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Healthcare: Support Workers

Volume 742: debated on Monday 28 January 2013


Asked By

To ask Her Majesty’s Government what plans they have to train and register health care support workers.

My Lords, my right honourable friend the Prime Minister has announced a £13 million innovation fund, which will provide opportunities for healthcare assistants to progress to nursing roles, and a review of induction training for care staff by the Care Quality Commission. In addition, new training and conduct standards for care staff will be published shortly. We are considering what further action is required in the light of the findings of the public inquiry into Mid Staffordshire NHS Foundation Trust.

I thank my noble friend for that very helpful reply. However, does she accept that at the moment there are literally tens of thousands of elderly, frail patients, often with comorbidities, being looked after in domiciliary or care homes by an army of well meaning healthcare support workers who receive virtually no training and who are unregistered, unregulated and often unsupervised? Will my noble friend do three things in the forthcoming legislation: will she ask the NMC, first, to set standards for all healthcare support workers; secondly, to make that training mandatory; and, thirdly, to set out a timetable by which if employers do not use trained staff, it will in fact be an illegal act?

My noble friend makes some very cogent points; of course, he has recently reviewed this whole area in the Willis report. As I mentioned just now, we are imminently to receive the report on the Mid Staffs situation, which continued over a long period. My understanding is that it will be published on 6 February. The Government will be responding to what its recommendations might be, but I have already mentioned that Skills for Health and Skills for Care are developing standards for the training and conduct of support workers. They should report on that very shortly. The CQC has also been commissioned to review induction training, so we are acutely aware of this and are working on it at the moment.

My Lords, in view of the fact that Skills for Health has a UK remit, whereas I believe that Skills for Care has an England-only remit, can the noble Baroness tell the House what consultation there has been with the Governments in Wales and Scotland to ensure, on the one hand, that lessons are learned from each other and, on the other hand, that the training needs are co-ordinated to the benefit of everyone?

We are in constant contact with the devolved Administrations; I have information from both Wales and Scotland. It is indeed extremely important that we learn from each other, as the noble Lord has flagged up.

My Lords, I, too, congratulate the Government on the steps that they have taken so far, although they have taken a long time to do them. In addition to the area that the noble Lord, Lord Willis, talked about, there are still issues inside hospitals of patients not understanding that healthcare assistants are qualified to do the work that they are doing, while the healthcare assistants desperately want them to understand that. The Government’s failure to push this forward quickly is damaging that relationship. It also makes patients feel unsafe when they really have no need to.

In many parts of the health service, there is excellent care. I have certainly seen that first-hand. We have to make sure, as the noble Baroness does within her trust, that all care is consistent, safe, effective and compassionate. I take seriously the point that she makes.

My Lords, does the Minister accept that, with regard to out-patients, a common path is often beaten to their door by NHS workers on the one hand and social service workers on the other? Very often, there is a total lack of co-ordination between them, with each group acting as if they came from independent—and sometimes even jealous—empires. In the circumstances, does she not agree that there is a strong case for support workers to be jointly employed, jointly trained and jointly answerable in respect of these matters?

This is an issue which the noble Baroness, Lady Emerton, has flagged up and I think she made a very cogent case. Health workers and social care workers move between the two sectors. We are trying to make sure—as previous administrations have sought to do—that the two systems are better integrated, because a patient is one person. They may cross between the two sectors, but they should have the same standards of care, whichever part of the system they are in.

My Lords, given that there is a visible difference between homes where all the staff are trained and those where it is a bit patchy—to be favourable about it—can the Minister confirm whether the Government will be looking for compulsory training, which seems absolutely key to success in protecting both patients and staff?

I can assure my noble friend that all options will be considered when we receive the Mid Staffs report.

My Lords, is the Minister aware that, without registration of these care workers, they can go anywhere and work anywhere, when they are dangerous and not suitable for work because they cannot be tracked?

As the noble Baroness knows, employers have a responsibility to make sure that those whom they employ are suitable and do not have the kind of record that she has indicated. We also know that regulation per se does not necessarily mean that good care is given; therefore, a proportionate and intelligent response is needed if we are to ensure that the care given is of the consistency, safety and quality that we all wish to see.