Cavendish Review: Healthcare assistants are performing the same tasks as nurses and even doctors without standardised training

Review calls for standardised training for healthcare assistants

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An independent review has found that there is no minimum standard of care for healthcare assistants before they are allowed to work unsupervised.

Some healthcare assistants (HCAs) were performing tasks usually reserved for doctors and nurses, such as taking blood samples from patients, without receiving standardised training. The Cavendish Review found that employers were instead deciding independently what training their staff required.

The review also found that whilst HCAs were carrying out the jobs nurses are trained to complete such as inserting IV drips, withdrawing blood and plastering, they were paid at three levels below a newly qualified nurse.

The report, conducted by journalist Camilla Cavendish, argues that all HCAs should be put through a universal system of training, which would then provide them with accreditation upon finishing before they are allowed to work unsupervised. HCAs would be awarded a ‘Certificate of Fundamental Care’, Ms Cavendish said, “written in plain English, to make a positive statement about caring”.

In the review, Ms Cavendish said she was “struck by how disconnected the systems are which care for the public” as “the NHS operates in silos, and social care is seen as a distant land occupied by a different tribe”. She highlighted the 1.3 million frontline staff who are not registered as nurses, but deliver the majority of hands-on care.

The report added that in the NHS, 12-hour shifts "have become the norm", and asked whether such long working hours were compatible with maintaining compassionate care, "especially when looking after patients with complex needs". The report continued: "The perspective of healthcare assistants must be taken very seriously when this is investigated by NHS England.”

Finally, in recognition of the key role that HCAs play in health and social care, the review suggested that their job title should change to ‘Nursing Assistant’.

Ms Cavendish was asked to author the review after serious failings in care were discovered after the Mid Staffordshire NHS Foundation Trust scandal.

The Government is expected to provide a formal response to the review when it releases its response to the Francis Report into the Mid Staffordshire public inquiry later in the year.

The British Red Cross spoke out on Wednesday to welcome the "explicit reference" in the review to the need for first skills and the proposed first aid training. They said: "That some HCAs are performing tasks usually reserved for doctors and nurses - some without standardised training - is extremely worrying. The recently published Cavendish Review report highlights the serious shortfall in training for HCAs despite their vital contribution to our health system. 

"The explicit reference to first aid skills in the proposed training package is warmly welcomed by the British Red Cross. Basic life-saving skills should be acknowledged as an essential and fundamental element for the training of those involved in providing professional healthcare."

Additional reporting by PA