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Student nurses must work as HCAs, Hunt says

Student nurses must work as HCAs, Hunt says

Student nurses must work as HCAs, Hunt says

Nurses will have to work as healthcare assistants for at least a year in order to complete their training, the government has announced. 

In reply to the Francis report released just over two months ago, Health Secretary Jeremy Hunt said the rules apply to any nurse who seeks NHS funding for their degree.

After an introductory pilot scheme, it is hoped the rules will “promote frontline caring experience and values, as well as academic strength”. 

Promises to introduce specialist nurses to care for older people have been axed, with the report suggesting that enhanced training for all nurses would take the quality of care a step “further”. 

The report said: “We will strengthen the focus on the complex physical and emotional needs of frail older people throughout nursing and other healthcare training to ensure that older people needing nursing care will benefit from a nursing workforce that is trained to deal with their needs.” 

Healthcare support workers and adult social workers will have a code of conduct and minimum training standards, released today. 

Although healthcare assistants will not be subject to regulation, there will be an opportunity for them to progress into a role as a nurse, according to Care and Support Minister Norman Lamb. 

He said: “There is no reason why an excellent healthcare assistant should not aspire to be a nurse. 

“Whether you’re a care support worker working in a hospital ward or working in a care home, the importance of training is just as important.” 

New powers

A training scheme launched today by Health Education England, Higher Education institutions and the Nursing and Midwifery Council (NMC) will “ensure all new nurses have the skills to work with the large numbers of older people.” 

The NMC will also be granted new powers to revalidate nurses’ qualifications, in the same way that the General Medical Council (GMC) must validate doctors.

However, the government acknowledged that the NMC first has to “turn around its current poor performance” and said its current focus “must be to ensure that professional confidence is restored.”

The government has explicitly asked the NMC to “tighten and speed up” their procedures for fitness to practice proceedings. 

The government has also announced two new roles – a Chief Inspector for Hospitals and a Chief Inspector of Social Care. 

The Chief Inspector of Hospitals will introduce and develop ‘Ofsted-style’ ratings of hospital performance, and the Inspector of Social care will “ensure the same rigour is applied across the health and care system”. 

“A Chief Inspector of Social Care will ensure that we don’t become hospital centric, but we have someone who can look at the wider care system to ensure that the same principles apply across the board,” Lamb said. 

DH is also discussing the possibility of introducing a Chief Inspector of Primary Care. 

Although the Health Secretary said changes announced today would apply to the whole healthcare system, a response specific to primary and community care will be released in the coming year. 

The Health Secretary said: “Today I am setting out an initial response to Robert Francis’ recommendations. But this is just the start to a fundamental change to the system.” 


This suggestion that newly qualified nurses/students to work as HCAs defeats the purpose of training to become a registered nurse. I am a student nurse and I have been in placement now for almost 2000 hours in the last 14 months and we are already being delegated tasks of HCAs as well as trained staff so we are already equipped with both skills and we make up the numbers on the wards. So to suggest that after all this training when I finally become a registered nurse, I should then work as HCA is totally unfair to our training. I have a further 1000 hours left to complete in placement so this idea or suggestion needs to be shelved.

Students are always like to relish in snow days. Schools are closed and they enjoy with our families and friends.Every teacher select a topic of cheap essay UK which student like.Blue Waffle

I think this is a good idea. I'm 25 now and will train as a nurse in September. since I was 19 I have been a carer and most recently a HCA. One day on the ward I needed help with an elderly lady who was bed bound. A second year student nurse came to help me. She didn't have a clue how to use a slide sheet or correctly roll a patient. At one point the patient asked her to stop leaning on her whilst holding her back. But she can take vital signs etc!!
HCAs are fantastic. When I moved from being a residential carer for 5 years to the hospital it was such a shock, I was clueless. I met some great HCA who taught me a lot. So why not when these student nurses come onto the ward for placement why not have them be assigned a HCA as a mentor for a few weeks? They may only teach them the basics but I think it will be one of the most important things they are taught. What's the point in being able to give out medication take vital signs if you don't know how to wash patients, use slide sheets feed them??

I agree at all students need the experience so they know what to expect. The Nursing and Midwifery Council and other professional regulators will also be required “to tighten their procedures for breaches of professional standards.

Nurses will have to spend up to a year helping patients eat, wash and get dressed – work usually done by healthcare assistants – under government plans to shake up NHS care in response to the Mid Staffordshire hospital scandal

I see a lot of comments here saying that being a HCA is a lowly position m I add I have worked with many wonderful hcas who are amazing and quite often show up many so called trained nurses... who even tho they may have the qualified title they no nothing about nursing In the real world... I think we need to bring back nursing schools like when I trained then see how patient care will improve drastically give the less academic a chance too...

This article is astonishing for so many reasons.
It reflects a continual culture of dumbing down the nursing profession and understating the complex work required to competently perform in today's evidence-based health care environment.

Surely nurses need education not training. Training reeks of apprenticeships. Modern nursing requires a far higher level of education than on-the-job 'training'. Research has consistently shown that mortality is significantly decreased as the education of nurses increase.

I am astonished that a healthcare assistant can 'have an opportunity to progress to a nurse' as if this is a right. Surely, education is the means by which a person becomes a nurse.
Nurses in the UK -- You should not take this lying down! The take home message here is - don't get sick in Britain - you may not survive the health care system!

So you're basically saying if you get treated by a hca who's trained later as a nurse then you're not going to survive? Please. As someone mentioned before there have been times where hcas have out smarted nurses. It's happened too many times where 'properly trained' nurse has made a mistake on a visit and us hcas have had to sort it out. Just because we were hcas to begin doesn't mean we haven't bothered to get an education, we just wanted the experience before hand too. And no it isn't a right, but it would be good to have the opportunity to progress in our careers, are we not allowed that?

The best nurses i have ever come across are those who where nursing assistants and PROGRESSES to become an RN. The new DEGREE only nurses we are seeing today are nothing short of incompetent.

This is pretty bad and degrading for nurses who are bushly paid amongst all healthcare workers; to condescend as a HCA support worker after qualification. What will you do to doctors with bad practices that kills patients every day.

Soooo, as well as working for 3 years for nothing but debt, a student nurse now has to not only work for a further year on "basic care,"
he/she must work for a year before even applying as a hca. 5 years in all to earn a grand total of £21k to pay off the staggering debt they will incur just to become a nurse with a prospect of fighting for a band 6 that he/she may get after years of back breakingly hard andurecognised labour.
Its insulting in the extreme, that Hunt (is that rhyming slang??) is singling out nurses for this type of punishment. Many many student nurses have worked as hca's, many work whilst training as a hca to keep body and soul together. Many many nurses do not wish to do a degree, but would prefer to train in the "old school" type way; when student nurses were part of the ward team and were paid appropriately. It is pointless beating all student nurses with a big stick as we will very soon run out of candidates. Who on earth would want to train to become a nurse today? The rich? the pious? what about ordinary, kind hearted, hard working youngsters who just want to do a job 'helping' people?
The lofty attitude from Mrs "I'm a Health Visitor" (above) make me sick. Are you so old/pious/righteous that you have lost sight? I too am a middle aged advanced nurse practitioner, and I can honestly say that of all the students I have mentored, I cannot think of one that did not care. Some I did'nt like too much, some were not suited to my area of nursing, but I really cant think of one that did'nt care at all.
Why would a bright young thing go through what is not an easy process to get a nursing degree, when they could instead study something that would give them better renumeration and less public vilification?
What are we doing putting up with this terrible onslaught against nurses?Why should we be held responsible for the Governments lack of action regarding minimum numbers of nurses on wards? Wake up wake up and lets start supporting other nurses and student especially.

About time Government!!!! If you actually listen to the front line people not the management who have no idea of what works etc!!!! Please ask the front line staff who work in those situation daily would tell you what works and what does not and what need improvements and how appropriate staffing levels daily on each shift boosts staff morale and improves basic care as well as patient faith and trust back into nursing and caring of patients. Oh and all the paper work that the government thinks is necessary can be correctly and have the time to fill in accurately. Please will you use the knowledge of front line staff to improve rather than spend wasted money on people who have no idea. Also our government need to look into the billions wasted on drugs wasted

These changes are positive for the good of patients' experience. It is a bit nonsensical to ask nurses to work as HCA to validate their degree as in a view of responsibility and accountability there are no such identical regulation for the two different position. Furthermore, newly qualified nurse working as HCA would be deskilled in their clinical practice and a foreseeing issue would occur in their job description about what they would be allow to do as HCA knowing there are trained nurse. This would be a confusing situation of status to manage on busy ward where lack of leadership would lead to HCA (newly trained nurse) would do qualified nurse job with no-one to cover their back. I would find it personally depressing and downgrading to have spent 3 years working hard and sometime treated like cheap labour to have learning outcomes signed off, to further have to bear further humiliation and work as cheap labour as newly trained nurse being paid as HCA. I wonder if in these plan put in place their have been consideration of individuals. Don't think so!

What would make more sense however is that, as most HCA are recruited through interviews only, without having a huge background in healthcare (which I found particularly scary) , HCAs would have a nominated mentor (nurse) and co-mentor (senior HCA) while working as HCA and both mentors would be responsible and accountable for the quality of care HCA provide. This would allow to promote only HCA who have demonstrated sufficient skills, humanity, good behaviour and professionalism toward a secondment in nursing. Prior to that, to qualify to a training, HCA would attend an access course to nursing school to assess their level in math, english and knowledge in care. Then HCA would become trained nurse for 3 years and at the end of the program, ensure that the allocated preceptor is fully supportive during the first year in post as new qualified nurse. Not all new qualified nurses have the chance to be fully supported by their preceptor and some never know who are their preceptor as sometime there is a breakdown in communication that allow this to happen.

Last but not least, as HCAs are providing care to patient the same way nurses do , at the only difference that nurse deliver meds, HCAs should be regulated by the NMC and be also accountable for their action and omissions. This to say that since the implementation of EPR or electronic patient record, some HCA still don't have the understanding of the new scoring system and some HCA still forget to communicate with their allocated nurses the result of their observations. Or taking blood sugar but not recording it, or emptying catheter and not documenting it...HCA are supposed to release and/or support qualified nurses. If every nurses have to pass behind each HCAs to check if a job has been done, better to say that HCA are not essential but extra nurses are.

There are lots of professions that expect experience at a 'lowly' level before you can be accepted for training why should nursing be any different?
As a nurse, midwife an health visitor I believe the current training divorces students from what they are there to do and has contributed to the loss of an ethos within hospitals that allows events like mid staffs to occur. Previously students were an all important part of the workforce now as supernumeraries they have little to contribute and at times learn little from their lack of involvement on a placement.
I am also appalled by their behaviour on placement - frequently late, they sit texting in the office and generally present in a way unbecoming of a future professional.
I do not have all the answers but I think the bar is set far too low for personal attributes for entry into training. A goodly proportion would not have made it through the door previously - some are uncouth, barely articulate, stink of cigarettes and cannabis, tattooed , pierced and so scruffy that it beggars belief. Roll on them needing a work reference to turn things around!

I hope this comment was written as joke. If not maybe it was written by someone who writes for the tabloids and believes that nurses are gin swilling prostitutes.

Spoken like a true health visitor! It must be lovely up there in your specilaist community practicioner ivory towers. To refer to the HCA role as 'lowly' is abhorrent and proves the point that Hunt is making. Sadly I fear he has missed the point. Rather than newly qualifieds being made to go back to basics I feel that over qualified narrow minded individuals like yourself should be thrown back onto the wards and made to go back to basics. I am a qualified nurse myself ( with tattoos no less) and I would never express such judgemental attitudes towards my fellow peers, team or patients. I would love to know how you reach out to your families in need and build rapport with such a terrible attitude to diversity.

I obviously struck a cord with you...... There is no mention of HCA in my comment. There are other ways of working in "lowly" positions. I was an NA for over 2 years before I trained as were many of my peers. I have also worked in various service industries in a variety of jobs.
As with most people who have a sensitivity.. Me, I cannot see the attraction of Tattoos that in some cases are frankly offensive - vulgar and sexist, and have no wish to look at them. Perhaps in your case it is an inability to read the word tattoo in the context of the whole sentence, or is it ok to enter someones home stinking of tobacco or cannabis, sit on their sofa texting and having such poor communication skills they yawn and pick their nails during a home visit..... Or Students who think its beneath them to help set out chairs for group teaching and help to wash up afterwards. all jobs that come within my brief. This is my very real experience of some student nurses. That is my concern.

OK, are you really a professional? if so i suggest you act like one.
your personal likes and dislikes regarding appearances should not spill over into your professional life. Your dislike of tattoos and piercings are extreme and as such i am concerned that you may treat your pierced and tattooed patients differently.
as nurses and professionals we are not supposed to be prejudiced.
as long as a nurse is professionally dressed and acts in a professional and caring manner, that is what you should be bothered about, not the superficial elements you seem to be hung up on.
also, how could you possibly let a student nurse behave as you have described above in a patients home? maybe you are too bothered about what they look like to spend time teaching them what is acceptable as their mentor.

Nope, no cord twanging here..the article is about HCA roles for student nurses before entry onto the register. Its not really that surpirising that I made that association from your comment really is it?

Most of your reply was twaddle but two points are worth commenting on.
1) You are not paid to have sensitivities. You are there to deliver care with unconditional positive regard and you should treat your patients, peers and students accordingly. No one really cares what you find offensive. You are a professional at work.

2)It concerns me greatly that as a mentor you actually let a student smelling of cannibis into a patients house and then let them sit and use their mobile phone. Patient confidentiality?? Safeguarding patients??? Did you rip up your code of conduct when you got your pin number?

I suspect as a previous person has noted that this is a bogus comment left to provoke. If it is not its an NMC referal in the making. I would stop worrying about peoples appearances and level of fatigue and start doing your job properly.

As usual, the focus is on 'what looks good on paper'...So, chief inspectors bla that money, and use it to improve staffing levels instead, which is the PRIORITY at the moment!!!!!
So, the chief Inspector will introduce more paperwork,ward rounds bla bla... where are the nurses to do it?
Ah, I see!!! Same nr of nurses, greater workload..nurses are human beings,not machines!!!One pair of legs and one pair of hands, that's all!! Only if people knew the long hours that nurses are on their feet without a drink, something to eat, and still have to disguise the tiredness, hunger, thirst,even dizziness every time they see a patient!!!How safe is that for the patient, and mostly important but often forgotten, the nurse?A great advice: First fix staffing levels 1:4-7 General and ancill.; then fix ward budgets (clinical equipment that actually works etc); now you are ready to INSPECT because you have given the necessary basic resources to PRODUCE excellence in care, got it!? :/Grrr

I think nurses working as HCAs would therefore be required to identify aspects of their role where they had used their nursing knowledge and skills sufficiently to maintain competency as a nurse.

So students are expected to study for three or four years with a measly £500 a month, which on placement works out at £2 odds an hour, only to work as HCA's for a year after working hard to earn their nursing degrees? Children are getting bad grades in schools and there's always reports about the growing levels of illiteracy in school leavers etc... Why aren't student teachers being made to work as classroom assistants for at least a year to get experience working with small groups of children or one on one before being allowed a whole class? Or why don't doctors have to work as nurses so they understand the nurses role more? These are all stupid ideas that's why, a classroom assistant isn't a teacher, a nurse isn't a doctor, and a HCA isn't a nurse. Making student nurses work as HCA's is not in any way going to improve their nursing abilities! They've already spent 4 years in uni effectively being HCAs and used as an extra pair of hand whilst on placement! This country is run by complete and utter morons!

A patient is admitted to a hospital ward. A member of staff comes in and introduces him/herself. The staff member orientates the patient to the ward, takes the patients vital signs, attends to the patients needs, listens to their concerns, assures them. At this point a call bell goes off. The member of staff say excuse me but i have to go answer the bell. On attending the next patient the staff member assists the patient to the bathroom. In the middle of all this it is time to do the vitals round, there is a repeat ECG in Bay four, a patient needs a cannula and bloods need to be taken. The call bell goes off and the staff member helps the patient out of the bathroom and then returns to the clinical duties. Another call bell rings and it is the patient in the room that had been admitted at the start of this. The patient is in pain and wants some pain relief.....but the staff member has to call someone else because....yes how many of you thought when reading this the staff member was a registered nurse and not a HCA. Who is the actual NURSE here. I rest my case.

Totally agree, just another cost cutting measure.

I totally sgree with ybis comment. I hsve just qualified last year after working hard to gain my degree. Hca do s great job but they sre not nurses and donot have responsibilits of nurses. Its a disgrace tht that unions are allowing thisto happen

So here we see yet another government reform with proposals that are half baked. So nurses must become HCA's before they can nurse effectively, like every healthcare support worker is nurse material. What about those who have cared for friends or family members in informal roles .They may be experienced and have knowledge, will they still have to become healthcare support workers? Mister Hunt does not want to regulate HCA's but yet nurses will be subject to tighter regulation . So bad pratice with no profeessional accountability is perfectly acceptable when you train as a nurse, as you will have to be a HCA, but not acceptable when you become registered. Come on MR Hunt, surely to promote the standards you want and to prevent another stafford you need to regulate this profession because if you do not you may risk someone commiting misconduct as a HCA worker . And the NMC know nothing of this when someone applies to join a register. Thats really effective regulation isn't it. I myself have experience of recieving support from social care and would indeed go further. It is not just HCA's that need to be regulated but the whole adult social care workforce. By doing this we would restore pride in a profession taht is seen as being low paid and low prospects for its practitioners. We would also restore confidence in it for its users, many of whom are some of the most vulnerable people in society. If we are to call ourselves a civilised society, safeguarding and improving services is something we must strive to do continuosly and view it as something of paramount importance .

Yep add more red tape and box ticking that will fix the staff shortage ohh no add 2 vey well paid positions to go check on hospitals it does nomatter what accreditation system u have hospitals will meet it on the day want the real truth
No thought not why when they look at these reports don't they ask the people on the wards how to fix it
The NHS sells a programme the productive ward etc to Australia and yet it can't fix it's own problems
I left the NHS over 25 yrs ago cos of staffing levels and poor pay and the chance to move to Australia
Now Australia is going through the same issues as health world wide
Health is haemoraging great nurses who are not willing to give patients second rate care and no one is listening
No lets do a audit on that no if ur serious go be a patient or even a secret shopper
It's all bla bla bla as its all about ticking a box not patient care
If all these reports worked y isn't anything fixed

My daughter is in her 2nd year of training to become a paediatric nurse. As part if her degree she has to spend 21 weeks a year working FULL TIME on a children's ward with NO PAY whatsoever, on to of this she has to pay for all her own transport and living costs on a measly student loan of £1800 per YEAR!!!!!!
Don't take out this crisis on the new upcoming student nurses. What the government need to do is ensure wards are staffed by the full amount of trained nurses and HCAs in order for patient care to improve.

there are many of us out here with 20 years plus experience trying to get back into nursing after childcare breaks.
Some help in doing this rather than a bill for £1600 and 150 + hours unpaid work, no student loan an no help for childcare might provide more staff with experience!
Only if you live in an area where the course is run is an NHS busary available, the old postcode lottery applies. I have to travel 2 hours by train to get to study days.

It is staff shortages that is the biggest issue in the NHS, you can make staff nurses work as HCAs however if the numbers are still short it will do absolutely nothing to make sure mid staffordshire never happens again. Cutting staff and saving pennies will always impact upon patient care. If you have 7 buzzers going at the one time and only 3 members of staff, regardless of uniform colour it is a bit hard to get to everyone.

Why should nurses reassure the public confidence. It's not nurses that are letting the Nhs down . All care staff, auxiliary,hca, students and qualified nurses do their job because they care and they want to make a difference. Caring includes being able to utilise lots of skills including bed baths, bedside manner and the most important of all communication skills. The latter seems to be the one which the government appears to have lapsed themselves. Why are you not talking to the people who are in the front line? Why are you not supporting us instead of demoralising us? I for one disappointed with the lack of support for nurses, the congratulations, the pat on the back for actually making a difference for the majority of the people we care for. There will always be a minority of bad in any situation but why does it have to always affect the care in the Nhs. I would like to congratulate my nhs colleagues for the fantastic work you all do that is unseen, unheard and unbelievably not recognised by people who seem to demoralise us.

i think that phasing out of enrolled nurses have resulted in lowering of knowledge on the ward floor.we were there to support the s/n's to allow them to manage the ward and deal with discharges and admissions.we were trained for 2 years, learning about comunication, pressure area care ,mouthcare and total patient care with the theory behind it.we did learn alot on our ward placements but it depended on restrictions of time of the permanent staff and their standards of care.we had assessments on each ward to evaluate our knowledge on basic nursing care.i know there are alot of fantastic hca's out there but they dont always receive all then training they need.even if the staff are motivated and highly skilled though, if the numbers are not adequate,standards will only drop.

Nursing is a profession in medical field which focuses on taking care of sick and recovering individuals, families and communities.

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