'Untrained' healthcare assistants 'put patients at risk'

A hospital ward Image copyright Thinkstock
Image caption The BBC spoke to health care assistants around the country

Patients are being "put at risk" because some healthcare assistants are working without proper training or supervision, a BBC investigation found.

Hospital support workers say they have been left alone on wards with up to 40 patients, with junior staff asked to take blood samples and insert IV drips.

The Royal College of Nursing blamed a "woeful lack" of trained nurses.

Health secretary Jeremy Hunt said record numbers of healthcare assistants were being trained.

The BBC has spoken to 32 care assistants from 19 hospitals across the East of England, West Midlands, East Midlands, London and South West.

The investigation found they were often asked to "act up" to perform roles designated for doctors and nurses.

Image caption Catherine Foot, of the King's Fund, said pressure on the NHS had created "an all hands on deck mentality"

National Institute for Health and Care Excellence (NICE) guidelines say healthcare assistants are expected to work under professional supervision.

One worker, who wanted to remain anonymous, said she went into surgery after two shadow shifts.

She said she touched the glove of a surgeon during an operation, forcing him to rescrub.

"I just did not know what I was doing," she told the BBC.

Comments from healthcare assistants

"There's not enough training, and no time to train even if we wanted to."

"I am always asked to work above my duty - like lifting patients without lifting training."

"HCAs are running the clinics. If something goes wrong, we have to run to get a nurse."

"You cannot cut corners on care work. If that is the case you may as well send anybody off the street to look after people."

"We had a patient who should have been lifted by six people being rolled only by me and one other staff member."

"Medication has been given to the wrong people."

Source: BBC interviews

The Department of Health says there are about 110,000 healthcare assistants across England.

Their recommended duties range from washing and dressing patients, feeding and bed making to taking blood tests and looking after wounds, depending on their seniority.

Catherine Foot, assistant director of policy at health charity the King's Fund, said the wide range of roles meant "it is not always clear" to clinical teams what skills support workers have.

She said the government's new care certificate, due to be introduced in April, would "provide minimum standards of training and skills", meaning support workers are less likely to be asked to do things they are not trained for in the future.

But she said she understood how increased pressure on the health service was creating "an all hands on deck mentality".

"It takes a lot of strength, maturity, resilience and confidence for support workers to say 'no, I don't know how to do that'," she said.

NICE guidelines on health care assistants

  • There should be sufficient designated registered nurses who are experienced and trained to determine on-the-day nursing requirements
  • Staffing requirements should consider if there are enough registered nurses available to support and supervise health care assistants
  • HCAs should only be given tasks and duties within their scope of competence
  • HCAs should not be used to plug gaps in nursing shifts
  • The type of duties performed by HCAs include washing and dressing, toileting and bed making

Image caption The Royal College of Nursing says there is a "woeful lack" of nurses in the NHS

Karen Webb, regional director of the Royal College of Nursing in the East, said a lack of nurses meant healthcare assistants were being placed in a position where they "feel they need to do work they are not educated to do".

She said some hospitals have "a woeful lack" of qualified nurses.

"That is placing health care assistants in a dangerous situation."

She said support workers were "left paddling around" without adequate supervision, a situation that "puts patients at risk".

In July 2013, Sunday Times journalist Camilla Cavendish was asked by the government to review the unregistered workforce in the wake of the Francis Inquiry, which examined failings in care at Mid Staffordshire NHS Foundation Trust between 2005 and 2009.

The Cavendish Review found training for health assistants was "neither sufficiently consistent, nor sufficiently supervised".

Mr Hunt said "no-one should do anything without the right training", but added there were 7,500 more nurses across the country than when the coalition government came to power in 2010.

The Department of Health said it was "never acceptable for unqualified staff to be asked to undertake any task for which they are not trained or supervised".

"Staff who raise concerns about patient safety help protect patients, and they have the government's strong support," a spokesman said.

"The Care Certificate, which comes into effect in April 2015, will be a means of providing clear evidence to employers, patients and service users that the healthcare assistant or social care worker in front of them has been trained to a specific set of standards."

Inside Out in the East will have more on the story on Monday 23 March at 19:30 GMT on BBC One

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