My personal push for regulation

Published: 17 August 2011

Lorraine Hicking-Woodison is an assistant practitioner working in a busy GP surgery. She undertakes many of the tasks traditionally completed by a registered nurse and feels strongly that people in her position should be regulated. Earlier this year she embarked on a journey to get her views heard and influence people at the highest level. This is her story

I started working as a health care assistant five years ago and last year completed a foundation degree to become an assistant practitioner. I independently lead the weight-management programme where I work and provide direct care to patients on a day-to-day basis.

Although duties are delegated to me, I’m able to make limited patient assessments and have the freedom to act on what I believe people need. Many patients assume I’m a nurse.

So it makes no sense to me that I’m not regulated. The skill mix in nursing is changing and health care support workers are the future of the profession. Yet there are hundreds of thousands of us out there characterised by a bewildering range of titles and roles and no agreed common qualifications or standards. It’s no wonder the patients are confused.

We need to be clear about who we are and be able to reassure patients about the quality of our care by working to agreed national standards. We can’t go on with a system where practically anyone can get employed, be given a uniform and the next day be delivering patient care. It’s just not safe and it discredits the quality and commitment of many of us for whom this career is a serious business.

Taking action

So I guess I’ve always held pretty strong views on the issue, but it wasn’t until I attended RCN Congress in Liverpool this year that I felt inspired to take action. The atmosphere was electric and everyone was so passionate about improving systems for the benefit of patient care. I left all fired up and determined to make a difference. I decided to draft a letter to Health Secretary Andrew Lansley.

Needless to say, it took ages to get a response and it came from a central source so I resolved to take a different tack and sent the letter to my MP. This time I got a quicker response but it still didn’t address my concerns. It was a generic letter and spoke of plans the Government has for setting up a voluntary system of assured regulation overseen by the Council for Healthcare Regulatory Excellence (CHRE).

Now, I don’t know about you, but it sounded complicated to me so I decided to investigate. Basically, the Government presented a command paper to Parliament back in February called Enabling Excellence (chapter four is most relevant). It suggested that mandatory regulation of health care support workers wasn’t needed but that people could choose to join a voluntary register to provide assurance that they were trained, trusted and competent in their role. People wouldn’t be compelled to join and employers wouldn’t be required to employ staff from the register.

Not giving up

So as far as I’m concerned, what’s the point? To me, it seems a costly way to achieve very little. People who have been dismissed for poor conduct could still gain employment elsewhere in the same role and public safety isn’t improved.

I looked on the CHRE website and researched who I could write to next. Christine Braithwaite’s name came up as the Director of Policy and External Relations so I sent her an email and within an hour she responded. She wanted to meet me to get my perspective and two weeks ago, did just that.

She came to my workplace and for two hours we debated the pros and cons of different types of regulation. I was on the edge of my seat with excitement and got the opportunity to truly express how I feel. Christine made lots of notes and seemed to digest my argument but remained unconvinced that statutory regulation was the right way forward.

She explained the difficulties of the logistics and raised questions about who would be the regulator and how much it would cost. It is her belief that health care support workers are so poorly paid that they don’t stay long enough in the role to warrant regulation.

I disagree and remain firm in my beliefs. I’m not sure how much difference our meeting will make but I valued the chance to get my voice heard and am hopeful that the cracks I felt I highlighted in Christine’s argument will have some influence. She’s now asked me to be involved in a workshop at the CHRE next week and I’ll be sure to present my views just as strongly then.

In the meantime, I urge you to lobby your local politicians to help achieve change. As a workforce we need to stand united in our calls for regulation. The RCN is behind us and together we can make a difference. Check out the RCN’s new regulation web pages or take a look at my letter (Word 25KB) for inspiration.

More information

Lorraine Hicking-Woodison is Chair of the RCN’s HCA/AP Committee but made contact with the people named above in a personal capacity. You can share your views about regulation on the RCN Discussion Zone or get in touch with the RCN HCA/AP team by emailing hca@rcn.org.uk