Standardised training for HCAs – Cavendish

All healthcare assistants (HCAs) and social care support workers must undergo the same basic training, a new review has recommended. Camilla Cavendish was charged with investigating how standards in HCAs could be improved, following the Francis review.

Her report calls for a standard ‘Certificate of Fundamental Care’ before HCAs can care for people unsupervised.

Other recommendations include opportunities for care workers to progress into nursing and social care through a Higher Certificate of Fundamental Care, a reduction in the number of job titles available to improve clarity, and for Health Education England (HEE) to develop a system of quality assurance.

The Nursing and Midwifery Council should make caring experience a prerequisite to start a nursing degree, and the legal processes for challenging poor performance should be reviewed.

Cavendish said: “There are more care assistants than nurses working in England. Many of us will rely on them at some point in our lives, in particular in old age, and we need them to be as good as they can possibly be – especially as some support workers are carrying out procedures which used to be done by nurses, even doctors.

“I have seen many examples of excellent and skilled care, but I have been struck by how disconnected the systems are. The airline industry figured out 30 years ago that the most junior staff could be a critical link in the passenger safety chain. Patient safety in the NHS and social care depends on recognising the contribution of support workers, valuing and training them as part of a team.

“For people to get the best care, there must be less complexity and duplication and a greater focus on ensuring that support staff are treated with the seriousness they deserve – for some of them are the most caring of all.”

Health secretary Jeremy Hunt said: “We are determined to build a compassionate health and social care system – one where people are always treated as individuals, with kindness and respect.

“I am very grateful to Camilla Cavendish for the work she has put into this review. It rightly highlights some of the best practices on the frontline – where staff with the right values have been recruited and offered the training and support to do their jobs not just competently but also with compassion. But it also shines a light on how disconnected the health and social care systems can be and the stark variations in training that staff receive.”

Dean Royles, chief executive of the NHS Employers organisation, said: “The Cavendish Review is a welcome contribution to the debate on how the NHS can best deliver high quality, compassionate and dignified care.

“It recognises the work employers have put in to ensure nursing support staff are an essential, well supervised part of the team. Strong recruitment, induction and development programmes are widespread in the NHS, helping ensure healthcare assistants are supported to do a fantastic job.

“Nursing support workers are often unappreciated by society, often working in very challenging circumstances, and it’s important this is being acknowledged. But they provide a crucial role in ensuring compassionate care. They are as much a part of patients’ experience of the NHS as registered nurses or doctors.”

Dr Peter Carter, chief executive and general secretary of the RCN said: “Improving training and support for healthcare support workers is not only desirable, it is essential. With a rising population of older people, this is a workforce without which the NHS could not function. We welcome this review, in particular Camilla Cavendish’s proposal for a Certificate of Fundamental Care for all healthcare support workers. It is vital we invest in this group and give greater clarity to their care role.

“However, we remain concerned that without mandatory regulation to support this, there is a danger that those staff who are found to be unsuitable could move from one employer to another unchecked. The priority must now be to underpin the recommendations made by Camilla Cavendish in the regulatory structure which governs care.”

Tell us what you think – have your say below, or email us directly at [email protected]


Linda   10/07/2013 at 15:37

Some concerns that this fails to recognise differences in jobs that staff do care workers and staff in GPs environment do radically different jobs. . Our HCA started in Jan and has been training and supervised since - she is already a qualified phlebotomist. Once her competencees are signed off she will work alone not before. GPs are vicariously liable for the actions of their staff so to fail to ensure training and insurance for HCA would be very silly. I also question whether 2 weeks at the beginning is anything like enough training- regular updates should be required, many people can genuinely think they are able to do a job for a couple of weeks I would want to know what they were doing one /two years on from the initial training.

Add your comment

national health executive tv

more videos >

latest news

View all News


NHS England dementia director prescribes rugby for mental health and dementia patients

23/09/2019NHS England dementia director prescribes rugby for mental health and dementia patients

Reason to celebrate as NHS says watching rugby can be good for your mental ... more >
Peter Kyle MP: It’s time to say thank you this Public Service Day

21/06/2019Peter Kyle MP: It’s time to say thank you this Public Service Day

Taking time to say thank you is one of the hidden pillars of a society. Bei... more >

editor's comment

26/06/2020Adapting and Innovating

Matt Roberts, National Health Executive Editorial Lead. NHE May/June 2020 Edition We’ve been through so much as a health sector and a society in recent months with coronavirus and nothing can take away from the loss and difficulties that we’ve faced but it vital we also don’t disregard the amazing efforts we’ve witnessed. Staff have gone above and beyond, whole hospitals and trusts have flexed virtually at will to meet demand and pressures and we’ve... read more >

last word

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad, president of the Association of the British Pharmaceutical Industry (ABPI), sits down with National Health Executive as part of our Last Word Q&A series. Would you talk us throu more > more last word articles >


Matt Hancock says GP recruitment is on the rise to support ‘bedrock of the NHS’

24/10/2019Matt Hancock says GP recruitment is on the rise to support ‘bedrock of the NHS’

Today, speaking at the Royal College of General Practitioners (RCGP) annual... more >

the scalpel's daily blog

Covid-19 can signal a new deal with the public on health

28/08/2020Covid-19 can signal a new deal with the public on health

Danny Mortimer, Chief Executive, NHS Employers & Deputy Chief Executive, NHS Confederation The common enemy of coronavirus united the public side by side wi... more >
read more blog posts from 'the scalpel' >

healthcare events

events calendar


September 2020

mon tue wed thu fri sat sun
31 1 2 3 4 5 6
7 8 9 10 11 12 13
14 15 16 17 18 19 20
21 22 23 24 25 26 27
28 29 30 1 2 3 4
5 6 7 8 9 10 11

featured articles

View all News