National Health Service History

Geoffrey Rivett

New nurses lack caring skills, says RCN Chief

Interview in The Times, 22 September 2011

Many new nurses arrive in hospital incapable of caring for patients because they have spent too much time in the classroom and not enough on the wards, the leader of the nursing union has said.

Peter Carter, the chief executive of the Royal College of Nursing, said that matters were even worse because the NHS was also becoming increasingly reliant on unregulated and untrained healthcare assistants to do basic nursing. 

He added that too many new nurses were "simply not up to the mark", while the dependence on untrained staff was "a disgrace" that made scandals such as those at the Winterbourne View care home in Bristol more likely.   

"What we have on hospital wards, and particularly in domiciliary care and care homes, is an unregulated, untrained workforce ... Frankly, it's nothing short of a disgrace," he said.   

"We require regulation and training in just about every other walk of life. But somehow when it comes to patient care we've got this ... and then people wonder from time to time why there are problems."   

Healthcare assistants are employed to help nurses with basic tasks such as washing and feeding patients. Dr Carter said that their number had grown "exponentially" over the past decade as care homes and hospitals had sought to focus nurses' efforts on more complex procedures.

There are thought to be about 300,000 assistants working in the NHS and the same number again in private homes and domestic care.   Dr Carter, whose organisation represents nurses and healthcare assistants, said that most were doing a good job, but many were being asked to perform specialist tasks with no formal training. 

"You don't need registered nurses to do every task. But things like wound care, nutrition, hygiene, moving people in bed, these are techniques that need to be properly taught, and not some­thing that should be picked up on the job," he said.   

"I visited an A&E in the Midlands and the healthcare assistants were doing all the suturing, taking blood, doing ECGs, really complex interven­tions, and they'd all been taught locally in-house. There's no regulation, no benchmarks at all." 

Some home carers were being sent to look after frail elderly people with no training other than being given a DVD to watch in their spare time, he said. "That's just unacceptable." 

Dr Carter added: "A lot of people in hospital wards think they're being cared for by nurses, but they are health­care assistants. It's unfair to them and not good for patient care. I would suggest that there's a lot of bullet­ dodging going on, but logic would suggest that there are failures."   With no automatic way of striking off healthcare assistants, even those accused of severe abuses, such as those at Winterbourne View home, where secret filming showed adults with learning difficulties being pinned down, slapped and taunted, they could be re-employed elsewhere.

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