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Healthcare assistants increasingly being used as ‘nurses on the cheap’

Calling on HCAs to fill nurse staffing gaps is bad for patients – Unison
Healthcare assistant performing an ECG on a patient

Calling on HCAs to fill nurse staffing gaps is bad for patients Unison

Healthcare assistants (HCAs) are continuing to serve as nurses on the cheap, according to research that found they are increasingly being asked to perform the work of registered staff.

A survey of almost 2,000 HCAs by public sector union Unison, found that 51% had performed tasks for which they were not trained, with 9% of these stating this was a daily occurrence. The winter 2017 results continue a pattern identified in a similar survey in 2016 .

Nursing tasks that HCAs said they undertake:

  • Dressing wounds (42%).
  • Stoma care (35%).
  • Carrying out ECGs (21%).
  • Administering medication (18%).
  • Monitoring blood sugar levels (19%).

Additionally, 63% of HCAs

Calling on HCAs to fill nurse staffing gaps is bad for patients – Unison


Picture: John Houlilhan

Healthcare assistants (HCAs) are continuing to serve as ‘nurses on the cheap’, according to research that found they are increasingly being asked to perform the work of registered staff.

A survey of almost 2,000 HCAs by public sector union Unison, found that 51% had performed tasks for which they were not trained, with 9% of these stating this was a daily occurrence. The winter 2017 results continue a pattern identified in a similar survey in 2016

Nursing tasks that HCAs said they undertake: 

  • Dressing wounds (42%).
  • Stoma care (35%).
  • Carrying out ECGs (21%).
  • Administering medication (18%).
  • Monitoring blood sugar levels (19%).

Additionally, 63% of HCAs reported that they had been asked to perform clinical tasks without proper supervision from a qualified professional, such as a nurse, with 27% of this group stating this happened on a daily basis.

Easing pressure

Almost 75% of respondents also reported they had picked up extra work to ease the pressure caused by unfilled registered nursing and clinical professional posts, with 19% of respondents stating this occurred every day.

Most of the HCAs said the problem was worse than in winter 2016. According to the survey, 41% of HCAs reported being asked to undertake tasks without adequate training more often than in the previous year, with 57% reporting they were picking up more work due to unfilled registered nursing or clinical professional posts.

In Unison's 2016 survey, 39% of HCAs stated they had not received the training necessary to provide the care expected of them and 45% feeling the tasks they being asked to do were appropriate to their competence level.

Lack of career pathway

The latest survey also reported 43% of HCAs said they would like training to become a nurse or other healthcare professional but that their employer was not providing them with enough support or opportunity to do this.

‘Health outcomes improve with more registered nurses on duty’

Janet Davies

RCN general secretary Janet Davies said the survey reflected the current staffing pressures facing the NHS.

‘As the shortage of nurses continues to bite, shifts are increasingly filled with more unregistered care staff,’ she said.

Ms Davies added that HCAs perform a critical role, but it was unfair to them and to patients that they were being asked to perform nursing duties.  

‘Support workers play an extremely important role, but they should supplement the work of nurses, not replace them,’ she said. ‘Health outcomes improve with more registered nurses on duty.’

Bad for patients

Ms Davies urged the government to do more to address the shortage. She said: ‘The government must not allow nursing on the cheap and increasing the supply of registered nurses must be a priority.’

Unison head of health Sara Gorton echoed Ms Davies' sentiment.

‘Healthcare assistants are being left to fill staffing gaps and do vital tasks without recognition or reward,’ she said. ‘It’s bad for them and bad for patients.’


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