A "ghastly national disaster" could be avoided if the Nursing and Midwifery Council (NMC) were to regulate healthcare support workers, its chief executive claims.
Dickon Weir-Hughes told The Times there is nothing preventing nurses who have previously been struck off for risking patient safety coming back to work as a healthcare assistant.
He has called upon government ministers to create standardised regulations to stop such a practice.
Speaking at the Nursing in Practice conference in London last week (20 September), Weir-Hughes told delegates he is "begging the Health Select Committee to allow the NMC to regulate healthcare support workers."
He told The Times that even though hundreds of complaints are made about healthcare assistants each year, officials have no power to act.
"All we can do is to say you either have to go to the person's employer, or if it's sufficiently serious call the police. There are no other mechanisms," he said.
"This isn't just about waiting for some ghastly national disaster, it's about saying, 'How long do we leave this issue? How do we really value our elderly people in care homes? What value do we place on the care of vulnerable people in their own homes?'"
Weir-Hughes also criticised the management of some GP practices at the NiP conference, claiming they do not have the right HR policies in place and fail to check registrations sufficiently.
He warned that the NMC will now take "a very hard line" on those who allow their registration to lapse. "The consequences are quite severe," he said.
"Those nurses whose registrations have lapsed will be reported to the Care and Quality Commission and the senior partner of the practice will be reported to the General Medical Council."
We asked if you think the NMC should be allowed to regulate healthcare support workers. Your comments (terms and conditions apply):
"Yes I think it is important that HCAs are regulated by the NMC" - Name and address supplied
"Yes, the NMC should be allowed to regulate healthcare support workers. Unbelievable that this does not happen already" - Jenny, Uxbridge
"Yes I think HCAs should be regulated by the NMC as this can help to monitor and reduce the number of medication errors in health and social care. HCAs in residential homes administer medications following medications awareness sessions whereas nurses took formal training in this field" - Winnie, West Midlands
"The NMC should regulate healthcare support workers. I would not want anyone that has been struck off for any reason looking after me or any of my family or friends" - M Moxon, East Yorkshire
"Does regulating the HCA mean keeping a register, providing them with appropriate training, appropriate pay? Where do we start from, those already in the system or new ones? Are we doing this to generate fund for NMC rather than for quality output? Why was the SEN scrapped? What does the future hold for HCA? These and a lot of other questions need to be addressed. As we have bad HCAs so also we have bad trained nurses" - Rilwan Adebiyi, Trafford
"Yes HCAs should be regulated. I also believe that so should all people providing healthcare. As a registered nurse I strongly believe that patients would benefit as registration could prevent unsuitable workers from shifting to other vulnerable areas of nursing to continue bad practice ie, nursing homes, community. It would also make health care providers more accountable" - Angela Oji, Manchester
"Yes I am an HCA and have been for many years I consider myself to be properly trained and my practice has protocols in place to protect both myself and the patients I enjoy my job very much and give 100% to it my financial reward is not as great as it might be as I am at the top of my pay scale being level 3 in healthcare. I would welcome the change to be
regulated. I am very lucky as where I work the trained nurses treat me as one of the team" - Angela, Merseyside
"Yes healthcare support workers should be regulated as they have standards to meet as well in patient care as often lone workers in the community. This should then put pay to HCAs from care settings wearing a staff nurse uniform or even navy which causes much confusion to vulnarable adults" - Claire Goodyear, Rugby
"I agree HCAs should be regulated, and so should advanced nurse practitioners. But the NMC has continuously failed to regulate advanced practice, so I find it unlikely that it is competent to regulate healthcare assistants adequately. Once healthcare assistants are regulated, it will be similar to the older SRN/SEN system we used to have - which worked very well. My bug bear is that Weir-Hughes is not begging the Health Select Committee to allow the NMC to regulate advanced nursing practice as is the case in other Western countries – why is the UK so behind?" - Ellen Nicholson, Somerset
"Regulation and training has to be essential as so many HCAs are now working in GP practices doing so many jobs practice nurses used to do, often with only a bit of in house training" - Karen, London
"I agree that HCAs would benefit from NMC regulation and this should help those that work and study hard to become better recognised as a semi-profession. Working in primary care, I appreciate the varied array of HCA tasks and skills required within this setting and usually for minimum financial reward. Hence proper regulation would further protect patients,
staff and everyone involved. Unquestionably there are many HCAs that could no doubt go on and successfully complete their nurse training and also many that could not, it is not purely the financial hurdle of going to university, there needs to be a full appreciation by HCAs and employers that their job, roles and responsibilities are very different to those of a qualified nurse, even when performing same and similar tasks. HCAs need to be proud of their title and wear their badges with pride as I have known too many to hide behind the 'if I could afford my training I would be a nurse'. They need to stand up and be proud that they are valued members of the nursing team and regulation should benefit the general population as a whole" - Name and address supplied
"Healthcare assistants are cheap labour, for GPs and NHS. They will eventually oust the nurses. Nurse training should be made cheaper. More nurses encouraged and proper facilities provided. A few years ago a good nurse level was scrapped by the NMC, ie, the SEN. Today, we have careless, uncaring, money grabbing HCAs more than the caring ones" - dkaur
"Before regulation you need training: patients and nurses deserve trained healthcare assistants and the healthcare assistants deserve to be valued and trained for the contribution they make to patient care, which will become increasingly important as we look to a future of nursing shortages
and an increasing elderly population. Training and regulation of healthcare assistants has to be a part of the future of the NHS" - Donaghy, France
"The NMC has the greatest difficulty in doing the job it already has assigned to it. Dysfunctional is the most common description. So what makes Mr Weir-Hughes so sure his organisation can drastically improve enough to regulate healthcare support workers? The first thing to do is clearly have the regulators house put in a semblance of order" - Name and address supplied
"I am an HCA and think we should be regulated. There are too many so called assistants that have no skills nor a caring bone in their body but then there are also a lot of HCAs with lots of skills experience, knowledge and care. I like many can't afford to go to uni to train for a nursing diploma or degree but I have like many others worked hard to achieve NVQs and other skills. I would love to be regulated as I have nothing to hide. There are many that don't but in my opinion it's because they do have something to hide like the evil people that were shown on the Panorama programme. Regulation would weed out the weeds and hopefully keep the HCAs who are good at their jobs but maybe can't like myself afford to become a fully trained registered nurse" - Julie, Stockport
"NMC regulation of healthcare assistants can be a good thing if done for the right reasons and not just for the sake of regulation. It is only a shame that this country always copies policies from the USA and then changes it beyond recognition just for exploitation rather than for sanity. Healthcare assistants are already taking on roles from the nurses
when it comes to bedside nursing, example is doing observations in hospitals. The most dangerous thing is that some healthcare assistants do not understand what it is they are doing and why they are doing it. If the NMC is asking for regulation of healthcare assistants, then they must
remember that with such regulation goes appropriate training and consequently decent pay structure and working conditions otherwise it will not benefit nor guarantee safe practice. There are serious-minded healthcare assistants out there who are doing a wonderful and fantastic job without regulation and by the same token there are nurses out there who are a disgrace to the profession even with the regulation. There regulation is
not a guarantee for safe and effective practice. We should better look at what we do, why we do what we do? Let make sure that we do what we do for the right motive, and then the other issue is that we get the right people for the right job, train and pay them adequately for what they do, only
then will regulation be appropriate and effective" - Paul Ekwuruke, London
"Yes, especially as in general practice the HCA role is evolving with more responsibility" - Maxine Smith, Dudley
"Yes if us nurses must be then so should they, they are just as important in patients' care but they need to know what they are doing and be regulated, there are many out there that do a fantastic job but they are let down by those who have poor knowledge and just do it because it's a job!" - Kitty, Bedfordshire
"I think the head of the NMC should try working a few shifts in 'frontline healthcare' as opposed to making ill-judged comments from the comfort of his office desk. He should look at the failings of his own organisation and that of the GMC before he subjects millions more employees to further regulation. It took a BBC reporter to blow the whistle at Castlebeck, neither the Care Quality Commission nor the NMC were effective there. He should also look at what incentives there are for healthcare workers ie minimum wage and lack of secure employment. If nurses and healthcare workers were held responsible for every minor 'wrong word' or 'minor transgression' when they are being subjected to regular verbal abuse and assaults over a 30-40 year career there wouldn't be a service at all. As a retired Police Officer and Healthcare worker I have nothing but praise for my colleagues in the public and private sectors of healthcare. If any changes need making it should start with the regulators" - Name and address supplied
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