Should Healthcare Assistants be Regulated?

One of the significant current discussions in healthcare since the Francis Report, concerns the regulation and training of Healthcare Assistants. Healthcare Assistants (HCAs), also known as Healthcare Support Workers, work in a wide variety of healthcare settings from GP surgeries and clinics to acute hospital wards. There are 1.3 million of them working in front-line care roles in the UK (DoH, 2013). These workers are currently unregulated and at present there is no compulsory role-specific training. HCAs are legally permitted to carry out most clinical tasks of a Registered Nurse, however, there is no definitive list stating what tasks they can or cannot undertake. This paper will attempt to demonstrate that there is an urgent need for HCA regulation and standardised training. It has been divided into four parts. The first part deals with the arguments for HCA regulation, the second with the hurdles that regulation would bring and the last part will attempt to draw some concussions and recommendations.

In response the Francis Report (Francis, 2013), published in February 2013, which highlighted poor care and management at the Mid-Staffordshire NHS Trust, the Independent Cavendish Review made recommendations regarding the recruitment, training and regulation of HCAs. The Cavendish Review (DoH, 2013) concluded that HCA training varies greatly between NHS trusts. This is particularly concerning when the core of patient care is now being carried out by HCAs rather than Nurses (Kessler, 2012). There also exists ambiguity surrounding what tasks HCAs are allowed to carry out. This poses significant risks to patients, nursing staff and HCAs themselves. The Nursing and Midwifery Council state that;

‘A nurse or midwife should only del...

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...nover of these workers they need to address these areas. The message being sent out to these workers is that they are not worth investing in. This message must be changed urgently. Unless governments adopt standardised training, regulation of HCAs and Improved pay and conditions; excellent levels of patient care and safety will not be attained. in order to deliver excellent patient care and to better the training, employment and living prospects of the largest proportion of the ‘nursing’ workforce. The paradox is that the lowest paid care workers are those who we expect to work the most independently, going into the homes of strangers, and having to deal with what they find there, without any direct supervision. This requires a high level of resilience. Calling this “basic” care does not reflect the fact that getting it right is a deeply skilled task (DoH, 2013).