Support workers face compulsory regulation on back of Mid Staffs probe

Inquiry's proposed register for healthcare support workers would cover staff in care homes and specialist hospitals.

Photo credit: Image Broker/Rex Features
Photo credit: Image Broker/Rex Features

Healthcare support workers (HCSW) in care homes and specialist hospitals face compulsory regulation under proposals to root out unsuitable staff members put forward by the Mid Staffordshire NHS Foundation Trust Public Inquiry.

Unregistered staff and those sacked by employers should be prevented from working in HCSW roles, said today’s final report from the inquiry into the Stafford Hospital scandal. The government is due to respond to the report’s recommendations next month.

The report said HCSWs delivered intimate personal care to vulnerable patients and had access to confidential records, but often worked without supervision from nurses and were only required to have Criminal Records Bureau checks.

‘No protection for patients’

“There is almost no protection available to patients or the public,” said the inquiry by Robert Francis QC. “There are no minimum standards of training or competence. Should a healthcare support worker be dismissed by an employer for being unfit to undertake this form of work, there is no system which prevents the worker being re-engaged by another employer, or even to ensure that a prospective employer is aware of any adverse past history.”

The proposed register would be managed by the Nursing and Midwifery Council and would be complemented by a code of conduct and training standards for HCSWs; however, the nurses’ regulator would not, in the first instance, have the power to investigate or sanction breaches of the code.

Crucially, Francis said the register should apply to HCSWs in care homes and specialist hospitals, such as those for people with mental health problems or learning disabilities, as well as those in acute hospitals. The recommendation would also have implications for other staff working in direct care roles across adult social care.

Implications for adult care staff

Minimum training standards and a code of conduct for both HCSWs and adult social care staff are due to be published shortly by workforce development councils Skills for Care and Skills for Health. At the same time, the Health and Care Professions Council is developing plans for a “negative register” for adult care staff; there would be no requirement to register but the HCPC would investigate serious complaints against relevant staff and those found unfit to practise would be prevented from taking other jobs.

Were the government to accept Francis’s proposal, it would need to address issues such as whether HCSWs and adult social care staff should be subject to different regulatory regimes operated by different regulators, but bound by the same code of conduct.

The Mid Staffordshire inquiry also proposed that nurses, including those in care homes and specialist hospitals, should face regular revalidation of their fitness to practise, along the lines recently introduced for doctors by the General Medical Council.

Francis stopped short of recommending the regulation of senior managers in healthcare; however, he proposed that they should be subject to a code of conduct and standards, with serious breaches leading to them being barred from holding senior roles.

More information

Read a summary of the Mid-Staffordshire inquiry report

Read the prime minister’s response to the report

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