Paving the Way 21 May 2012 Accountability, regulation and latest developments in HCA role. Tanis Hand HCA Adviser

From the patient’s perspective What do patients want to know about the people caring for them?

What 3 things need to be in place in order for a person to be accountable? In order for someone, such as an HCA, to be accountable they must:  have the ability to perform the task  accept the responsibility for doing the task  have the authority to do the task from their job description, and the policies and protocols of the organisation Knowledge check point !

What 3 questions need to be asked when considering delegation of activities? The three questions that need to be asked are:  does the registered practitioner view the support worker as competent to carry out the tasks?  does the HCA feel confident to perform the activity?  does the task require an ongoing assessment of the patient to be made? Knowledge check point !

         Best interest of the patient Education and training Competent with written evidence of assessment Protocols Job description Everyone knows task has been delegated Supervision and mentorship Risk management Ongoing professional development

Accountability and delegation Educational film and associated materials Accountability and Delegation Film

Patients RNs Make clinical judgements and provide nursing care Delegate and supervise nursing care APs May transcend professional boundaries Work is guided by standard protocols HCAs Are delegated nursing tasks Work is supervised by registered professionals Common goals, different roles: briefing paper RCN 2012

Regulation – latest developments

The RCN believes all HCAs and APs should be regulated in the interests of public protection and is committed to supporting steps towards mandatory regulation This has been a major policy position for the RCN for many years

Some models of regulation Professionally-led (statutory) Employer-led Voluntary registration

Reducing regulation is a key priority for Coalition Government u Aim: to drive up standards... to improve service-users’ experience... through a system of “assured voluntary registration” u First proposed in “Enabling Excellence” (DH 2011), now passed in Health & Social Care Act 2012

Proposals for 2012 & 2013 u The Government has tasked Skills for Health and Skills for Care with developing a set of codes and training standards for HCSWs in England by end Sept 2012 u These codes and standards will be used as a basis for voluntary registers to be developed during 2013 and to be overseen by the Council for Healthcare Regulatory Excellence (CHRE)

Continued.... u CHRE will set standards against which the voluntary registers will be judged u Existing statutory regulatory bodies will be given powers to establish voluntary registers (funded by those who choose to join the registers) u Voluntary registrants will not be subject to full statutory regulation

Voluntary model PROS & CONS u Flexible, more “proportionate approach” u May assist public seeking care from self-employed practitioners to choose those on voluntary register u Regulation will be avoided by some u Removal from register would not be very meaningful u Employers are not compelled to employ staff from registers u There will still be a cost to register

RCN response u Now that the Health and Social Care Act 2012 has received Royal Assent, the RCN respects the democratic process and will be working with Skills for Health and Skills for Care in the development of the standards and codes for England. u We will continue to call for mandatory regulation of all HCSWs and for the system of voluntary registration to be reviewed at an appropriate time.

Any questions ?