the title of Enrolled Nurse, then we can encourage them to do an Enrolled Nurse Conversion Programme - Nursing Times Team - have we been here before?

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