06/09/2011 - The propsed regulation of HCA's

#NurChat to discuss the proposed regulation of HCA's 06/09/2011 8pm

With the coalition governments plan to create a voluntary register for Healthcare Assistants (HCA’s) and the recent spate of poor care cultures that have come to light in places such as Winterbourne View in Bristol the regulation and training of HCA’s is a very important subject in nursing at the moment.  Both the NMC and the RCN and an estimated 80% of HCA’s want regulation.  Is this what is needed to ensure that patients get the best possible care? (Thanks to anonymous for this suggestion)

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Below are some online articles that may help you prepare for the discussion:







Summary by Teresa Chinn RN
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Post Chat Summary

This discussion kicked off by discussing whether we thought that HCAs should be regulated - the overall opinion was that they should be. 
There was some discussion around if the register should be voluntary and some very good points were made around this as to whether a voluntary register would only attract the best HCAs and how a voluntary register could be seen as being in the publics best interest. 
It was also discussed who the regulating body should be and it was generally agreed that the NMC or HCP should take on the role. 
The issue of funding the regulation was a point of debate - some participants raised concerns over HCAs being able to afford fees, such as those paid by nurses to the NMC, and some thought that it was necessary for HCAs to pay stating that if low paid people such as security guards could pay to be regulated the surely HCAs should. 
Whether regulation would reduce the incidence of things like Winterbourne View was discussed and it was suggested that it may not stop it but improve things.  There was some chat around how regulation could work to ensure that incompetance and long term issues could be dealt with and other issues that wouldn't necessarily involve the police or safeguarding issues.
The chat concluded with some history on how nurses came to be regulated.

Thank you to all who took part and to the annonymous person who suggested this discussion.  Please feel free to share the transcript below with you nurse colleagues or add any further comment below.

Summary by Teresa Chinn RN
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Chat Transcript (Reverse chronogical order) :

 |  tracyok69 @AgencyNurse great conversation as always, thanks for tonight #NurChat 9:11 PM
 |  NurChat RT @andyjaeger thanks for hosting - more from the NMC on this subject http://t.co/id2fAe3 http://t.co/2a7j4bD http://t.co/AhYpNFJ #nurchat 9:06 PM
 |  mariedawndancer RT @NurChat: So this evening we aretalking about the proposed regulation of HCAs - so i guess the first question is should HCAs be regulated? #nurchat 9:06 PM
 |  AgencyNurse Been a lovely chat as always - going away now to brush up on my nurse history :D #Nurchat 9:05 PM
 |  NurChat thanks all - please feel free to suggest subjects for future discussions, this chat is all about what nurses want #nurchat 9:04 PM
 |  andyjaeger @NurChat thanks for hosting - more from the NMC on this subject http://t.co/JEtX3ey http://t.co/1CV79LP http://t.co/W8bRo08 #nurchat 9:03 PM
 |  gerrybolger RT @Gage91: @NurChat Its been a pleasure :) #nurchat 9:03 PM
 |  Gage91 @NurChat Its been a pleasure :) #nurchat 9:03 PM
 |  AgencyNurse @andyjaeger yes very much so !!! But hasn't the reg of HCAs also been a long time on the agenda ? #Nurchat 9:03 PM
 |  NurChat well guys NurChat will be signing off now but feel free to keep chatting ... thanks so much for all the chat #nurchat 9:01 PM
 |  gerrybolger @andyjaeger The value (let alone importance) is now estbalished why is there such indifference? Cost? responsibility? #irony #nurchat 9:00 PM
 |  andyjaeger @AgencyNurse ...and the battle was for recognition of the importance of it... sound familiar? #irony #nurchat 9:00 PM
 |  andyjaeger @AgencyNurse some did, some didn't (inc Florence Nightingale!) #nurchat 8:59 PM
 |  gerrybolger @NurChat So why should HCAs have a voluntary regulation and Assistant Practitioners not? #nurchat 8:59 PM
 |  AgencyNurse RT @gerrybolger: RT @AgencyNurse: Why has it taken so long for HCAs regulation ??? - lol more of a statement than a question !!! #Nurchat 8:58 PM
 |  gerrybolger RT @AgencyNurse: Why has it taken so long for HCAs regulation ??? #Nurchat 8:57 PM
 |  AgencyNurse Why has it taken so long for HCAs regulation ??? #Nurchat 8:57 PM
 |  AgencyNurse @andyjaeger that early ??? A battle with whom ?? Did nurses want regulation ? #Nurchat 8:56 PM
 |  gerrybolger RT @NathanWhitfiel: nathan Health economic regular has a role as the quality regulator and the professions regulators' #nurchat wietfiel 8:55 PM
 |  andyjaeger @AgencyNurse nurses since 1919, midwives since 1902 - long-fought battle in both cases #nurchat 8:55 PM
 |  AgencyNurse @Gage91 I will ... Maybe it would give some insight on which way to go with HCAs #Nurchat 8:55 PM
 |  gerrybolger @AgencyNurse I can remember back to the General Nursing Council #Nurchat 8:55 PM
 |  Gage91 @AgencyNurse Its a very interesting part of Nursing History, you should research it! I defo found it interesting :) #regulation #Nurchat 8:54 PM
 |  NathanWhitfiel nathan Health economic regular has a role as the quality regulator and the professions regulators' #nurchat wietfiel 8:54 PM
 |  gerrybolger Health economic regular has a role as the quality regulator and the professions regulators' #nurchat 8:53 PM
 |  AgencyNurse Does anyone know if nurses have always been regulated ? #Nurchat 8:52 PM
 |  Gage91 @andyjaeger @gerrybolger ..could certainly question your competence, as the NMC would. #nurchat 8:52 PM
 |  Gage91 @andyjaeger @gerrybolger You can't really be added to the ISA register for regular omission of medication example, but regulator.. #nurchat 8:52 PM
 |  gerrybolger @andyjaeger Yes, we need to see regulation like a wedding cake, several layers & interconnected with separation of responsibilities #nurchat 8:51 PM
 |  andyjaeger @gerrybolger regulators can deal with issues which wouldn't be "serious" enough to involve police or safeguarding authorities #nurchat 8:50 PM
 |  AgencyNurse RT @andyjaeger:@NurChat incompetence or long term problems might not get dealt with in that way though - yes you are right #Nurchat 8:49 PM
 |  gerrybolger @andyjaeger pls expand... #nurchat 8:48 PM
 |  andyjaeger @AgencyNurse @NurChat incompetence or long term problems might not get dealt with in that way though #nurchat 8:48 PM
 |  AgencyNurse @gerrybolger I agree regulation will not stop things like winterbourne #Nurchat 8:47 PM
 |  gerrybolger RT @Gage91: @NurChat Might not stop it, but will improve things. #nurchat 8:47 PM
 |  Gage91 @NurChat Might not stop it, but will improve things. #nurchat 8:47 PM
 |  gerrybolger @NurChat Will HCA regukation stop system failure = No, thats a wider issue & there's a responsibility for the individual & employer #nurchat 8:46 PM
 |  AgencyNurse @andyjaeger @NurChat Doesn't that already happen with HCAs ? if a safeguarding adults / children's issue put on a register ? #Nurchat 8:45 PM
 |  Gage91 @gerrybolger @andyjaeger I meant HPC Gerry :) got mixed up, HCP - Health Care Professional, HPC - Health Professionals Council #nurchat 8:45 PM
 |  andyjaeger @NurChat regulation also provides an additional barrier to HCAs dismissed for poor care getting jobs elsewhere #nurchat 8:43 PM
 |  gerrybolger RT @NurChat: the general opinion seems to be that regulation is the way forward ... #nurchat I agree 8:43 PM
 |  NurChat @gerrybolger weare discussing would regulation stop ythings like winterbourne #nurchat 8:43 PM
 |  gerrybolger @andyjaeger thanks, for the fees on HCP #nurchat 8:43 PM
 |  gerrybolger #nurchat lost my internet... where are we... 8:42 PM
 |  Gage91 RT "@AgencyNurse: @NurChat I think it would ensure accountability Agreed. And possibly greater education and consistent standards #Nurchat" 8:42 PM
 |  AgencyNurse I guess that a register is not nearly enough, a code of conduct, proffessional accountability etc all need to be standard ... #Nurchat 8:42 PM
 |  Gage91 @AgencyNurse @andyjaeger @gerrybolger To me personally £76 seems reasonable #Nurchat 8:41 PM
 |  AgencyNurse @NurChat I think it would ensure accountability #Nurchat 8:41 PM
 |  AgencyNurse @andyjaeger @gerrybolger @Gage91 Really is it an industry standard??? #Nurchat 8:39 PM
 |  andyjaeger @NurChat depends who you ask - government and CHRE do not agree #nurchat 8:39 PM
 |  NurChat do you think that regulation would reduce the incidence of bad care though eg winterbourne view? #nurchat 8:39 PM
 |  Gage91 @AgencyNurse I meant HPC - Health Professionals Council, :) http://t.co/7VL7ba0 Just an idea that popped in to my head! #nurchat 8:38 PM
 |  AgencyNurse @gerrybolger thank you :-) #Nurchat 8:37 PM
 |  andyjaeger @gerrybolger @Gage91 if you mean HPC (Health Professions Council), it's also £76 #nurchat 8:37 PM
 |  NurChat the general opinion seems to be that regulation is the way forward ... #nurchat 8:37 PM
 |  gerrybolger @AgencyNurse it's the register for a wide range of staff including therapists, paramedics and others not on he other registers #Nurchat 8:37 PM
 |  gerrybolger @Gage91 If HCP register how much is that per year then? #nurchat 8:35 PM
 |  AgencyNurse RT @andyjaeger: @gerrybolger pay is an issue, but then security guards pay to be registered, other low paid workers too -agreed #Nurchat 8:35 PM
 |  gerrybolger @Gage91 I'm not wedded to one register or another because HCAs support healh care in a wide range of setting including social care #nurchat 8:34 PM
 |  Gage91 And defo agree abour poor pay and cost, not fair for them to have to pay the £76 fee on the NMC, maybe a reduced price? #nurchat 8:34 PM
 |  AgencyNurse @Gage91 I don't know about that register please tell me more? #Nurchat 8:34 PM
 |  andyjaeger @gerrybolger @AgencyNurse pay is an issue, but then security guards pay to be registered, other low paid workers too #nurchat 8:34 PM
 |  gerrybolger @chunky_monkey88 it's about regulation versus being on a register... I think there's a difference others on here know better #nurchat 8:33 PM
 |  AgencyNurse @chunky_monkey88 I guess it would have to be funded some how #Nurchat 8:33 PM
 |  Gage91 I believe HCA's should be regulated but registered to the HCP register rather than by the NMC? #nurchat 8:33 PM
 |  gerrybolger @AgencyNurse I'm sympathetic about pay; maybe regulation could be at fixed cost rather than at same as RN/RM etc rate #Nurchat 8:32 PM
 |  chunky_monkey88 Would HCA's pay to join register? #nurchat 8:32 PM
 |  NurChat RT @gerrybolger: @AnneDuell Regulation isn;t an NHS or public sector issue its a health issue regardless of provider #nurchat 8:32 PM
 |  AgencyNurse @gerrybolger @andyjaeger I agree if you don't register u can't work ... But very harsh on poorly paid HCAs #Nurchat 8:31 PM
 |  gerrybolger @AgencyNurse I think the cost of regulation must be based on affordability and if too expensive then it won't #Nurchat 8:30 PM
 |  chunky_monkey88 @AgencyNurse I think would offer some support, more support should come from employers though #nurchat 8:30 PM
 |  AgencyNurse RT @andyjaeger: @AgencyNurse I know some nurses who arent happy paying £76 a year! ;-) <- lol yes !!!! #Nurchat 8:29 PM
 |  gerrybolger @AnneDuell Regulation isn;t an NHS or public sector issue it's a health issue regardless of provider #nurchat 8:29 PM
 |  gerrybolger @andyjaeger I think choice to pay isn't the issue = don't pass GO & don't get £200 analogy, if they refuse they don't get paid #nurchat 8:29 PM
 |  andyjaeger @AgencyNurse I know some nurses who aren't happy paying £76 a year! ;-) #nurchat 8:28 PM
 |  AgencyNurse @chunky_monkey88 @AgencyNurse do you think that regulation would offer greater support ?? #Nurchat 8:28 PM
 |  AgencyNurse I can't think of many HCAs who would be happy to pay £76 per year #Nurchat 8:27 PM
 |  NurChat RT @AnneDuell: #nurchat. How will this fit in with the regulation of care staff in the private sector too? #nurchat 8:26 PM
 |  AgencyNurse RT @AnneDuell: #nurchat. How will this fit in with the regulation of care staff in the private sector too? - good point ! #Nurchat 8:26 PM
 |  AgencyNurse @gerrybolger @AgencyNurse So do you think the NMC should take responsibility ? #Nurchat 8:26 PM
 |  AnneDuell #nurchat. How will this fit in with the regulation of care staff in the private sector too? 8:26 PM
 |  chunky_monkey88 @AgencyNurse I would have felt ok as don't think hca's r always well supported. Being supported makes u feel more valued #nurchat 8:25 PM
 |  andyjaeger @AgencyNurse @gerrybolger is it impossible to think that HCAs would want to pay? At a low rate? #nurchat 8:25 PM
 |  gerrybolger @AgencyNurse I think affordability is key for this to work, a new regulators' cost would be possibly higher than an existing one #Nurchat 8:25 PM
 |  gerrybolger @andyjaeger it can't be an optional extra thus the need for it being compulsory, and as such CQC registration would be linked #nurchat 8:23 PM
 |  AgencyNurse @andyjaeger @gerrybolger So given that HCAs are often very poorly paid who would pay for this ? #Nurchat 8:22 PM
 |  gerrybolger @AgencyNurse regulatory body versus professional organisation, it has to be a regulator to have confidence in the system #Nurchat 8:22 PM
 |  AgencyNurse @gerrybolger @AgencyNurse Regulatory body eg NMC #Nurchat 8:21 PM
 |  andyjaeger @gerrybolger I agree - vol reg would need strong employer buy in, and for orgs in trouble, it could be an optional extra #nurchat 8:21 PM
 |  gerrybolger @AgencyNurse define 'body' #Nurchat 8:21 PM
 |  NurChat so the million dollar question is who should regulate HCAs and who should pay ? #nurchat 8:21 PM
 |  gerrybolger For effective regulation there needs to be support across the wide specturm, not form one or two bodies, thus its all or nothing #nurchat 8:20 PM
 |  AgencyNurse @chunky_monkey88 do you think that being in a "body" would make you feel more valued ? #Nurchat 8:19 PM
 |  gerrybolger @AgencyNurse In response to your question I had no choice and am glad I am on a public register so people can heck I am bona fide #Nurchat 8:19 PM
 |  AgencyNurse RT @gerrybolger: possibly but it would b devalued as soon as 1 HCA as exposed and politically bet it would be scrapped - good point #Nurchat 8:18 PM
 |  andyjaeger @AgencyNurse @gerrybolger there's certainly an argument for that #nurchat 8:17 PM
 |  gerrybolger @AgencyNurse possibly but it would be devalued as soon as one HCA as exposed and politically bet it would be scrapped #Nurchat 8:17 PM
 |  AgencyNurse @chunky_monkey88 As an ex HCA how would you have felt if you were asked to join a register ? #Nurchat 8:17 PM
 |  chunky_monkey88 If there was a body for all HCA's would they feel more part of the nursing team? I know I felt like 'just a HCA' sometimes #nurchat 8:17 PM
 |  AgencyNurse @gerrybolger I agree it's a worthless exercise 2 have a voluntary register .. But could it be part of transition 2 compulsory? #Nurchat 8:15 PM
 |  chunky_monkey88 No shouldn't be voluntary if in publics best interest #nurchat 8:14 PM
 |  gerrybolger Having a vlunatry register how would an employer check for issues should the HCA choose not to be regulated? #nurchat 8:14 PM
 |  gerrybolger RT @AgencyNurse: I think a voluntary register would be a huge step in the wrong direction #Nurchat 8:13 PM
 |  AgencyNurse RT @andyjaeger: @NurChat voluntary regulation is a problem - surely only the best HCAs would want to be regulated? <-agreed #Nurchat 8:13 PM
 |  gerrybolger @andyjaeger and those who are not the best avoid being regulated, hence voluntary isn't a viable option #nurchat 8:13 PM
 |  AgencyNurse I think a voluntary register would be a huge step in the wrong direction #Nurchat 8:13 PM
 |  gerrybolger @NurChat No, what's the point of having voluntary regulation, if its acceptable HCAs why isn't it good for all other health profs #nurchat 8:13 PM
 |  andyjaeger @NurChat voluntary regulation is a problem - surely only the best HCAs would want to be regulated? #nurchat 8:12 PM
 |  NurChat RT @gerrybolger: Responsibility of care lies with the employer, but that needs to be supported and enforced through regulation #nurchat 8:12 PM
 |  gerrybolger Responsibility of care lies with the employer/provider, but that needs to be supported and enforced through regulation #nurchat 8:11 PM
 |  NurChat so if the regulation of HCAs is about protecting the public should the register be voluntary? #nurchat 8:11 PM
 |  Gage91 @NurChat Hi from MK! Just mostly observing from my blackberry! :) #nurchat 8:11 PM
 |  AgencyNurse @gerrybolger Surely though its about much more, yes I agree regulation is good but what about training ? #Nurchat 8:11 PM
 |  ReedyfordGP RT @AgencyNurse: RT @nmcnews: Just enough time 2 have a quick read around tonights #NurChat "HCA regulation" http://t.co/2nLrKk6 chatting starts 8pm #Nurchat 8:10 PM
 |  ReedyfordGP RT @NurChat: hi all, as always we will start with introductions - so who is out there this evening? #nurchat 8:10 PM
 |  ReedyfordGP RT @NurChat: So this evening we aretalking about the proposed regulation of HCAs - so i guess the first question is should HCAs be regulated? #nurchat 8:10 PM
 |  gerrybolger @AgencyNurse No it doesn;t, but it;s purpose is having a system to add protection, and ensure standards #Nurchat 8:10 PM
 |  gerrybolger If regulation isn't about protecting the public then disestablish the medical, nursing & HP Council regulators and CHRE! #nurchat 8:09 PM
 |  andyjaeger @gerrybolger working for the NMC, I'm bound to say that it does protect the public! #nurchat 8:08 PM
 |  AgencyNurse @gerrybolger @NurChat Surely regulation alone does not stop bad things happening? #Nurchat 8:08 PM
 |  chunky_monkey88 As HCA responsibilities are ever growing, a reg.body should be in place as HCA's can be heavily relied on and should be supported #nurchat 8:07 PM
 |  gerrybolger Regulation should protect the public, if not why have it? #nurchat 8:07 PM
 |  AgencyNurse @gerrybolger @NurChat will regulation protect the public ? #Nurchat 8:06 PM
 |  gerrybolger @NurChat DH seem to think compulsory regn not required Isn't it about protecting the public, & if they're not how do you protect #nurchat 8:05 PM
 |  susiqa #NurChat to discuss the proposed regulation of HCA’s 06/09/11 8pm #NurseUK http://t.co/W8lVek4 via @NurChat 8:05 PM
 |  AgencyNurse Hi everyone .. I think that HCAs should be regulated but as to who and how I don't know #Nurchat 8:04 PM
 |  chunky_monkey88 Good evening @NurChat and other nurses! I am a newly qualified nurse with 5 yrs HCA experience and ready to chat :) x #nurchat 8:04 PM
 |  gerrybolger @NurChat DH seem to think compulsory regn; but isn't it about protecting the public, so if they're not regulated how do you protect #nurchat 8:04 PM
 |  andyjaeger @AgencyNurse evening Teresa - I'm Andy and I work in communications for the NMC #nurchat 8:03 PM
 |  HollyBest1 #nurchat Hi from Cornwall! 8:03 PM
 |  NurChat So this evening we aretalking about the proposed regulation of HCAs - so i guess the first question is should HCAs be regulated? #nurchat 8:02 PM

 |  AgencyNurse Hi - Teresa RN and agency nurse here #Nurchat 8:00 PM
 |  gerrybolger @NurChat Hi from London #nurchat 8:00 PM
 |  NurChat hi all, as always we will start with introductions - so who is out there this evening? #nurchat 8:00 PM
 |  NurChat just a few things to remember 1- your opinions are all your own 2- pls bear in mind the NMC guidelines whilst tweeting #nurchat 7:55 PM
 |  gerrybolger My followers not an increase in tweets from me tonight as I join #nurchat 7:52 PM
 |  NurChat good evening everyone we will be starting the chat in 15 minutes #nurchat 7:45 PM
 |  AgencyNurse RT @nmcnews: Just enough time 2 have a quick read around tonights #NurChat "HCA regulation" http://t.co/2nLrKk6 chatting starts 8pm #Nurchat 7:10 PM
 |  NurChat 1 hour until we kick off tonights chat about the proposed regulation of HCAs as always the chat will take place via #nurchat #nurchat 7:01 PM
nmcnews RT @NurChat: Just enough time to have a quick read around tonight's #NurChat subject "HCA regulation" http://t.co/DjM95D3 chatting starts at 8pm 4:54 PM

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