'There is no minimum standard of training for healthcare assistants before they can work unsupervised, an independent report has found.' This is exactly what I discovered when I arrived in the UK four years ago and started working in a private hospital in the south-west. I now work occasionally in NHS hospitals in the south-west and find that, although, it is a much safer situation than in the private hospital I experienced, it is still not optimum.
HCAs (Health Care Assistants) are paid a minimum wage but expected to form the main structure of the healthcare system. In theory, as Registered Nurses, we supervise their practice and are ultimately responsible for all care provided during our shift. In practice, on a busy ward, there may not be sufficient time to check the work of the HCA on your team. HCAs perform nursing procedures and procedures which were previously done by junior doctors, such as taking blood. In most areas of the NHS hospitals where I have worked, HCAs are 'trained' to at least NVQ2 level, often NVQ3 level. They may,however, have done the 'training' as a distance learning course. In the private hospital, there was no such guarantee. Several of the HCAs had received little or no training at all (apart from mandatory training) but still performed nursing tasks.
This was at odds with the system I knew in Australia where the minimum training for a healthcare worker (called Personal Carer or similar) was a Certificate III in Aged Care. Learners attend lectures at TAFE (vocational college) and do placements in Aged Care facilities only after passing competency-based assessments in the practice ward. With this level of training, most learners work in nursing homes or hostels. Any who work in hospitals are able to make beds, toilet patients and restock ward shelves. They are not deemed to be trained to take observations or perform nursing tasks.
The next level in Australia is the Enrolled Nurse (Endorsed Enrolled Nurse - with an endorsement to administer some medications). This course is taken at Diploma level. Registered Nurses study a Bachelor of Nursing.
I have come across many fine HCAs as I work in different wards through an agency. They are in general extremely hard-working and compassionate and I feel they deserve more. They deserve the assurance that before they start working on the ward, they have been fully trained within their scope of practice. This must be compulsory if we are to be sure that the healthcare workers who provide the bulk of the care in NHS and private hospitals,nursing homes and in the community are competent and confident in their performance.
This also means competent in English language skills as well. Many HCAs do not speak English as their first language. Much of their work is communicating with patients so it is vital that they can do this. English for carers is another area of EMP which needs to be explored (on my list!).