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05.11.12

‘Unacceptable’ care from healthcare assistants

A report commissioned by the Royal College of Nursing suggests that many NHS patients are receiving “unacceptable” levels of care from healthcare assistants, more than 50,000 of whom now work in hospitals and care homes.

For vulnerable patients especially, there are “serious concerns about public protection”, according to the commission led by Lib Dem peer Lord Willis of Knaresborough.

They feed patients and take their temperature, but are not trained to spot warning signs such as dehydration or rapid body heat changes.

The report says all healthcare assistants should be trained to at least NVQ level 3.

The report says: “The commission finds it unacceptable that staff whose competence is not regulated or monitored are caring for vulnerable citizens. It is equally unacceptable that registered nurses must take responsibility for supervising colleagues on whose competency they cannot rely.”

By September 2013 all nurses will be required to have degree-level training, which the commission says is “not simply desirable but essential”.

Lord Willis told the Telegraph: “The registered nurses now are doing more highly specialised tasks and it is not good enough to say someone else can do those basic nursing tasks, they are not just add-ons.

“You really have to have people who do not just put food in front of someone, but understand the significance that a patient takes food and hydration. It is not good enough to simply know how to do something, you have to know why you are doing it.”

Dr Peter Carter, chief executive of the Royal College of Nursing, said: “Improvements will need to be made to the profession in the future, notably in the regulation of healthcare assistants and the need to make all student placements match the very best.

“However the evidence in this report makes it very clear – the way to do this is to continue with nursing as an all-graduate profession. There is no truth in the suggestion that because nurses receive training from universities as well as on the ward they become less caring.”

A Department of Health spokesman told the newspaper that a code of conduct and minimum training standards for healthcare support workers will be drawn up by January but added: “Public confidence is really important, however in the case of healthcare assistants, there is no evidence that compulsory regulation would lead to higher standards.

“They are supervised by professionally qualified staff, and often by experienced nurses. Regulation does not, in itself, change culture and is no substitute for proper performance management, good leadership and day to day high quality patient care.”

NHS Employers’ head Dean Royles said: “The Willis Commission's report is another useful contribution to the debate, but we need to look at it in the context of the real challenges that NHS employers are facing on a daily basis.

“Employers are as passionate about providing high quality care as the nurses they employ, but they are operating in an increasingly challenging environment.

“Employers want to provide high quality care while coping with limited resources, increasing demand for services, and rising expectations from patients and their families. It would be great to see a report that truly recognises these very real challenges.

“I understand the move to make nursing an all-graduate profession. However, it is essential that we continue to value the fantastic contribution of the many nurses that qualified through a different route. They are the backbone of the NHS and will continue to be so for years to come. We must value their fantastic work and we cannot let them be seen as second class carers.”

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