NHS assistants 'under-trained'
Healthcare assistants are taking on jobs for which they are not always properly trained, including looking after intensive care patients, according to new research.
A large survey of more than 2,500 NHS staff found examples where healthcare assistants (HCAs) are working beyond their competence, sometimes putting patients at risk. Nurses cited cases where lesser-trained HCAs administer drugs without proper training while others were left in sole charge of patients with complex needs.
Examples from the 2,554 people who responded to a Nursing Standard survey - made up mostly of qualified nurses and nursing students - said HCAs were also managing colleagues and running units and clinics.
Some nurses said HCAs had received training, but others said this was lacking - or HCAs were not competent in interpreting information about patients. One respondent said HCAs were involved in "caring for 'low-risk' ventilated tracheostomy patients in an intensive care environment".
"The registered nurse working next to them is expected to supervise and overlook everything they do but this is an impossible task when they themselves are looking after a level-3 ventilated patient. As far as I'm concerned this is dangerous practice and unfair on all parties concerned."
In another example, HCAs looked after intubated and ventilated patients in intensive care.
This means "on break times a trained member of staff could be left with only a support worker with them and no other registered member of staff, this can create issues with regards to giving intravenous (IV) medications. Also Band 4 HCAs are giving oral medications unchecked and there are plans for them to start giving IVs".
Other examples included HCAs drawing up care plans with no training, interpreting blood levels, complex wound care and carrying out electrocardiograms (ECGs) for heart patients. HCAs also gave antipsychotic medication without proper training.
One respondent said: "As a nurse manager I tend to supervise any practice that is deemed complex. ECGs are the most common but prior to being a manager I witnessed an HCA doing a catheterisation. They had no training and I was horrified."
Health minister Lord Howe said: "Healthcare assistants aim to give the very highest quality of care to patients, but they shouldn't be allowed to carry out tasks they are not qualified for. Employers must take responsibility for the quality of services provided and professionals, like nurses, must ensure appropriate delegation and supervision of tasks."