Matter for Discussion: Nursing support workers

In 2000, RCN members voted to open membership to health care assistants (HCA) with higher level vocational qualifications and in 2001, HCAs were admitted into membership. In 2019, the name of health practitioners changed to nursing support workers (NSW) as it was believed that this was a more accurate description of who they were (RCN, 2019).

However, the NSW workforce and “support staff” have been neglected (Cavendish, 2013 and Kessler et al., 2020) in relation to workforce policy, planning, management, training, development, progression, and research (Griffin, 2023). They have historically struggled to access “consistent” training (Willis, 2015) and not seen as important enough to receive the support for their professional development (Griffin, 2023). 

NHS Education for Scotland has completed a review of career pathways for Health Care Support Workers (HCSW). The aim is to create a national framework to support defining HCSW roles, career progression and a focus on how HCSWs support registered professionals. The Scottish Social Services Council requires HCSWs to register and be working towards an appropriate certification.

In 2022 an all-Wales assistant practitioner governance framework was developed with associated all-Wales job descriptions. The Chief Nursing Officer has also employed two professional secondees to review HCSW practice. 

RCN Northern Ireland have delivered an extensive range of learning and development activity aimed specifically at the nursing support workforce. This programme includes a development day for HCAs. The Open University in Northern Ireland also provides a range of learning and development activity aimed at this group.

A decade after Cavendish’s review (Cavendish, 2013), the support workforce remains unseen and unheard as they continue to fight for equity in learning, development and progression. Given the growing contribution that the support workforce makes, especially during the COVID-19 pandemic and other ongoing health crises, the estimated training budget for support staff is less than 3% of the NHS training budget (Kessler et al., 2019). This neglect means that training, development, education, and progression have not evolved to meet with current demands.

The NHS and social care faces increasing demands in its services and to meet this challenge, the nursing support workforce needs to be fully realised and supported. The RCN is pivotal in making change happen and this must include a push for further development and expansion of learning and educational resources. There is an urgent need for the RCN to lobby the NHS and Social Care for greater equity in learning, development and progression for the nursing support workforce as well as increasing recruitment of NSWs to the RCN across all sectors and the UK.

Reading list for this debate available at rcn.libguides.com/congress2023.

References 

Cavendish C (2013) The Cavendish Review: An independent review into Healthcare Assistants and Support Workers in the NHS and social care settings. London: Department of Health. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/236212/Cavendish_Review.pdf (Accessed 16 March 2023).

Griffin R (2023) Healthcare Support Workers: A practical guide for training and development. London: Routledge.

Kessler I, Bach S and Nath V (2019) The construction of career aspirations amongst health care support workers: beyond the rational and the mundane?, Industrial Relations Journal, 50(2), pp.150-167. https://doi.org/10.1111/irj.12245

Kessler I, Bach S, Griffin R and Grimshaw D (2020) Fair Care Work: A post Covid-19 agenda for integrated employment relations in health and social care. King’s Business School. Available at: https://www.kcl.ac.uk/business/assets/pdf/fair-care-work.pdf (Accessed 16 March 2023).

Royal College of Nursing (2019) Royal College of Nursing Annual General Meeting 2019, ACC Liverpool, 20 May.

Willis P (2015) Raising the Bar: Shape of Caring: A review of the future Education and Training of Registered Nurses and Care Assistants. Health Education England. Available at: https://www.hee.nhs.uk/sites/default/files/documents/2348-Shape-of-caring-review-FINAL.pdf (Accessed 16 March 2023).