Healthcare assistants employed while nursing posts remain unfilled

healthcare_assistants08:09 Monday 23rd March 2015
BBC Radio Cambridgeshire

DOTTY MCLEOD: Would you be happy for a healthcare assistant rather than a fully trained nurse to take your blood, to dress your wounds, or to give you injections while you’re in hospital? Well healthcare assistants from Cambridgeshire have told the BBC that is exactly what they are being asked to do in some cases. An investigation for Inside Out spoke to staff from ten hospitals across the Eastern region. Let’s find out more about exactly what a healthcare assistant is. Joanne Bennis is the Chief Nurse at Peterborough City Hospital. Joanne, roughly how many healthcare assistants do you have at PCH?
JOANNE BENNIS: Good morning Dotty. We have on average on clinical area about 65% of the nurses that we have on the ward are registered nurses, and 35% of those are unregistered, or healthcare assistants.
DOTTY MCLEOD: And let’s talk about the training. What is the difference between the training that a nurse has and the training that an HCA has?

JOANNE BENNIS: OK. So a registered nurse undergoes a three to four year programme at a university. It currently now is a degree level programme. 50% of that is practical, so they come into the workplace and work against some skills clusters and some practical assessments, and learn how to do the job in a vocational way. And 50% of that is theory, so that they can relate their theory to practice.
DOTTY MCLEOD: And an HCA, what kind of training might they receive?
JOANNE BENNIS: So our healthcare assistants when they come into post in the Hospital have a two week induction. They also can undertake something that’s called the National Vocational Qualifications that have now been superceded by the Qualifications and Credits Framework Scheme. That’s additional training which is both theory and practice, for them to undertake some additional skills if it’s felt to be appropriate.
DOTTY MCLEOD: That is still a vast difference, isn’t it, between the training that a nurse gets and the training that an HCA might get. Does it worry you Joanne that in some hospitals HCAs are being asked to perform tasks that really should be done by nurses?
JOANNE BENNIS: I think it’s really difficult to comment on other providers, other hospitals.
DOTTY MCLEOD: Have you seen it happen at Peterborough?
JOANNE BENNIS: I know what happens here. We have some healthcare assistants, depending on their band and their training, that do undertake venopuncture, so can take blood from patients, and actually can put a cannula in. That is relevant in areas such as Out-patients and some of our In-patient areas. But we have some very defined competencies that they are assessed by a registered nurse to do.
DOTTY MCLEOD: OK. And there will not be a situation at Peterborough City Hospital where because you’re a nurse down an HCA will be asked to act up?
JOANNE BENNIS: We don’t ask our healthcare assistants to act into a registered nurse post. So it is a clear difference between the two roles. Registered nurses are accountable to a professional body and unregistered nurses aren’t. They have delegated responsibility, and they work under the guidance of a registered nurse.
DOTTY MCLEOD: Joanne, thank you for joining is this morning. Joanne Bennis there who is the Chief Nurse at Peterborough City Hospital, just giving is a glimpse of the picture there. And let’s talk to Tracey Lambert. Tracey is the East of England representative for Unison the union. Tracey do you hear of this happening where HCAs are asked to do jobs that they have not been trained for?
TRACEY LAMBERT: Yes we do have that, and we have watched and listened to your investigation with great interest, because it echoes issues that are raised with us by our members on a daily basis. And whilst in Peterborough they seem to be following what we would want, across the whole of the East of England sadly that isn’t the case, because there is a lack of registered general nurses. We have 2,000 vacancies across the East of England, and healthcare assistants are working unsupervised beyond their competences. And your investigation has highlighted that this morning.
DOTTY MCLEOD: So you think that’s the problem, a lack of nurses?
TRACEY LAMBERT: There’s two issues regarding healthcare assistants. One is the lack of registered nurses to supervise and have the delegated responsibility. And secondly the training for healthcare assistants. You’ve heard the training is pretty basic. We have been working with the Government and the Department of Health to have a new care standard certificate introduced which comes into place on 1st April. And we’re also working with Health Education East of England to have a more formal training programme for healthcare assistants, because although they only make up 35% of the nursing team, they deliver about 60% of the nursing care that patients receive.
DOTTY MCLEOD: I think that a third of nursing teams being HCAs is actually quite a lot. They are a lot cheaper than nurses. Is that why hospitals employ a lot of HCAs?
TRACEY LAMBERT: Well healthcare assistants were introduced when nurse training was moved into universities. For example when I trained as a nurse, I worked in the hospital as a student nurse. I was part of the nursing team. And with the move to universities of student nurse training, a new grade of staff were introduced to make up that slack of student nurses not being on the wards. And that’s how healthcare assistants came into being. So they’re not a cheaper option. They’re an alternative option to student nurses. But they are a vital member of the nursing team.
DOTTY MCLEOD: And what are your fears Tracey as to the effect that this could be having on patients?
TRACEY LAMBERT: Well obviously patient care is at the centre of all of this, and we need to ensure that patients receive the best care possible, which is why we are working with the various agencies to ensure that our healthcare assistant members are adequately supervised and are able to perform the duties that they are trained and assessed to undertake in the most appropriate fashion.
DOTTY MCLEOD: And we do just have this question that Brenda in Mildenhall has asked this morning Tracey. “Do HCAs equate to State Enrolled Nurses?”
TRACEY LAMBERT: No they don’t. We don’t have State Enrolled Nurses any more.
DOTTY MCLEOD: So they’re not a sort of replacement.
DOTTY MCLEOD: OK. Thank you very much for talking to us this morning. Tracey Lambert there, the East of England representative for the union Unison.