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Readers’ panel: Are healthcare assistants providing ‘nursing on the cheap’?

A Unison survey of almost 2,300 UK healthcare assistants found that many are doing the jobs of nurses without the equivalent pay or education – 39% said they had not received training to provide the care expected of them, such as looking after patients with dementia. Nursing Standard’s readers’ panellists have their say

A Unison survey of almost 2,300 UK healthcare assistants found that many are doing the jobs of nurses without the equivalent pay or education – 39% said they had not received training to provide the care expected of them, such as looking after patients with dementia. Nursing Standard’s readers’ panellists have their say 


Grant Byrne(@GGByrne) is a nursing student in Scotland

Grant Byrne

The importance of training, even for straightforward nursing tasks, is often missed by those in government, who think a caring smile is all it takes.
Even though some healthcare assistants (HCAs) go without formal training, many rise to the challenge of additional duties. But when things go wrong, patients pay the price. 
The NHS should support HCAs to develop, but this must be coupled with an understanding that excellent nursing care only comes with the appropriate training and pay. 
We must not allow our hard-working HCAs to become knock-off nurses.


Jane Brown is quality governance manager, clinical support, at Worcestershire Acute Hospitals NHS Trust

Jane Brown

HCAs are essential in delivering fundamental care to patients, and I do not think they are doing ‘nursing on the cheap’. 
They do have training, especially in caring for patients with dementia. If they do not feel competent to carry out the tasks they are given, they must speak to senior staff because they could be putting patients at risk.
Roles and responsibilities need to be defined for all levels of staff to ensure the highest standard of patient care.


Daniel Athey (@danjathey) is a charge nurse on an acute medical unit at University Hospitals Coventry and Warwickshire NHS trust

Daniel Athey

HCAs provide a large proportion of ‘hands-on’ care, and I do not want to undermine the great work they do. 
However, their role is to assist the nurse, with whom the ultimate responsibility for patient welfare lies.
Unison deputy head of health Sara Gorton says HCAs could earn more money stacking supermarket shelves. This may be so, but, like nurses and other professions in the NHS, they are not in it for the money. 


Liz Charalambous (@lizcharalambou) is a staff nurse, health care of older people, Nottingham University Hospitals NHS Trust

Liz Charalambous

While recognising the important contribution HCAs make to health care, I wager that registered nurses provide excellent value for money, with much of their ‘invisible’ preventative work saving the taxpayer a fortune. 
Caring for patients with dementia can be complex. It requires comprehensive knowledge and skills, gained through education and experience. This is about accountability as well as competence – who will be held responsible if things go wrong? 
All healthcare staff should be properly trained to provide the care they are expected to deliver. 


Readers’ panel members give their views in a personal capacity and do not represent their organisations

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