Meet the Other Phone. A phone that grows with your child.

Meet the Other Phone.
A phone that grows with your child.

Buy now

Please or to access all these features

Chat

Join the discussion and chat with other Mumsnetters about everyday life, relationships and parenting.

Who do you consider to be a HCP?

110 replies

Oldenpeculiar · 24/02/2021 11:51

As in health care professional?

Do you consider allied jobs such as a health care assistant on a ward a HCP? Or care assistants in the community or care homes to be HCPs?

I'm doing some training as a care worker and it's surprised me that I am considered by some, to be a HCP. I don't think this is the general perception of care workers is it?

Although the course I'm doing is nvq level 5 (management) having completed 3, and that required a lot of knowledge, practical skills and evidence to pass. Looking at 5 there's a lot more. A really good thing.

I don't think generally, people realise how much in depth training into care and general health, good practice and legislation etc is covered in the training offered to care assistants, and thus don't consider them a professional. Though a higher level of training can command a better hourly rate, it often doesn't. I'm still on nmw despite having my 3.
I quite often hear how care is unskilled, and not a profession, to justify low pay and poor working conditions, however with the training being improved all the time, surely it should start to be considered as a profession?
It's quite demoralising to hear despite the training you've done, the skills you've learned, you're unskilled and bottom of the heap - and I don't think that reflects well on societies view towards those we look after either.
I'd welcome some regulation of care workers, like a pin, although the flip side to all this is care costing more, which affects everyone.
What do you think?

OP posts:
CoffeeWithCheese · 24/02/2021 21:43

Personally I'd put the list of the Allied Health Professions (with the HCPC registration requirements and protected titles) as one group of health professionals, and then a wider group of professionals working in healthcare (but I'd also be expecting anyone doing any job to behave in a professional manner appropriate for the job they were doing anyway just as a matter of course).

RightYesButNo · 24/02/2021 21:52

This actually has to do with the English language: occupation vs. profession. A profession means that to do the job, you must have specialized education and there must be a framework for a formal qualification. So “professions” are lawyers, doctors, nurses, accountants, teachers, and engineers. I’m sure there are more.

Having said that, HCAs are by no means “unskilled” and it makes me so cross to hear that said.

The issue, I think, is that so many occupations aren’t professions because, like care assistants, it’s a real grab bag. Yes, you may have someone like OP who has gone through training and has experience. Or you may get a 17 year old who just left school who was hired a month ago. There isn’t a requirement that every care assistant meets the same educational milestones. For example, care assistant was a very popular job with those in my town who, I’m sad to say, didn’t do very well at school, and didn’t have any real job experience. But like I said, then you have people like OP, who is obviously very caring and motivated. And there’s nothing to point out which is which, because they’re all just called care assistant.

A poor decision from an HCA can cause injury, harm or even death. It is a vital job with a huge responsibility attached & very severely undervalued in society. What other job holds so much responsibility for minimum wage?

Now this I 100% agree with. It’s absolutely ridiculous that a care assistant who DOES have a ton of experience and continued training should receive the same pay as a teenager with no experience. That should be ridiculous in any job. But that’s not just to do with being a “professional” or not; in the case of many places, that’s greed from whoever is in charge. While the NHS may be floundering, there is a tremendous amount of money to be made in private particularly-elderly care as a for-profit industry. They’d rather have high turnover of care assistants due to bad pay rather than pay more as the assistants become more experienced, which is really wrong.

Crissy83 · 24/02/2021 22:07

...''holds so much responsibility for minimum wage?''

I guess early years care? Not my area at all but another sector that is massively undervalued and underpaid...

hopsalong · 24/02/2021 23:55

Doctors and nurses. Midwives might officially be HCP but imvho they know fuck all about medicine. When a midwife told me that the brown crystals in my son's early nappies (he actually had G6PD deficiency and very bad jaundice!) were 'to do with hormonal withdrawal' as if it was a kind of neonatal withdrawal bleeding I lost all faith.

Oldenpeculiar · 25/02/2021 01:11

This.

Who do you think the HCA is accountable to?

Yes, in a care setting where there isn't a nurse, who is the HCA accountable to? If there's no nurse to delegate, who am I accountable to?
The CQC, the regulating body.

With respect many of you are assuming that all care assistants work directly under nurses, in residential settings and the community that's not true. Senior care staff are the ones who take on that responsibility, are accountable for their own practice and the juniors they may delegate to. Accountable to the CQC because they're the ones who will be doing the investigation of things go wrong.
There is no nurse 'above' me to take the accountability and responsibility, that's what my training is geared towards, giving me the skills and knowledge to make those decisions and taking responsibility for them.

So while the nurse may be accountable for care assistants they work alongside ultimately, if there isn't one, the buck stops with the care assistant.

OP posts:
vodkaredbullgirl · 25/02/2021 03:30

I look after 25 residents and have the help of 2 carers. I am the senior carer on nights responsible for all of them. No nurses they are in a different building, we are a separate unit/building.

TheMatryoshka · 25/02/2021 07:57

As I understand it the CQC regulates the home/care company rather than individual carers. Carers aren't registered directly with CQC and it is the employer who bears ultimate responsibility and will be sanctioned. Carers can't be "struck off" unlike HCPs. That's not to say it's not a responsible job or that carers aren't criminally liable if somebody gets hurt. No matter the training or seniority carers still aren't HCPs though by law or by definition for all the reasons outlined in previous posts. Again, it's not a "diss" because it simply isn't up for interpretation or opinion

EmilySpinach · 25/02/2021 08:22

The CQC is a regulator, not a professional body like the GMC or NMC.

Multicover · 25/02/2021 09:09

‘Yes, in a care setting where there isn't a nurse, who is the HCA accountable to? If there's no nurse to delegate, who am I accountable to?
The CQC, the regulating body. ‘

Hmm Really?

Stompythedinosaur · 25/02/2021 09:11

I think HCA are highly trained and valuable colleagues, but they aren't professionals because they aren't regulated by a professional body, registered and legally responsible in the same way.

Not being a professional doesn't mean they aren't important.

Endofthelinefinally · 25/02/2021 09:12

Rather than try to change the definition of words, it would be a good plan for the various training and quality assurance bodies to get together and set up a professional register and all that goes with that. As pp has said, the current situation of using the word " carer" or "HCA" for such a wide variety of roles is not helpful.

Endofthelinefinally · 25/02/2021 13:29

Aside from professional registers, my parents and PIL were all in care homes with no nurses on the staff. It was very, very difficult to manage their medical conditions, medication, basic care needs. None of them qualified for nursing input, but had the sorts of needs that many elderly people have. My dad got pressure sores. His indwelling catheter blocked several times, but none of his carers could recognise bladder distension. He had CCF, but was frequently put to bed lying flat, then an ambulance called when he couldn't breathe. His diuretics ran out and none of the staff could appreciate the risks and life threatening nature of this.
This was a very expensive, highly rated home and the staff were nice, well meaning people and kind hearted. It did make me wonder about the extent and content of their training.
This is not directed at the OP who has stated that her training is extensive. But it does suggest to me that the standard is variable and cannot be assumed.

Oldenpeculiar · 25/02/2021 19:44

@Endofthelinefinally

Rather than try to change the definition of words, it would be a good plan for the various training and quality assurance bodies to get together and set up a professional register and all that goes with that. As pp has said, the current situation of using the word " carer" or "HCA" for such a wide variety of roles is not helpful.
Yes! Which is why I've said (and pretty much been ignored on this point) that care assistants that have been trained should be considered professionals in their own right, and register/be pinned, not be able to call themselves nurses or doctors or odps or any of the protected titles as some seem to have assumed. But given the status as a reflection of the training they've done, which is also as I stated, much better and more in depth than it ever used to be. Be included in the umbrella term HCP, Healthcare, not medical. I'm not trying to pretend that I've got medical knowledge or qualifications here, just that the knowledge, skills and qualifications we do possess aren't worthless because they're not medical or a degree. They're really important, and raise the standards of care, and if more people were working towards or attained them, with a recognised and respected registration at the end of that, it could only be a good thing. All I've had though is a list of reasons why I'm not, and should never be considered to be a HCP. HCP in itself doesn't appear to be a protected title in the way nurse, or paramedic or radiographer (for example is). Situations like you describe with your PIL would be less and caught earlier with care assistants needing to work towards a minimum standard - and actually being recognised as having training and therefore listened to. Quite often our concerns, elevated to someone else with medical knowledge are ignored or eye rolled at by those medical staff because of the attitudes towards care workers in general - as seen here "You're not trained so why should I listen to you" Then it's too late. And obviously there's the lack of knowledge and training within the staff themselves. With the training, and respect for that, it could only improve things.

There's been posts about how I'm not accountable, only the trained nurse is, but when you point out that in many settings there isn't one, you get "Really 🙄" because I say well yes I'm accountable to the CQC who will be the one who investigates any mistake I make, they'll investigate the whole service, but in relation to that incident, that problem, yes I'll have to justify my actions or lack thereof to them ultimately. But as I don't pay them £120 a year, the concequences of that (prosecution, losing my job or being put on the barred list) are ignored. Is it the same as an NMC hearing? No. Does it mean that I can carry on regardless with no thought for what I'm doing as there's no concequences, also no. Is it enough? No, it's not. There should be more. Much more.
But again, all that's come back is different variations of
"You're not a nurse"
"You're not accountable"
"You don't have responsibility"
"You don't have training or a degree anywhere near a nurse/odp/registrar"
"You don't have to register, complete cpd"
Ad infinitum.

And again when you point out that there's no one above the care assistants that work in residential settings, that there's no one to delegate or take those decisions, right those care plans and then be responsible, that all falls on the senior care staff with training, you're belittled and told "It's not a diss at you, it's just not up for discussion".
That yes, I do have to do cpd, I have to attend training that's mandatory. Nope, you're not a nurse though are you. No, I'm not, but then I'm not claiming to be either.

So as I said in a pp, if collectively, care assistants are going to be dismissed (as they have been here) even though they have a good level of training, have taken the time and effort (and sometimes money too) to improve their own knowledge, skills and qualifications, to improve care, then really what's the point of that training? Why bother because it's not improving anything is it if someone like me, who's done all that is as summarily dismissed as the 18 year old who's got 2 weeks experience and no qualifications.
I can recognise the signs of a blocked catheter, I know what to try (within my remit) I know who to contact, and fast. I know how important diuretics are, and the possible knock on effects of running out. Me knowing all that though is pointless if the nurse I contact doesn't listen to my assessment of the situation, of the patient I know, or the gp, or pharmacist take forever and a day to reissue a script or the actual tablets because they've had a review and the dose has increased, and I know they're going to run out and what the concequences of that could be. But rather have the attitude that I'm probably wrong because I don't know what I'm talking about.
Then yes, it gets to crisis point and ambulances are called because the patient is now in a life threatening situation.

Similar to eol, signposted to 111 if the cnt are busy, when say breakthrough is needed above the syringe driver. What do they do? Send a 999 ambulance! It's not what I've requested, it's not what's needed, it's not on the care plan, they've got a dnar which is communicated, but protocol takes over, and then the finger is pointed at my lack of knowledge and training being the problem. I have that knowledge and training, but I'm not listened to.

As I said, I've seen these attitudes towards care assistants for years, the replies on here are of no surprise. But that doesn't mean that I'm wrong, or stupid for wanting to be recognised and respected for the training I have got, it does seem though that some are just utterly determined though to dismiss me as they do professionally.

"Oh you're very well liked, and yeah, you do a good job" Pat on the head "But don't get ideas above your station, little bum wipers".

OP posts:
CoffeeRunner · 25/02/2021 19:51

@Multicover

‘Yes, in a care setting where there isn't a nurse, who is the HCA accountable to? If there's no nurse to delegate, who am I accountable to? The CQC, the regulating body. ‘

Hmm Really?

Residential Care Home Managers absolutely will tell their Senior Carers this.

It’s not actually true however.

CoffeeRunner · 25/02/2021 19:53

@Oldenpeculiar

This.

Who do you think the HCA is accountable to?

Yes, in a care setting where there isn't a nurse, who is the HCA accountable to? If there's no nurse to delegate, who am I accountable to?
The CQC, the regulating body.

With respect many of you are assuming that all care assistants work directly under nurses, in residential settings and the community that's not true. Senior care staff are the ones who take on that responsibility, are accountable for their own practice and the juniors they may delegate to. Accountable to the CQC because they're the ones who will be doing the investigation of things go wrong.
There is no nurse 'above' me to take the accountability and responsibility, that's what my training is geared towards, giving me the skills and knowledge to make those decisions and taking responsibility for them.

So while the nurse may be accountable for care assistants they work alongside ultimately, if there isn't one, the buck stops with the care assistant.

In a residential care setting there has to be a “Responsible Person”.

If the setting employs no nurses, this will be the registered Manager.

Multicover · 25/02/2021 20:27

OP you’re clearly very passionate and very experienced.
But you’re also incredibly defensive, projecting and spinning things that simply haven’t been said.
Your question is about should HCAs be considered as HCPs.
Currently no. Because of all the reasons given. You don’t actually have a clear understanding of what accountability actually is. That’s not me putting you down. Or being a bitch. Or any of the other things that you think I’m doing.
I’m absolutely 100% behind much tighter regulation of the HCA/Carer role. 100% behind improved standards of education and training for staff. I spend a large part of my time providing education and training in a specific area where HCAs and social care staff are an integral part of the team.

There are too many variations in skills, knowledge and training. Too many gaps in prior experience when staff are recruited and thrown in at the deep end. I’ve done teaching sessions with roomfuls of care staff who had never, ever been taught or shown how to carry out oral hygiene for dying patients. We need to start with the basics.

TheMatryoshka · 25/02/2021 20:53

Absolutely agree @Multicover, there's too much defensiveness and not enough understanding of accountability here.
OP nobody is belittling you, my comment about it not being up for discussion wasn't an attempt to shut down the conversation, just a factual observation that professional status is not a matter of opinion, it's very clearly defined.
I work in a care home, like @CoffeeRunner said, the registered manager is the "responsible person" and I know our seniors have to escalate to our home manager when anything serious happens. I know how hard we all work and I know how important our job is. I also know how different training to be a registered HCP is because I'm 3 months away from qualifying.
Again, there should absolutely be a proper progression route in care work and it should be properly rewarded. There absolutely should be a route to professional status but it should absolutely not be considered a professional role unless the same standards of education, CPD and registration are achieved.

ThanksItHasPockets · 25/02/2021 20:59

I can’t think of a profession that I would consider to be a HCP which doesn’t require a degree or equivalent. Doctors, nurses (post 2011), physios, OTs, orthotists, paramedics, midwives...

vodkaredbullgirl · 25/02/2021 21:24

As someone who has been working in care for 29years,I've got plenty of experience and qualifications as any junior nurse. Only thing is I'm not a nurse as plenty say on this thread.

Kitkat151 · 25/02/2021 21:26

A health care assistant is accountable to their employer.

A HCP is accountable to their employer, they have professional accountability ( to their regulatory body, an ethical accountability and a legal accountability.

This doesn’t belittle the job role ....it’s just the difference between the 2.

Multicover · 25/02/2021 21:34

@vodkaredbullgirl

As someone who has been working in care for 29years,I've got plenty of experience and qualifications as any junior nurse. Only thing is I'm not a nurse as plenty say on this thread.
Again, NOBODY has said that. This is rapidly becoming an absolutely pointless thread.
franklyshankly2 · 25/02/2021 21:46

This thread is only pointless because you won’t listen @Multicover

I typed a long reply to you last night which didn’t seem to post but might type it up again later.

Thistles24 · 25/02/2021 22:04

I think it’s becoming a grey area tbh, and I’d guess a lot of people don’t realise how much HCA’s do, especially those who have done further training or specialised in one area (eg. stroke rehab). From what I see, as the degree requirement jobs (nurse, physio, pharmacist etc) are changing and require much more documentation a lot of what they traditionally did is now being done by assistants/technicians. Can’t speak for the HCA or other support staff, but any pharmacy Technicians have to be registered, pay annual fees and submit CPD each year. At our hospital, they vary from band 4-6, so some are on par pay wise with physios/OT and actually paid more than staff nurses on a ward, despite not having a degree.

Multicover · 25/02/2021 22:04

@franklyshankly2

This thread is only pointless because you won’t listen *@Multicover*

I typed a long reply to you last night which didn’t seem to post but might type it up again later.

Listen? To what? People saying they want to be something they don’t have the training, qualifications, regulation, accountability and mandatory professional development required to be? Yes I’ve listened to a few people saying that. I want to be a millionaire. But I don’t have the money required to be one. Repeating 40 times that I want to be a millionaire or I should be a millionaire won’t make me a millionaire. That’s why this is a pointless thread.
franklyshankly2 · 25/02/2021 22:10

But I already do have all of that- as I live in Scotland. I’ve already mentioned this.

Swipe left for the next trending thread