NHS patients are receiving an “unacceptable” level of care from a growing army of unqualified healthcare assistants who have taken over nursing roles on wards and in care homes due to budget cuts.
Basic tasks which were once the job of trained nurses are being carried out by more than 50,000 low-paid and unregulated assistants due to budget cuts and growing demands on nurses’ time.
Putting vulnerable patients in the care of well-meaning but “unreliable” nursing assistants raises “serious concerns about public protection”, a commission led by Lord Willis of Knaresborough, the Liberal Democrat peer, says in a report published today.
Healthcare assistants are employed for simple tasks like keeping patients fed and hydrated or taking their temperature, but are not currently trained to spot warning signs such as dehydration or rapid changes in body heat.
The report recommends training all healthcare assistants to at least NVQ level three – the non-academic equivalent of A-levels – to tackle the “widespread concern” about their growing presence on wards and care homes.
The report says:
The commission finds it unacceptable that staff whose competence is not regulated or monitored are caring for vulnerable citizens.
It is equally unacceptable that registered nurses must take responsibility for supervising colleagues on whose competency they cannot rely.
The report was commissioned by the Royal College of Nursing, to examine the training system for nurses amid concerns about their competence and attitude following a string of “stories of appalling care and mismanagement”.
Figures released last month revealed that 43 hospital patients had starved to death and 11 died of thirst due to failures in the most basic levels of care on hospital wards, while 78 died from bedsores.
The report raises concerns over the regulation of unqualified staff after NHS managers claimed the new demands on nurses will force them to rely more heavily on unqualified healthcare assistants for basic care.
Previous studies have found a direct link between a lower proportion of registered nurses and a worse quality of care, and concerns are such that the Royal College of Nursing has led calls for systematic training and regulation of support workers.
Lord Willis said:
The registered nurses now are doing more highly specialised tasks and it is not good enough to say someone else can do those basic nursing tasks, they are not just add-ons.
You really have to have people who do not just put food in front of someone, but understand the significance that a patient takes food and hydration. It is not good enough to simply know how to do something, you have to know why you are doing it.